bluuebunny/crossref_metadata_2025 huggingface dataset:
Are serum autoantibodies associated with brain changes in systemic lupus erythematosus? MRI data from the Leiden NP-SLE cohort
Authors: Magro-Checa C. , Kumar S. , Ramiro S. , Beaart-van de Voorde L.J. , Eikenboom J. , Ronen I. , de Bresser J , van Buchem M.A , Huizinga T.W. , Steup-Beekman G.M.
Published: December 2018

Objective

The effect of serum autoantibodies on the brain of systemic lupus erythematosus (SLE) patients remains unclear. We investigated whether serum autoantibodies, individually and assessed in groups, are associated with specific brain-MRI abnormalities or whether these structural changes are associated with other SLE-related or traditional cardiovascular disease risk factors.

Methods

All patients underwent brain 3Tesla-MRI. White matter hyperintensities (WMHs), ischemic lesions, inflammatory-like lesions and cerebral atrophy were scored. Serum autoantibodies analyzed included lupus anticoagulant (LAC), anticardiolipine (aCL) IgG and IgM (first 3 also grouped into antiphospholipid autoantibodies (aPL)), anti-dsDNA, anti-SSA, anti-SSB, anti-RNP, and anti-Sm (the latter 5 grouped into SLE-related autoantibodies). Associations were assessed using logistic regression analysis adjusted for potential confounders. Furthermore, a sensitivity analysis including anti-Beta2 glycoprotein-1 antibodies (anti-β2GP1) in the aPL group was performed and the potential modification role of the neuropsychiatric clinical status in the model was assessed.

Results

325 patients (mean age 42 years (SD 14), 89% female) were included. The following MRI-brain abnormalities were found: WMHs (71%), lacunar infarcts (21%), gliosis (11%), micro-hemorrhages (5%), large hemorrhages (2%), inflammatory-like lesions (6%) and atrophy (14%). No associations were found between individual or total SLE-related autoantibodies and inflammatory-like lesions. A higher number of positive aPL was associated with lacunar infarcts (OR 1.37 (95%CI 1.02–1.99) and gliosis (OR 2.15 (1.37–3.37)). LAC was associated with lacunar infarcts in white matter (OR 3.38 (1.32–8.68)) and atrophy (OR 2.49 (1.01–6.15)), and aCL IgG with gliosis (OR 2.71 (1.05–7.02)). Among other variables, SLE patients with hypertension presented a higher chance for WMHs (OR 5.61 (2.52–12.48)) and lacunar infarcts in WM (OR 2.52 (1.10–5.74)) and basal ganglia (OR 8.34 (2.19–31.70)), while cumulative SLE-damage was correlated with lacunar infarcts in WM (OR 1.43 (1.07–1.90)), basal ganglia (OR 1.72 (1.18–2.51)) and cerebellum (OR 1.79 (1.33–2.41)). These associations were confirmed in the sensitivity analysis.

Conclusions

Brain abnormalities in SLE represent different underlying pathogenic mechanisms. aPL are associated with ischemic brain changes in SLE, while the presence of SLE-related serum autoantibodies is not related to inflammatory-like lesions. Hypertension and cumulative SLE-damage associate with ischemic MRI-brain changes in SLE, suggesting the importance of accelerated atherosclerosis in this process.
Invasive fungal disease in patients with systemic lupus erythematosus from Southern China: a retrospective study
Authors: Lao M. , Wang X. , Ding M. , Yang Z. , Chen H. , Liang L. , Zhan Z. , Chen D.
Published: December 2018

Objective

To investigate the characteristics and associated factors of invasive fungal disease in patients with systemic lupus erythematosus from Southern China.

Methods

A retrospective study was performed. Demographic and clinical characteristics, laboratory data, and radiographic manifestations were recorded.

Results

A total of 45 lupus patients with invasive fungal disease (incidence 1.1%) were included. Twenty-three cases (51.1%) were infected with mold and 22 cases (48.9%) with yeast. Aspergillus spp. (44.4%) and Cryptococcus spp. (33.3%) were common. Aspergillosis mainly occurred in the lung. Cryptococcosis developed in the lung (40.0%), meninges (46.7%) and bloodstream (13.3%). Compared with yeast infection, mold infection tended to develop in patients with active lupus nephritis (65.2% vs. 31.8%, P = 0.03) and the mortality rate was higher (20.0% vs. 0%, P = 0.001). Co-infection with bacteria, virus or superficial fungi occurred in 12 patients (26.7%). Multivariate logistic regression analysis indicated that lymphopenia (odds ratio 2.65, 95% confidential interval 1.14–6.20, P = 0.02) and an accumulated dose of glucocorticoid (odds ratio 1.58, 95% confidence interval 1.10–2.25, P = 0.01) was associated with invasive fungal disease in lupus patients.

Conclusion

Mold infection tended to develop in patients with active lupus disease with high mortality. Co-infection is not rare. Lymphopenia and an accumulated dose of glucocorticoid are associated with invasive fungal disease in lupus patients.
Disease course patterns in systemic lupus erythematosus
Authors: Tselios K. , Gladman D.D. , Touma Z. , Su J. , Anderson N. , Urowitz M.B.
Published: December 2018

Background

Disease activity in systemic lupus erythematosus follows three different courses: long quiescent, relapsing remitting and persistently active. However, the patterns of disease course since diagnosis are not known. This study aimed to assess the prevalence and characteristics of such patterns over 10 years.

Patients and methods

The inception cohort of the Toronto Lupus Clinic (≥10 year follow up, between visit interval ≤18 months) was investigated. Prolonged remission was defined as a clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 achieved within 5 years of enrolment and maintained for ≥10 years. The relapsing-remitting pattern was defined based on ≥2 remission periods (clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 for two consecutive visits). Patients with no remission were categorized as persistently active. Groups were compared for baseline characteristics, cumulative damage, flare rate, mortality and certain co-morbidities.

Results

Of 267 patients, 27 (10.1%) achieved prolonged remission, 180 (67.4%) relapsing-remitting and 25 (9.4%) persistently active. In total, 35 (13.1%) had only one remission period (hybrid). At enrollment, there were no differences regarding clinical and immunological variables. At 10 years, persistently active patients had accumulated significantly more damage than the prolonged remission and relapsing-remitting patients. Being of Black race and higher adjusted mean Systemic Lupus Erythematosus Disease Activity Index 2000 over the first 2 years were associated with a more severe disease course. Relapsing-remitting and persistently active patients had an increased flare rate and accrued more osteoporosis, osteonecrosis and cardiovascular events.

Conclusions

Approximately 70% of systemic lupus erythematosus patients followed a relapsing-remitting course, whereas 10% displayed prolonged remission and another 10% a persistently active course. Early response to treatment was associated with a less severe course and better prognosis.
Chylous ascites and podocytopathy as the presentation of childhood lupus—an unusual occurrence
Authors: Pilania R K , Jindal A K , Sandesh G , Vignesh P , Suri D , Nada R , Singh S
Published: December 2018

Systemic lupus erythematosus (SLE) is an autoimmune disorder that can affect virtually any organ. Chylous ascites as a presenting manifestation of SLE has been described in a handful of cases in adults. However, to the best of our knowledge this presentation has never been reported in the pediatric age group. Podocytopathy in SLE was initially considered to be a chance association. However, more recently it has been suggested that minimal change disease is not only a chance association; it is part of the lupus nephritis spectrum.
Nivolumab-induced acute-onset type 1 diabetes mellitus as an immune-related adverse event: A case report
Authors: Hatakeyama Yukihisa , Ohnishi Hisashi , Suda Kentaro , Okamura Kayoko , Shimada Temiko , Yoshimura Sho
Published: December 2018

A 60-year-old Japanese man, with no medical or family history of diabetes, presented with acute-onset type 1 diabetes following nivolumab treatment for advanced non-small-cell lung cancer. During cycle 35 of nivolumab therapy, his glycated hemoglobin level increased from 7.6% to 9.1% in one month. Test results for islet-related and anti-thyroid peroxidase antibodies were negative. A glucagon tolerance test showed insulin dependency. Type 1 diabetes after anti-programmed death-ligand 1 antibody administration is an immune-related adverse event, and numerous reports suggest that fulminant type 1 diabetes can develop in these patients. However, there are few reports of acute-onset type 1 diabetes mellitus.
From advocacy to accountability in experiential learning practices
Authors: Wright Sarah , Forray Jeanie M , Lund Dean Kathy
Published: December 2018

A core ethical value of many professions, especially those where power dynamics and potential for injury in practice exist, is minimising harm to those served. The same expectations, however, cannot be linked to the use of classroom-based experiential practices in management education settings. In this article, we explore ethical issues associated with experiential learning practices and the potential for student harm. In particular, we confront the issues of power dynamics, deception and informed consent in classroom exercises, the ability to opt-out of simulated experiences, and the facilitation skills required to responsibly manage and debrief the experience. We review the state of ethics attention in management education, and challenge the assumptions that experiential educators both know, and take steps to resolve, ethical issues associated with classroom exercises. We consider experiential practices of other professions, and discuss findings from a study of institutional declarations of ethical principles or policy statements related to experiential learning practices among Association to Advance Collegiate Schools of Business accredited business schools. Finding none of the latter, we argue that responsibility for student welfare in a learning environment requires values-based standards for the utilisation of classroom-based experiential learning practices and offer suggestions for establishing expectations with respect to various experiential approaches.
Needle’s vibration in needle-disk electrospinning process: Theoretical model and experimental verification
Authors: Zhao Jianghui , Li Xiaoxia , Liu Zhi
Published: December 2018

Needle-disk electrospinning is a new technology for mass production of nanofibers. During the spinning process, the needle fixed on the rotating disk will vibrate. A vibration model is established, and the vibration frequency and largest deflection are obtained. The effect of the inertia force due to needle’s vibration on the spinning process is elucidated. All theoretical results are in well agreement with the experiment data. The present theoretical results are helpful to optimize the needle-disk electrospinning.
A comparative study of geometrical curvature expressions for the large displacement analysis of spatial absolute nodal coordinate formulation Euler–Bernoulli beam motion
Authors: Zhang Dayu , Luo Jianjun
Published: December 2018

While the geometrical curvature expressions have become widely used in the beams based on absolute nodal coordinate formulation, they have not yet been compared and sufficiently verified, particularly for the spatial beam motion. In this paper, two geometrical curvature expressions for the large displacement analysis of spatial beam motion are compared and their fundamental differences are highlighted: the exact curvature model and general curvature model. In order to examine numerically the ability of two curvature expressions in the large displacement analysis, a three-dimensional absolute nodal coordinate formulation Euler–Bernoulli beam element is selected as the candidate. Several static and dynamical benchmarks are performed to assess their accuracy and differences. It is shown that the exact curvature model can be effectively and efficiently used in static applications, particularly in the highly nonlinear static analysis. In dynamics problems, the accuracy of two curvature models is equivalent, while the exact curvature model is more time-consuming. These conclusions can be a recommendation for the choice of geometrical curvature expressions in some certain practical examples.
Piezoelectric matrix-assisted ionization
Authors: Banstola Bijay , Szot Carson W , Deenamulla Kankanamalage Achala P , Murray Kermit K
Published: December 2018

We have developed a new actuation method for matrix-assisted ionization with good temporal and spatial resolution using piezoelectric cantilever. A strike from the piezoelectric bimorph cantilever on a thin metal foil was used to remove materials deposited on the opposite side facing the mass spectrometer inlet. Highly charged ions of peptides and proteins were generated from dried droplet deposits and sampled into the inlet of the mass spectrometer. A lateral resolution of 1 mm was obtained with the piezoelectric sampling configuration. Singly charged lipids and gangliosides were detected from tissue with piezoelectric matrix-assisted ionization using a silica nanoparticle co-matrix.
Non-pharmacological interventions for people with dementia: A review of reviews
Authors: Meyer Claudia , O’Keefe Fleur
Published: December 2018

Objective

Aged care services increasingly respond to the needs of people with dementia. Non-pharmacological approaches are preferable to reduce responsive behaviours, improve/maintain functional capacity and reduce emotional disorders. This rapid review of systematic reviews aimed to consolidate the evidence for non-pharmacological interventions and determine outcome effectiveness.

Methods

Systematic review literature was comprehensively searched for non-pharmacological interventions for dementia in residential care. Quality ratings used adapted GRADE methodology, and ease of implementation assessed.

Results

Of 629 abstracts screened, 81 full-text articles were retrieved, 38 articles included. The strongest evidence for reducing responsive behaviours was music, sensory stimulation, simulated presence and validation therapies. Exercise and light therapy improved/maintained activities of daily living, while cognitive stimulation and reminiscence improved cognition. Strongest evidence for reducing emotional disorders was music, psychological interventions and reminiscence.

Conclusion

Much evidence of varying quality exists, with resource-constrained residential care providers now able to make evidence-based decisions about non-pharmacological interventions.
Using unwrapped filament tows to strengthen sandwich composites: Puncture and bursting resistance
Authors: Li Jia-Hsun , Lou Ching-Wen , Hsieh Jing-Chzi , Lin Jia-Horng
Published: December 2018

The combination of appropriate materials and structural design can compensate for flaw of a single pattern, providing the products with better functionalities. In this study, the custom-made nonwoven fabric machine can unwrap the filament tows before needle punching stage. Sandwich composites are proposed, consisting of two nonwoven fabrics as surface layers and laminated loops of filaments as the core. The puncture resistance of the sandwich composites are examined in terms of weight of filament loops and needle-punching depth, examining their influences. The employment of filaments has a remarkable influence on the mechanical performance of the composites. GF4G has static puncture resistance, dynamic puncture resistance, and bursting strength that are 89%, 30%, 88% higher than those of GF1G; 332%, 127%, and 500% higher than those of 2G; and 671%, 400%, and 1260% higher than those of G. Using filaments to reinforce nonwoven fabrics only requires simple equipment and easy operation. Furthermore, based on the requirements of different final products, diverse filaments and multiple parameters can be combined, thereby providing the composites with efficient production, solid reinforcement, and broad applications.
Improving cushioning properties of a 3D weft knitted spacer fabric in a novel design with NiTi monofilaments
Authors: Hamedi Mohsen , Salimi Parisa , Jamshidi Nima
Published: December 2018

Cushioning pads alleviate the effects of mechanical stress on the human body due to impacts and daily activities. One relevant application for such pads is orthopedic insoles used for diabetic foot to improve energy absorption and reduce stress gradient by using suitable materials and structures. This article considers a novel design that improves the energy absorption capabilities of cushioning pads. Experiments were conducted to evaluate the properties of the designed weft knitted spacer fabrics. Six groups of samples were knitted in which steel, polyamide, and shape memory alloy materials were utilized as spacer monofilament. Stress–strain, energy absorption and efficiency diagrams were obtained following the quasi-static compression tests carried out on the samples. Three investigation groups were adopted to evaluate the effect of the spacer monofilament material, diameter, and slope on energy absorption capacity. It was determined that shape memory alloy monofilament with 0.1 mm diameter was the optimum configuration to be utilized as spacer yarn in a typical 3D weft knitted fabric. It was also concluded that higher-inclined spacer monofilament in spacer fabric was the optimum choice for knitting cushioning pads as it absorbed more energy. The energy absorption capacity of the optimum design of spacer fabric obtained in this study, increased by a factor of 2.4 compared with commercial polyamide pads. This design can be utilized in any cushioning pad exposed to high mechanical stress due to impact, sports and daily activities.
Systematic Review of Commercially Available Mobile Phone Applications for Prostate Cancer Education
Authors: Owens Otis L. , Beer Jenay M. , Reyes Ligia I. , Thomas Tracey L.
Published: December 2018

Prostate cancer is the most commonly diagnosed non-skin cancer among all men and the second most common cause of death. To ameliorate the burden of prostate cancer, there is a critical need to identify strategies for providing men with information about prostate cancer screening and the importance of informed decision making. With mobile phones becoming more ubiquitous, many individuals are adopting their phones as sources for health information. The objective of this systematic review is to identify and evaluate commercially available apps for promoting informed prostate cancer screening decisions. Two keywords “prostate cancer screening” and “prostate cancer” were entered into the search engines of Google and iOS app stores in May 2017. Evaluations were conducted on apps’ (a) quality, (b) grade-level readability, (c) cultural sensitivity, and (d) usability heuristics. None of the 14 apps meeting the inclusion criteria contained the full breadth of information covered in the 2016 American Cancer Society’s Prostate Cancer Prevention and Early Detection Guidelines, but over half were inclusive of topics consistent with these guidelines. Most apps’ readability was higher than an eighth-grade reading level. Most apps were also not framed and had a neutral tone. Only four apps met most criteria for being culturally sensitive to African Americans. Usability among apps was variable, but some contained major usability concerns. Recommendations for improving educational apps for prostate cancer screening include: disseminating evidence-based information; using culturally sensitive language; knowing the implications of the one and framing of content; making apps interactive; and following common usability principles.
Friction compensation and observer-based adaptive sliding mode control of electromechanical actuator
Authors: Zhang Mingyue , Zhou Man , Liu Hui , Zhang Baiqiang , Zhang Yulian , Chu Hairong
Published: December 2018

The performance of the electromechanical actuator system is usually affected by the nonlinear friction torque disturbance, model uncertainty, and unknown disturbances. In order to solve this problem, a model-based friction compensation method combined with an observer-based adaptive sliding mode controller for the speed loop of electromechanical actuator system is presented in this article. All the disturbances and model uncertainty of electromechanical actuator system are divided into two parts. One is model-based friction torque disturbance which can be identified by experiments, and the other is the residual disturbance which cannot be identified by experiments. A modified LuGre model is adopted to describe the friction torque disturbance of electromechanical actuator system. An extended state observer is designed to estimate the residual disturbance. An adaptive sliding mode controller is designed to control the system and compensate the friction torque disturbance and the residual disturbance. The stability of the electromechanical actuator system is discussed with Lyapunov stability theory and Barbalat’s lemma. Experiments are designed to validate the proposed method. The results demonstrate that the proposed control strategy not only provides better disturbance rejecting ability but also provides better steady state and dynamic performance.
Research on design method of non-circular planetary gear train transplanting mechanism based on precise poses and trajectory optimization
Authors: Zhao Xiong , Chu Mengyan , Ma Xingxiao , Dai Li , Ye Bingliang , Chen Jianneng
Published: December 2018

Among all kinds of transplanting mechanisms which are the important parts of transplanters, the planetary gear train transplanting mechanism is widely used for its excellent transmission performance, but it is difficult to design the gear pitch curves and structural parameters according to the trajectory and pose requirements of transplanting. The current design method of the non-circular planetary gear train transplanting mechanism cannot ensure the precise position and posture in the crucial points of transplanting trajectory, nor take both the anticipated trajectory and the smoothness of the gear pitch curves into account, it will only get one solution which is available for mechanism design. In order to solve those problems, the non-circular planetary gear train transplanting mechanism is analyzed as a combination of the bar-group and gear train system. According to the transplanting requirements, three points with precise position and posture which called pose points in the trajectory are given to obtain the solution domain of the parameters of bar-group, and then trajectory shape control points are inlet to design the desired shape of the transplanting trajectory and obtain the transmission ratio curve which can be used to get the gear pitch curve. The most suitable parameters of bar-group in solution domain are selected based on the smoothness of the gear pitch curves. This article establishes three-dimensional model of the mechanism and utilizes the ADAMS to carry out a motion simulation; all simulation results are consistent with theoretical design results, which confirm that the design method based on prescribed pose points and trajectory control points is adequate for the transplanting mechanism. With the proposed method, the selectivity of the mechanism’s parameters solution is increased, and transmission performance benefits from the integrated design of trajectory control and the smoothness of the pitch curves.
Investing in human capital: exploring causes, consequences and solutions to nurses’ dissatisfaction
Authors: Halder Neel
Published: December 2018

Background

Human capital (employees) is the most important asset for healthcare. However, nurses experience some of the highest rates of burnout and dissatisfaction. In 2017, the Nursing and Midwifery Council reported that, for the first time since 2008, more nurses and midwives are leaving the profession in the UK than joining it.

Aims

The aim of this paper is to explore the literature regarding the importance of human capital within healthcare sectors in the UK, with a particular focus on nurses and job satisfaction.

Methods

A literature review was conducted with the focus on the aim, as stated above. Findings and conclusions have been summarised. Potential causes, consequences and solutions to job dissatisfaction are explored.

Results

Factors related to job satisfaction include pay, respect, security, workload, recognition, responsibility, environment, autonomy, personal growth, administrative bureaucracy and caseload. Investing and promoting ‘organisational compassion’ could be a key part of the solution.

Conclusions

More research using the same validated tools for measuring job satisfaction will help with consistency and comparability across hospitals. It is hoped this could provide information aiding recruitment and retention, which is a problem within both the NHS and independent sectors.
Linear Motion Coverage as a Determinant of Transparent Liquid Perception
Authors: Kawabe Takahiro
Published: December 2018

When a transparent liquid flows, the background image behind the flow dynamically deforms due to light refraction. The dynamic deformations of a background image (dynamic image deformations) are one of the visual features used by the visual system to infer the existence of a transparent liquid flow. Although previous studies have discussed the role of the narrow band components of the spatiotemporal deformation frequency, it was still unclear whether motion signals, one of the constituents of dynamic image deformations, were the determinant of the perception of a transparent liquid. Manipulating the flow speed of image deformation, which is a critical parameter for changing motion signals in dynamic image deformations, we asked observers to judge whether a transparent liquid was included in the clips or not. We found that the proportions of reporting that they saw a transparent liquid increased with the flow speed of image deformations. Analyzing motion signals of the stimulus clips, we found that the faster the flow of image deformations the fewer linear motion signals were contained. The results indicate that the perception of a transparent liquid arises when the dynamic image deformations contain fewer linear motion signals.
Cut of Clothes Maximizes the Effect of Amodal Completion to Make You Look Thinner
Authors: Kiritani Yoshie , Kawasaki Akane , Chang Ikjoon
Published: December 2018

Amodal completion has various functional effects, including an apparent slimming effect achieved by clothes. Local and global completion factors have been examined in previous studies, which also apply to the apparent slimming effect. Exposed parts of the body constitute the local factor at the junction area, while the shape or cut of the clothes is concerned with the whole configuration. This study investigated which is more important, the local or whole factors, for amodal completion in relation to the apparent slimming effect using drawings as stimuli. In Experiment 1, we examined the effects of the length and cut of a skirt. The length of the skirt corresponds to the local factor of the body, that is, the legs, because the exposed parts of the legs depend on skirt length (assuming a person of consistent height). We found that skirts' cut influenced their effect more than their length did. Experiments 2 and 3 revealed that the vertical form of clothes affects slimming by hiding thicker parts of the body and highlighting thinner parts. A supplemental experiment using geometrical figures suggested that the apparent slimming effect of clothes might occur only in the human body configuration.
NSQIP Impacts Patient Experience
Authors: Castaldi Maria , George Geena , Turner Pamela , McNelis John
Published: December 2018

National Quality Improvement Project (NSQIP) semiannual reports (SARs) revealed high observed to expected ratios for venous thromboembolic events (VTEs) on the surgical service. Press Ganey scores identified an area of particular weakness in shared decision-making in patient care. Patients reported little to no participation in shared decision-making. A performance improvement project was developed with a 2-fold objective: decrease the percentages of patients sustaining VTE through adequate screening and prophylaxis (VTEP) and to engage patients in shared decision-making to accept VTEP through enhanced patient-centered discussions and education on the risks and benefits of VTEP. A clinical pathway was developed to implement VTEP using a standardized risk assessment tool. Patient-centered discussion introduced VTEP and impact on perioperative safety. Results included telephone survey, NSQIP SARs, and Press Ganey patient experience survey. Using NSQIP data and a pathway developed for both VTE risk assessment and patient engagement, the authors observe immediate improvements in patient experience and decreased rates of VTE.
Utilization and Validity of the Dental Diagnostic System over Time in Academic and Private Practice
Authors: Yansane A. , Tokede O. , White J. , Etolue J. , McClellan L. , Walji M. , Obadan-Udoh E. , Kalenderian E.
Published: December 2018

Introduction:

To fill the void created by insufficient dental terminologies, a multi-institutional workgroup was formed among members of the Consortium for Oral Health Research and Informatics to develop the Dental Diagnostic System (DDS) in 2009. The adoption of dental diagnosis terminologies by providers must be accompanied by rigorous usability and validity assessments to ensure their effectiveness in practice.

Objectives:

The primary objective of this study was to describe the utilization and correct use of the DDS over a 4-y period.

Methods:

Electronic health record data were amassed from 2013 to 2016 where diagnostic terms and Current Dental Terminology procedure code pairs were adjudicated by calibrated dentists. With the resultant data, we report on the 4-y utilization and validity of the DDS at 5 dental institutions. Utilization refers to the proportion of instances that diagnoses are documented in a structured format, and validity is defined as the frequency of valid pairs divided by the number of all treatment codes entered.

Results:

Nearly 10 million procedures ( n = 9,946,975) were documented at the 5 participating institutions between 2013 and 2016. There was a 1.5-fold increase in the number of unique diagnoses documented during the 4-y period. The utilization and validity proportions of the DDS had statistically significant increases from 2013 to 2016 ( P < 0.0001). Academic dental sites were more likely to document diagnoses associated with orthodontic and restorative procedures, while the private dental site was equally likely to document diagnoses associated with all procedures. Overall, the private dental site had significantly higher utilization and validity proportions than the academic dental sites.

Conclusion:

The results demonstrate an improvement in utilization and validity of the DDS terminology over time. These findings also yield insight into the factors that influence the usability, adoption, and validity of dental terminologies, raising the need for more focused training of dental students.

Knowledge Transfer Statement:

Ensuring that providers use standardized methods for documentation of diagnoses represents a challenge within dentistry. The results of this study can be used by clinicians when evaluating the utility of diagnostic terminologies embedded within the electronic health record.
Full-waveform inversion and joint migration inversion with an automatic directional total variation constraint
Authors: Qu Shan , Verschuur Eric , Chen Yangkang
Published: December 2018

As full-waveform inversion (FWI) is a nonunique and typically ill-posed inversion problem, it needs proper regularization to avoid cycle skipping. To reduce the nonlinearity of FWI, we have developed joint migration inversion (JMI) as an alternative, explaining the reflection data with decoupled velocity and reflectivity parameters. However, the velocity update may also suffer from being trapped in local minima. To optimally include geologic information, we have developed FWI/JMI with directional total variation (TV) as an L1-norm regularization on the velocity. We design the directional TV operator based on the local dip field, instead of ignoring the local structural direction of the subsurface and only using horizontal and vertical gradients in the traditional TV. The local dip field is estimated using plane-wave destruction based on a raw reflectivity model, which is usually calculated from the initial velocity model. With two complex synthetic examples, based on the Marmousi model, we determine that our method is much more effective compared with FWI/JMI without regularization and FWI/JMI with the conventional TV regularization. In the JMI-based example, we also determine that L1 directional TV works better than L2 directional Laplacian smoothing. In addition, by comparing these two examples, it can be seen that the impact of regularization is larger for FWI than for JMI because in JMI the velocity model only explains the propagation effects and, thereby, makes it less sensitive to the details in the velocity model.
Imaging conditions for elastic reverse time migration
Authors: Zhang Wei , Shi Ying
Published: December 2018

Elastic reverse time migration (RTM) has the ability to retrieve accurately migrated images of complex subsurface structures by imaging the multicomponent seismic data. However, the imaging condition applied in elastic RTM significantly influences the quality of the migrated images. We evaluated three kinds of imaging conditions in elastic RTM. The first kind of imaging condition involves the crosscorrelation between the Cartesian components of the particle-velocity wavefields to yield migrated images of subsurface structures. An alternative crosscorrelation imaging condition between the separated pure wave modes obtained by a Helmholtz-like decomposition method could produce reflectivity images with explicit physical meaning and fewer crosstalk artifacts. A drawback of this approach, though, was that the polarity reversal of the separated S-wave could cause destructive interference in the converted-wave image after stacking over multiple shots. Unlike the conventional decomposition method, the elastic wavefields can also be decomposed in the vector domain using the decoupled elastic wave equation, which preserves the amplitude and phase information of the original elastic wavefields. We have developed an inner-product imaging condition to match the vector-separated P- and S-wave modes to obtain scalar reflectivity images of the subsurface. Moreover, an auxiliary P-wave stress image can supplement the elastic imaging. Using synthetic examples with a layered model, the Marmousi 2 model, and a fault model, we determined that the inner-product imaging condition has prominent advantages over the other two imaging conditions and generates images with preserved amplitude and phase attributes.
Anesthetic Management of Jael Syndrome With Impacted Blade in Close Proximity to the Internal Carotid Artery: A Case Report
Authors: Gluncic Vicko , Lukić Anita , Hanko Eva , Lynch John
Published: December 2018

A patient presented with a stab injury caused by a knife penetrating the orbital floor and maxillary sinus along the skull base with the tip situated adjacent to the left internal carotid artery. A flexible fiberoptic bronchoscope loaded with an endotracheal tube was initially positioned superior to the vocal cords and advanced into the trachea immediately following induction. The blade was removed after occluding endovascular balloons were positioned distal and proximal to the potential internal carotid artery injury site. Therefore, contralateral nasal fiberoptic intubation might be safely performed in patients with unilateral maxillofacial trauma, no intracranial penetration, and minimal bleeding.
Physical Activity from Childhood to Adulthood and Cognitive Performance in Midlife
Authors: HAKALA JUUSO O. , ROVIO SUVI P. , PAHKALA KATJA , NEVALAINEN JAAKKO , JUONALA MARKUS , HUTRI-KÄHÖNEN NINA , HEINONEN OLLI J. , HIRVENSALO MIRJA , TELAMA RISTO , VIIKARI JORMA S. A. , TAMMELIN TUIJA H. , RAITAKARI OLLI T.
Published: December 2018

Introduction

Physical activity (PA) has been suggested to protect against old-age cognitive deficits. However, the independent role of childhood/youth PA for adulthood cognitive performance is unknown. This study investigated the association between PA from childhood to adulthood and midlife cognitive performance.

Methods

This study is a part of the Cardiovascular Risk in Young Finns Study. Since 1980, a population-based cohort of 3596 children (age, 3–18 yr) have been followed up in 3- to 9-yr intervals. PA has been queried in all study phases. Cumulative PA was determined in childhood (age, 6–12 yr), adolescence (age, 12–18 yr), young adulthood (age, 18–24 yr), and adulthood (age, 24–37 yr). Cognitive performance was assessed using computerized neuropsychological test, CANTAB® (N = 2026; age, 34–49 yr) in 2011.

Results

High PA in childhood (β = 0.119; 95% confidence interval [CI], 0.055–0.182) and adolescence (β = 0.125; 95% CI, 0.063–0.188) were associated with better reaction time in midlife independent of PA in other age frames. Additionally, an independent association of high PA in young adulthood with better visual processing and sustained attention in midlife was observed among men (β = 0.101; 95% CI, 0.001–0.200). There were no associations for other cognitive domains.

Conclusions

Cumulative exposure to PA from childhood to adulthood was found to be associated with better midlife reaction time. Furthermore, cumulative PA exposure in young adulthood and adulthood was associated with better visual processing and sustained attention in men. All associations were independent of participants PA level in other measured age frames. Therefore, a physically active lifestyle should be adopted already in childhood, adolescence, and young adulthood and continued into midlife to ensure the plausible benefits of PA on midlife cognitive performance.
Acute High-Intensity Interval Exercise in Multiple Sclerosis with Mobility Disability
Authors: HUBBARD ELIZABETH A. , MOTL ROBERT W. , FERNHALL BO
Published: December 2018

Introduction

Multiple sclerosis (MS) is an immune-mediated, neurological disease that results in physiological deconditioning with increasing disability. High-intensity interval training (HIIT) exercise has induced significant improvements in physiological conditioning in healthy and clinical populations and might be appropriate for persons with MS who have mobility disability. The feasibility and acute effects of HIIT using recumbent stepping in persons with MS who have mobility disability are relatively unknown.

Methods

The physiological effects of single sessions of HIIT and continuous (CON), steady-state aerobic exercise using recumbent stepping were compared in 20 persons with MS with mobility disability (i.e., Expanded Disability Status Scale of 4.0–6.5). The HIIT bout included 10 cycles of 1-min intervals at the work rate associated with 90% peak aerobic capacity (V˙O2peak) followed by 1-min recovery intervals at 15 W, totaling 20 min in length. The CON bout consisted of 20 min at the work rate associated with 50% to 60% V˙O2peak. Physiological (i.e., power output, oxygen consumption, carbon dioxide expiration, respiratory exchange ratio, ventilation, HR, and core temperature) and perceptual (i.e., ratings of perceived exertion) measures were collected across the acute sessions.

Results

There were statistically significant condition–time interactions for all physiological measures and ratings of perceived exertion expressing differential patterns of change over time for HIIT versus CON (P < 0.05). The main effect of condition was significant for all physiological outcomes, except core temperature, with the HIIT condition inducing significantly higher values than CON (P < 0.05).

Conclusions

High-intensity interval training exercise taxes the cardiorespiratory system significantly more than CON, yet without deleterious effects on core temperature in persons with MS. This has important implications for informing an evidence-based exercise prescription that is appropriate for improving physiological conditioning in persons with MS who have mobility disabilities.
Acceleration of Laboratory Rats: Synthetic Study of Data for the Century in the Aspect of Possible Relationship with Radiosensitivity
Authors: Котеров А. , Koterov A. , Ушенкова Л. , Ushenkova L. , Зубенкова Э. , Zubenkova E. , Вайнсон А. , Vaynson A. , Андрианова И. , Andrianova I. , Лукьянова С. , Luk'yanova S. , Лягинская А. , Lyaginskaya A. , Мальцев В. , Maltsev V. , Ильин Л. , Il'in L. , Самойлов А. , Samoylov A. , Уйба В. , Uyba V.
Published: December 2018

Purpose: A synthetic study of published data on the growth and development of laboratory rats (albino random-bred, Wistar and Long–Evans) depending on the period of their breeding since 1906 was carried out. Material and methods: Data for the dynamics of growth and age periods of rats were used for calculations and general analysis. Results: Acceleration in terms of age–weight indices for strain animals was found: in conditions of complete diets ad libitum the contemporary rats grew several times faster than the bred ones of 1906–1932. For random-bred rats only the tendency to acceleration was obtained. For more than a century, the Wistar males showed an inverse linear correlation between the breeding year and the age (in weeks) at the of the onset of puberty period (according to the Spearman test: r = –0.952; p = 0.00026; Pearson’s criterion: r = –0.950, p = 0.0003). There was also a direct correlation between the body mass of rats at the time of puberty onset and the year of their breeding (according to the Spearman test: r = 0.975; p = 0.005; Pearson criterion: r = 0.927; p = 0.023). The possible reasons for the acceleration of laboratory growth of rats, which are unlikely to be analogous to the factors presumably causing the known ‘growth acceleration’ in humans (changes in natural and artificial lighting, the effect of heterosis, improvement of socio-hygienic conditions, the growth of information flow, warming of the climate, change in the geomagnetic or radiation background, etc.) were discussed. Apparently, in addition to the probability of special and/or subconscious selection during century, the stimulation of rat acceleration may be explained by the ‘increase in living space and resources’ due to improved standards for keeping animals in the modern period (fewer animals in the cage or even an individual cage). In random-bred animals such standards can be apply for economic reasons to a lesser extent. Conclusions: It is concluded that the physiological, anatomical, possibly behavioral and other standards and patterns for strain rats, including, possibly, its radiosensitivity, published even 30 years ago, and especially more than 50 years ago, should be cautiously transferred to the animals grown under present-day conditions.
Simulation Approach in Forecasting Radioactive Situation in Case of Forest Fires in Radioactive Contaminated Zones
Authors: Береснева Е. , Beresneva E , Галушкин Б. , Galushkin B. , Горбунов С. , Gorbunov S. , Клочков В. , Klochkov V. , Рубцов В. , Rubcov V. , Молоканов А. , Molokanov A.
Published: December 2018

Purpose: The accident at the Chernobyl NPP caused radioactive contamination of large areas, including forestry. For the last decades forest fires in the RF tend to increase and, more alarmingly, their burnt-out area significantly expands. So, the risk of large-scale forest fires in the area of radioactive contamination increases. Effectiveness of the measures for radiation protection of population and personnel involved in fire response is directly related to existence of valid methods of radiation situation prognostication. The work is aimed to develop a method of prognostication of radiation situation at forest fire in the area of radioactive contamination, taking into account random nature of atmospheric turbulence and a convective column over the body of fire, and to estimate validity of this method.

Material and methods: Methods of simulation modeling of mass transfer processes in the atmosphere (method of Bird) based on the molecular-kinetic theory and gas-dynamic theory were used when developing the prognostication method.

Results: The simulation model of formation, spreading and fall-out of radioactive cloud taking into account random nature of atmospheric turbulence and presence of a convective column over the body of fire has been developed; the method of prognostication of radiation situation at forest fire in the area of radioactive contamination has been developed and verified based on data of European experiment E1. The relative error of received values in the control points of radiation situation parameters based on data of experiment E1 did not exceed 0.25.

Conclusion: Use of modified method of Bird allowed developing 3D dynamic model of spreading of radioactive impurity into atmosphere at convective rising by heated air flow from underlying surface. This model takes into account random nature of atmospheric turbulence and presence of a convective column over the body of fire which significantly increases accuracy of the method of radiation situation prognostication.
Methodical Apparatus for the Development of Typical Scenarios of Beyond Design Basis Accidents with VVER Reactors in the Planning and Implementation of Protective Measures for the Population
Authors: Галушкин Б. , Galushkin B. , Горбунов С. , Gorbunov S. , Клочков В. , Klochkov V. , Рубцов В. , Rubcov V. , Молоканов А. , Molokanov A.
Published: December 2018

To develop a simple methodological apparatus for constructing typical scenarios of accidents and estimate of emissions of radioactive substances from nuclear power plants with VVER reactors in the planning and implementation of protective measures for the population.Material and methods_ To build the model of release of radionuclides into the environment in case of an accident used literary experimental data of outputs of the radioactive substances from the fuel when it is heating and melting, the destruction of the fuel rod cladding, the use of technical means retention of radioactive substances in the containment of the reactor and their behaviour in the containment (sedimentation, sorption, etc.).Results_ Mathematical apparatus has been developed to quantify the magnitude of emissions of radioactive substances at nuclear power plants with VVER reactors depending on the time for dose-forming radionuclides in the instantaneous rupture of cooling pipelines in the presence of additional failure of NPP safety systems. The amount of emission of each deterministic of an accident correspond to the level 4 to 7 of the INES scale. Radionuclide release into the environment was calculated in the following physical and chemical processes_ heating and melting of fuel, depressurization of fuel rod claddings, peculiarities of the behavior of radionuclides in the containment shell (deposition, etc.) and operation of technical means to ensure radiation safety, structural leakages of the buildings. As an example, the assessment of the release of radionuclides into the environment depending on the time for level 5 of the INES accident scale is given. Conclusion_ Methodical apparatus can be used in the construction of typical scenarios for the development of basis accidents and assessment of radioactive emissions at nuclear power plants with VVER reactors in the planning and implementation of protective measures for the population and emergency exercises and training_