bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of an external iliac artery chronic total occlusion using alternate access sites
Authors: Ratcliffe Justin , Gorenchtein Mike , Khullar Pankaj , Casso Dominguez Abel , Satish Mohan , Green Philip , Puma Joseph
Published: December 2019

Background

With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases.

Case presentation

A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up.

Conclusion

This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.
Phytoremediation of some heavy metals in contaminated soil
Authors: Shehata Sherine M. , Badawy Reham K. , Aboulsoud Yasmin I. E.
Published: December 2019

Background

Several cultivated areas are irrigated with low-quality waters from the drainage system due to the shortage of suitable source of water for agricultural activities. Most of these drainage waters are contaminated with heavy metals which are concentrated in surface layer of the soil and translocated to plant and food chains. The region of Sahl El Husseiniya, Alsharqia government, is mainly irrigated with wastewater of Bahr El-Baqar drain.

Objective

Two types of hyperaccumulator plants represented by kenaf (Hibiscus cannabinus L.) and flax (Linum usitatissimum L.) were cultivated successively in the study area. Humic acid and gibberellin were used in this experiment as foliar sprayings to enhance the plant ability to absorb heavy metal ions from the soil. In addition, three soil additives represented by sulfur, vermiculite, and compost were also applied.

Results

Sulfur was the soil additive of the most pronounced effect on the uptake of Cr, Co, Cd, and Mn by the hyperaccumulator plants, while humic acid was of more favorable effect as a foliar treatment on Co and Cr uptake by flax and Cd and Mn uptake by kenaf. However, the foliar application of gibberellin enhanced plant growth and was of the best effect on both Co and Cr uptake by kenaf-cultivated soils and both Cd and Mn in flax-cultivated soils. In general, heavy metals were more concentrated in roots than in shoots. Comparing the efficiency of the two crops in cleaning soils, results implied that kenaf was of more favorable effect on the removal of Cr, Co, and Cd, while flax was of higher superiority in the removal of Mn. The efficiency of kenaf on removal of the studied metal ions followed the descending order of Cr > Co > Mn > Cd where their removal percentage values reached 50.71, 38.27, 33.98, and 14.43%, respectively. Flax phytoremediation efficiency followed the descending order of Mn > Cr > Co > Cd, where their removal percentage values reached 54.36, 36.95, 28.72, and 11.37%, respectively. Double season phytoremediation efficiency followed the order of Cr ≥ Mn > Co > Cd achieving 66.87, 65.63, 54.66, and 23.40%, respectively.
Signatures of immune reprogramming in anti-CD52 therapy of MS: markers for risk stratification and treatment response
Authors: Bierhansl Laura , Ruck Tobias , Pfeuffer Steffen , Gross Catharina C. , Wiendl Heinz , Meuth Sven G.
Published: December 2019

Background

Multiple sclerosis is one of the most prevalent neurological diseases in young adults affecting over 2 million people worldwide. Alemtuzumab is a highly effective therapy in relapsing remitting MS. Alemtuzumab is a monoclonal CD52 antibody that proved its efficacy against an active comparator (interferon [IFN]-β1a) in a phase II trial and two phase III trials regarding clinical and MRI outcomes. Nevertheless, the exact mode of action is still unknown. Alemtuzumab is commonly associated with secondary autoimmune disorders significantly affecting the risk-benefit ratio. Therefore, new biomarkers predicting treatment response and adverse events are urgently needed. This study aims to further elucidate the mechanism of action of the neuroprotective potential of alemtuzumab in relapsing-remitting multiple sclerosis (RRMS).

Methods/Design

This is a 3-year multicentre, explorative study including overall 150 patients comprising three different groups: (i) de novo patients prior and after alemtuzumab treatment initiation, (ii) patients under alemtuzumab treatment and (iii) patients requiring more than two alemtuzumab infusions. Peripheral blood and serum samples will be collected semi-annually for several in vitro/ex vivo assays to detect and characterize immune cells including their functional activity. Furthermore, data of MRI scans and disease-related impairment (using EDSS and MSFC), as well as the number and time of relapses, will be assessed. The clinical study is registered at clinicaltrials.gov (NCT04082260).

Perspective

Our study will provide deep insights into the underlying immunological changes in a longitudinal analysis of alemtuzumab treated RRMS patients. By combining clinical, radiological and functional immune-phenotype data, we will be able to identify biomarkers and/or immune signatures predicting treatment response and adverse events. Thereby, the understanding of the mechanisms of action of alemtuzumab will improve its efficacy and safety for present and future patients.
Continuous positive airway pressure in patients with rapid eye movement (REM)-specific obstructive sleep apnea, a retrospective match-controlled chart review
Authors: Soca Rodolfo , Buchner Erica , Attarian Hrayr
Published: December 2019

Background: Rapid eye movement (REM) obstructive sleep apnea (OSA) represents 13 to 35% of all OSA cases and is more common in women. Continuous positive airway pressure (CPAP) is the gold standard for treatment of all forms of OSA but we do not know if patients with REM OSA have different pressure requirements than those with non-stage dependent OSA.

Methods: This was a retrospective case control study. We first identified individuals with REM OSA and then tried to identify apnea hypopnea index (AHI), gender, and body mass index (BMI) matching controls that had non-stage specific OSA. Individuals were considered to have REM OSA if the REM AHI was greater than 5 events/hour, and the ratio of REM AHI / non-rapid eye movement (NREM) AHI was greater than 2. Demographic variables and the recommended CPAP pressure were analyzed using paired Student’s T-Tests.

Results: Our study included a total of 16 individuals with REM OSA and equal number of AHI, gender, and BMI matching controls. Both groups had similar demographic and polysomnographic characteristics.  Individuals with REM OSA required similar CPAP pressures as controls (7.5 cm H 2O vs 7.4 cm H 2O p=0.78).

Conclusion: Individuals with REM might require similar CPAP pressures as their AHI, gender, and BMI matching controls.
The World Health Organization 2030 goals for Taenia solium: Insights and perspectives from transmission dynamics modelling
Authors:   CystiTeam Group for Epidemiology and Modelling of Taenia solium Taeniasis/Cysticercosis
Published: December 2019

Taenia solium (TS), responsible for porcine cysticercosis, human taeniasis and (neuro)cysticercosis, was included in the World Health Organization neglected tropical disease (NTD) roadmap published in 2012. Targets set in this roadmap have not been met, but T. solium has been included in the consultation process for the new 2030 goals proposed for priority NTDs. Taenia solium transmission dynamics models can contribute to this process. A recent review has compared existing T. solium transmission models, identifying their similarities and differences in structure, parameterization and modelled intervention approaches. While a formal model comparison to investigate the impact of interventions is yet to be conducted, the models agree on the importance of coverage for intervention effectiveness and on the fact that human- and pig-focused interventions can be optimally combined. One of these models, cystiSim, an individual-based, stochastic model has been used to assess field-applicable interventions, some currently under evaluation in on-going trials in Zambia. The EPICYST, population-based, deterministic model has highlighted, based on simulating a generic sub-Saharan Africa setting, the higher efficacy (measured as the percentage of human cysticercosis cases prevented) of biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection. Important questions remain regarding which strategies and combinations thereof provide sustainable solutions for severely resource-constrained endemic settings. Defining realistic timeframes to achieve feasible targets, and establishing suitable measures of effectiveness for these targets that can be quantified with current monitoring and evaluation tools, are current major barriers to identifying validated strategies. Taenia solium transmission models can support setting achievable 2030 goals; however, the refinement of these models is first required. Incorporating socio-economic elements, improved understanding of underlying biological processes, and consideration of spatial dynamics are key knowledge gaps that need addressing to support model development.
Generation Scotland participant survey on data collection
Authors: Edwards Rachel , Campbell Archie , Porteous David
Published: December 2019

Background: Generation Scotland (GS) is a population and family-based study of genetic and environmental health determinants. Recruitment to the Scottish Family Health Study component of GS took place between 2006-2011. Participants were aged 18 or over and consented to genetic studies, linkage to health records and recontact. Several recontact exercises have been successfully conducted aimed at a) recruitment to embedded or partner studies and b) the collection of additional data. As the cohort matures in age, we were interested in surveying attitudes to potential new approaches to data collection and recruitment.

Methods: A ten-question online survey was sent to those participants who provided an email address.

Results: We report a high level of positive responses to encouraging relatives to participate, to remote data and sample collection and for research access to stored newborn dried blood spots.

Conclusions: The majority of current and prospective GS participants are likely to respond positively to future requests for remote data and sample collection.
Consensus-based statements for the management of mitochondrial stroke-like episodes
Authors: Ng Yi Shiau , Bindoff Laurence A. , Gorman Gráinne S. , Horvath Rita , Klopstock Thomas , Mancuso Michelangelo , Martikainen Mika H. , Mcfarland Robert , Nesbitt Victoria , Pitceathly Robert D. S. , Schaefer Andrew M. , Turnbull Doug M.
Published: December 2019

Background: Focal-onset seizures and encephalopathy are prominent features of a stroke-like episode, which is a severe neurological manifestation associated with subtypes of mitochondrial disease. Despite more than 30 years of research, the acute treatment of stroke-like episodes remains controversial.

Methods: We used the modified Delphi process to harness the clinical expertise of a group of mitochondrial disease specialists from five European countries to produce consensus guidance for the acute management of stroke-like episodes and commonly associated complications.

Results: Consensus on a new definition of mitochondrial stroke-like episodes was achieved and enabled the group to develop diagnostic criteria based on clinical features, neuroimaging and/or electroencephalogram findings. Guidelines for the management of strokelike episodes were agreed with aggressive seizure management strongly recommended at the outset of stroke-like episodes.

Conclusions: Our consensus statement defines stroke-like episodes in terms of an epileptic encephalopathy and we have used this to revise both diagnostic criteria and guidelines for management. A prospective, multi-centre, randomised controlled trial is required for evaluating the efficacy of any compound on modifying the trajectory of stroke-like episodes.
О ПОКАЗАТЕЛЯХ БЕЗОПАСНОСТИ ОБРАЗОВАТЕЛЬНОЙ СРЕДЫ
Authors: Yamileva D. V. , Bikkinin I. A.
Published: December 2019

В данной статье рассматривается проблема психологической безопасности образовательной среды и психического здоровья обучающихся. Актуальность темы обусловлена увеличением числа правонарушений и преступлений в образовательных учреждениях. Стрессогенная среда рассматривается как причина снижения психического благополучия школьников. На основании классификации групп детей по уровню психологического здоровья по И.В. Дубровиной предлагаются необходимые виды профилактических работ для выделенных групп. Подчеркивается идея о крайней необходимости повышения уровня профессиональной компетентности психологов и педагогов с целью своевременного выявление нарушений безопасности и понижения ощущений психологической незащищенности в образовательном учреждении.
Technology: a workshop on labor education
Authors: Vygonov Viktor
Published: December 2019

The textbook discusses the main types of practical work on the subject of "Technology", highlights the various types of artistic, creative and design activities of children, underlying this aspect of teaching younger students. Detailed material is given about the methods of processing and the possibilities of using different types of paper and cardboard.
It can be useful for primary school teachers, teachers and counselors of children's recreation camps, students of pedagogical universities, parents, teachers of additional education.
Organization of assistance in the areas of physical and rehabilitation medicine
Authors: Ponomarenko Gennadiy , Lavrinenko Inna , Isaeva Anna , Akhmedov Vadim
Published: December 2019

The practical guide presents the organization of specialized care for medical rehabilitation, physiotherapy, therapeutic physical culture and Spa treatment. The procedures and stages of assistance, job descriptions of employees, the device and equipment of units, sanitary and epidemic regime, quality control and safety of medical activities are considered.
It is addressed to the heads of medical organizations and health resorts, doctors of medical rehabilitation, physiotherapists, doctors of physical therapy, secondary medical personnel.
Road resilience: adaptive education for emerging challenges
Authors: Lazarsfeld-Jensen Ann
Published: December 2019

The reality of paramedicine can cause students emotional distress, especially if this tests their values or beliefs. Therefore, educating students to be resilient and prepared for unpredictable, distressing events should be considered. The need to increase professional longevity in paramedicine has shifted employers' focus from road readiness to road resilience, which presents a complex challenge for educators. This article is the first of a series to discuss the use of supporting sciences to build road resilience in undergraduate paramedicine programmes. A review of the literature on paramedic education demonstrates there is new knowledge, based on experience in clinical practice and research, that paramedic educators can draw on to develop their discipline. Paramedics with postgraduate qualifications can shape the future of their professional discipline when their research produces a new discourse that informs a curriculum which can meet contemporary challenges. Discussion of a fictional case study illustrates how an emotional crisis could provide a platform for reflective learning and make a student more effective as a paramedic, and the educational environment needed to facilitate this.
Student paramedics' views on placements in general practice as part of a degree
Authors: Proctor Alyesha
Published: December 2019

Background:

Frontline paramedics are increasingly attending to non-emergency problems and calls that could be managed by a primary care provider. Alongside this, there is a growing pressure to manage patients at home or use an alternative care pathway and reduce hospital conveyance. Student paramedic training, including both placement and taught elements at university, should therefore reflect this. However, placement opportunities for student paramedics in primary care settings is variable across the UK.

Aim:

To explore student paramedics' views on incorporating a placement within general practice as part of their degree and its effects on their learning and development as an autonomous paramedic.

Method:

A small pedagogic study as part of a postgraduate certificate in academic practice for higher education, involving a case study, qualitative approach using face-to-face, semi-structured interviews and thematic analysis, was carried out.

Findings:

Student paramedics feel that incorporating a placement in general practice as part of their degree will significantly help in their learning and development as autonomous paramedics. Specifically, they feel it: will help them understand the role of the GP and what the GP expects of them; will help them to focus their assessments and improve confidence in decisions not to convey patients; may lead to better knowledge of alternative care pathways; and, finally, may provide an insight into the role of the paramedic in general practice as a future career opportunity. There are a few reservations about whether students would be able to use the skills and knowledge gained in this setting, as they feel they do not have access to the tools or the authority in a frontline ambulance service. Students would prefer to have a placement in a GP surgery in the final year of their university degree.

Conclusion:

Placement within a GP surgery for student paramedics should be included as part of a paramedic science degree as a priority. This is necessary, particularly given the changing role of the contemporary paramedic who attends to non-emergency problems.
Application of pelvic binders by student paramedics: an observational cohort study
Authors: Magner Andre , Smith Neil , Douglin Troy
Published: December 2019

Background:

Pelvic fractures occur in approximately 20% of all multi-system traumas and can lead to loss of life through exsanguination. Advanced Trauma Life Support (ATLS) guidelines advocate application of a pelvic binder, which is most effective when placed at the level of the greater trochanters; however, multiple studies demonstrate a high degree of misplacement.

Aims:

The aim of the current study was to assess the ability of UK student paramedics to locate the greater trochanters and optimally apply pelvic binders.

Methods:

A total of 52 student paramedics from UK universities were asked to apply a pelvic binder to a healthy volunteer using a recognised technique. The primary outcome was the location of the pelvic binder compared with an optimally applied device.

Findings:

n=52 with 17/49 pelvic binders incorrectly located (34%); 18% were too low and 16% were too high.

Conclusion:

The results demonstrate a high degree of misplacement; this represents both a challenge and an opportunity for UK higher education institutions to review the manner in which pelvic binder application is taught to the next generation of prehospital practitioners.
Prehospital use of supplemental oxygen therapy in the non-hypoxic patient
Authors: Killick Desmond , Ward Gerard
Published: December 2019

Supplemental oxygen therapy in the prehospital setting can be life saving in the treatment of hypoxaemia. However, it is often administered liberally in a routine manner without clinical indication. In hyperoxaemia, it is associated with a higher risk of morbidity and mortality in acutely ill patients. An audit was performed on the use of supplemental oxygen therapy in the Irish ambulance service, which looked at: reasons for ambulance transfer; delivery device used to administer supplemental oxygen; oxygen saturation levels before and after therapy; and level of the practitioner giving the treatment. The audit results were screened against formal international guidelines, and recommendations were made to improve practice, with a view to re-auditing in the future.
Interlaminar Shear and Tensile Strengths of the Polymer Composites Based on CNT Films
Authors: Aouraghe Mohamed Amine , Marriam Ifra , Sun Lijun , Wang Yifan , Xu Fujun , Qiu Yiping
Published: December 2019

Carbon nanotubes demonstrate excellent electrical, mechanical and thermal properties due to their unique structure. To bring this astonish properties into macroscale, CNTs were assembled into large scale film via FCCVD method. However, the obtained CNT film mechanical properties remained unsatisfactory and leaves room for further improvement. Herein, different mixtures of Epoxy and PVA polymer matrix were incorporated via vacuum assisted resin transfer molding (VARTM) technique into CNT film and successfully enhanced its mechanical properties. The obtained CNT film/Epoxy and CNT film/PVA tensile strength increased by 3.5 and 4.7 times compared to pristine CNT film tensile strength. In addition, polymer matrix compatibility with CNT film was investigated by interlaminar strength method. CNT films/epoxy composite exhibited significantly higher peeling strength (633.7 N/m) compared to those with PVA (70.8 N/m) demonstrating the good affinity of epoxy with CNT film.
A case of extensive symptomatic lower limb heterotopic ossification in a boy
Authors: Kartika Inez , Martadiani Elysanti Dwi , Wiratnaya I Gede Eka , Sumadi I Wayan Juli
Published: December 2019

Heterotopic ossification refers to the abnormal growth of bone in the soft tissue. This report highlighted the case of heterotopic ossification in early childhood. A 3-year-old boy was presented with poor lower limb mobility and rigid left leg. At the age of 10 days, he developed a small lump as large as a quail egg in his left groin. Within 3 months, the lump grew bigger and spread to his leg and feet. His parents claimed no trauma history. It was confirmed by computed tomography scan which revealed multiple ossifications of the soft tissue infiltrating the lower limb muscles and infiltrating the skin, the pathological features showed hard mature trabeculated bone, mature fatty tissue, and loose connective tissue. The patient was treated with a series of soft tissue resections and was still under the care of surgeon with good prognosis.
Perception of internet addiction among psychiatric residents in an urban area in Indonesia
Authors: Hanafi Enjeline , Siste Kristiana , Kurniawan Andreas , Nasrun Martina Wiwie Setiawan , Kusumadewi Irmia
Published: December 2019

BACKGROUND In the last two years, many suspected cases of internet addiction have been reported by the media. However, many physicians do not have comprehensive knowledge of internet addiction. Currently, there has been no study conducted among psychiatric residents. This study was aimed to determine the perception of internet addiction among psychiatric residents.

METHODS This cross-sectional study was done from April to May 2018. Subjects were recruited by a total sampling method consisting of all psychiatric residents of the Faculty of Medicine, Universitas Indonesia. Perceptions of internet addiction were measured using the illness perception questionnaire revised version for addiction. The calculation of subscales was based on the algorithms available for this instrument. The Mann–Whitney U test was used to determine the association of different years of psychiatric education and the perception of internet addiction.

RESULTS Fifty-two subjects completed the survey, and 85% of them reported feeling that they did not have adequate knowledge of internet addiction. They believed that their current knowledge was not sufficient to make diagnosis and management decisions. Junior residents had significantly lower consequence scale scores, with mean (standard deviation) scores of 4.1 (0.54) for juniors and 4.4 (0.48) for seniors (p = 0.021).

CONCLUSIONS Psychiatric residents perceived internet addiction as emotionally stressful, understandable, and cyclical, but difficult to control. Senior psychiatric residents had a better perception internet addiction consequences compared with their juniors, who have received only basic knowledge about addiction without clinical exposure, but the perceptions could still be improved.
Effectivity of microscopic test as a simple diagnostic method to detect fat malabsorption in children
Authors: Widodo Ariani Dewi , Kadim Muzal , Timan Ina Susianti , Susanti Nuraini Irma , Alatas Fatima Safira , Firmansyah Agus
Published: December 2019

BACKGROUND Lipid malabsorption causes many health problems, for example stunting, a major worldwide issue. There has not been any assessment on the effectivity of lipid microscopic test in diagnosing lipid malabsorption. This research was aimed to study the effectivity of lipid microscopic test in detecting lipid malabsorption in children. METHODS This was a cross-sectional diagnostic study that evaluated the effectivity of lipid microscopic test using Sudan III against steatocrit test as the gold standard in diagnosing lipid malabsorption. The study was done in 68 children aged 6–60 months in Cipto Mangunkusumo Hospital, Jakarta. Results of lipid microscopic test were compared with that of steatocrit test among children with lipid malabsorption and normal children. The primary endpoints of this study are the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS A total of 68 children consisting of 41 boys and 27 girls were included, with a median age of 14.3 months. The most frequently found stool consistency was mushy (50%). The most common result of microscopic test, found in 42% of subjects, was positive 1. Sensitivity, specificity, PPV, and NPV of lipid microscopic test were 49.15%, 66.67%, 90.63%, and 16.67%, respectively. CONCLUSIONS Lipid microscopic test has a moderate sensitivity in diagnosing fat malabsorption and needs to be complemented with other methods such as steatocrit.
Liquid crystal filled dual-channel self-calibration optical-fiber surface plasmon resonance thermometer
Authors: Bao Jiayu , Zong Xueyang , Li Lixia , Yu Kun , Liu Yufang
Published: December 2019

In this paper, we propose and demonstrate a dual-channel self-calibration multimode optical-fiber surface plasmon resonance thermometer. The structure of this thermometer is mainly composed by dual sensing channels, in which one channel is coated with a gold layer surrounded by liquid crystal (LC), and the other is prepared with bilayers of silver and thin indium tin oxide (ITO) layer. The gold channel is the main channel, and the channel of the ITO layer with high refractive index is viewed as a configuration of self-calibration. The experimental results of the system show that the temperature sensitivities are 1.006 nm/°C in the range of 20°C–34°C and 0.058 nm/°C in the range of 35°C–80°C. In particular, at the phase transition temperature 34.5°C of changing from the nematic to the isotropic phase of the LC, the temperature sensitivity shows a step increase of 6.8 nm with a unit temperature change. This structure can be highly advantageous for temperature controlling and alarming in laboratory monitoring and industrial production.
Field-only surface integral equations: scattering from a perfect electric conductor
Authors: Sun Qiang , Klaseboer Evert , Yuffa Alex J. , Chan Derek Y. C.
Published: December 2019

A field-only boundary integral formulation of electromagnetics is
derived without the use of surface currents that appear in the
Stratton–Chu formulation. For scattering by a perfect electrical
conductor (PEC), the components of the electric field are obtained
directly from surface integral equation solutions of three scalar
Helmholtz equations for the field components. The divergence-free
condition is enforced via a boundary condition on the normal component
of the field and its normal derivative. Field values and their normal
derivatives at the surface of the PEC are obtained directly from
surface integral equations that do not contain divergent kernels.
Consequently, high-order elements with fewer degrees of freedom can be
used to represent surface features to a higher precision than the
traditional planar elements. This theoretical framework is illustrated
with numerical examples that provide further physical insight into the
role of the surface curvature in scattering problems.
Strong Purcell effect for magnetic dipole emission with spoof plasmonic spiral structure
Authors: Wu Hong-Wei , Quan Jia-Qi , Yin Yun-Qiao , Sheng Zong-Qiang
Published: December 2019

The ability to manipulate the interaction between light and optical emitters is essential for enhancing the capability of optical devices. Multifarious metallic and all-dielectric structures have been proposed frequently to enhance the emission of electromagnetic dipoles through the Purcell effect, in which its performances depend on two confinement mechanisms: temporal confinement (photon cavity period) and spatial confinement (localized light in an enclosed space), which can be described by the quality factor and mode volume, respectively. Here, we demonstrate that a hollow spoof plasmonic spiral structure in deep-subwavelength scale, which is constituted by periodically inserting spiral-shaped metallic arms into a hollow silicon cylinder, can drastically enhance emission of magnetic dipoles. Particularly, ultrahigh quality factor and ultrasmall mode volume of the magnetic resonance can be realized by further increasing the spiral degree of metallic arms. The results indicate that the quality factor of magnetic dipole mode in the structure can be enhanced to 2600 (silicon

∼

5.5

for same scale) for spiral degree

4

π

, and the Purcell factor can be enhanced to

5

×

10

6

(silicon

∼

5.1

) for a magnetic dipole emission. These results may provide a new avenue for designing optical cavities and enhancing magnetic dipole emission in low frequency.
Asymmetric silicon–polymer hybrid waveguide for second-harmonic generation based on modal phase matching
Authors: Janjan Babak , Ahmadi Vahid , Miri Mehdi , Fathi Davood
Published: December 2019

We propose and design a nonlinear-polymer-filled asymmetric silicon slot waveguide (SSW) for efficient second-harmonic generation. The distinct modal dispersion of the designed asymmetric SSW is used to achieve phase matching between the zeroth-order waveguide mode at the fundamental frequency (

λ
=

3.1

µ

m

) and the second-order mode at the second-harmonic frequency (

λ
=

1.55

µ

m

). Simulation results show a conversion efficiency of

P

2
ω

/

P
ω

=

32

%

with only 10 mW pump power. This high efficiency is a consequence of introducing an asymmetry in the SSW which not only could provide modal phase matching but also preserves high modal overlap between the interacting waves and leads to relatively low propagation loss. The proposed structure, which is well realizable with current CMOS technology, allows extra tuning by the electro-optic effect for eliminating phase mismatch resulting from fabrication errors.
Low noise measurement method based on differential optical interferometer for cold atom experiments
Authors: Ma Xiaoxiao , Zhang Xian , Huang Kaikai , Lu Xuanhui
Published: December 2019

We proposed and realized a low noise measurement method based on differential optical interferometer to measure trapped cold atoms in a magneto-optical trap (MOT). The configuration is based on a Mach-Zehnder type interferometer, which is composed of two beams of different frequencies. A long-term stability in phase monitor has been obtained by use of the vibration immune mechanism through subtraction of the interferograms imaged on the two photodetectors. With this new configuration, the noise caused by environmental perturbation is greatly reduced at low frequency while the signal of phase shift keeps a good long-term stability.
An in vitro and in silico evaluation of the antibacterial activity of the bioactive compounds in Majapahit (Crescentia cujete L.) fruit
Authors: Rahmaningsih Sri , Pujiastutik Hernik
Published: December 2019

Background and Aim: Majapahit (Crescentia cujete L.) fruit extract acts as a natural antibacterial agent due to its bioactive constituents such as tannins, flavonoids, triterpenoids, and saponins. The aim of this study was to determine the antibacterial activity of Majapahit fruit against Vibrio harveyi both in vitro and in silico.

Materials and Methods: Column chromatography, minimum inhibitory concentration (MIC) determination, and transmission electron microscopy (TEM) were used for in vitro analysis. In silico analysis was performed using PubChem® database, Pass Online (Way2Drug.com©), Search Tool 17 Interacting Chemicals (STITCH), and UNIPROT database (https://www.uniprot.org/).

Results: The MIC was found to be 0.313 mg/mL. Within the concentration range of 0.313 mg/mL-10 mg/mL, Majapahit fruit extract could inhibit the growth of V. harveyi, while lower concentrations of 0.078 mg/mL and 0.165 mg/mL indicated the presence of bacterial growth. The pathogenic mechanism of V. harveyi on vannamei shrimp (Litopenaeus vannamei) involved targeting cytochrome P450, cyclin-dependent kinase 6, and caspases 3 and 8. This was indicated by cell damage observed through TEM.

Conclusion: This study provides comprehensive results on the potential of Majapahit fruit as a natural antibacterial agent. Thus, Majapahit fruit can be considered for functional food applications.
Disease Severity Is Associated With Higher Healthcare Utilization in Nonalcoholic Steatohepatitis Medicare Patients
Authors: C. Gordon Stuart , Fraysse Jeremy , Li Suying , Ozbay A. Burak , Wong Robert J.
Published: December 2019

OBJECTIVES:

As the prevalence of nonalcoholic steatohepatitis (NASH) in the elderly population increases, healthcare resource utilization (HCRU) and costs are also predicted to rise substantially.

METHODS:

This retrospective, observational cohort study used the Medicare 20% sample data set to evaluate the impact of NASH severity on HCRU and costs over 8 years (2007–2015). The sample included 255,681 patients with nonalcoholic fatty liver disease (NAFLD)/NASH: 185,407 (72.5%) with NAFLD/NASH and no further progression to advanced liver disease, 3,454 (1.3%) with compensated cirrhosis (CC), 65,926 (25.8%) with decompensated cirrhosis (DCC), 473 (0.2%) with liver transplant (LT), and 421 (0.2%) with hepatocellular carcinoma (HCC).

RESULTS:

Rates of comorbid diabetes, hypertension, hyperlipidemia, and cardiovascular disease were significantly higher in patients with CC or more severe liver disease compared with NAFLD/NASH and no progression. The annual mean number of all-cause healthcare visits increased from 32.1 for NAFLD/NASH with no progression to 37.3 for CC, 59.8 for DCC, 74.1 for LT, and 59.3 for HCC (P < 0.05). Total annual costs for inpatient, outpatient, physician, and pharmacy services rose from $19,908 in NAFLD/NASH with no progression to $129,276 for LT (P < 0.05). Generalized linear model adjusted for patient characteristics and comorbidities revealed that costs were 1.19, 3.15, 5.02, and 3.33 times significantly higher in patients diagnosed with CC, DCC, LT, or HCC, respectively, compared with NAFLD/NASH and no progression.

DISCUSSION:

These results confirm the substantial impact of NASH, particularly more severe disease, on HCRU and costs and identify patients who may benefit from interventions to prevent progression and subsequently reduce HCRU and costs.
Adjunctive Yield of Wide-Area Transepithelial Sampling for Dysplasia Detection After Advanced Imaging and Random Biopsies in Barrett's Esophagus
Authors: Raphael Kara L. , Stewart Molly , Sejpal Divyesh V. , Cheung Mary , Whitson Matthew J. , Han Dennis , Benias Petros C. , Lee Calvin , Miller Larry S. , Trindade Arvind J.
Published: December 2019

INTRODUCTION:

Little is known about the additive yield of wide-area transepithelial sampling with computer-assisted three-dimensional analysis (WATS-3D) after a thorough examination with advanced imaging. The aim was to evaluate the adjunctive yield of WATS-3D after advanced imaging.

METHODS:

This is an observational cohort study from January 2017 to December 2018 for consecutive patients who underwent an examination that consists of high-definition white light endoscopy (HDWLE), narrow-band imaging (NBI), volumetric laser endomicroscopy (VLE), and Seattle protocol (SP) biopsies (collectively termed HDWLE-NBI-VLE-SP examination). Raised lesions were removed by endoscopic resection. Areas suspicious for dysplasia on NBI and VLE were biopsied. This was followed by random biopsies and WATS-3D brush biopsies.

RESULTS:

One hundred thirty-eight cases were included in this study. Thirty-five cases (25% of the total) were identified as some degree of dysplasia on the HDWLE-NBI-VLE-SP examination. Adjunctive use of WATS-3D yielded an additional 12 new cases of dysplasia (9 with crypt dysplasia and 3 with low-grade dysplasia [LGD]), for added yield of 34.3% (=12/35, 95% confidence interval 14.6%–62.2%). When restricting the analysis to LGD and higher, 21 dysplastic cases (15% of the total cases) were identified by HDWLE-NBI-VLE-SP, while WATS-3D found 4 additional new cases (3 with LGD and 1 with high-grade dysplasia) for an added yield of 19% (=4/21, 95% confidence interval 0.6%–45.7%).

DISCUSSION:

The addition of WATS-3D to an already thorough examination with HDWLE-NBI-VLE-SP may increase the yield of dysplasia detection.
Komplikasi Edema Paru pada Kasus Preeklampsia Berat dan Eklampsia
Authors: Setiawan Agus Harman , Airlangga Prananda Surya , Rahardjo Eddy
Published: December 2019

Latar Belakang: Angka kematian ibu (AKI) di Indonesia masih cukup tinggi dengan jumlah 305 per 100.000 kelahiran hidup pada tahun 2015. Angka ini menjadikan AKI Indonesia lebih tinggi daripada AKI negara Asia Tenggara lainnya. Preeklampsia merupakan penyumbang terbesar nomer dua pada kasus keguguran atau kematian janin. Edema paru merupakan komplikasi berat dari preeklampsia dengan angka kejadian 2,9-5%.Kasus: Terdapat 3 kasus yang dilaporkan. Kasus pertama adalah PEB dengan edema paru, dilakukan terminasi kehamilan, ventilasi mekanik dan diuretik, didapatkan respon penyapihan ventilasi mekanik. Pada kasus kedua adalah PEB disertai dengan dengue haemorhagic fever (DHF) grade II dan edema paru dilakukan terminasi kehamilan, ventilasi mekanik dan diuretik, respon kemajuan berlangsung cepat. Pada kasus ketiga adalah eklampsia dengan ganguan fungsi ginjal dan anuria walaupun telah diberikan diuretika, analisa gas darah yang asidosis metabolik berat disertai peningkatan ureum dan serum kreatinin, setelah dilakukan hemodialisa dan ultrafiltrasi pasien dapat disapih dari ventilasi mekanik.Pembahasan: Preeklampsia adalah penyebab utama morbiditas dan mortalitas ibu hamil di Indonesia. Edema paru adalah salah satu komplikasi utama yang berhubungan dengan kematian ibu hamil. Dengan mengetahui etiologi edema paru pada PEB dan eklampsia, dapat diberikan terapi yang tepat. Penggunaan ventilasi mekanik sebagai komponen oksigenasi PEEP dan ventilasi, restriksi cairan, diuretik dan keseimbangan cairan yang negatif dapat mempercepat proses penyembuhan edema paru.Kesimpulan: Salah satu penyebab morbiditas dan mortalitas pada pasien PEB dan eklampsia adalah edema paru. Dengan memahami etiologi edema paru pada pasien preeklampsia, diharapkan pola pemberian terapi dapat dilakukan dengan tepat sehingga morbiditas dan mortalitas ibu hamil dapat diturunkan.
Hubungan Volume Cairan dengan Cardiac Output dan Venous Return pada Pasien Kritis
Authors: Sartika Listiana Dewi , Pradian Erwin , Dian Nurita , Sudjud Reza W , Aditya Ricky
Published: December 2019

Pemberian cairan merupakan salah satu intervensi medis yang sering dilakukan pada pasien kritis di intensif care unit (ICU). Perkembangan ilmu mengenai cairan tubuh dulu lebih menitikberatkan pada fisiologi jantung kiri. Cardiac output, pada mulanya lebih dikenal sebagai fungsi jantung kiri dimana cardiac output ditentukan oleh jumlah darah yang dipompa dari ventrikel kiri dalam semenit (stroke volume) dan heart rate. Namun demikian, ternyata pemahaman fisiologi kardiovaskular tidak sesederhana itu. Menurut Starling, jantung hanya akan memompa darah yang masuk ke dalam jantung kanan. Dengan demikian, jumlah darah yang masuk ke jantung kanan harus sama dengan jumlah darah yang dipompa oleh jantung kiri, dimana keduanya adalah cardiac output. Ini kemudian diteliti lagi oleh Guyton. Guyton mencoba memandang cardiac output sebagai darah yang masuk ke jantung kanan (venous return). Terdapat banyak faktor yang menentukan kembalinya cairan ke jantung kanan. Faktor perbedaan tekanan antara mean systemic filling pressure (MSFP) dengan tekanan atrium kanan, serta faktor resistensi vena merupakan faktor penentu dalam fungsi venous return. Guyton juga mencari hubungan antara fungsi jantung dengan fungsi venous return. Pemahaman cardiac output secara utuh baik sebagai fungsi jantung dan sebagai venous return ini dapat menjelaskan banyak hal yang berhubungan dengan disfungsi kardiovaskular maupun gangguan ekstra kardiak pada pasien kritis dengan kondisi syok. Oleh karena itu, sangat penting bagi klinisi untuk memahami hubungan antara cairan tubuh dengan cardiac output dan venous return.
Calculation of water balance of the weighing lysimeter for assessment of aquifer recharge
Authors: ČENČUR CURK Barbara , ŠERJAK Špela , ZUPANC Vesna
Published: December 2019

Ljubljana field aquifer is an important source of drinking water for the Ljubljana city and surrounding areas. Knowledge of the water balance and of the water flow dynamics through the unsaturated zone and recharge of Ljubljana field aquifer is crucial. The water balance assessment of the upper unsaturated zone provides an insight into groundwater recharge and renewal. With the help of build-in monolith weighing lysimeter in Kleče in Ljubljana we have assessed the water balance for hydrological year from March 2014 to February 2015. Water balance parameters, precipitation and evapotranspiration were determined from the changes in the mass of lysimeter and outflow tank. Precipitation events were evaluated based on their duration, intensity and the amount of precipitation. Evapotranspiration and the duration of precipitation were estimated based on the changes of the lysimeter mass. Results show that the chosen period was extremely wet. In the selected hydrological year, precipitation contributed to positive water balance of the upper unsaturated zone, as well as to the recharge of the aquifer.
Animal spirits in an open economy: an interaction-based approach to the business cycle
Authors: Jang Tae-Seok
Published: December 2019

This paper examines the effects of boundedly rational expectation on the business cycle in a two-country New Keynesian model. Forecast heuristics in a closed-economy, De Grauwe’s (2011) model, is extended, and the effects of heterogeneous agents are incorporated in an open economy. In particular, the expectation formation process is constrained by waves of optimists and pessimists – the so-called “animal spirits.” As a result, the model is able to explain group behavior based on forecast performance, which has significant effects on output and inflation dynamics in the two countries. The simulation results suggest that heterogeneity in group behavior and nominal rigidities, as well as a moderate degree of international trade, amplify spillover effects on international business cycles leading to high cross-correlations in output and inflation.
Dual-frequency bioelectrical phase angle to estimate the platelet count for the prognosis of dengue fever in Indian children
Authors: Devarasu Neelamegam , Sudha Gnanou Florence
Published: December 2019

A noninvasive investigation to ascertain the platelet (PLT) count was conducted on 44 hospitalized dengue hemorrhagic fever (DHF) subjects, male and female aged between 3 and 14 years using bioelectrical phase angle (BPhA). Among the 44 subjects, 30 subjects were confirmed to be non-structural protein-1 (NS1) positive at the time of admission, whose blood investigations such as hematocrit (HCT) level, PLT count, aspartate aminotransferase (AST) level and alanine aminotransferase (ALT) level were performed for the classification of risk as low-risk (LR) and high-risk (HR) DHF. It was found that the BPhA of the body reflects a linear correlation with the PLT count. To provide a better and more accurate estimate of PLT, a dual-frequency method is proposed to calculate the phase angle of the total body. The resistance at 5 kHz and reactance at 100 kHz were used to estimate the phase angle of the total body. The statistical analysis identified that the PLT count estimated using the proposed dual-frequency method shows a good correlation with the blood investigation results. In addition, statistical analysis of the proposed method on other fever subjects indicated a significant difference with DHF.
美国华裔家庭日常口语与文化传承模式研究（下）： 语言社会化与家庭伦理秩序
Authors: 邱 新富
Published: December 2019

本文采用了对话分析与交际民族志学的研究方法论，微观细腻地描述了大洛杉矶地区华裔移民家庭语言的真实使用。借由呈现于分析华裔移民家庭中的语言评价行为的择用与发展，本文提供了具体例证，阐述耻感文化导向的华人伦理秩序，是如何潜移默化地在孩童社会化的过程中建构起来的。虽说移民父母往往会以负面情绪导向的语言手法评价仍才疏学浅的孩童的社会行为，并且将孩童的属性做负面类归，但笔者以为，这样的互动手法是深受传统华人社会所重视的耻感文化洗礼的影响。若孩童能够明确了解自身能力的不足，并能跟着有能力前辈的步伐迈进，这样熟稔伦理观念的美籍孩童，则可建构起他们受到主流族裔语言社群所认同的华裔身份。
External possession of body-part nouns in Jumjum: Possessor raising with possessum incorporation
Authors: Andersen Torben
Published: December 2019

In Jumjum, a Western Nilotic language, some body-part nouns, and only such nouns, may be externally possessed in transitive and antipassive clauses. In these external possessor constructions, the possessor is either the object of a transitive verb or the demoted patient of an antipassive verb. The externally possessed body-part noun is partly incorporated into the verb, as shown by the following properties: It immediately follows the verb, its tone is determined by the final tone of the verb, it may combine with a nominalized verb in a kind of compound, and it does not exhibit the root-final nasalization that is prevalent in monosyllabic singular nouns in Jumjum, including internally possessed body-part nouns.
Kuvale: A Bantu language of southwestern Angola
Authors: Fehn Anne-Maria
Published: December 2019

This paper uses historical-comparative approaches in combination with quantitative methods to analyse data from a survey of varieties of the Bantu languages Herero and Kuvale spoken by ethnically diverse groups from southwestern Angola. We assess the status and position of the underdocumented “Kuvale” variety in relation to its closest geographic neighbours, and address questions about the history of the area. We find that Kuvale is lexically differentiated from its closest relatives Herero, Wambo and Nyaneka-Nkhumbi and should probably be considered a language in its own right. Within the lexicon and phoneme inventories of the surveyed varieties, no obvious indications of a substrate were found, including in data collected among the formerly Kwadi-speaking Kwepe, and among the Kwisi and Twa foragers, who have been hypothesized to constitute a remnant layer of non-Bantu, non-Khoisan foragers in the Namib desert.