bluuebunny/crossref_metadata_2025 huggingface dataset:
ICMetric Security System for Achieving Embedded Devices Security
Authors: Al_Dosary Duaa , Ali Alheeti Khattab M , Al-Rawi Salah Sleibi
Published: March 2021

The interesting with embedded systems is related to the matters of providing privacy and security. There is a need to ensure the integrity and authenticity of the system. The methods such as passwords can be stolen or forgotten therefore the security of any data kept on the system can be exposed by any unauthorised access. In this paper, a new proposal is introduced that exploits Integrated Circuit Metrics (ICMetric) technology to provide identification and improve system security. ICMetric generates device identification based on the features of a device. In this paper, device identification can be generated by using the MEMS sensors, which are gyroscope and magnetometer embedded in many devices. The experiment is based on sensors embedded in intelligent wheelchair. Readings are obtained from the sensors and analysed mathematically and statistically to generate ICMetric number that used to provide identification of the device. ICMetric number is integrated to the dataset extracted from the trace file generated by network simulator version two (ns-2). If the system is attacked, there will be no theft because the ICMetric is not stored on the system and can be regenerated when necessary. The proposed system shows that the using of MEMS sensors to generate ICMetric number increase authentication and security of the system. The simulation results have been compared and studied for high levels of performance metrics and detection capability.
The product of Gamma Subacts of Multiplication Gamma Act
Authors: Abbas M. S. , Adnan Samer
Published: March 2021

In this paper, we introduce the notion of prime gamma subact and study some of its properties. Also, we define the concept of product gamma subacts of gamma act, particularly product gamma subacts of multiplication gamma act then we obtain some related results. Using our concept to introduce new mathematical system which is called the semigroup associative with multiplication gamma act and its basic properties are discussed. Also, by definition of product gamma subacts, we introduce the concept of gamma nilpotent. Finally, the concepts of (meet principal and weak meet principle ) gamma subact are introduced to study the product of multiplication gamma ideals of gamma semigroups. Relation among the multiplication, meet principal and weak meet principle gamma subacts are investigated.
Using a new line search method with gradient direction to solve nonlinear systems of equations
Authors: Hashim Karrar Habeeb , Shiker Mushtak A. K.
Published: March 2021

The line search techniques together with the Newton method are the best methods to solve nonlinear systems of equations. These methods use the gradient directions because they required low storage. In this paper, we suggest a new line search algorithm with gradient direction to solve the nonlinear systems of equations. The purpose of this algorithm is to reduce the number of iterations and the function evaluations, and it can increase the effectiveness of the approach. The algorithms global convergence is proved. The numerical results indicates the efficiency of the new algorithm and it is promised for solving nonlinear systems of equations.
Solving Systems of Nonlinear Monotone Equations by Using a New Projection Approach
Authors: Mahdi Mohammed M. , Dwail Hasan Hadi , Wasi H. A. , Hashim Karrar Habeeb , Dreeb Nabiha kahtan , Hussein Hussein Ali , Shiker Mushtak A. K.
Published: March 2021

The projection technique is one of the famous method and highly useful to solve the optimization problems and nonlinear systems of equations. In this work, a new projection approach for solving systems of nonlinear monotone equation is proposed combining with the conjugate gradient direction because of their low storage. The new algorithm can be used to solve the large-scale nonlinear systems of equations and satisfy the sufficient descent condition. The new algorithm generates appropriate direction then employs a good line search along this direction to reach a new point. If this point solves the problem then the algorithm stops, otherwise, it constructs a suitable hyperplane that strictly separate the current point from the solution set. The next iteration is obtained by projection the new point onto the separating hyperplane. We proved that the line search of the new projection algorithm is well defined. Furthermore, we established the global convergence under some mild conditions. The numerical experiment indicates that the new method is effective and very well.
Review on Anatomical Medical Images Classification Methods: Diagnostic Value
Authors: Yousif Ahmed Sabeeh , Sheikh Usman Ullah , Omar Zaid , Mahmood Omar Ahmed
Published: March 2021

Deep learning (DL) based convolutional neural network (CNN) has grown rapidly and become a selected choice for medical imaging fields. The paper reviews into three categories; 1) exploring the supervised machine learning methods, 2) reviews the limitations in deep learning, 3) and finally reviews the majors deep learning techniques within a specific summarized on lesion classification-based DL in term of (application, method, type of lesion diseases classification, cons).
Approximate Solutions and Error Bounds for Continuous-Time Separated Linear Programming Problem and Its Extensions
Authors: Khlefh Ahmed Rasheed , Al-Salih Rasheed , Laith Watheq
Published: March 2021

Continuous-time separated linear programming problems have a wide range of real-world applications such as in business, economics, finances, communications, manufacturing, and so on. In this paper, we extend the technique that is presented by Wen et al. [1] for two classes of these problems. We introduce both primal and dual models for separated problems. In addition, by using discrete problems we obtain approximate solutions with error bounds. Moreover, we establish a computational procedure, to solve any separated continuous-time model and any state-constrained separated model. Furthermore, after we put the separated problem in the form that is presented by Wen et al. [1], we conclude that approximate solutions converge to an optimal solution for continuous-time separated problems.
A Survey of Sobel Edge Detection VLSI Architectures
Authors: Sri Chakrapani Y , Venkatewsara Rao N , Kamaraju M
Published: March 2021

Edge detection is an essential processused to determine the object margins in most of the computer vision applications. Sobel edge detection algorithm, which is a simple method of edge detection, detects edges of various objects in an image. Real-time image applications need to be processed with large pixel data for a given time interval. So, Most of the VLSI architectures proposed for implementing sobeledge detection systems use FPGA, due to the parallel computing and reconfigurable feature. So, this paper introduces various VLSI architectures of sobel edge detection and comparesthe parameters like execution time, power dissipation with respect to similar input image size, different clock frequencies.
Performance Analysis of 5:2 compressor with 58 transistors
Authors: Bhavani Kothakonda Durga , Sireesha R , Raju Kongala , Ganesh Kumar M , Naik RatalaKoteswara , Nagedram Sanam
Published: March 2021

In the present generation of VLSI domain, designing a circuit with less power, area, and delay has become challenge for every designer. In this article we have design and implemented a design for 5:2 compressor which is the vital component in CMOS multiplier circuits. The proposed compressor circuit design requires less transistor count i.e. 58 transistors. The Simulation results of proposed 5:2 compressor has substantially expanded the performance of power delay in contrast to earlier designs.
Temperature aware variable time-slot assignment priority-based routing algorithm for WBANs in IoT based eHealthcare systems
Authors: Rajendra Prasad Ch. , Bojja Polaiah , Kumari Pamula Raja , Girirajan B.
Published: March 2021

The wireless body area networks are an integral part of the Internet of Things for eHealthcare applications. These networks suffer from two major problems such as energy consumption and lifetime of the overall network. To address these problems, a temperature aware priority-based routing algorithm for WBANs is proposed. This algorithm employs temperature aware routing, priority-based routing, and variable time-slot assignment. The temperature-aware routing enhances the stability of the overall network by providing an alternate route. The priority-based routing facilitates reliable data transmission among the sink and the sensor nodes which will enhance the lifetime of the overall network. The variable time-slot assignment in the scheduling phase prevents the collisions by employing a new synchronization schem e which will minimize overall network energy consumption. The performance proposed algorithm was analyzed with three network parameters and the results showed improved performance as compared with the traditional routing protocols.
Development of Blink Restoration Model for Facial Paralysis Detection
Authors: Kalivaraprasad  , Prasad VD. M , Harshavardhan L
Published: March 2021

On account of blink feature, patients suffer from facial paralysis that lead to disfiguration and loss of vision. Ultimately, facial pacing aims to improve the the standard of life of individuals suffering from facial unilateral paralysis A device is designed that can analyze electromyography signals from the healthy side of the face eye and trigger the corresponding muscle with electrical stimulation on the paralysed side simultaneously. FES is one of the possible ways for restoration of blink of these patients. The system modelled will achieve the EMG signal extraction and blink detection algorithm for stimulation by real time signals. Finally, the device has been experimented on humans, rabbits, dogs with EMG signal data set. The attenuation of power frequency is about 51dB with 80% accuracy.
Design of Concurrent Dual-Band Band Pass Filter using Hybrid Metal insulator Metal for Nanoscale Applications
Authors: Bitra Surendra Kumar , Sridhar M
Published: March 2021

In this paper, investigation on Hybrid Metal Insulator Metal (HMIM) plasmonic waveguide (PWG) filters for dual-band applications. The filters are designed using circular ring resonator (CRR) and CRR with single as well as dual slits. The filters are connected using coupled line feed. The dual-band Band Pass Filter (BPF) characteristics can be realized by varying radius (r) and gap (g) between the feed and ring resonator. The proposed CRRs are operated at THz frequencies. The filters are designed and simulated using commercially available CST studio suite software under Perfect Matched Layer (PML) boundary conditions by keeping 5 nm x 5 nm mesh size. The transmission and reflection characteristics of the filters are explained by the resonance conditions, which agrees with theoretical calculations. The proposed work is best suitable for the plasmonic integrated optical circuits for nanoscale applications.
Design and Analysis of a Circularly polarized flexible, compact and transparent antenna for Vehicular Communication Applications
Authors: Anil Babu B , Madhav BTP , Vineel B , Chandini G , Amrutha Ch , Rao MC
Published: March 2021

A Compact, flexible, and circularly polarized transparent monopole antenna is proposed for vehicular communication applications by IEEE 802.1p standard. Canopy mesh is used as a conductive layer and the PDMS substrate is used as a substrate with dielectric constant e
r = 2.66 and loss tangent tan 6= 0.023. The overall dimension of the proposed antenna is 20 × 20 × 1 mm3. The rectangular patch with a T-shape slot with a truncated corner and partial ground provide resonant frequency at 5.85 GHz with a reflection coefficient (S11) bandwidth of 5.2-6.86 GHz (1.66 GHz) and axial ratio(dB) bandwidth of 5.7 GHz-6.14 GHz (404 MHz).
High Level Synchronization and Computations of Feed Forward Cut-Set based Multiply Accumulate Unit
Authors: Srikanth I , Aunmetha S
Published: March 2021

In a modern technology-based application, digital signal processing (DSP) is a major priority one, in this gadgets application, the Multiply Accumulate Unit (MAC) will occupy more memory usages, power consumptions and critical path delay. Due to the number of arithmetic operations, this MAC unit will play’s a major role in this application product. Thus, the pipelined based architecture will be used to reduce the number of critical paths delay and to improve the performance of MAC architecture. However, the number of flip flops will be increased in the MAC unit, due to number of pipelined architectures. Consequently, it will increase the area and the power consumption. Thus, proposed work of this paper will get a novelty process of feed forward cut-set based MAC architecture with high level synchronization of XOR-MUX full adder with compressor technique. It will reduce the number of logic gates in MAC architecture and hence prove the performance in FPGA Implementation of LUT based area, critical path delay and average power consumption.
A Comprehensive Review on Millimeter Waves Applications and Antennas
Authors: Chittimoju Gayatri , Yalavarthi Usha Devi
Published: March 2021

Millimeter wave (mmWave) bands attract large research interest as they can potentially lead to data rate of almost 10Gbits/sec and huge available bandwidth where as the microwave frequencies are limited to 1Gbits/s. This paper presents a comprehensive review of millimeter wave communications, frequency bands proposed by ITU, applications of mmWaves, advantages, limitations, challenges and research directions. Various antennas proposed by researchers for mmWave applications are described in detail. The described models are analyzed and compared with common antenna parameters. Applications like HD gaming, ultra high definition multimedia, security and surveillance demand for high data rates and more bandwidth. These all applications will drive mmWvaes technology to develop and offer wide bandwidths with high speed data.
Investigation of partially crystalline metallic glass Fe38Ni36B18Si8
Authors: Hrvat K , Lozančić M , Sulejmanović S , Gazdić I , Bajrović N , Salčinović Fetić A
Published: March 2021

Partially crystalline metallic glass Fe38Ni36B18Si8 was produced by rapidly solidifying in the form of ribbon. Chemical composition and homogeneity of the sample were determined using Scanning Electron Microscopy, equipped with energy-dispersive X-ray spectroscopy. The diffractogram exhibits a characteristic diffuse halo pattern superimposed with crystalline peaks, indicating existence of crystalline phases. The crystallization kinetics in non-isothermal conditions was studied by Differential Scanning Calorimetry. The electrical resistivity and the dimensions of samples Fe38Ni36B18Si8 were measured at room temperature. The temperature dependence of electrical resistivity was studied from 80 to 273 K. The measurements have shown a positive coefficient of electrical resistivity.
Effect of alloy powder on the properties of ZTA particles reinforced high chromium cast iron composites
Authors: Zeng Hongbin , Sui Yudong , Niu Ge , He Han , Jiang Yehua , Zhou Mojin
Published: March 2021

Micrometer scale zirconia toughened alumina particles (ZTAp) reinforced high chromium cast iron (HCCI) matrix composites were prepared by the non-pressure infiltration casting process, which solved the poor compounding of micrometer scale ceramic particle preforms under seepage. The effects of the microstructure and the mechanical properties of ZTAp reinforced HCCI matrix composites by micro-powder contents in the preforms were systematically investigated. Alloy powder content of 65 wt.%, 55 wt.%, 45 wt.%, 35 wt.% and 25 wt.% was added to the composite material respectively. Phases of the composites was identified by optical microscope (OM), energy dispersive spectrometer (EDS) and x-ray diffraction (XRD). The best compressive properties of the composites were obtained when the content of alloy powder at 45 wt.%, which the strain reached 6.32% with a stress of 1229.63 ± 39.05 MPa. The fracture mechanism of the ZTAp reinforced HCCI composites mainly was brittle fracture and the ductile fracture was minor. This study shows that the addition of micrometer powder was contributed to improve the organization and properties of the ZTAp reinforced HCCI matrix composites. The reinforcement mechanism of composites not only depends on the load sharing of the reinforcing particles, the strength of the matrix was also critical.
𝖲𝖾𝖺𝗅𝗂𝗇𝗀 from iterability
Authors: Sargsyan Grigor , Trang Nam
Published: March 2021

We show that if

V
V

has a proper class of Woodin cardinals, a strong cardinal, and a generically universally Baire iteration strategy (as defined in the paper) then

S
e
a
l
i
n
g

\mathsf {Sealing}

holds after collapsing the successor of the least strong cardinal to be countable. This result is complementary to other work by the authors where it is shown that

S
e
a
l
i
n
g

\mathsf {Sealing}

holds in a generic extension of a certain minimal universe. The current theorem is more general in that no minimality assumption is needed. A corollary of the main theorem is that

S
e
a
l
i
n
g

\mathsf {Sealing}

is consistent relative to the existence of a Woodin cardinal which is a limit of Woodin cardinals. This improves significantly on the first consistency of

S
e
a
l
i
n
g

\mathsf {Sealing}

obtained by W.H. Woodin.

The
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="sans-serif upper L sans-serif a sans-serif r sans-serif g sans-serif e sans-serif s sans-serif t sans-serif sans-serif upper S sans-serif u sans-serif s sans-serif l sans-serif i sans-serif n sans-serif sans-serif upper A sans-serif x sans-serif i sans-serif o sans-serif m">

L
a
r
g
e
s
t
 
S
u
s
l
i
n
 
A
x
i
o
m

\mathsf {Largest\ Suslin\ Axiom}

(

L
S
A

\mathsf {LSA}

) is a determinacy axiom isolated by Woodin. It asserts that the largest Suslin cardinal is inaccessible for ordinal definable bijections. Let

L
S
A
-
o
v
e
r
-
u
B

\mathsf {LSA\text {-}over\text {-}uB}

be the statement that in all (set) generic extensions there is a model of

L
S
A

\mathsf {LSA}

whose Suslin, co-Suslin sets are the universally Baire sets. The other main result of the paper shows that assuming

V
V

has a proper class of inaccessible cardinals which are limit of Woodin cardinals, a strong cardinal, and a generically universally Baire iteration strategy, in the universe

V
[
g
]

V[g]

, where

g
g

is

V
V

-generic for the collapse of the successor of the least strong cardinal to be countable, the theory

L
S
A

\mathsf {LSA}

-

o
v
e
r

\mathsf {over}

-

U
B

\mathsf {UB}

fails; this implies that

L
S
A
-
o
v
e
r
-
U
B

\mathsf {LSA\text {-}over\text {-}UB}

is not equivalent to

S
e
a
l
i
n
g

\mathsf {Sealing}

(over the base theory of

V
[
g
]

V[g]

). This is interesting and somewhat unexpected, in light of other work by the authors. Compare this result with Steel’s well-known theorem that “

A
D

L
(

R

)

\mathsf {AD}^{L(\mathbb {R})}

holds in all generic extensions” is equivalent to “the theory of

L
(

R

)

L(\mathbb {R})

is sealed” in the presence of a proper class of measurable cardinals.
Three-Dimensional Computed Tomography Scanning of Temporal Vessels to Assess the Safety of Filler Injections
Authors: Chen Chun-Lin , Cong Li-Yao , Kong Xiang-Xue , Zhao Wei-Rui , Hong Wei-Jin , Luo Cheng-En , Luo Sheng-Kang
Published: March 2021

Background

Temple filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon.

Objectives

This study aimed to investigate the anatomy of the temporal vessels and provide a more accurate protocol for temple filler injection.

Methods

Computed tomography (CT) scans of 56 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3-dimensional (3D) images of the temporal vessels described by a coordinate system based on the bilateral tragus and right lateral canthus.

Results

In the XOY plane, the superficial temporal artery (STA), middle temporal artery (MTA), zygomatico-orbital artery (ZOA), posterior branch of the deep temporal artery (PDTA), and lateral margin of the orbital rim divide the temple into 4 parts (A, B, C, and D). The probabilities of the STA, MTA, ZOA, and PDTA appearing in parts A, B, C, and D were 30.73%, 37.06%, 39.48%, and 77.18%, respectively. In 3D images, these vessels together compose an arterial network that is anastomosed with other vessels, such as the external carotid, facial, and ocular arteries.

Conclusions

3D CT images can digitally elucidate the exact positions of temporal vessels in a coordinate system, improving the safety of temple filler injections in a clinical setting.
Characterizing protein conformers by cross-linking mass spectrometry and pattern recognition
Authors: Kurt Louise U , Clasen Milan A , Santos Marlon D M , Lyra Eduardo S B , Santos Luana O , Ramos Carlos H I , Lima Diogo B , Gozzo Fabio C , Carvalho Paulo C
Published: March 2021

Motivation

Chemical cross-linking coupled to mass spectrometry (XLMS) emerged as a powerful technique for studying protein structures and large-scale protein-protein interactions. Nonetheless, XLMS lacks software tailored toward dealing with multiple conformers; this scenario can lead to high-quality identifications that are mutually exclusive. This limitation hampers the applicability of XLMS in structural experiments of dynamic protein systems, where less abundant conformers of the target protein are expected in the sample.

Results

We present QUIN-XL, a software that uses unsupervised clustering to group cross-link identifications by their quantitative profile across multiple samples. QUIN-XL highlights regions of the protein or system presenting changes in its conformation when comparing different biological conditions. We demonstrate our software’s usefulness by revisiting the HSP90 protein, comparing three of its different conformers. QUIN-XL’s clusters correlate directly to known protein 3D structures of the conformers and therefore validates our software.

Availabilityand implementation

QUIN-XL and a user tutorial are freely available at http://patternlabforproteomics.org/quinxl for academic users.

Supplementary information

Supplementary data are available at Bioinformatics online.
Plasma Concentrations of Magnesium and Risk of Dementia: A General Population Study of 102 648 Individuals
Authors: Thomassen Jesper Qvist , Tolstrup Janne S , Nordestgaard Børge G , Tybjærg-Hansen Anne , Frikke-Schmidt Ruth
Published: March 2021

Background

Low and high concentrations of plasma magnesium are associated with increased risk of future all-cause dementia; however, the underlying reasons remain elusive. The magnesium ion is an important electrolyte serving as a cofactor in many enzymatic processes in the human organism. Magnesium affects both neuronal and vascular functions. We investigated the associations of plasma concentrations of magnesium associate with common subtypes of dementia as Alzheimer dementia and non-Alzheimer dementia, and potential pathways by which magnesium may affect risk of dementia.

Methods

Plasma concentrations of magnesium were measured in 102 648 individuals from the Copenhagen General Population Study. Cox regression and natural effects mediation analyses evaluated associations with either Alzheimer dementia or non-Alzheimer dementia.

Results

Multifactorially adjusted hazard ratios for non-Alzheimer dementia were 1.50(95% confidence interval (CI):1.21–1.87) for the lowest and 1.34(1.07–1.69) for the highest vs the fourth quintile (reference) of plasma magnesium concentrations. Diabetes, cumulated smoking, stroke, and systolic blood pressure mediated 10.4%(3.1–22.8%), 6.8%(1.2–14.0%), 1.3%(0.1–3.6%), and 1.0%(0.2–2.6%), respectively, in the lowest quintile, whereas stroke mediated 3.2%(0.4–11.9%) in the highest quintile. No associations were observed for Alzheimer dementia.

Conclusions

Low and high plasma magnesium concentrations were associated with high risk of vascular-related non-Alzheimer dementia, with the lowest risk observed at a concentration of 2.07 mg/dL (0.85 mmol/L). No association was observed for Alzheimer dementia. Mediation analysis suggested that diabetes may be in the causal pathway between low plasma magnesium concentrations and high risk of non-Alzheimer dementia, while cumulated smoking, stroke, and systolic blood pressure played minor mediating roles.
The Microbiota-Gut-Brain Axis in Mental Health and Medication Response: Parsing Directionality and Causality
Authors: Bastiaanssen Thomaz F S , Cryan John F
Published: March 2021

There is increasing evidence for the role of the microbiome in various mental health disorders. Moreover, there has been a growing understanding of the importance of the microbiome in mediating both the efficacy and side effects of various medications, including psychotropics. In this issue, Tomizawa and colleagues report on the effect of psychotropic drugs on the gut microbiome of 40 patients with depression and/or anxiety disorders. In their longitudinal cohort, the authors find that antipsychotics, but not anxiolytics, decrease microbiome alpha diversity. They further find that antipsychotics dosage was negatively correlated with alpha diversity in these patients. The health consequences of these microbiome alterations remain to be fully understood. In this commentary, we will discuss such findings through the lens of several recent studies on the microbiota-gut-brain axis. We also use the paper as a backdrop to discuss directionality and, by extension, causality in relation to microbiota-gut-brain-brain signaling.
Modelling and solving the bi-objective production–transportation problem with time windows and social sustainability
Authors: Shahrabi Fatemeh , Tavakkoli-Moghaddam Reza , Triki Chefi , Pahlevani Mahsa , Rahimi Yaser
Published: March 2021

We model and solve the production routing problem (PRP) with time windows, product deterioration and split delivery. A bi-objective PRP model for a single perishable product, which is subject to deterioration, is presented. The two objectives represent the economic and social aspects of sustainability, whereas the environmental impact is enforced by incorporating ad-hoc constraints. The economic dimension of sustainability consists of minimizing the costs related to the production, setup, holding, transportation and lateness penalty. The social responsibilities are modelled through maximizing the total freshness of the delivered products at all nodes over the planning horizon. The outcomes of our formulation are represented by the lot sizes, and the amounts of product to be delivered, as well as the routing at each planning period. To solve the resulting problem, we develop an interval robust possibilistic approach, and we carry out an experimental study and a sensitivity analysis. Finally, we further validate our optimization model and solution method using a real-life case of a food factory producing a product that is subject to perishability and deterioration.
‘Cosmopolitan Citizenship’, Territorial Borders, and Bringing Denationalized Terrorists to Justice
Authors: Seet Matthew
Published: March 2021

This article challenges scholarly claims that a post-national ‘cosmopolitan citizenship’ — an expanded and less territorially bounded belonging of ‘humanity’ — has been emerging in the international criminal justice context. In examining the contemporary denationalization of terrorists from the under-explored angle of criminal justice, this article argues that states’ territorial borders prevent denationalized terrorists — deemed enemies of ‘humanity’ — from being brought to justice. Some states strip citizenship from terrorists without holding them accountable for terrorist offences and international crimes, subsequently deporting them to — or leaving them stranded in — states which are, according to international criminal law, ‘unable’ or ‘unwilling’ to prosecute. As such, states’ territorial borders serve as a ‘shield’ which not only enable denationalized terrorists to avoid accountability for their terrorist offences and international crimes, but which also enable states to avoid their international obligations to bring terrorists to justice. This case study of denationalized terrorists not only demonstrates the enduring relevance of territoriality to international criminal justice but also broadly demonstrates how post-national ‘citizenship’ remains tied to the territorial state in a globalized world.
COVID-19 Exposure and Family Impact Scales: Factor Structure and Initial Psychometrics
Authors: Kazak Anne E , Alderfer Melissa , Enlow Paul T , Lewis Amanda M , Vega Gabriela , Barakat Lamia , Kassam-Adams Nancy , Pai Ahna , Canter Kimberly S , Hildenbrand Aimee K , McDonnell Glynnis A , Price Julia , Schultz Corinna , Sood Erica , Phan Thao-Ly
Published: March 2021

Objective

In response to the rapidly unfolding coronavirus disease 2019 (COVID-19) pandemic in spring 2020, we developed a caregiver-report measure to understand the extent to which children and families were exposed to events related to COVID-19 and their perceptions of its impact. This article reports on the factor structure and psychometric properties of this measure.

Methods

The COVID-19 Exposure and Family Impact Scales (CEFIS) were developed by a multidisciplinary, multi-institutional team using a rapid iterative process. Data from 1805 caregivers recruited from 28 programs at 15 institutions across the United States were collected from May—September 2020. We examined the underlying structure of the CEFIS using exploratory factor analyses and its internal consistency (Cronbach’s alpha).

Results

Participants reported a range of COVID-19-related events (M = 8.71 events of 25). On the bidirectional 4-point impact scale, mean scores were mostly above the midpoint, indicating a slightly negative impact. Cronbach’s alpha was excellent for Exposure (α = .80) and Impact (α = .92). Factor analysis identified six factors for Exposure (COVID-19 experiences, Access to essentials, Disruptions to living conditions, Loss of income, Family caregiving and activities, and Designation as an essential worker). There were three factors for Impact (Personal well-being, Family interactions, and Distress).

Discussion

The CEFIS has strong factors assessing Exposure to events related to COVID-19, and the Impact of these events on families of children in pediatric healthcare. These initial validation data support use of the CEFIS for measuring the effect of the pandemic.
Xanthogranuloma of the external auditory canal—an atypical anatomical manifestation
Authors: Connell James T , Nguyen Thu , Carney Andrew S , Chong Sheldon
Published: March 2021

Juvenile xanthogranuloma is a proliferative cutaneous manifestation encountered in the paediatric population. Adult cases are uncommon, but have been reported. Lesions are prevalent in the head and neck region, but rarely observed in the external auditory canal. We present the case of a 39-year-old female with a rapidly progressing obstructive soft tissue lesion of the external auditory canal. Surgical excision diagnosed the lesion as a rarely observed otological manifestation of juvenile xanthogranuloma. Surgical excision was curative with no locoregional recurrence. Otolaryngologists should consider juvenile xanthogranuloma as a differential for atypical soft tissue cutaneous lesions of the head and neck, including in divergent populations.
Force majeure clauses in LNG sales and purchase agreements: how do they stand up during the Covid-19 pandemic?
Authors: Denison M J
Published: March 2021

During the Covid-19 pandemic companies have declared force majeure on contracts across the energy value chain. LNG Sales and Purchase Agreements (SPAs) are no exception. Courts in several jurisdictions have declared Covid-19 a force majeure event. Governments have issued guidelines on managing Covid-related contract disputes. The stage is set for high-value litigation turning on the validity of force majeure clauses. The purpose of this article is to help make sense of these developments. It will review the theory and application of the law of force majeure and, through comparison of six published LNG SPAs, ‘stress test’ current force majeure provisions. The article will consider how contractual risk is presently allocated in these model contracts, what drafting modifications might be applied to improve coverage, align with current case law, better reflect the market environment, and ensure contractual stability under Covid-19 conditions. The focus is on English law, given that this is the lex fori in the majority of the published contracts.
Finding the Best Care
Authors: Broussard Beth , Compton Michael T.
Published: March 2021

In many places around the world, there are specialty clinics that are devoted to people in the early stages of psychosis. These are sometimes called early intervention services or coordinated specialty care programs. Specialty programs usually do a full evaluation of the young person and provide ongoing medication management as well as psychosocial treatments. Many specialty programs for early psychosis also offer group meetings just for young people who have recently been diagnosed with psychosis, as well as group meetings for families of these young people. Specialty programs for early psychosis focus on recovery, shared decision-making, and individuals’ life goals. These programs also provide outreach to the community to aid in earlier detection that will hopefully reduce delays to getting into care. In some places, specialized clinics and treatment programs have been developed to try to identify and help young people who may be about to develop psychosis, before the psychosis begins. Such programs provide treatments and services to people who appear to be at elevated risk for developing psychosis.
Medicines Used to Treat Psychosis
Authors: Broussard Beth , Compton Michael T.
Published: March 2021

Many mental health professionals view medicines to be of utmost importance in the treatment of psychosis. The main types of medicines used to treat psychosis are antipsychotics, which are most effective for what are referred to as “positive symptoms” like hallucinations and delusions. Antipsychotics work by binding to dopamine (and, in some cases, serotonin) receptors in the brain, which affects the ways certain neurons communicate with one another. The length of time the medicine should be taken is based on the types of symptoms one experiences and how long the symptoms last. Sometimes antipsychotics cause side effects. It is important to discuss possible side effects from specific medicines with the psychiatrist, so that the person with psychosis and their families know which side effects to expect and how to handle them if they happen. Doctors usually try to find the lowest effective dose in order to minimize side effects, while still being effective in treating symptoms.
Reducing Stress, Coping, and Communicating Effectively
Authors: Broussard Beth , Compton Michael T.
Published: March 2021

Families are key in the recovery process because they love the person with the illness, care for them, and want to help. But stress in a family can sometimes start to break down communication between family members. Certain symptoms of psychosis can also make communication difficult at times. It is vital to create a supportive family environment by reducing stress, coping, and communicating effectively. It is impossible to get rid of all stressors because some are just a natural part of life or trying to reach personal goals. Learning to manage stress is important to everyone’s mental and physical health. Working together to develop better ways of handling stress strengthens relationships and improves the quality of life for everyone in the family. Effective communication helps to improve relationships, resulting in fewer conflicts and unresolved disagreements.
Survival Following Primary Androgen Deprivation Therapy Among Men With Localized Prostate Cancer
Authors: Zabell Joseph
Published: March 2021

This chapter summarizes the findings of a population-based, observational study comparing men with clinically localized prostate cancer who received primary androgen-deprivation therapy (ADT) or were treated conservatively. The investigator used instrumental variable analysis to adjust for potential confounders. This study found no improvement in survival for men receiving primary ADT.
Cis-Diamminedichloroplatinum, Vinblastine, and Bleomycin Combination Chemotherapy in Disseminated Testicular Cancer
Authors: Risk Michael
Published: March 2021

This chapter reviews a pivotal, single-armed observational study of consecutive patients with metastatic testicular germ cell tumor treated with a combination of bleomycin, vinblastine, and cisplatin. This study established that cisplatin-based combination chemotherapy resulted in a much better prognosis in patients with metastatic testicular cancer than historically observed with any other treatment and also resulted in high response rates.
Extracorporeal Shock Wave Lithotripsy Versus Percutaneous Nephrolithotomy for Lower-Pole Nephrolithiasis
Authors: Bird Vincent G. , Borofsky Michael S.
Published: March 2021

This chapter summarizes the results of the Lower Pole Study I study in which patients with symptomatic lower pole renal calculi were randomized to receive extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL). The study found that patients receiving ESWL had lower stone-clearance rates and a more frequent need for retreatment but lower morbidity, whereas those receiving PCNL had higher stone-clearance rate and fewer retreatments but greater morbidity.
Medical Expulsive Therapy (MET) in Adults With Ureteric Colic
Authors: Borofsky Michael S. , Bird Vincent G.
Published: March 2021

This chapter summarizes the results of the SUSPEND trial, a methodologically rigorous three-armed randomized controlled trial of medical expulsive therapy in the form of the alpha-blocker tamsulosin or the calcium channel blocker nifedipine versus placebo. The mean stone size in all three groups was comparable and three-quarters of the stones were 5 mm or less. It was a “negative trial” that failed to demonstrate a substantial benefit from the widely established practice of treating patients with small ureteral stones with medical expulsive therapy. Serious adverse events were very infrequent.
Anticholinergic Therapy Versus Onabotulinumtoxin A for Urgency Urinary Incontinence
Authors: Lane Giulia I. , Dixon Colby A. , Louis Moy M. , Fok Cynthia S.
Published: March 2021

This chapter summarizes the results of the Anticholinergic Versus Botulinum Toxin Comparison (ABC) trial, in which women with urgency urinary incontinence were randomized to receive daily oral anticholinergic therapy versus a one-time intradetrusor injection of 100 units of onabotulinumtoxin A (Botox). Women in both groups reported a similar reduction of about three in the mean number of incontinence episodes. Complete resolution of symptoms was more likely in the Botox group. Dry mouth was reported more frequently by women in the anticholinergic group; women in the Botox group had higher rates of urinary tract infections. This study demonstrated similar outcomes for both treatments with respect to symptoms of urinary incontinence but the two treatments had different side-effect profiles.
Why work in respiratory nursing?
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Working in the specialty of respiratory medicine and thoracic surgery offers an interesting, diverse, and wide-ranging choice of excellent opportunities for an appealing and fulfilling career. The specialty includes over 30 different medical conditions of which some are common and some relatively rare so there is ample opportunity to subspecialize as well as to take a more generalist pathway. Nurses in this specialty are often members of a multidisciplinary team working with other specialist nurses, consultants, general practitioners, physiotherapists, occupational therapists, pharmacists, and respiratory technicians. This chapter gives a brief overview of the nurse’s role in respiratory medicine and thoracic surgery and their position in a multidisciplinary team in acute settings or within the community. The desirable qualities for a respiratory nurse are outlined, and the relevant training courses and study days are covered.
Cystic fibrosis
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Cystic fibrosis (CF) is the most common, life-threatening, and recessively inherited disease in the Western world. This chapter provides an overview of the condition, including its aetiology, pathology, and genetics. It then covers the clinical presentations and confirmation of diagnosis of CF, complications (respiratory, gastrointestinal, pancreatic, bowel, hepatic, reproductive, and diabetic). Anyone recognized as having high risk of having a baby with CF and in whom pregnancy is contemplated, or who has a newborn with CF, should be offered screening and early genetic advice. Care and management are described in detail, including nutrition, physiotherapy, infection control, antibiotics, the transition from paediatric to adult care, transplant, and end-of-life care.
Obstructive sleep apnoea
Authors: Robinson Terry , Scullion Jane
Published: March 2021

This chapter covers the causes, signs, and symptoms of obstructive sleep apnoea (OSA). It explains the process of diagnosis, from a history, medications, family, and psychosocial history, occupation, and diagnostic procedures. Differential diagnoses that should be excluded are listed. The prevalence of OSA is estimated to be around 4% of the population. It is quite a common disorder, although this figure may be an underestimate as many people may not seek treatment. Prevalence figures also vary according to the chosen threshold for defining a significant sleep abnormality and symptoms. Treatment options are also outlined, and the specific aspects of nursing care are listed.
Pneumothorax
Authors: Robinson Terry , Scullion Jane
Published: March 2021

A pneumothorax is defined as air in the pleural space. It can be spontaneous, occur as the result of trauma, or be iatrogenic. Patients with a pneumothorax commonly present with pleuritic chest pain on the affected side and/or breathlessness. Younger patients often have minimal breathlessness although in secondary pneumothorax breathlessness may be increased. A pneumothorax will reduce the compliance of the lungs and so the lungs will become stiffer. Because of reduced compliance in the affected lung greater pressure needs to be generated during inspiration to move the same volume of air into the lungs. As a result, breathing will become more of an effort and the sensation of breathlessness will be increased. The patient may also have pleuritic chest pain from inflammation of the pleura, generally due to bleeding, and heightened by attempts to inflate the affected lung. This chapter covers the incidence, risk factors, features, and investigations of the condition, different management options and prognosis, and different aspects of nursing care. Practical care of chest drains and management of the pregnant patient is also covered.
Pulmonary hypertension
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Pulmonary arterial hypertension (PH) is an often-misdiagnosed lung disorder occurring as a primary idiopathic disease or as a complication of a large number of respiratory and cardiac diseases. It was previously thought to be a rare condition with a relentlessly progressive course and few treatment options. However, it is increasingly recognized in association with other conditions and recent advances have resulted in the development of effective therapies. This has focused attention on making an early and accurate diagnosis. Despite these recent advances, it is important to consider that it remains an alarming, incurable disease with a poor prognosis. PH describes a number of devastating diseases causing breathlessness, loss of exercise capacity, and death due to right-sided heart failure. This chapter begins by defining the condition, including the ESC and ERS guidelines, then goes on to give help with diagnosis and functional classification. Clinical features and investigations are outlined, as well as further assessment and key respiratory, cardiac, and haematological investigations. Specific targeted therapies, general treatment, and nursing care and advice are covered too.
Pulmonary rehabilitation
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Pulmonary rehabilitation (PR) is an important component in the management, care, and treatment of patients with chronic lung disease, particularly with COPD and increasingly in ILD. Breathlessness is a symptom of the underlying lung disease, and can result in reduced patient activity, which in turn reduces fitness, leads to social isolation, and can exacerbate depression and anxiety. PR is a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. This chapter describes the rationale for PR, how to set up an effective rehabilitation regime through education and physical exercise, and how to provide follow-up care.
The multidisciplinary team
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Respiratory services should be delivered in an integrated way, taking into account the overlap in patient population and in the personnel providing care. The majority of patients with respiratory disease are cared for by a team of health professionals from both primary and secondary care. Respiratory nurses work as part of the multidisciplinary team. This team includes doctors, ward-based, and outpatient nurses, physiotherapists, occupational therapists, lung-function technicians, community pharmacists, social services and, of course, the patient, and their family and carers. This chapter outlines the responsibilities and contributions of each member of the multidisciplinary team in providing respiratory services.
Flying, altitude, and diving
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Up to an altitude of approximately 30,000 feet, the composition of the gas in the air we breathe remains almost constant. Atmospheric pressure decreases exponentially with altitude. This means that although the gas composition at high altitude remains the same, the air is less dense, resulting in less available oxygen for gaseous exchange. Hypobaric hypoxia therefore develops as a result of low atmospheric atmosphere. This chapter discusses the effects of flying, high altitudes, and diving on respiration. It starts by describing atmospheric pressure and altitude, the then-acute mountain sickness (AMS) and its management. Flying with lung disease is covered, alongside fitness to fly, the use of in-flight oxygen, and general precautions to take. Diving, diving-related illnesses, and practising the sport with pre-existing lung conditions are also included.
Glossary
Authors: Robinson Terry , Scullion Jane
Published: March 2021

This chapter provides an alphabetical glossary of terms used in respiratory medicine, which are comprehensively covered in this second edition of the Oxford Handbook of Respiratory Nursing. These include subjects such as altitude and its effect of the lungs, to angina, antigens, anoxia, and apnoea; breathlessness, bronchiolitis, and bronchospasm; through to vasodilation, ventilation, and vesicular sounds. While the main text covers these subjects comprehensively with systematic description of the main respiratory diseases found in adults, this glossary is an at-a-glance guide to the terms a medical professional will need to know, particularly when discussing and meeting the needs of respiratory patients.