bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study to Examine the Effect of Needle Gauge on Pain Perception in Patients Receiving Treatment With Botulinum Toxin in 2 Different Anatomical Areas
Authors: Hollingsworth Karen E. , Brown Tim
Published: April 2020

Botulinum toxin injection for treatment of rhytids is the commonest cosmetic intervention undertaken worldwide. It requires re-treatment at 3-month intervals for the effect to remain. Consequently, patient comfort is paramount in order for the procedure to remain acceptable. Intuitively, patients expect that smaller needles will be less painful, and this study examines the pain caused by needles of 2 gauges (31 and 32) when administering botulinum toxin in 2 anatomical areas. Patients were randomized into having the left or right side of their face treated with either a 31- or 32-gauge needle during botulinum toxin administration. Participants were asked to determine whether the left- or right-side treatment was most painful. The study was repeated in the glabellar and paraorbital regions. A total of 103 participants entered the study; 98 had the glabellar region treated and 76 the crow’s feet, and 72 patients had both regions treated. For the glabellar region, the smaller 32-gauge needle was significantly more painful than the larger 31-gauge needle ( P < .01). There was no difference in patient’s pain perception between gauges of needle when treating the crow’s feet area ( P = .9). The 31-gauge needles produce significantly less pain than smaller 32-gauge needles when treating the glabellar region with botulinum toxin, but not in the periorbital region. We propose that this is due to differences in fascial adherence between the 2 areas. Consequently, we would recommend administering botulinum toxin with a 31-gauge needle in all areas.
The Impact of State-Level Research and Development Tax Credits on the Quantity and Quality of Entrepreneurship
Authors: Fazio Catherine , Guzman Jorge , Stern Scott
Published: April 2020

U.S. states often cite the acceleration of start-up activity as a rationale for the research and development (R&D) tax credit. While a strong empirical base links the R&D tax credit to increased innovation, prior work provides no causal evidence that the credit effects the rate of formation and growth potential of new businesses. This article combines data from the Startup Cartography Project with the Panel Database on Incentives and Taxes to implement a difference-in-differences estimate of the impact of state R&D tax credits on the quantity and quality-adjusted quantity of entrepreneurship. The authors find that the R&D tax credit is associated with a significant long-term impact on both. In contrast, the authors observe that state investment tax credits have no impact on the quantity of entrepreneurship and lead to a marked decline in the rate of formation of growth-oriented start-ups over time. The results indicate the potential of state R&D tax credits to stimulate entrepreneurship.
Cefoxitin-Serum Creatinine Interference in a Patient With Nontuberculous Mycobacteria Ventriculomeningitis
Authors: Wang Dan , Emanuel Anthony J. , Neyens Ron R. , Bakharev Eugene , Babic Nikolina
Published: April 2020

Cefoxitin is a second-generation cephamycin antibiotic, which at concentrations ≥100 µg/mL is known to modestly interfere, for up to 2 hours post-infusion, with serum creatinine measurement via the traditional Jaffe-based assay. We report a case of a severe serum creatinine elevation while utilizing cefoxitin as a component of an antimicrobial regimen in a critically ill patient with Mycobacterium abscessus ventriculomeningitis. Our results, both via patient serum analysis and a cefoxitin spiking experiment, demonstrate interference despite the utilization of improved modern Jaffe-based assays. In fact, the cefoxitin-creatinine interference may be clinically relevant at concentrations 3 times lower than that listed in the package insert and may display more than a modest interference at typical therapeutic concentrations.
Effect of toughened polyamide/carbon fiber interlace braid fabric on the mechanical performance of CFRP laminates
Authors: Eun Jong Hyun , Kim Dong Hyun , Lee Joon Seok , Chon Jin Sung
Published: April 2020

Delamination resistance and epoxy matrix brittle fracture have been the main issues in carbon/epoxy composites laminates. Various studies have been reported to complement the brittle fracture of epoxy matrix. Conventional methods of fabricating toughened carbon/epoxy composite laminates were thermo-plastic veils and films interleaving methods, directly toughening the matrix resin and dispersing nanoparticles in the matrix. In this study, the carbon/epoxy composites laminates were manufactured using carbon fiber/polyamide fiber braided fabrics. The chemical interactions between polyamide and epoxy matrix resin were investigated by Fourier transform infrared spectroscopy, which resulted in ring opening of the epoxide group by the amide group. The compression after impact strength and the interlaminar toughness of the carbon/epoxy composite laminate were increased by 31%, and the strain energy release rates were increased by 120% compared to the virgin interface composite. In the case of carbon/epoxy composite laminates interlaced with polyamide fibers, the mechanical properties, such as the tensile strength and fatigue properties, were improved as tensile modulus decreased.
India–South Korea Relations Under ‘Special Strategic Partnership’: ‘Act East Policy’ Meets ‘New Southern Policy’
Authors: John Jojin V.
Published: April 2020

Of late India–South Korea relations have witnessed an upswing with the elevation of bilateral relation to Special Strategic Partnership (SSP) in 2015. Explaining the context and developments in bilateral relations, the article observes that the new momentum articulated in SSP constitutes a convergence of interests through the meeting of India’s ‘Act East Policy’ and South Korea’s ‘New Southern Policy’. The growing cooperation in defence, security, development, industry and a shared vision for regional order has visibly enhanced the scope and depth of the strategic partnership between the two countries, however, not without challenges in the emerging Indo-Pacific regional context.
Nuclear Weapon-free World: Reconciling Moral and Security Imperatives
Authors: Dubey Muchkund , Sharma Sheel Kant
Published: April 2020

The arms control approach of more than six decades to deal with the nuclear peril lies in shambles. Nuclear weapons remain in huge numbers, and the dire consequences of their use remain undiminished, with portents of a new era of deadlier weapons and a new spiral of arms race. Hence a detailed and deeper examination of all issues connected with nuclear weapons is called for. Key to this is centrality of nuclear disarmament and the overriding international commitment to abolish nuclear weapons and the premise that nuclear weapons are the instrument of mass annihilation and cannot be used as weapons of war. This basic premise was lost sight of in the political expediency and compulsions of the Cold War and the subsequent play of geopolitics. There is a need to return to this basic premise, which should not be subordinated to political management of a renewed nuclear arms race. In keeping with these basics the pathways to the ultimate goal of abolition have been delineated.
Heat-Related Illness Among Latinx Child Farmworkers in North Carolina: A Mixed-Methods Study
Authors: Arnold Taylor J. , Arcury Thomas A. , Sandberg Joanne C. , Quandt Sara A. , Talton Jennifer W. , Mora Dana C. , Kearney Gregory D. , Chen Haiying , Wiggins Melinda F. , Daniel Stephanie S.
Published: April 2020

Children as young as ten are legally hired for farm work. In North Carolina, many of these hired children are Latinx; they often work long hours during hot and humid summer conditions. Heat-related illness occurs along a continuum of severity ranging from heat cramps and rashes to heat exhaustion and heat stroke, which can be fatal. The literature on the negative health effects of occupational heat exposure is growing; however, few studies have examined this exposure and health outcomes among child agricultural workers. To understand Latinx child farmworkers’ experiences of working in heat, we conducted in-depth interviews (n = 30). To estimate the prevalence of heat-related illness symptoms and associated factors, we conducted survey interviews (n = 165). Heat-related illness is common among these child farmworkers. While children often understand the dangers of working in heat, work organization often prevents their taking precautions. Formal workplace protections to prevent heat-related illness are limited.
Medication Regimen Complexity Index Prediction of Adverse Drug Reaction–Related Hospital Admissions
Authors: Curtain Colin M. , Chang Jie Yi , Cousins Justin , Parameswaran Nair Nibu , Bereznicki Bonnie , Bereznicki Luke
Published: April 2020

Background:

The relationship between the medication regimen complexity index (MRCI) and adverse drug reaction (ADR)-related hospital admissions has not yet specifically been investigated.

Objective:

To evaluate the MRCI and compare with medication count for prediction of ADR-related hospital admissions in older patients.

Methods:

This was a retrospective analysis of a prospectively collected convenience sample of 768 unplanned medical admissions of Australians aged 65 years old and older. The sample consisted of 115 (15.0%) ADR-related unplanned hospital admissions and 653 (85.0%) non–ADR-related unplanned medical admissions. The MRCI score was calculated from the medical records and analyzed to predict ADR-related hospital admissions.

Results:

The cohort had a median age of 81 years, 5 comorbidities, and 11 medications, with a slight majority of women. The MRCI score was not significantly different in patients who had ADR-related admissions compared with other medical admissions—38.5 versus 34.0, respectively; Wilcoxon Rank Sum test W = 33 522; P = 0.067. The medication count was significantly different between the ADR-related admissions compared with other medical admissions: 12 versus 10; W = 32 508; P = 0.021. However, the medication count was not a strong predictor of ADR-related admissions; unadjusted odds ratio = 1.044; 95% CI = 1.006-1.084.

Conclusion and Relevance:

The MRCI score did not discriminate between ADR-related admissions and other medical admissions despite taking time to calculate with potential for inconsistent application. Medication count is more readily applicable with marginally greater relevance in this cohort; however, both measures do not appear to be useful when used alone for clinicians to identify patients at risk of ADRs.
High-vibration diagnosis of gas turbines: An experimental investigation
Authors: Akhtar Muhammad , Kamran Muhammad S , Hayat Nasir , Rehman Anees Ur , Khan Awais A
Published: April 2020

Rotordynamics is a very challenging field because of machine complexities. Many internal and external factors contribute toward change in the structural dynamic characteristics. One of these factors is broad-band high-vibration amplitudes. In this article, a similar high vibration issue on a gas turbine is investigated using bode, orbit, and shaft centerline plots. Data from proximity probes installed on turbine generator system are captured and analyzed against any factor contributing toward high vibration issue. Fish bone diagram was used for root cause investigation. Main components investigated for the root cause of high vibration issue include generator rotor and casing. Rotor behavior has been examined by capturing orbit and shaft centerline diagrams, whereas casing contribution has been investigated by conducting operating deflection shape analysis. A comparison is drawn between a machine suffering from high vibration issue and a normal machine. Resonance was identified as the root cause, and stiffness enhancement was recommended to change the natural frequency of casing. Based on investigations, recommendations are given and a final comparison is drawn after structural modification was done. In addition to early fault finding, reduction in maximum vibration was 38% after implementation of the fix that confirmed the accuracy of the root cause investigation process.
Impact of pharmacist’s intervention on decreasing erlotinib interactions in the treatment of lung cancer patients in low resource settings
Authors: Kovacevic Tijana , Kovacevic Sandra Vezmar , Stanetic Mirko , Kovacevic Pedja , Miljkovic Branislava
Published: April 2020

Background

This study aimed to demonstrate that having clinical pharmacist as a member of oncology team in low and middle income countries might lead to significant reduction in the number of erlotinib interactions in the treatment of non-small cell lung cancer patients.

Methods

A group of 44 patients was labeled as intervention group and they were analyzed prospectively in the period from 1 January 2017 to 1 May 2018 during clinical pharmacist’s participation in regular weekly multidisciplinary oncology team meetings. The control group consisted of 44 out of 110 patients treated with erlotinib before the involvement of a clinical pharmacist in oncology team, match paired with 44 patients in intervention group.

Results

Clinically significant interactions were identified in two-thirds of studied patients (57 out of 88). Most drug interactions, 38%, potentially result in decrease of serum concentration of erlotinib. Clinical pharmacist provided therapy modification suggestions for 32 out of 44 (72.72%) patients in the intervention group, most of which were accepted by doctors. In the intervention group, there were significantly less clinically significant interactions compared to the control group (10 versus 24, p = 0.002). Progression-free survival was significantly longer in the pharmacist’s intervention group (p = 0.001).

Conclusions

Clinical pharmacist’s intervention led to significant decrease in erlotinib interactions which may result in treatment optimization of lung cancer patients.
A Meta-Analysis of Frontline Employees’ Role Behavior and the Moderating Effects of National Culture
Authors: Schepers Jeroen J. L. , van der Borgh Michel
Published: April 2020

Many empirical studies have focused on understanding the frontline role process, which reflects the chain of effects including the antecedents and outcomes of frontline employees’ in-role behavior and extra-role behavior. A close examination of past findings reveals discrepancies across cultures. This meta-analysis provides insights into the moderating effects of national culture on the frontline role process. We build on role theory to consolidate role behavior’s antecedents to reflect the expectations emanating from four stakeholders of the frontline role: the organization, manager, peers, and customers. We formulate hypotheses on the moderating effects of national culture dimensions (i.e., power distance, individualism, masculinity, and uncertainty avoidance) and meta-analyze 105 articles, including 100 independent samples with 32,364 participants from 35 different countries, to test our predictions. The results show that customer expectations are the strongest antecedent to both in-role and extra-role behavior and furthermore confirm that the frontline role process differs across cultures. We offer managers advice on how to adapt expectations for sales and service employees across countries to enhance frontline performance evaluations, customer satisfaction, and ultimately the firm’s competitiveness. We also link our results to new frontline trends (e.g., service robots, artificial intelligence, remote service technology) and provide a future research agenda.
Surgical management of a case of contractile peripapillary staphyloma with retinal detachment and macular hole
Authors: Vidal Sofía H , Ponce Diego Bueso , Unigarro Juan Esteban , Limo Sergio Arrascue , Caballero Carlos Abdala
Published: April 2020

A healthy 4-year-old male presented a fundus examination with a unilateral contractile peripapillary staphyloma surrounded by redundant retina and retinal pigment epithelium atrophy. Five years later, best-corrected visual acuity decreased to hand motion due to a retinal detachment with macular hole. One month after first vitrectomy, scleral buckle and intraocular gas, retina re-detached. Second surgery was performed with silicon oil tamponade and lensectomy without intraocular lens (IOL). Subretinal silicon oil was detected at the third month of follow-up when vitrectomy, inferior retinectomy, and laser photocoagulation of temporal border of staphyloma with silicon oil tamponade were performed. The retina remained attached and best-corrected visual acuity was 20/600 with intraocular silicon oil. A fourth surgery was performed for emulsified silicon oil extraction replaced with intraocular gas. At 6 months of follow-up, the retina re-detached again. This is a challenging vitreoretinal surgery in which re-detachments were due to retinal folds around the contractile staphyloma that raised macular hole. This is the first report of the combined presentation of contractile peripapillary staphyloma, retinal detachment and macular hole with a long-time follow-up period of years.
Physician Assistant Students’ Knowledge of Zika Virus: A Pilot Study
Authors: Wishner Carolina , Taylor Colleen , Leigh Laurasona , Williams Monica , Bell Mary Ann , Luebke Suzanne
Published: April 2020

Objective:

The aim of this study was to assess physician assistant students’ knowledge about the screening, transmission, management, and prevention of Zika virus infection.

Background:

It is important for health care providers in the United States to recognize the symptoms of Zika so that they can screen, diagnose, and or treat persons exposed to or infected by the virus. Physician assistant students, on completion of their educational program and passing their board examinations, provide care for patients in primary care or specialty settings where they may treat patients who either have the virus or post-virus exposure.

Methods:

A convenience sample of 37 students enrolled in a physician assistant studies program in the Midwestern United States completed an in-person self-administered paper-and-pencil questionnaire that tested their knowledge about Zika virus infection.

Results:

All the respondents knew that the disease is of viral origin; however, only 89% knew that mosquitoes were the natural host. Primary modes of transmission were identified as sexual contact and blood transfusion (47% and 44% of respondents respectively); 47% incorrectly identified amniotic fluid as a transmission mode. More than half (61%) knew that health care providers should ask pregnant women about any possible virus exposure before and during pregnancy at each prenatal visit. Most respondents knew that muscle/joint pain (67%) was one of the symptoms of Zika infection, but only 39%, 25%, and 19% also identified low-grade fever, maculopapular rash, and conjunctivitis respectively as other symptoms. Some participants incorrectly identified antivirals (44%) and nonsteroidal anti-inflammatory medications (36%) rather than the recommended treatments of pain relief (30%) and fever relief (42%) medications for clinical management of the disease.
Book review: Kararach, G., Besada, H. and Shaw T.M., editors, 2016: Development in Africa: Refocusing the Lens After the Millennium Development Goals
Authors: Segura Karen Gabriela Linan
Published: April 2020

Kararach, G., Besada, H. and Shaw T.M., editors, 2016: Development in Africa: Refocusing the Lens After the Millennium Development Goals. Bristol, UK: University of Bristol Policy Press. 411 pp. $36.95. ISBN: 9781447328544 (paperback).
Book review: Oberoi, R. and Halsall J., editors, 2018: Revisiting globalization: From a borderless to gated globe
Authors: Dennis Maggie
Published: April 2020

Oberoi, R. and Halsall J., editors, 2018: Revisiting globalization: From a borderless to gated globe. Cham, Switzerland: Springer International Publishing. 197 pp. £77.30 hardcover, £61.85 eBook. ISBN: 978 3 319 79122 7 (hardcover). ISBN: 978 3 319 79123 4 (eBook).
Quantitative high-resolution transmission electron microscopy nanostructure analysis of soot oxidized in diesel spray flame periphery
Authors: Aizawa Tetsuya , Toyama Yoshiaki , Kusakari Ryosuke
Published: April 2020

In order to better understand the in-flame diesel soot oxidation processes, soot particles at the oxidation-dominant periphery of diesel spray flame were sampled via newly developed suck type soot sampler employing a high-speed solenoid valve, and their morphology and nanostructure were observed and analyzed via high-resolution transmission electron microscopy. A single-shot diesel flame for the soot sampling experiment was achieved in a constant-volume vessel under a diesel-like condition (9.5 kg/m3, 2.5 MPa, 1070 K, and 21%O2). Morphology of soot aggregates, inner-core/outer-shell structure of primary particles within the aggregates, and carbon crystallite nanostructures within the primary particles were compared between the soot aggregates sampled at the diesel flame core near the central axis and the oxidation-dominant flame periphery. The morphology observation and the inner-core/outer-shell structure characteristics obtained by newly employed concentricity analysis showed that the flame core soot exhibits graphitic primary particles with clear outlines and boundaries similarly observed for engine exhaust soot. Each primary particle contained a well-defined inner core surrounded by thick graphitic outer shell. On the contrary, the flame periphery soot exhibited smaller primary particles with unclear and lumpy outlines containing multiple obscured inner cores surrounded by thinner outer shell. The analysis of carbon crystallite nanostructures within the primary particles showed that the in-flame soot nanostructure shifts toward amorphous from the flame core to the periphery. On the contrary, the engine soot nanostructure in the literature shifts toward graphitic from the in-cylinder TDC to the exhaust, exhibiting the opposite trend with the in-flame soot. These results suggest that the engine exhaust soot has not experienced the rapid in-flame oxidation by OH radicals and is therefore considered not to be the remains of incomplete or partial oxidation, but the runaways escaped from the flame core to the exhaust without being attacked by the in-flame OH radicals.
Swiss land improvement syndicates: ‘Impure’ Coasian solutions?
Authors: Shahab Sina , Viallon François-Xavier
Published: April 2020

An increasing number of planners have explored the implication of Coase theorem for planning theory and practice. As there are often a large and dispersed number of actors involved in planning issues, the application of ‘Pure’ Coasian solutions has proved to be limited. However, some studies argue that when the conditions for a ‘Pure’ Coasian solution do not exist, ‘Impure’ Coasian solutions may still be achievable. This article examines how, when conditions of ‘Impure’ Coasian solutions are available, local authorities in Switzerland use land improvement syndicates as a policy instrument in order to achieve negotiated solutions in relation to development processes involving multiple landowners. With a syndicate in the commune of Cheseaux as an illustrative example, the article analyses how this policy instrument has been utilised to reduce transaction costs, correct information asymmetries and clarify property rights. The focus has been on an interpretation of the Coasian theorem that identifies attempts to reduce transaction costs and clarify property rights as the main roles of governments or local authorities.
The Hitchhiker’s Guide to Hydrogen Peroxide Fumigation, Part 2: Verifying and Validating Hydrogen Peroxide Fumigation Cycles
Authors: Kümin Daniel , Albert Monika Gsell , Weber Benjamin , Summermatter Kathrin
Published: April 2020

Introduction:

Part 1 of this two-part series describes the use of hydrogen peroxide as a fumigant and compares it with other fumigants on the market. Technical requirements are outlined while considering physical and biological limitations of the system. This second part focuses primarily on the use of process controls to verify and validate hydrogen peroxide fumigations. Finally, a model encompassing the entire fumigation process is presented.

Methods:

Part 2 of the series focuses on the authors’ long-time personal experiences in room and filter fumigation using various fumigation systems and is supplemented with relevant literature searches.

Results:

The reader is introduced to the planning and implementation of fumigation process validations. Biological indicators help users develop safe and efficient processes. Chemical indicators can be used as process controls, while measuring physical parameters will help avoid condensation of hydrogen peroxide. How many biological and chemical indicators and what type should be applied for cycle development are additionally explained.

Discussion:

It is important to consider numerous technical requirements when planning to implement hydrogen peroxide fumigation at an institution. Also, considerable thought needs to go into the verification and validation of the fumigation process.

Conclusions:

Part 1 of this series presents an overview of different fumigation systems based on hydrogen peroxide on the market and their technical requirements. Part 2 focuses on validation and verification of hydrogen peroxide fumigation while considering the entire fumigation process. The two parts together will serve users as a guide to establishing hydrogen peroxide fumigations at their facilities.
E-I E-I Woe: Mossy Cell Regulation of Granule Cell Activity in Temporal Lobe Epilepsy
Authors: Goicouria Luis , Liu Judy
Published: April 2020

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U.S.-Born Mexican-Origin Women’s Descriptions About Their Eating Patterns
Authors: Garcia Juanita Terrie , VandeVusse Leona
Published: April 2020

Introduction

Mexican origin (MO) women comprise the largest Hispanic subgroup of Latinas in the United States. This subgroup has high incidences of obesity and associated chronic diseases. Modifiable risk factors for these include unhealthy diets and eating patterns. Efforts to understand eating patterns of Hispanics have focused on primarily first-generation Hispanics. The purpose of this study was to explore U.S.-born MO women’s descriptions about eating patterns.

Method

A qualitative exploratory-descriptive study, using a thematic analysis approach, was employed. Fifteen MO women were interviewed. The participants were second to fourth generation and reported higher educational attainment, middle-income socioeconomic brackets, and English proficiency compared with previous groups studied.

Results

Five themes were identified: (a) personal agency, (b) relationships with people about food, (c) cultural and familial influences, (d) environments, and (e) time and money. Themes comprised multiple factors to classify the varied aspects of the women’s eating patterns.

Conclusion

This study provides insights about descriptions of eating patterns from a subgroup, generational, and gender-specific perspective that extended beyond acculturative and homogeneous group viewpoints to a broader structural view. The structural layers that affected the women’s eating patterns were multifaceted and complex.
Endovascular Aortic Repair After Proximal Stent Graft Migration of a Modified Frozen Elephant Trunk
Authors: Dalal Alex R. , Pedroza Albert J. , Iwakoshi Shinichi , Lee Jason T. , Fleischmann Dominik , Watkins A. Claire
Published: April 2020

We describe the endovascular repair for a proximal endograft migration following a modified frozen elephant trunk (mFET) repair for a retrograde type A dissection (retro-A AD). A 40-year-old man presented with a type B aortic dissection that progressed to a retro-A AD. He was emergently taken to the operating room for an mFET repair. Computed tomography (CT) angiogram on the day of discharge revealed that the proximal end of the endograft migrated through the primary intimal tear resulting in obstruction of true lumen flow. The patient returned to the catheterization lab for endovascular repair utilizing a through-and-through wire to extend the endograft proximally and a left carotid-subclavian artery bypass. This complication highlights the importance of postoperative CT surveillance and the endovascular technique utilized to restore aortic true lumen flow.
Avoiding Arch Manipulation with Catheterization of Left Subclavian Artery for Endovascular Repair of Distal Descending Aorta: Acibadem Technique
Authors: Senay Sahin , Akansel Serdar , Güllü Ahmet Ümit , Alhan Cem
Published: April 2020

Although thoracic endovascular aortic repair (TEVAR) is associated with reduced mortality and shorter hospital stay compared to open surgery, the decrease in stroke risk did not reach the desired rates. Aortic arch manipulation is one of the main concerns leading to stroke during TEVAR. Here, we describe a new technique called “Acibadem Technique” to avoid arch and ascending aorta manipulation with catheterization of left subclavian artery for endovascular distal descending aortic repair.
Initial Experience with Non-Sternotomy Minimally Invasive Pulmonary Embolectomy with Thoracoscopic Assistance
Authors: Fallon John M. , Greenberg Jason W. , Gupta Luvika , Lattouf Omar M.
Published: April 2020

The endpoint in emergent management of acute massive pulmonary embolism (PE) has traditionally been with embolectomy through standard median sternotomy. This approach is limited in both exposure and concomitant functional morbidity associated with sternotomy. Herein we describe a novel minimally invasive, thoracoscopically assisted approach to pulmonary embolectomy. This utilizes a small 5-cm left parasternal thoracotomy and femoral cardiopulmonary bypass to conduct thoracoscopically assisted surgical pulmonary embolectomy. This novel minimally invasive approach has been developed and successfully utilized in 3 patients with massive PE at our institution. The assistance of the thoracoscope allowed for complete visualization and clot extraction of the main and segmental pulmonary arteries bilaterally. The use of a non-sternotomy approach sped both functional and pulmonary recovery times and decreased length of stay. These initial data suggest that non-sternotomy minimally invasive surgical pulmonary embolectomy with thoracoscopic assistance is a feasible and safe approach for acute massive PE that may result in enhanced recovery times and decreased hospital length of stay.
Borrowing from Adult Cardiac Surgeons—Bringing Congenital Heart Surgery Up to Speed in the Minimally Invasive Era
Authors: Alsarraj Mohammed K. , Nellis Joseph R. , Vekstein Andrew M. , Andersen Nicholas D. , Turek Joseph W.
Published: April 2020

The majority of congenital and adult cardiac surgery is performed through a median sternotomy. For surgeons, this incision provides excellent exposure; however, for patients, a median sternotomy confers a poorer cosmetic outcome and the possibility of postoperative respiratory dysfunction, chronic pain, and deep sternal wound infections. Despite the advances in adult cardiac surgery, the use of minimally invasive techniques in pediatric patients is largely limited to small case series and less complex repairs. In this article, we review the risks, benefits, and limitations of the minimally invasive congenital cardiac approaches being performed today. The interest in these approaches continues to grow as more data supporting reduced morbidity, decreased length of stay, and faster recovery are published. In the future, as the technology and surgical familiarity improve, these alternative approaches will become more common, and may someday become the standard of care.
Left Anterior Mini-Incision for Pulmonary Valve Replacement in a 12-Year-Old
Authors: Vekstein Andrew M. , Nellis Joseph R. , Meza James M. , Andersen Nicholas D. , Haney John C. , Turek Joseph W.
Published: April 2020

A 12-year-old, 32 kg male with history of Tetralogy of Fallot status post repair at 8 days of life presented with progressive pulmonary insufficiency and left pulmonary artery stenosis. Surgical options were discussed, and the patient and his family elected to pursue minimally invasive pulmonary valve replacement with left pulmonary artery augmentation through a 5-cm left anterior mini-incision. The procedure was performed without complication, and he was discharged on postoperative day 3. At the time of his last follow-up, the patient was recovering well without evidence of pulmonary stenosis or insufficiency.
Impact of Pretreatment Total Cholesterol Level Is Associated With Metastasis of Prostate Cancer
Authors: Hirano Hisashi , Ide Hisamitsu , Lu Yan , Inoue Yasuyuki , Okada Hiroshi , Horie Shigeo
Published: April 2020

Metabolic syndrome is reported to play a role in the genesis and development not only of angina, arteriosclerosis, diabetes, and osteoporosis but also of prostate cancer. Hypercholesterolemia is a strong risk factor in prostate cancer development. The current study was conducted to analyze whether pretreatment serum levels of cholesterol correlate with prostate cancer metastasis. Three hundred fifty-one subjects who received a histopathological diagnosis of prostate cancer were evaluated by clinical factors such as age, body mass index (BMI), disease stage, Gleason score, prostate-specific antigen (PSA), total cholesterol, Luteinizing hormone (LH), testosterone, and free testosterone. A multivariate analysis was performed on these factors, and a statistically significant difference was identified in total cholesterol level ( p =.01) and PSA ( p < .001). The total cholesterol level was higher in cases of metastatic prostate cancer compared to nonmetastatic prostate cancer in this study and therefore may be a predictive factor for poor prognosis.
Metaheuristic algorithm for solving the multi-objective vehicle routing problem with time window and drones
Authors: Han Yun-qi , Li Jun-qing , Liu Zhengmin , Liu Chuang , Tian Jie
Published: April 2020

In some special rescue scenarios, the needed goods should be transported by drones because of the landform. Therefore, in this study, we investigate a multi-objective vehicle routing problem with time window and drone transportation constraints. The vehicles are used to transport the goods and drones to customer locations, while the drones are used to transport goods vertically and timely to the customer. Three types of objectives are considered simultaneously, including minimization of the total energy consumption of the trucks, total energy consumption of the drones, and the total number of trucks. An improved artificial bee colony algorithm is designed to solve the problem. In the proposed algorithm, each solution is represented by a two-dimensional vector, and the initialization method based on the Push-Forward Insertion Heuristic is embedded. To enhance the exploitation abilities, an improved employed heuristic is developed to perform detailed local search. Meanwhile, a novel scout bee strategy is presented to improve the global search abilities of the proposed algorithm. Several instances extended from the Solomon instances are used to test the performance of the proposed improved artificial bee colony algorithm. Experimental comparisons with the other efficient algorithms in the literature verify the competitive performance of the proposed algorithm.
Analysis on energy consumption of blended-wing-body underwater glider
Authors: Du Xiaoxu , Zhang Lianying
Published: April 2020

As a new type of underwater observation platform, underwater glider is widely used in marine explorations and military surveys, and most gliders are powered by their own batteries whose capacities are limited. It is therefore necessary to analyze the energy consumption of underwater glider. In this article, the variation law of seawater density changing with depth is considered; based on the theory of rigid body dynamics, the motion model of blended-wing-body underwater glider is established; the energy consumption model of each component module is accounted by analyzing the energy consumption composition in the working process of blended-wing-body underwater glider; and the energy consumption under different navigation depths, different glide ratios, and different buoyancy adjustments regulation is simulated. The results demonstrate that as the glide depth is increased, the total energy consumption increases in a single cycle and decreases per gliding distance, leading to a smaller energy consumption ratio for the attitude adjustment module; on the other hand, as the buoyancy adjustment is increased, more energy is consumed in a single cycle and less energy is consumed per gliding distanced, resulting in a larger energy consumption ratio for the attitude adjustment module. As the glide ratio increases, the total energy consumption in a single cycle first increases and then decreases, while the energy consumption of per gliding distance and the energy consumption ratio of the attitude adjustment module are decreased.
Lane-level localization system using surround-view cameras adaptive to different driving conditions
Authors: Li Tianyi , Qian Yuhan , de La Fortelle Arnaud , Chan Ching-Yao , Wang Chunxiang
Published: April 2020

This article presents a lane-level localization system adaptive to different driving conditions, such as occlusions, complicated road structures, and lane-changing maneuvers. The system uses surround-view cameras, other low-cost sensors, and a lane-level road map which suits for mass deployment. A map-matching localizer is proposed to estimate the probabilistic lateral position. It consists of a sub-map extraction module, a perceptual model, and a matching model. A probabilistic lateral road feature is devised as a sub-map without limitations of road structures. The perceptual model is a deep learning network that processes raw images from surround-view cameras to extract a local probabilistic lateral road feature. Unlike conventional deep-learning-based methods, the perceptual model is trained by auto-generated labels from the lane-level map to reduce manual effort. The matching model computes the correlation between the sub-map and the local probabilistic lateral road feature to output the probabilistic lateral estimation. A particle-filter-based framework is developed to fuse the output of map-matching localizer with the measurements from wheel speed sensors and an inertial measurement unit. Experimental results demonstrate that the proposed system provides the localization results with submeter accuracy in different driving conditions.
Fatigue monitoring of climbing ropes
Authors: Galluzzi Renato , Feraco Stefano , Zenerino Enrico C , Tonoli Andrea , Bonfitto Angelo , Hegde Shailesh
Published: April 2020

Safety improvements in mountaineering gear have enabled the increasing popularity of rock climbing as a sport. Both amateurs and experts want to know the condition of their equipment with a high degree of reliability. For climbing ropes, diagnostics are only carried out qualitatively by visual inspection. The assessment is left to the personal judgment of the user, thus leaving considerable margins of uncertainty on the rope’s condition. To address this shortcoming, this article explores the possibility of estimating fatigue damage from the impact force on the rope. This value is estimated from the measurements of the climber’s acceleration using a wearable device. Then, force data are correlated to the fatigue characteristic of the rope. In this study, three ropes were used by professional climbers through different routes. After this field conditioning, the ropes were tested following the UIAA standard and compared to a control rope. The results show that the proposed method can estimate the rope cumulative damage, but it relies on the accuracy of the damage model. In particular, the parameter describing the contact between the rope and the runner is important for a correct estimate.
N6-methyladenosine demethylases Alkbh5/Fto regulate cerebral ischemia-reperfusion injury
Authors: Xu Kaiwei , Mo Yunchang , Li Dan , Yu Qimin , Wang Lu , Lin Feihong , Kong Chang , Balelang Meita Felicia , Zhang Anqi , Chen Sijia , Dai Qinxue , Wang Junlu
Published: April 2020

Background:

Although N6-methyladenosine (m6A) plays a very important role in different biological processes, its function in the brain has not been fully explored. Thus, we investigated the roles of the RNA demethylases Alkbh5/Fto in cerebral ischemia-reperfusion injury.

Methods:

We used a rat model and primary neuronal cell culture to study the role of m6A and Alkbh5/Fto in the cerebral cortex ischemic penumbra after cerebral ischemia-reperfusion injury. We used Alkbh5-shRNA and Lv-Fto ( in vitro) to regulate the expression of Alkbh5/Fto to study their regulation of m6A in the cerebral cortex and to study brain function after ischemia-reperfusion injury.

Results:

We found that RNA m6A levels increased consecutive to the increase of Alkbh5 expression in both the cerebral cortex of rats after middle cerebral artery occlusion, and in primary neurons after oxygen deprivation/reoxygenation. In contrast, Fto expression decreased after these perturbations. Our results suggest that knocking down Alkbh5 can aggravate neuronal damage. This is due to the demethylation of Alkbh5 and Fto, which selectively demethylate the Bcl2 transcript, preventing Bcl2 transcript degradation and enhancing Bcl2 protein expression.

Conclusion:

Collectively, our results demonstrate that the demethylases Alkbh5/Fto co-regulate m6A demethylation, which plays a crucial role in cerebral ischemia-reperfusion injury. The results provide novel insights into potential therapeutic mechanisms for stroke.
The COVID-19 epidemic, its mortality, and the role of non-pharmaceutical interventions
Authors: Hens Niel , Vranck Pascal , Molenberghs Geert
Published: April 2020

COVID-19 has developed into a pandemic, hitting hard on our communities. As the pandemic continues to bring health and economic hardship, keeping mortality as low as possible will be the highest priority for individuals; hence governments must put in place measures to ameliorate the inevitable economic downturn. The course of an epidemic may be defined by a series of key factors. In the early stages of a new infectious disease outbreak, it is crucial to understand the transmission dynamics of the infection. The basic reproduction number ( R0), which defines the mean number of secondary cases generated by one primary case when the population is largely susceptible to infection (‘totally naïve’), determines the overall number of people who are likely to be infected, or, more precisely, the area under the epidemic curve. Estimation of changes in transmission over time can provide insights into the epidemiological situation and identify whether outbreak control measures are having a measurable effect. For R0 > 1, the number infected tends to increase, and for R0 < 1, transmission dies out. Non-pharmaceutical strategies to handle the epidemic are sketched and based on current knowledge, the current situation is sketched and scenarios for the near future discussed.
Never too rich to care about prices: Effects of price endings on customer perceptions of luxury
Authors: Fraccaro Annalisa , Macé Sandrine
Published: April 2020

In this article, we build on the existing literature on price endings in the fast-moving consumer goods and luxury pricing to highlight the potential paradox of adopting odd pricing (i.e. setting prices just below the round number) for luxury goods, which should mostly use even pricing (i.e. round numbers). In a first experiment concerning luxury handbags, we test the impact of three types of price endings (–90, –00, and “other”) on luxury image and its sub-facets. We propose four mediators of the relationship between price endings and overall luxury image, that is, quality, prestige, uniqueness, and expensiveness. In a second experiment, we find that price endings have connotations specific to the luxury sector and to different segments of consumers. We conclude with recommendations to help pricing managers strategically adjust their price-ending practice to target different consumer segments.
Internet-Based Communications: A Threat or Strength to National Security?
Authors: Asogwa Chika Euphemia
Published: April 2020

This study examined how internet-based communication channels impact on national security in Nigeria. The study was conducted in Enugu State, South East Nigeria. Three research questions guided the study and three null hypotheses were tested at .05 level of significance. A total of 385 internet users were selected using a combination of purposive and snow ball sampling techniques. In the analysis of data for the study, correlation analysis and multiple regression were used. The result of the analysis showed that internet-based media of communication like the Facebook, Gmail, YouTube, Yahoo mail, and Twitter significantly correlate national security. It was also found that there are specific ways through which negative use of the internet could impact negatively on national security. Such predictors include using internet-based media to recruit agents of national security challenges, to finance such efforts, to radicalize such agents, to train such agents, and to spread incitement that may be inimical to national security. It was also found that internet-based media could be useful for creating awareness on national security threats, raising alarm on national security issues, and making people alert on national security issues. Base on the result of this study, the researcher recommends, among others, that the traditional media like radio, TV, newspapers, and magazines should form a synergy with security agencies on how to create awareness to Nigerians regarding how security alertness for the overall benefit of national security.
YOUTH KICKER’S KNEE: LATERAL DISTAL FEMORAL HEMIPHYSEAL ARREST SECONDARY TO CHRONIC REPETITIVE MICROTRAUMA
Authors: Dempewolf Michael , Kwan Kevin , Sherman Benjamin , Schlechter John A.
Published: April 2020

Background:

Year-round competitive sports places the youth athlete at risk for injury from chronic repetitive stress. Various conditions have been reported secondary to overuse. Stress injuries to the distal femoral physis in active adolescents are rare.

Hypothesis/Purpose:

The purpose if this report is to highlight 3 male youth soccer players who presented with a lateral distal femoral hemiphyseal arrest and subsequent unilateral genu valgum deformity in their dominant “kicking leg” due to repetitive microtrauma a phenomenon we refer to as youth kicker’s knee.

Methods:

A retrospective review of adolescents that presented to our orthopedic clinic for lateral distal femoral hemiphyseal arrest secondary to chronic repetitive kicking was performed from 2010 to 2018. History, physical exam and imaging findings were obtained as well as the treatment course for all adolescents.

Results:

All patients were 14 years of age, and all participated in year-round high intensity soccer and American football. Patient specific data is summarized in Table 1 and 2. Imaging studies demonstrated aberration of the distal lateral femoral physis in all. (Figure 1) To address their limb deformity all adolescents were surgically treated with guided growth which was successful in correcting the mechanical axis in 2 of the 3 adolescents Patient Numbers (PN) 1 and 3. (Figure 2) The adolescent (PN 2) that failed to correct was definitively treated with a lateral distal femoral opening osteotomy successfully realigning his limb.

Conclusion:

Our series illustrates a unique presentation of a chronic overuse / stress injury in hyper sporting adolescents resulting in an ipsilateral genu valgum deformity. Understanding adolescent growth and developmental characteristics is paramount to appropriate care, prevention, and treatment of physeal injuries that may occur from repetitive overuse and avoid surgery in these young athletes when possible.

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