bluuebunny/crossref_metadata_2025 huggingface dataset:
Buccinator Re-Repair (Bs + Re: IVVP): A Combined Procedure to Maximize the Palate Form and Function in Difficult VPI Cases
Authors: Elsherbiny Ahmed , Gelany Ahmed , Mazeed Ahmed S. , Mostafa Eman , Ahmed Mohammed A. , Allam Karam A. , Nabeih Ahlam A. N.
Published: January 2020

Objectives:

To assess the outcome of a modified buccinator flaps’ palatal lengthening combined with radical intravelar veloplasty (Bs + Re: IVVP) for the management of postpalatoplasty velopharyngeal incompetence and report the functional and structural changes occurring in the palate.

Design:

Prospective cohort study of consecutive cleft patients presenting with velopharyngeal incompetence and managed by buccinator re-repair procedure. Blind assessment of randomized recordings of speech and evaluation of velar form and function with nasoendoscopy and lateral videofluoroscopy were done. Patients’ demographic data were also collected.

Patients:

Among 30 consecutive cases who had Bs + Re: IVVP, 24 had adequate pre- and postoperative records of speech outcome data.

Setting:

Multidisciplinary cleft team in a tertiary referral center.

Results:

There were significant improvements in hypernasality, nasal emission, facial grimace and weak consonants, and overall intelligibility of speech. Endoscopy and lateral videofluoroscopy showed significant improvement in total and functional velar length, closure ratio, velopharyngeal gap at closure, palatal thickness, palatal convexity, and mobility. Regarding the procedure complications, no flap ischemia, fistula, or obstructive sleep apnea reported, but there were one cheek hematoma and two minor oral mucosal dehiscence which healed spontaneously.

Conclusions:

Buccinator re-repair (Bs + Re: IVVP) has been shown to be an effective and safe procedure in treating difficult postpalatoplasty velopharyngeal incompetence. It was also shown that it is still a physiological nonobstructive procedure with low morbidity.
Strength prediction of woven composite rings using progressive damage modeling
Authors: Khayyam Rayeni H , Mazaheri AH , Taheri-Behrooz F
Published: January 2020

The ultimate failure of the woven composite pipes has been investigated using progressive damage modeling. The composite pipe specimens were made of (E) glass plain weave fabrics according to the ASTM D2290 standard. The hoop strength of these specimens has been obtained from the tensile tests. The damage initiation and propagation of composite pipe have been predicted by a numerical multi-scale method. For this purpose, the damage of the yarns and resin of the plain weave laminate was investigated by modeling a representative volume element. Then, the macroscopic stresses and strains of the representative volume element were calculated to obtain the equivalent stiffness matrix using suitable boundary conditions. Then, the mechanical properties of the laminate and material properties degradation coefficients were derived by this equivalent stiffness matrix. Hashin and Von Mises failure criteria were utilized in USDLFD subroutine to predict the damage initiation of the yarn and resin in the representative volume element, respectively. The sudden degradation method has been used to investigate the damage propagation in these constituents. Then, the woven composite ring was modeled in ABAQUS software and its ultimate strength was predicted by UMAT subroutine using obtained degradation coefficients of the representative volume element from the previous step. Finally, the numerical results were compared with the experimental data which show good agreement between the results.
Impact of an Antimicrobial Stewardship Team on Reducing Antiretroviral Medication Errors
Authors: Nimarko Kwabena , Bandali Aiman , Bias Tiffany E. , Mindel Sharon
Published: January 2020

Background: Numerous interventions have been used to reduce medication errors related to antiretroviral (ARV) therapy for hospitalized patients with HIV. Objective: This study assessed the impact of an antimicrobial stewardship (ASP) team intervention on reducing the rate of ARV therapy errors in patients admitted to an academic medical center. Methods: This observational, retrospective study included patients who received ARV therapy from June 2016 to December 2017. The primary outcome was evaluation of ASP team performance in detecting ARV medication errors in the inpatient setting. Errors were further categorized by type (interaction, dosing, regimen). The Mann-Whitney U test and χ2 tests were utilized to analyze continuous and categorical data, respectively. Results: Medication errors occurred in 51% of patients in the preintervention group (n = 152) and 48% of patients in the postintervention group (n = 203; P = 0.43). The most frequent medication error type was drug interactions in both groups, involving integrase strand transfer inhibitors and polyvalent cations (64% vs 67%). There was a significant difference between preintervention and postintervention groups regarding number of errors detected (13 vs 106, P < 0.001), corrected (12 vs 86, P < 0.001), and persisting at discharge (106 vs 18, P < 0.001). Conclusion and Relevance: Review of ARV regimens by an ASP team significantly decreased medication errors. Drug interactions are the most common medication error found in HIV-positive patients admitted to our academic center.
The Reasons for Living Inventory for Young Adults (RFL-YA-II)
Authors: Pirani Saifa , Kulhanek Cheyenne , Wainwright Katherine , Osman Augustine
Published: January 2020

Suicide remains the second leading cause of death among young adults aged 15 years and older. Given its negative impact, it is essential to conduct studies that offer a greater understanding of the reasons young adults give for not engaging in suicide-related behaviors. The Reasons for Living Inventory for Young Adults is designed to explore this idea. This novel 24-item instrument measures four protective dimensions of reasons: Peer Acceptance and Support, Family Sources of Support, Faith-Related Support, and Personal Perceived Strength. The current investigations include two validation studies designed to examine further the psychometric properties of this instrument. Participants were undergraduate students at a state university in the U.S. Southwest. The first aim of the study was to evaluate the dimensionality of the instrument. We used confirmatory and bifactor confirmatory factor analyses to address this goal. The second aim was to examine the evidence for reliability estimates and concurrent validity. Results from both studies provided adequate support for a four-factor model across methods, acceptable internal consistency reliability, and concurrent validity for the dimensions of this instrument.

Public Significance Statement: Suicide remains a significant mental health concern for young adults. The present studies found empirical support for the psychometric properties of a new measure for assessing four dimensions of the target construct: Peer-Acceptance and Social Support, Family Sources of Support, Faith-Related Support, and Personal Perceived Strength.
Readability of Cancer Clinical Trials Websites
Authors: Hillyer Grace Clarke , Beauchemin Melissa , Garcia Philip , Kelsen Moshe , Brogan Frances L. , Schwartz Gary K. , Basch Corey H.
Published: January 2020

Clinical trials are critically important for the development of new cancer treatments. According to recent estimates, however, clinical trial enrollment is only about 8%. Lack of patient understanding or awareness of clinical trials is one reason for the low rate of participation. The purpose of this observational study was to evaluate the readability of cancer clinical trial websites designed to educate the general public and patients about clinical trials. Nearly 90% of Americans use Google to search for health-related information. We conducted a Google Chrome Incognito search in 2018 using the keywords “cancer clinical trial” and “cancer clinical trials.” Content of the 100 cancer clinical trial websites was analyzed using an online readability panel consisting of Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook scales. Reading level difficulty was assessed and compared between commercial versus non-commercial URL extensions. Content readability was found to be “difficult” (10.7 grade level). No significant difference in readability, overall, and between commercial and non-commercial URL extensions was found using 4/5 measures of readability; 90.9% of commercial versus 49.4% of non-commercial websites were written at a >10th grade ( P = .013) using Gunning-Fog Index. Written cancer clinical trials content on the Internet is written at a reading level beyond the literacy capabilities of the average American reader. Improving readability to accommodate readers with basic literacy skills will provide an opportunity for greater comprehension that could potentially result in higher rates of clinical trial enrollment.
Effectively Integrating Direct Instruction and Discrete Trial Training Across Routines, Activities, and Environments
Authors: Mitsch Maryssa Kucskar , Riggleman Samantha
Published: January 2020

With young children, there is often an instructional focus on naturalistic interactions between the child and environment. In special education, there are times when direct instruction (di) and discrete trial training (DTT) are both needed, requiring a balance of explicit DTT and child-initiated instruction. This article discusses what individually and developmentally appropriate di and DTT practice and real-life examples look and sound like, and explains how to embed them across routines, activities, and environments.
A degradation phase division technique based on Gath–Geva fuzzy clustering
Authors: Wang Bing , Wei Wang , Hu Xiong , Sun Dejian
Published: January 2020

In allusion to the issue of degradation feature extraction and degradation phase division, a logistic chaotic map is used to study the variation pattern of spectral entropy, and a technique based on Gath–Geva fuzzy clustering is proposed. The degradation features include spectral entropy, root mean square, and “curved time,” which are more in line with the performance degradation process than degradation time. Gath–Geva fuzzy clustering is introduced to divide different phases in the degradation process. The rolling bearing lifetime vibration signal from the intelligent maintenance systems (IMS) bearing test center was introduced for instance analysis. The results show that spectral entropy is able to effectively describe the complexity variation pattern in the performance degradation process and has some advantages in sensitivity and calculation speed. The introduced “curved time” is able to reflect the agglomeration character of the degradation condition on a time scale, which is more in line with the performance degradation pattern of mechanical equipment. Gath–Geva fuzzy clustering is able to divide the degradation phase of mechanical equipment such as bearings accurately.
A combined neural network and model predictive control approach for ball transfer unit–magnetorheological elastomer–based vibration isolation of lightweight structures
Authors: Brancati Renato , Di Massa Giandomenico , Pagano Stefano , Petrillo Alberto , Santini Stefania
Published: January 2020

This study addresses the possibility of adopting semi-active magnetorheological elastomers–based isolators for protecting lightweight structures from ground vibration. The exploitation of these smart devices has the main advantage of controlling their stiffness and damping features by acting on the magnetic field generated by a coil on the basis of the actual conditions of both the lightweight structure and the surrounding environment. This allows for combining the reliability of passive devices with the benefits of active control methods. Both mechanical and control system designs could play a crucial role in the challenging problem of improving isolation performances. To solve this issue, we (i) suggest a novel ball transfer unit–magnetorheological elastomer–based isolation system prototype to obtain an improved isolation response of the lightweight structure with respect to the exclusive use of an magnetorheological elastomer and (ii) propose a novel robust combined neural network and model-predictive control approach, allowing proper functioning of the ball transfer unit–magnetorheological elastomer–based isolation system. The effectiveness of the proposed semi-active isolator in guaranteeing vibrational isolation of lightweight structures is evaluated by considering a rack cabinet composed of three storeys and subject to an El Centro earthquake. Numerical simulations confirm and disclose the efficacy of the proposed approach.
Brief Report: Evaluation of the Noncontingent Provision of Fidget Toys During Group Activities
Authors: Ledford Jennifer R. , Zimmerman Kathleen N. , Severini Katherine E. , Gast Hunter A. , Osborne Kirsten , Harbin Emilee R.
Published: January 2020

Provision of small “sensory” fidget toys during group activities is a low-effort intervention that may be used during group activities to encourage attendance and engagement by children with autism spectrum disorders (ASD). The purpose of this study was to evaluate the noncontingent provision of fidget toys during a group activity. Research activities occurred at a summer camp designed to improve social skills for young children with ASD. The impact of fidgets was compared with a baseline condition and contingent provision of tokens using a single case alternating treatments design. Results suggest contra-therapeutic effects or decreased engagement over time for the fidget condition. Practitioners should consider using evidence-based alternatives to improve engagement or should engage in careful data-based decision-making when fidgets are used with the intent to improve engagement in group activities.
Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care
Authors: Forde Dorothy , Deming Douglas D. , Tan John C. , Phillips Raylene M. , Fry-Bowers Eileen K. , Barger Mary K. , Bahjri Khaled , Angeles Danilyn M. , Boskovic Danilo S.
Published: January 2020

Objective:

Due to physiological and metabolic immaturity, prematurely born infants are at increased risk because of maternal separation in many neonatal intensive care units (NICUs). The stress induced from maternal–infant separation can lead to well-documented short-term physiologic instability and potentially lifelong neurological, sociological, or psychological sequelae. Based on previous studies of kangaroo mother care (KMC) that demonstrated improvement in physiologic parameters, we examined the impact of KMC on physiologic measures of stress (abdominal temperature, heart rate, oxygen saturation, perfusion index, near-infrared spectrometry), oxidative stress, and energy utilization/conservation in preterm infants.

Methods:

In this randomized, stratified study of premature neonates, we compared the effects on urinary concentrations of biomarkers of energy utilization and oxidative stress of 1 hr of KMC versus incubator care on Day 3 of life in intervention-group babies ( n = 26) and control-group babies ( n = 25), respectively. On Day 4, both groups received 1 hr of KMC. Urinary samples were collected 3 hr before and 3 hr after intervention/incubator care on both days. Energy utilization was assessed by measures of adenosine triphosphate (ATP) degradation (i.e., hypoxanthine, xanthine, and uric acid). Oxidative stress was assessed using urinary allantoin. Mixed-models analysis was used to assess differences in purine/allantoin.

Results:

Mean allantoin levels over Days 3 and 4 were significantly lower in the KMC group than in the control group ( p = .026).

Conclusions:

Results provide preliminary evidence that KMC reduces neonatal oxidative stress processes and that urinary allantoin could serve as an effective noninvasive marker for future studies.
Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: A prospective study
Authors: Savastano Alfonso , Lenzetti Chiara , Finocchio Lucia , Bacherini Daniela , Giansanti Fabrizio , Tartaro Ruggero , Piccirillo Valerio , Savastano Maria Cristina , Virgili Gianni , Rizzo Stanislao
Published: January 2020

Purpose:

To compare visual outcome and postoperative complications of combined 25-gauge pars plana vitrectomy and phacoemulsification with vitrectomy alone surgery in patients with epiretinal membrane and macular hole.

Methods:

A total of 110 eyes (73 eyes with epiretinal membrane and 37 eyes with macular hole) were enrolled in this prospective study. The eyes were divided into two groups: Group A included 55 eyes which underwent phacovitrectomy at the same time and Group B included 55 eyes which underwent vitrectomy alone. Follow-up visits were at 1, 3, and 6 months.

Results:

The best-corrected visual acuity correlation by analysis of variance measurement showed statistically non-significant differences between the two groups ( p = 0.32). The post hoc analysis from baseline, 1°, 2°, and 3° follow-ups was not statistically significant ( p > 0.05). The most common postoperative complication was cystoid macular edema that has been detected in 11 patients (10%) (seven eyes in Group A and four eyes in Group B): 2 patients (1.8%) developed a chronic macular edema. Intraocular hypertension occurred in five eyes (4.5%) (three in Group A and two in Group B). Four eyes (3.6%) underwent another surgical procedure for a persistent macular hole (two in Group A and two in Group B). The intraocular lens repositioning was performed one day after surgery in three eyes (2.7%) (Group A). The mean preoperative visual acuity was not different between the two groups ( p = 0.80).

Conclusion:

No significative differences between combined surgery and vitrectomy alone have been detected, in terms of postoperative complications and visual outcome.
Chronological changes of the anterior chamber structure, axial length, and refraction in patients with Vogt–Koyanagi–Harada disease
Authors: Muto Tetsuya , Machida Shigeki
Published: January 2020

Purpose:

To clarify the chronological changes in the anterior chamber structure and identify the spherical equivalent and axial length to assess the effects of steroid pulse treatment in patients with Vogt–Koyanagi–Harada disease with active uveitis.

Methods:

The anterior chamber condition, including anterior chamber volume, central anterior chamber depth, peripheral anterior chamber depth, anterior chamber angle, and pupil diameter, was measured using Pentacam, and axial length was measured using IOLMaster in patients with Vogt–Koyanagi–Harada disease between June 2015 and February 2018. Furthermore, the best-corrected visual acuity, spherical equivalent, and retinal foveola thickness were also analyzed. All patients were treated with steroid pulse. All these factors were compared before and at 1 and 6 months of treatment.

Results:

Significant changes were observed in the anterior chamber volume, central anterior chamber depth, peripheral anterior chamber depth, anterior chamber angle, axial length, best-corrected visual acuity, spherical equivalent, and retinal foveal thickness before and at 1 and 6 months of steroid pulse treatment ( P < 0.001, P < 0.001, P < 0.001, P = 0.0015, P = 0.027, P < 0.001, P = 0.0043, and P < 0.001, respectively). No significant difference was observed in the pupil diameter before and at 1 month and 6 months of steroid pulse treatment ( P = 0.11).

Conclusion:

The anterior chamber structure, axial length, best-corrected visual acuity, spherical equivalent, and retinal foveal thickness were dramatically changed by steroid pulse treatment in patients with Vogt–Koyanagi–Harada disease who develop active uveitis. These changes were completed within 1 month.
Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial
Authors: Yanicelli Lucía M , Goy Carla B , González Viviana del C , Palacios Gerardo N , Martínez Ernesto C , Herrera Myriam C
Published: January 2020

Introduction

The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients.

Methods

A randomized clinical trial that compares the efficacy of a home telemonitoring system –intervention group versus usual care control group – among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients’ self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period.

Results

104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence ( p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients ( p = 0.03) and a worsened self-care in the control group ( p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided.

Discussion

This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels. Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093
‘Dwelling at peace’: Europeanization and the marketing of Alpine tourism in post-war Britain
Authors: Hollows Joanne , Jancovich Mark
Published: January 2020

The Alps were a prominent feature in post-war British consumer culture and one of the key tourist destinations in the years leading up to the 1975 European Communities membership referendum. Through an analysis of holiday company Thomas Cook’s promotional materials, this article demonstrates how the Alps were represented as a region free from conflict, in which different groups lived in harmony and which offered a healthy, community-based way of life. These images not only offered a sense of an alternative to perceived deficiencies in post-war British society but also offered a sense of the possibilities of being at home in Europe.
Descriptive study of all Danish patients undergoing emergency exploratory laparotomies in the period 2003–2014
Authors: Toftlund Sarah A. , Gögenur Ismail , Thygesen Lau C.
Published: January 2020

Aim: Emergency exploratory laparotomy is a high-risk procedure, but most studies are based on small sample sizes, and no nationwide studies have reported the number of patients and the mortality risk. This descriptive study reports the prevalence, incidence and 30- and 365-day mortality of all patients undergoing emergency exploratory laparotomies in Denmark from 2003 to 2014. Methods: The study population is based on the Danish National Patient Register, which includes all patient contacts with Danish hospitals, including patients undergoing emergency surgery. All patients were followed in registers on mortality. Rates and proportions were estimated using Poisson and logistic regression models. Results: The number of prevalent patients was 15,330 through the period (2003–2014) of whom 13,795 were incident patients. Prevalence increased with age and peaked at 1% for the 80- to 84-year-old age group. The overall incidence was 27 per 100,000 person-years, which strongly increased with age (87 per 100,000 person-years among men and 85 per 100,000 person-years among women). The 30-day mortality was 16.5% and the 365-day mortality was 23.1%. Both increased strongly with age and did not improve over the study period. Both 30- and 365-day mortality were higher among unmarried patients compared to married patients. Conclusions: Emergency exploratory laparotomies are common high-risk procedures especially for the elderly population. These results can be used to focus on better postoperative care to reduce the mortality.
A statistical design optimization study of a multi-chamber reactive type silencer using simplex centroid mixture design
Authors: Seçgin Erkan , Arslan Hakan , Birgören Burak
Published: January 2020

This study aims to optimize the acoustic performance of a silencer with baffles having extension tubes. It considers the position, the number and the extension geometry of the baffles as design variables and sound transmission loss as the response variable to be optimized. The finite element analysis software ABAQUS is used to compute the response values for different combinations of design variables. The statistical design of the experiments provides a mathematical framework for such computer design optimization studies with multiple design variables. Yet, it has not been used for design optimization of silencers in the literature. In this study, simplex centroid mixture designs, a type of response surface method, are used in the statistical design of experiments. They can provide faster convergence on the optimization problem. The design involves one, two and three baffles with different positions and extension tube lengths. The outcome of this study indicates that obtaining ABAQUS software solutions at design points for each baffle number allows constructing nonlinear regression equations expressing the response variable as a function of the design variables. The equations obtained are then used to compute optimal values. Further evaluation of these equations indicates that better sound transmission loss values are obtained when the baffle number is increased, and the lengths of the extension tubes are set at high values. Moreover, it is possible to use the statistical experimental design approach implemented in this study for other types of silencers with different baffle geometries and design variables.
Epilepsy Benchmarks Area IV: Limit or Prevent Adverse Consequence of Seizures and Their Treatment Across the Life Span
Authors: Jones Jana E. , Asato Miya R. , Brown Mesha-Gay , Doss Julia L. , Felton Elizabeth A. , Kearney Jennifer A. , Talos Delia , Dacks Penny A. , Whittemore Vicky , Poduri Annapurna ,   for the NINDS/AES Benchmarks Stewards Committee
Published: January 2020

Epilepsy represents a complex spectrum disorder, with patients sharing seizures as a common symptom and manifesting a broad array of additional clinical phenotypes. To understand this disorder and treat individuals who live with epilepsy, it is important not only to identify pathogenic mechanisms underlying epilepsy but also to understand their relationships with other health-related factors. Benchmarks Area IV focuses on the impact of seizures and their treatment on quality of life, development, cognitive function, and other aspects and comorbidities that often affect individuals with epilepsy. Included in this review is a discussion on sudden unexpected death in epilepsy and other causes of mortality, a major area of research focus with still many unanswered questions. We also draw attention to special populations, such as individuals with nonepileptic seizures and pregnant women and their offspring. In this study, we review the progress made in these areas since the 2016 review of the Benchmarks Area IV and discuss challenges and opportunities for future study.
Hebbian-Type Primary Motor Cortex Stimulation: A Potential Treatment of Impaired Hand Function in Chronic Stroke Patients
Authors: Revill Kate Pirog , Haut Marc W. , Belagaje Samir R. , Nahab Fadi , Drake Daniel , Buetefisch Cathrin M.
Published: January 2020

Background. Stroke often involves primary motor cortex (M1) and its corticospinal (CST) projections. As hand function is critically dependent on these structures, its recovery is often incomplete. Objective. To determine whether impaired hand function in patients with chronic ischemic stroke involving M1 or CST benefits from the enhancing effect of Hebbian-type stimulation (pairing M1 afferent stimulation and M1 activity in a specific temporal relationship) on M1 plasticity and hand function. Methods. In a double-blind, randomized, sham-controlled design, 20 patients with chronic ischemic stroke affecting M1 or CST were randomly assigned to 5 days of hand motor training that was combined with either Hebbian-type (trainingHebb) or sham stimulation (trainingsham) of the lesioned M1. Measures of hand function and task-based M1 functional magnetic resonance imaging (fMRI) activity were collected prior to, immediately following, and 4 weeks after the intervention. Results. Both interventions were effective in improving affected hand function at the completion of training, but only participants in the trainingHebb group maintained functional gains. Changes in hand function and fMRI activity were positively correlated in both ipsilesional and contralesional M1. Compared with trainingsham, participants in the trainingHebb group showed a stronger relationship between improved hand function and changes in M1 functional activity. Conclusions. Only when motor training was combined with Hebbian-type stimulation were functional gains maintained over time and correlated with measures of M1 functional plasticity. As hand dexterity is critically dependent on M1 function, these results suggest that functional reorganization in M1 is facilitated by Hebbian-type stimulation. ClinicalTrials.gov Identifier: NCT01569607.
Multichannel adaptive deployment and reliable communication design for unmanned surface vessel
Authors: Yin Qiyu , Lv Yuezu
Published: January 2020

For the unmanned surface vessel in performing military missions, the safety and controllability are two basic requirements, which need reachable communication channel and reliable data transmission. This article proposes an adaptive switching model with multichannel resource and the unmanned surface vessel shore-to-sea data intercommunication design method. The scheme adopts various mechanisms such as data space, standardized encapsulation, numbering and verification, and active/passive retransmission, which can ensure reliable data transmission and provide reliable communication information for unmanned surface vessel during autonomous mission. A sea trial is also carried out on the unmanned surface vessel control system based on the design scheme. Data analysis shows that the system can successfully realize communication switching and continuous data transformation, which is consistent with design expectation, and guarantees the continuous monitoring and control of unmanned surface vessel by shore-based control station.
Expanding comparative media systems analysis from transitional to postcolonial societies
Authors: Rodny-Gumede Ylva
Published: January 2020

Comparative media systems theory has failed to pronounce on trajectories of media development in postcolonial societies in a meaningful way, as media development in postcolonial societies has been analysed from within normative liberal frameworks emanating from North America and Western Europe and later transitional societies in Eastern Europe and East Asia, societies with histories quite separate from the Colonial heritage and legacies that have, and keep, influencing the media–politics nexus in many postcolonial societies. To expand the analysis of media development in postcolonial societies, postcolonial studies have much to add to comparative media systems analysis, not only to expand the analysis beyond the global North but also for the analysis of global disruptions that are challenging normative models of media systems analysis.
Cost-effectiveness of the reverse total shoulder arthroplasty. Does indication affect outcome?
Authors: Nicholson Jamie A , Jones Rhiannon , MacDonald Deborah J , Brown Iain , McBirnie Julie
Published: January 2020

Background

The primary aim of this study was to determine the cost-effectiveness of the reverse total shoulder arthroplasty in a prospective cohort of patients over a two-year post-operative period.

Methods

Patients who underwent reverse total shoulder arthroplasty were prospectively monitored for 24 months post-operatively using the Oxford Shoulder Score, Disabilities of the Arm, Shoulder and Hand questionnaire and EuroQol 5-dimensional questionnaire. Any complications or use of health care resources were recorded. The incremental cost-effectiveness ratio was used to express the cost per quality-adjusted life year gained.

Results

Sixty-seven patients were analysed, 46 primary reverse total shoulder arthroplasty for cuff arthropathy and 21 revisions from previous arthroplasty. Both indications had comparable peri-operative shoulder scores without significant difference. Using the mean change of EuroQol 5-dimensional questionnaire at one year, the incremental cost-effectiveness ratio was calculated at £16,827.43 per quality-adjusted life year, decreasing to £8313.48 per quality-adjusted life year at two years. Primary was associated with a lower incremental cost-effectiveness ratio at two years (primary £7596.76 vs. revision £11,748.51). The estimated post-operative life expectancy of the cohort was 6.9 years with a projected cost per quality-adjusted life year of £2438.78.

Conclusions

Reverse total shoulder arthroplasty provides a cost-effective intervention with excellent patient outcomes at two years post-operatively.
Targeting non-small cell lung cancer: driver mutation beyond epidermal growth factor mutation and anaplastic lymphoma kinase fusion
Authors: Chu Quincy S.
Published: January 2020

The identification of driver mutations in epidermal growth factor receptor, anaplastic lymphoma kinase, the BRAF and ROS1 genes and subsequent successful clinical development of kinase inhibitors not only significantly improves clinical outcomes but also facilitates the discovery of other novel driver mutations in non-small cell lung cancer. These driver mutations can be categorized into mutations in or near the kinase domain, gene amplification or fusion. In this review, BRAF V600E, EGFR and HER-2 exon 20 mutation, FGFR1–4, K-RAS, MET, neuregulin-1, NRTK, PI3K/AKT/mTOR, RET and ROS1 gene aberration and their therapeutics will be discussed.
TNF-Alpha Inhibitors and Rhinosinusitis—A Systematic Review and Meta-Analysis
Authors: Piski Zalan , Gerlinger Imre , Nepp Nelli , Farkas Kornelia , Weber Rainer
Published: January 2020

Background

Tumor necrosis factor alpha (TNFα) plays key role in immunologic process. Patients receiving anti-TNFα therapy may likely be more predisposed to infections including sinus disorders.

Objectives

Our aims were to review literature and evaluate data regarding TNFα antagonist therapy and its association with reference to various sinus disorders in the form of a systematic review and meta-analysis.

Methods

Different keyword combinations were used in the screening of the literature including leading scientific databases (PubMed, Embase, and Web of Science). Papers reporting sinus disorders as supposed adverse events of the treatment were included into the meta-analysis.

Results

A thorough review of literature searches extracted 1154 records and 8 articles were found through other sources. Seventeen papers fulfilled our criteria for inclusion into the meta-analysis. Among 16 174 observed patients, 3018 suffered from a sinus infection. An event rate (ER) of 0.058 was calculated for all the cases. Analysis with regard to the confirmed diseases showed an 0.038 ER. Calculations were performed in accordance to the diagnostic categories used for sinus disorder. Six groups were found including the following: “Bacterial Sinusitis” (ER: 0.046), “Chronic Rhinosinusitis” (ER: 0.027), “Sinusitis Requiring Prescription Medication” (ER: 0.295), “Recurrent Sinusitis” (ER: 0.070), “Sinusitis” (ER: 0.076), “Acute Rhinosinusitis” (ER: 0.002) and, lastly, “Maxillary Sinusitis” (ER: 0.028).

Conclusions

Our results exhibited a similar prevalence to the healthy population; therefore, infective sinus disorders cannot directly be considered as complications of TNFα antagonist therapy.
Nano-graphene oxide/polyurethane nanofibers: mechanically flexible and myogenic stimulating matrix for skeletal tissue engineering
Authors: Jo Seung Bin , Erdenebileg Uyanga , Dashnyam Khandmaa , Jin Guang-Zhen , Cha Jae-Ryung , El-Fiqi Ahmed , Knowles Jonathan C. , Patel Kapil Dev , Lee Hae-Hyoung , Lee Jung-Hwan , Kim Hae-Won
Published: January 2020

For skeletal muscle engineering, scaffolds that can stimulate myogenic differentiation of cells while possessing suitable mechanical properties (e.g. flexibility) are required. In particular, the elastic property of scaffolds is of importance which helps to resist and support the dynamic conditions of muscle tissue environment. Here, we developed highly flexible nanocomposite nanofibrous scaffolds made of polycarbonate diol and isosorbide-based polyurethane and hydrophilic nano-graphene oxide added at concentrations up to 8%. The nano-graphene oxide incorporation increased the hydrophilicity, elasticity, and stress relaxation capacity of the polyurethane-derived nanofibrous scaffolds. When cultured with C2C12 cells, the polyurethane–nano-graphene oxide nanofibers enhanced the initial adhesion and spreading of cells and further the proliferation. Furthermore, the polyurethane–nano-graphene oxide scaffolds significantly up-regulated the myogenic mRNA levels and myosin heavy chain expression. Of note, the cells on the flexible polyurethane–nano-graphene oxide nanofibrous scaffolds could be mechanically stretched to experience dynamic tensional force. Under the dynamic force condition, the cells expressed significantly higher myogenic differentiation markers at both gene and protein levels and exhibited more aligned myotubular formation. The currently developed polyurethane–nano-graphene oxide nanofibrous scaffolds, due to their nanofibrous morphology and high mechanical flexibility, along with the stimulating capacity for myogenic differentiation, are considered to be a potential matrix for future skeletal muscle engineering.
Diagnostic and prognostic value of ST-segment deviation scores in suspected acute myocardial infarction
Authors: Grimm Karin , Twerenbold Raphael , Abaecherli Roger , Boeddinghaus Jasper , Nestelberger Thomas , Koechlin Luca , Troester Valentina , Bourtzou Anna , Keller Dagmar I , Geigy Nicolas , Kozhuharov Nikola , Wussler Desiree , Wildi Karin , Hillinger Petra , Rubini Giménez Maria , Strebel Ivo , Badertscher Patrick , Puelacher Christian , du Fay de Lavallaz Jeanne , Osswald Luca , Morawiec Beata , Kawecki Damian , Miró Òscar , Kühne Michael , Reichlin Tobias , Mueller Christian
Published: January 2020

Background:

Recent advances in digital electrocardiography technology allow evaluating ST-segment deviations in all 12 leads as quantitative variables and calculating summed ST-segment deviation scores. The diagnostic and prognostic utility of summed ST-segment deviation scores is largely unknown.

Methods:

We aimed to explore the diagnostic and prognostic utility of the conventional and the modified ST-segment deviation score (Better Analysis of ST-segment Elevations and Depressions in a 12- Lead-ECG-Score (BASEL-Score): sum of elevations in the augmented voltage right - lead (aVR) plus absolute, unsigned ST-segment depressions in the remaining leads) in patients presenting with suspected non-ST-segment elevation myocardial infarction. The diagnostic endpoint was non-ST-segment elevation myocardial infarction, adjudicated by two independent cardiologists. Prognostic endpoint was mortality during two-year follow up.

Results:

Among 1330 patients, non-ST-segment elevation myocardial infarction was present in 200 (15%) patients. Diagnostic accuracy for non-ST-segment elevation myocardial infarction as quantified by the area under the receiver-operating-characteristics curve was significantly higher for the BASEL-Score (0.73; 95% confidence interval 0.69–0.77) as compared to the conventional ST-segment deviation score (0.53; 95% confidence interval 0.49–0.57, p<0.001). The BASEL-Score provided additional independent diagnostic value to dichotomous electrocardiogram variables (ST-segment depression, T-inversion, both p<0.001) and to high-sensitivity cardiac troponin (p<0.001) as well as clinical judgment at 90 min (p<0.001). Similarly, only the BASEL-Score proved to be an independent predictor of two year mortality.

Conclusions:

The modified ST-segment deviation score BASEL-Score focusing on ST-segment elevation in aVR and ST-segment depressions in the remaining leads provides incremental diagnostic and prognostic information.
High-dose vitamin D supplementation in multiple sclerosis – results from the randomized EVIDIMS (efficacy of vitamin D supplementation in multiple sclerosis) trial
Authors: Dörr Jan , Bäcker-Koduah Priscilla , Wernecke Klaus-Dieter , Becker Elke , Hoffmann Frank , Faiss Jürgen , Brockmeier Bernd , Hoffmann Olaf , Anvari Kerstin , Wuerfel Jens , Piper Sophie K , Bellmann-Strobl Judith , Brandt Alexander U , Paul Friedemann
Published: January 2020

Background

Epidemiological, preclinical, and non-interventional studies link vitamin D (VD) serum levels and disease activity in multiple sclerosis (MS). It is unclear whether high-dose VD supplementation can be used as an intervention to reduce disease activity.

Objectives

The study aimed to compare the effects of every other day high- (20,400 IU) versus low-dose (400 IU) cholecalciferol supplementation on clinical and imaging markers of disease activity in patients with relapsing–remitting MS or clinically isolated syndrome.

Methods

The EVIDIMS (efficacy of vitamin D supplementation in multiple sclerosis) trial was a multicentre randomized/stratified actively controlled explorative phase 2a pilot trial with a double-blind intervention period of 18 months, add on to interferon-β1b.

Results

Fifty-three patients were randomized, and 41 patients completed the study. Cholecalciferol supplementation was well tolerated and safe in both arms. After 18 months, clinical (relapse rates, disability progression) and radiographical (T2-weighted lesion development, contrast-enhancing lesion development, brain atrophy) did not differ between both treatment arms. Post-study power calculations suggested that the sample size was too low to prove the hypothesis.

Conclusions

The results neither support nor disprove a therapeutic benefit of high-dose VD supplementation but provide a basis for sound sample size estimations in future confirmatory studies. www.clinicaltrials.gov/NCT01440062
The Knowns and Unknowns of Policy Instrument Analysis: Policy Tools and the Current Research Agenda on Policy Mixes
Authors: Capano Giliberto , Howlett Michael
Published: January 2020

Policies are made and pursue their goals through policy instruments. Furthermore, policy instruments have become a relevant topic in many policy fields due to their theoretical and empirical relevance. The study of this field dates back to Lowi and others who developed many typologies and theories in classic works by authors such as Hood, Salamon, Linder and Peters, Peters and van Nispen, Schneider and Ingram, Lascomes and Le Galès, among others. This is important work that is linked closely to current research on policy design but, despite much effort, many fundamental issues remain unknown or understudied with respect to the topic. It is time to take inventory of the knowns and unknowns about policy tools. The current article examines four clusters of basic issues in the field which require further research.
Assessment of the Effectiveness and the Adaption of CSR Management System in Food Industry: The Case of the South Asian versus the Western Food Companies
Authors: Ikram Muhammad , Qayyum Abdul , Mehmood Omer , Haider Jahanzaib
Published: January 2020

The purpose of this empirical study is to undertake a comparative analysis of the South Asian and Western food companies based on their corporate social responsibility (CSR) adoption and impact on firm performance. We conducted a survey of 24 South Asian and 20 Western companies. Later, we performed independent samples t-tests and ordinary least squares (OLS) regression. Furthermore, we applied Kingdon’s agenda and green consumer theories to explain how CSR in Western food companies could be advanced than the food companies in South Asia. Based on the aforementioned tests, the Western food companies obtained better scores than their counterparts in South Asia. This result was obvious as the West has a developed CSR management system compared to South Asia. However, this is interesting that we found a weak CSR performance link between the Western and the South Asian food companies. The lower CSR adoption levels of South Asian food companies show their greedy nature as these companies are hesitant to spend the portion of their profits on promoting CSR. South Asian governments with a vested interest in improving CSR performance provide tax breaks and other motivations for increasing CSR adoption among food companies. These findings have theoretical and practical implication for future research.
The Arabic/Lebanese Adaptation of Child Abuse Potential Inventory
Authors: Al-Shoura Hilda , Beyazit Utku
Published: January 2020

Lebanon lacks the proper instruments to detect and screen for child abuse potential. This study aimed to adapt the Child Abuse Potential Inventory (CAPI) for the Arabic/Lebanese society. The participants of the study were 350 caregivers from Lebanese society. In terms of the validity analysis, construct and criterion-related validity analyses were employed. The results of the confirmatory factor analysis showed a construct of 12 factors and 153 items. In the criterion-related validity analysis, both CAPI and Depression, Anxiety, Stress scale (DASS) scales were found to be significantly correlated ( p < .05). In terms of the reliability analysis, internal consistency was computed by using Cronbach’s alpha reliability coefficient. The reliability coefficient was found to be .838 for the total scores of CAPI. Based on these results, the Arabic version of CAPI is considered a valid and reliable instrument that can be used for detecting and screening child abuse potential in an Arabic/Lebanese sample.