bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex differences in sympathetic activity in obesity and its related hypertension
Authors: Fu Qi
Published: May 2019

The prevalence of obesity is rapidly increasing in the United States, particularly among women. Approximately 60−70% of hypertension in adults may be directly attributed to obesity. In addition, maternal obesity is a major risk factor for hypertensive disorders during pregnancy. The underlying mechanisms for the association between obesity and cardiovascular risk are multifactorial, but activation of the sympathetic nervous system is one significant contributing factor. This brief review summarizes the current knowledge on sex differences in sympathetic activity in obesity and its related hypertension, with a focus on studies in humans. Evidence suggests that abdominal visceral fat, rather than subcutaneous fat, is related to augmented sympathetic activity regardless of sex. Race/ethnicity may affect the relationship between obesity and sympathetic activity. Obesity‐related hypertension has an important neurogenic component, which is characterized by sympathetic overactivity. However, sex may influence the association between hypertension and sympathetic overactivity in obese people. Finally, both body weight and sympathetic overactivity seem to be involved in the development of gestational hypertensive disorders in women. Chronic hyperinsulinemia due to insulin resistance, high plasma levels of leptin, and/or obstructive sleep apnea may be responsible for sympathetic overactivity in obesity‐related hypertension.
Online sunscreen purchases: Impact of product characteristics and marketing claims
Authors: Prado Giselle , Ederle Ashley E. , Shahriari Shawhin R.K. , Svoboda Ryan M. , Farberg Aaron S. , Rigel Darrell S.
Published: May 2019

Background

Sunscreens, unlike prescription medications, are purchased by consumers directly from retailers. The proportion of online sunscreen sales is increasing. It is therefore important for dermatologists to know what factors influence online sunscreen purchases to optimize appropriate recommendations.

Methods

Data on the top 100 best‐selling sunscreens from an online retailer were collected. Variables included cost, formulation, product claims, ingredients, consumer ratings, and number of reviews. Ordinal logistic regression was used to analyze the impact of collected variables on position on the best‐seller list.

Results

Ninety‐six of the 100 search results could be defined as actual sunscreens with a total of 41 788 reviews. The median price per ounce was $3.02 (range $0.34‐$309.18). The most popular formulations were lotions. The most common unregulated claim was “non‐greasy” found in 57.3% of sunscreens. For 26 unregulated product claims analyzed, the mean number of claims per sunscreen was 5.2. Using an ordinal regression model, the following factors were found to significantly influence sunscreen sales: number of reviews, the claim “decreases the risk of skin cancer and early aging,” and the presence of six or more unregulated claims.

Conclusions

Multiple sunscreen options exist for consumers with varying price points, active ingredients, and formulations. Consumers who purchase online prefer sunscreens with a higher number of reviews and more unregulated marketing claims. FDA‐regulated claims such as “decreases the risk of skin cancer and early aging” are not as impactful in this purchasing cohort. To facilitate usage, dermatologists should be cognizant of factors that influence sunscreen selection among this group.
Services liberalization and global value chain participation: New evidence for heterogeneous effects by income level and provisions
Authors: Lee Woori
Published: May 2019

Participation in global value chains (GVCs) is a key element in the industrialization strategies of many developing nations. This paper investigates the role of services liberalization in promoting participation in GVCs. Using the gravity framework, I examine the impact of services trade agreements on gross trade and GVC trade (backward and forward participation) in goods. I find that services trade agreements promote both, but especially GVC trade, although the effects are heterogeneous: the impact is bigger for developing nation exporters. Moreover, services agreements that allow the export of services without local presence (nonestablishment rights) are particularly important in fostering GVC participation.
On Inequality‐Sensitive and Additive Achievement Measures Based on Ordinal Data
Authors: Apouey Bénédicte , Silber Jacques , Xu Yongsheng
Published: May 2019

This paper, following earlier work on the measurement of inequality when only ordinal information is available, proposes an axiomatic derivation of a new class of inequality‐sensitive and additive achievement measures. Use is then made of these indices to study health achievement in Europe, using information on self‐assessed health in 30 countries, based on the European Health Interview Survey (wave 2).
Molecular matching for patients with haematological diseases expressing altered RHD‐RHCE genotypes
Authors: Cruz Bruno Ribeiro , de Souza Silva Thamy Caroline , de Souza Castro Bianca , Chiba Akemi Kuroda , Moritz Elyse , Braga Josefina Pellegrini , Figueiredo Maria Stella , Bordin José O
Published: May 2019

Background and Objectives

The high homology and the inverted orientation of RHD and RHCE may give rise to non‐functional and aberrant RH alleles. RH genotyping is used to screen RH matched donors to African descent patients. This study aimed to define a strategy for testing RHD and RHCE variants in blood donors to provide compatible units for transfusion of patients with haematological diseases.

Materials and Methods

Samples from 132 patients [101 Sickle cell disease (SCD), 14 myelodysplastic syndrome (MDS), 17 acute myelogenous leukaemia (AML)] and 198 Brazilian donors were studied. Major blood group alleles, RHD, RHCE alleles and RHD zygosity were determined by the blood‐MLPA assay. Sequencing was performed to determine RHD and RHCE variant subtypes. A match was an RH genotype that did not encode Rh antigens absent in the patient, along with matching for ABO, MNS, KEL, FY, JK and DI antigens.

Results

Overall, 7·6% of blood donors and 17.4% of patients presented RH genotypes that predict expression of partial Rh antigens or lack of high prevalence Rh antigens. From 23 patients with clinically relevant RH genotypes, 15 had available matched donors.

Conclusion

We report the presence of clinically relevant RH genotypes in SCD and in non‐SCD patients. In our admixed population, many patients carry variant RHCE alleles in heterozygosity with normal RHCE alleles. Thus, our results suggest that donors could be selected based on the normal RH allele.
Acute spatial spread of NO‐mediated potentiation during hindpaw ischaemia in mice
Authors: Onishi Takeshi , Watanabe Tatsunori , Sasaki Mika , Kamiya Yoshinori , Horie Masao , Tsukano Hiroaki , Hishida Ryuichi , Kohno Tatsuro , Takebayashi Hirohide , Baba Hiroshi , Shibuki Katsuei
Published: May 2019

Key points

Neuropathic pain spreads spatially beyond the injured sites, and the mechanism underlying the spread has been attributed to inflammation occurring in the spinal cord.

However, the spatial spread of spinal/cortical potentiation induced by conduction block of the peripheral nerves can be observed prior to inflammation.

In the present study, we found that spreading potentiation and hypersensitivity acutely induced by unilateral hindpaw ischaemia are nitric oxide (NO)‐dependent and that NO is produced by ischaemia and quickly diffuses within the spinal cord.

We also found that NO production induced by ischaemia is not observed in the presence of an antagonist for group II metabotropic glutamate receptors (mGluRs) and that neuronal NO synthase‐positive dorsal horn neurons express group II mGluRs.

These results suggest strongly that NO‐mediated spreading potentiation in the spinal cord is one of the trigger mechanisms for neuropathic pain.

Cortical/spinal responses to hindpaw stimulation are bilaterally potentiated by unilateral hindpaw ischaemia in mice. We tested the hypothesis that hindpaw ischaemia produces nitric oxide (NO), which diffuses in the spinal cord to induce spatially spreading potentiation. Using flavoprotein fluorescence imaging, we confirmed that the spreading potentiation in hindpaw responses was induced during ischaemia in the non‐stimulated hindpaw. This spreading potentiation was blocked by spinal application of l‐NAME, an inhibitor of NO synthase (NOS). Furthermore, no spreading potentiation was observed in neural NOS (nNOS) knockout mice. Spinal application of an NO donor was enough to induce cortical potentiation and mechanical hypersensitivity. The spatial distribution of NO during unilateral hindpaw ischaemia was visualized using 4‐amino‐5‐methylamino‐2′,7′‐difluorofluorescein (DAF‐FM). An increase in fluorescence derived from the complex of DAF‐FM with NO was observed on the ischaemic side of the spinal cord. A similar but smaller increase was also observed on the contralateral side. Somatosensory potentiation after hindpaw ischaemia is known to be inhibited by spinal application of LY354740, an agonist of group II metabotropic glutamate receptors (mGluRs). We confirmed that the spinal DAF‐FM fluorescence increases during hindpaw ischaemia were not observed in the presence of LY354740. We also confirmed that approximately half of the nNOS‐positive neurons in the superficial laminae of the dorsal horn expressed mGluR2 mRNA. These results suggest that disinhibition of mGluR2 produces NO which in turn induces a spreading potentiation in a wide area of the spinal cord. Such spreading, along with the consequent non‐specific potentiation in the spinal cord, may trigger neuropathic pain.
Exergetic Performance Investigation of Varying Flashing From Single to Quadruple for Geothermal Power Plants
Authors: Siddiqui Osamah , Dincer Ibrahim
Published: May 2019

Geothermal power plants are considered important renewable energy resources for clean energy production. Flash steam type plants constitute a significant portion of worldwide geothermal power. In this study, single, double, triple, and quadruple flash steam geothermal power plants are investigated with reinjection options. The optimal operating points are determined specifically through optimal flashing pressures. The turbine power outputs, energy efficiencies, and exergy efficiencies are further studied. A rise in the flashing stages from single to double is found to increase the power outputs considerably. However, when the flashing stages are increased from double to triple and triple to quadruple, the increase in turbine power outputs is found to drop significantly. Also, both exergy efficiency and energy efficiency are found to reduce with increasing number of flash stages. The energy efficiencies are obtained as 28%, 25.5%, 24.2%, and 23.5% for single, double, triple, and quadruple plants, respectively. Furthermore, the exergy efficiencies are found to be 72.6%, 70.9%, 70.2%, and 69.8% for these plants, respectively.
Effect of Volume Element Geometry on Convergence to a Representative Volume
Authors: Acton Katherine , Sherod Connor , Bahmani Bahador , Abedi Reza
Published: May 2019

To accurately simulate fracture, it is necessary to account for small-scale randomness in the properties of a material. Apparent properties of statistical volume element (SVE) can be characterized below the scale of a representative volume element (RVE). Apparent properties cannot be defined uniquely for an SVE, in the manner that unique effective properties can be defined for an RVE. Both constitutive behavior and material strength properties in SVE must be statistically characterized. The geometrical partitioning method can be critically important in affecting the probability distributions of mesoscale material property parameters. Here, a Voronoi tessellation-based partitioning scheme is applied to generate SVE. Resulting material property distributions are compared with those from SVE generated by square partitioning. The proportional limit stress of the SVE is used to approximate SVE strength. Superposition of elastic results is used to obtain failure strength distributions from boundary conditions at variable angles of loading.
The Evaluation of a Novel Three-Dimensional Printed Expandable Pedicle Screw Sleeve Insert
Authors: Burkhart Timothy A. , Sadashivaiah Manjunath , Reeves Jacob , Rasounlinejad Paraham
Published: May 2019

When used in combination with decompression, spinal fusion is a successful procedure for treating patients with spinal stenosis and degenerative spondylolisthesis. While a number of auxiliary devices have been proposed to enhance the fixation of the screw within the pedicle and vertebral body, there is conflicting information regarding the efficacy of their use. Therefore, the aim of this study was to determine the ability of a novel expandable pedicle screw to improve the fixation of the pedicle screw within the pedicle and vertebral body. A three-dimensional (3D) printed, screw sleeve was designed that expanded within the pedicle and vertebral body when a standard pedicle screw was inserted into it. The left and right pedicle of ten (N = 10) cadaveric lumbar spine specimens (L3–L5) were randomly assigned to be instrumented with either a pedicle screw and the sleeve or a pedicle screw only. Following instrumentation, the screws were exposed to tensile load at 5 mm/min until failure. The failure force, failure deformation, and area under the force–deformation curve were determined and compared between screw conditions. There were no significant differences between the screws and sleeve, and the screw only conditions for the failure force (p = 0.24), failure displacement (p = 0.10), and area under the curve (p = 0.38). While the novel screw sleeve presented here performed as well as a screw without a sleeve, it was better than other screw augmentation devices reported previously. In addition, it is likely that this device would prove useful as an enhancement to revision.
Study of Entropy Generation in Heat Exchanger Tube With Multiple V Cuts in Perforated Twisted Tape Insert
Authors: Kumar Bipin , Patil Anil Kumar , Jain Siddharth , Kumar Manoj
Published: May 2019

The present work deals with the study of entropy generation in circular tube fitted with perforated twisted tape (PTT) insert with multiple V cuts. Experimental data pertaining to heat transfer and frictional losses are collected for solid twisted tape (STT), PTT, double V cut PTT, and PTT with multiple V cuts by varying the twist ratio in the range of 2–6 for the Reynolds number range of 2000–25,000. The entropy generation rate of heated tube with insert is found to be less than the smooth tube in most of the cases under similar operating conditions. The minimum value of entropy generation number corresponds to the PTT having twist ratio of 3.
Experimental Validation of Existing Numerical Models for the Interaction of Fluid Transients With In-Line Air Pockets
Authors: Alexander Jane , Lee Pedro J. , Davidson Mark , Duan Huan-Feng , Li Zhao , Murch Ross , Meniconi Silvia , Brunone Bruno
Published: May 2019

Entrapped air in pipeline systems can compromise the operation of the system by blocking flow and raising pumping costs. Fluid transients are a potential tool for characterizing entrapped air pockets, and a numerical model which is able to accurately predict transient pressures for a given air volume represents an asset to the diagnostic process. This paper presents a detailed study on our current capability for modeling and predicting the dynamics of an inline air pocket, and is one of a series of articles within a broader context on air pocket dynamics. This paper presents an assessment of the accuracy of the variable wave speed and accumulator models for modeling air pockets. The variable wave speed model was found to be unstable for the given conditions, while the accumulator model is affected by amplitude and time-delay errors. The time-delay error could be partially overcome by combining the two models.
Abnormally increased vocal responses to pitch feedback perturbations in patients with cerebellar degeneration
Authors: Houde John F. , Gill Jeevit S. , Agnew Zarinah , Kothare Hardik , Hickok Gregory , Parrell Benjamin , Ivry Richard B. , Nagarajan Srikantan S.
Published: May 2019

Cerebellar degeneration (CD) has deleterious effects on speech motor behavior. Recently, a dissociation between feedback and feedforward control of speaking was observed in CD: Whereas CD patients exhibited reduced adaptation across trials to consistent formant feedback alterations, they showed enhanced within-trial compensation for unpredictable formant feedback perturbations. In this study, it was found that CD patients exhibit abnormally increased within-trial vocal compensation responses to unpredictable pitch feedback perturbations. Taken together with recent findings, the results indicate that CD is associated with a general hypersensitivity to auditory feedback during speaking.
Applying a Computer-Assisted Tool for Semantic Analysis of Writing: Uses for STEM and ELL
Authors: Smith-Keiling Beverly L. , Hyun Hye In F.
Published: May 2019

In addition to human, close reading of student text with rubrics for assessment, educators use nonhuman, distant computer-assisted tools to help quantitatively measure otherwise qualitative keywords to prevent bias in grading and helpread beyond the sentencefor underlying cognitions. We apply the Linguistic Inquiry and Word Count (LIWC) software tool to analyze different forms of student writing used in STEM education and research to assess writing of native English speakers and non-native English Language Learners (ELLs), including international students. Available in several languages, LIWC measures four summary variables,Analytical Thinking,Clout,Authentic, andEmotional Tone, to provide outputs as raw word counts, as percentages of words used relative to the text compared with a dictionary of words in categories and sub-dictionaries, and as scores correlating these words algorithmically based on a dictionary of terms associated with underlying meanings. This tool can help measure student personal reflective writing for underlying psychosocial indicators or the cognitive and analytical process in other science writing. By selecting key variables, or creating a personal dictionary, LIWC can be used to analyze scientific writing to detect progressive development of student analytical writing from early draft to final version for different informal and formal writing styles. We share methods, examples, and the potential for using LIWC measures of cognitive processes for different measures of student writing in science courses.
Treatment failure with propranolol for subglottic haemangioma
Authors: Liu Zhaobo , Yeo Yen Huan , Jackson Conor , Trimble Keith
Published: May 2019

The use of propranolol for the treatment of subglottic haemangioma has become hugely popular due to its effectiveness and safety profile. We report a case of 7-month-old boy who presented with stridor and histopathology suggestive of subglottic haemangioma following microlaryngoscopy and bronchoscopy (MLB). However, he did not respond to propranolol treatment. This could be due to an older age of propranolol commencement. In general, early commencement of propranolol is necessary when diagnosis of symptomatic infantile haemangioma is made to achieve maximal improvement in symptoms and prevent further proliferation. There should be a high index of suspicion for subglottic haemangioma in children presenting with chronic biphasic stridor, with early MLB and diagnosis. This will allow early treatment, giving the best chance to avoid our situation.
Tracheo-oesophageal fistula in a case of button battery ingestion: CT virtual bronchoscopy imaging
Authors: Agarwal Sanika Sanjeev , Shetty Devdas Sudhakar , Joshi Manisha Vishnu , Manwar Siddhant Uttam
Published: May 2019

Foreign body ingestion in paediatric population is a very common problem. Usually the foreign bodies pass through the gastrointestinal tract without any complications; however, certain foreign bodies like button batteries might cause severe injuries like tracheo-oesophageal fistula (TOF), oesophago-aortic fistula, perforation and mediastinitis, vocal cord paralysis and stenosis after suspected perforation. In our case, an infant developed a TOF following ingestion of button battery which was diagnosed with the help of CT virtual bronchoscopy. It also contributed to the decision making regarding suitable operative techniques. Thus, CT virtual bronchoscopy can help in the diagnosis and detection of any complications due to foreign body ingestion with the added advantage of being non-invasive.
Can community pharmacists improve tuberculosis case finding? A mixed methods intervention study in India
Authors: Daftary Amrita , Satyanarayana Srinath , Jha Nita , Singh Mugdha , Mondal Shinjini , Vadnais Caroline , Pai Madhukar
Published: May 2019

Introduction

India has the world’s highest burden of tuberculosis (TB). Private retail pharmacies are the preferred provider for 40% of patients with TB symptoms and up to 25% of diagnosed patients. Engaging pharmacies in TB screening services could improve case detection.

Methods

A novel TB screening and referral intervention was piloted over 18 months, under the pragmatic staggered recruitment of 105 pharmacies in Patna, India. The intervention was integrated into an ongoing public–private mix (PPM) programme, with five added components: pharmacy training in TB screening, referral of patients with TB symptoms for a chest radiograph (CXR) followed by a doctor consultation, incentives for referral completion and TB diagnosis, short message service (SMS) reminders and field support. The intervention was evaluated using mixed methods.

Results

81% of pharmacies actively participated in the intervention. Over 132.49 pharmacy person-years of observation in the intervention group, 1674 referrals were made and 255 cases of TB were diagnosed. The rate of registration of symptomatic patients was 62 times higher in the intervention group compared with the control group (95% CI: 54 to 72). TB diagnosis was 25 times higher (95% CI: 20 to 32). Microbiological testing and test confirmation were also significantly higher among patients diagnosed in the intervention group (p<0.001). Perceived professional credibility, patient trust, symptom severity and providing access to a free screening test were seen to improve pharmacists’ engagement in the intervention. Workload, patient demand for over-the-counter medicines, doctor consultation fees and programme documentation impeded engagement. An additional 240 cases of TB were attributed to the intervention, and the approximate cost incurred per case detected due to the intervention was US$100.

Conclusions

It is feasible and impactful to engage pharmacies in TB screening and referral activities, especially if working within existing public-private mix (PPM) programmes, appealing to pharmacies’ business mindset and among pharmacies with strong community ties.
Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study
Authors: Göras Camilla , Olin Karolina , Unbeck Maria , Pukk-Härenstam Karin , Ehrenberg Anna , Tessma Mesfin Kassaye , Nilsson Ulrica , Ekstedt Mirjam
Published: May 2019

Objectives

The work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR.

Design

Prospective observational study using the Work Observation Method By Activity Timing tool.

Setting

An OR department at a county hospital in Sweden.

Participants

OR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9).

Results

The type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons’ and ORNs’ intraoperative time, while in RNAs’ work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs’ and surgeons’ work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication.

Conclusions

The surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system.

Trial registration number

2016/264.
‘Active & Safe Central’: development of an online resource for the prevention of injury in sport and recreational activity
Authors: Richmond Sarah A , Black Amanda M , Jacob John , Babul Shelina , Pike Ian
Published: May 2019

Background

Sport and recreation related injuries exert a significant cost on the healthcare system. As prevention researchers and practitioners, we have a responsibility to provide guidance towards prevention to those who participate in sport and recreation, and those that coach, treat and parent children that participate. The objective of this project was to use an integrated knowledge translation approach to develop an end user-driven digital platform that provides injury prevention information and resources across 51 sport and recreational activities.

Design

We used an integrated knowledge translation approach to scope and develop an online sport and recreational injury prevention resource. A project team was formed that included end users—coaches, parents and athletes, injury researchers and practitioners, as well as members of a digital design team. All members of the project team informed the development process, including a review of literature and existing resources, the translation of evidence and development of the platform. At all stages of development, members of the project team cocreated knowledge for the tool, including forming the research questions, the approach, feasibility and development of outcomes.

Conclusion

The ‘Active & Safe Central’ (https://activesafe.ca/) platform provides web-based sport injury and prevention information. This user-friendly, web and mobile accessible platform can increase the reach, awareness and implementation of prevention programming in sport and recreational activity.
Pathological review of primary cutaneous malignant melanoma by a specialist skin cancer multidisciplinary team improves patient care in the UK
Authors: Bhoyrul Bevin , Brent Geoffrey , Elliott Faye , McLorinan Joanna , Wilson Amy , Peach Howard , Mathew Bipin , Mitra Angana
Published: May 2019

Aims

The National Institute for Health and Care Excellence advocated the development of specialist skin cancer multidisciplinary teams (SSMDTs) for the management of higher risk invasive skin cancers in the UK. The interobserver variability in the histopathological assessment of primary cutaneous malignant melanoma (PCMM) is well recognised.

Methods

We evaluated the discordance rates in the assessment of the histopathological criteria of PCMM based on the eighth American Joint Committee on Cancer (AJCC) melanoma staging system and subsequent change in prognosis and management following pathology review by an SSMDT.

Results

353 cases of PCMM were referred to our SSMDT between April 2015 and May 2016. Cases in which there was a discrepancy in one or more histological parameters following expert review were collected retrospectively. Of 341 eligible cases, there were 94 (27.6%) in which there was an alteration in any parameter. There was interobserver agreement in final diagnosis in 96.8%, Breslow thickness in 86.8%, ulceration in 98.2%, microsatellites in 98.5%, tumour mitotic rate in 88.9%, histological subtype in 92.4%, growth phase in 98.5%, angiolymphatic invasion in 97.7%, perineural invasion in 98.8%, regression in 95.3% and tumour-infiltrating lymphocytes in 95.0%. A corresponding change in AJCC stage occurred in 23 cases (6.7%), with a resulting change in clinical management in 10 cases (2.9%).

Conclusions

Disagreements in the pathological assessment of PCMM can have significant clinical implications for a small number of patients. Our findings highlight the value of the SSMDT for high-quality care of patients with melanoma in the UK.
A competitive clinical environment improves procedural times in endovascular stroke treatment
Authors: Mertens Jessica , Singh Raveena , Reich Arno , Dekeyzer Sven , Wiesmann Martin , Nikoubashman Omid
Published: May 2019

Background and purpose

Despite numerous optimization attempts, time delays are still a relevant problem in endovascular stroke treatment. We hypothesized that public display of the fastest procedural times in our institution would raise awareness, which would result in improved procedural times.

Methods

We established a competition, which lasted 6 months, in which the fastest neurovascular team in terms of procedural times (image to reperfusion) was displayed on a public board in our institution and rewarded with public praise. During this time no other relevant procedural or infrastructural means for improvement of procedural times were introduced in our institution. We prospectively evaluated procedural times in 496 patients who received endovascular stroke treatment 9 months before the competition, during the competition, and during the four 6-month time periods for 2 years after the competition.

Results

Median image-to-reperfusion times improved significantly from 98 min before the competition to 85 min during the competition (p=0.005) and remained stable with a median of 81 min 2 years after the competition (p=0.837).

Conclusion

We were able to improve our procedural times significantly with a simple and cost-efficient competition. This effect was sustained 2 years after the competition was completed, implying that the improvement in procedural times was probably due to raised awareness.
Performance of a clinical/proteomic panel to predict obstructive peripheral artery disease in patients with and without diabetes mellitus
Authors: McCarthy Cian P , Shrestha Shreya , Ibrahim Nasrien , van Kimmenade Roland R J , Gaggin Hanna K , Mukai Renata , Magaret Craig , Barnes Grady , Rhyne Rhonda , Garasic Joseph M , Januzzi James L
Published: May 2019

Background

Patients with diabetes mellitus (DM) are at substantial risk of developing peripheral artery disease (PAD). We recently developed a clinical/proteomic panel to predict obstructive PAD. In this study, we compare the accuracy of this panel for the diagnosis of PAD in patients with and without DM.

Methods and results

The HART PAD panel consists of one clinical variable (history of hypertension) and concentrations of six biomarkers (midkine, kidney injury molecule-1, interleukin-23, follicle-stimulating hormone, angiopoietin-1 and eotaxin-1). In a prospective cohort of 354 patients undergoing peripheral and/or coronary angiography, performance of this diagnostic panel to detect ≥50% stenosis in at least one peripheral vessel was assessed in patients with (n=94) and without DM (n=260). The model had an area under the receiver operating characteristic curve (AUC) of 0.85 for obstructive PAD. At optimal cut-off, the model had 84% sensitivity, 75% specificity, positive predictive value (PPV) of 84% and negative predictive value (NPV) of 75% for detection of PAD among patients with DM, similar as in those without DM. In those with DM, partitioning the model into five levels resulted in a PPV of 95% and NPV of 100% in the highest and lowest levels, respectively. Abnormal scores were associated with a shorter time to revascularisation during 4.3 years of follow-up.

Conclusion

A clinical/biomarker model can predict with high accuracy the presence of PAD among patients with DM.

Trial registration number

NCT00842868.
A note on superluminosity
Authors: Sidharth B. G. , Das Abhishek
Published: May 2019

In this short paper, we comment on the possibility of superluminal velocities and present–future correlations with reference to a paper recently published.
Hilbert schemes, Verma modules and spectral functions of hyperbolic geometry with application to quantum invariants
Authors: Bytsenko A. A. , Chaichian M. , Gonçalves A. E.
Published: May 2019

In this paper we exploit Ruelle-type spectral functions and analyze the Verma module over Virasoro algebra, boson–fermion correspondence, the analytic torsion, the Chern–Simons and [Formula: see text] invariants, as well as the generating function associated to dimensions of the Hochschild homology of the crossed product [Formula: see text] ([Formula: see text] is the [Formula: see text]-Weyl algebra). After analyzing the Chern–Simons and [Formula: see text] invariants of Dirac operators by using irreducible [Formula: see text]-flat connections on locally symmetric manifolds of nonpositive section curvature, we describe the exponential action for the Chern–Simons theory.
Quantum corrections to thermodynamics of BTZ black hole
Authors: Nadeem-ul-islam  , Ganai Prince A.
Published: May 2019

The motivation behind this study is to enumerate the leading order corrections to the thermodynamics of BTZ black hole (named after three scientists; Banados, Teitelboim, and Zanelli). We first analyze the effect of quantum corrections (motivated from string theory and loop quantum gravity) on various thermodynamic variables for uncharged and stationary BTZ black hole. We, later on, endow charges and rotations to the same black hole and rederive all the expressions once again. The comparative analysis is done between the corrected and uncorrected thermodynamics via plots.
Research on Correlation Between Underground Squares’ Interface Morphology and Spatial Experience Based on Virtual Reality
Authors: Sun Liang , Feng Le , Zhang Yiyun , Ji Xiang , Wong Han , Wei Zhibin
Published: May 2019

Underground square, as a recreation and activity place for citizens, represents the underground space quality of a city, so its spatial experience is of great significance. This research discussed the influence and effects of underground squares’ interface morphology on spatial experience. By field research of ten large-scale urban underground spaces, the basic elements and related numerical interval of underground squares’ interface morphology were summarized, and on basis of this, underground square virtual models with different interface morphology were built. Based on the platform of immersive virtual reality system (IVRS), combing the isovist method and the SD method, this paper made a quantitative analysis on the relevance between interface morphology and spatial experience, and the relevant compliance indicators of interface morphology were summarized. The experimental results show that the spatial experience is good at the interface density of 0.402 and interface opening’s aspect ratio of 2–3. This can provide reference and foundation for urban underground spatial design in future.
Generating High-Quality Air-Coupled Ultrasonic Images for Wooden Material Characterization by Single Image Super-Resolution
Authors: Lin Lujun , Fang Yiming , Du Xiaochen , Zhou Zhu
Published: May 2019

As the practical applications in other fields, high-resolution images are usually expected to provide a more accurate assessment for the air-coupled ultrasonic (ACU) characterization of wooden materials. This paper investigated the feasibility of applying single image super-resolution (SISR) methods to recover high-quality ACU images from the raw observations that were constructed directly by the on-the-shelf ACU scanners. Four state-of-the-art SISR methods were applied to the low-resolution ACU images of wood products. The reconstructed images were evaluated by visual assessment and objective image quality metrics, including peak signal-to-noise-ratio and structural similarity. Both qualitative and quantitative evaluations indicated that the substantial improvement of image quality can be yielded. The results of the experiments demonstrated the superior performance and high reproducibility of the method for generating high-quality ACU images. Sparse coding based super-resolution and super-resolution convolutional neural network (SRCNN) significantly outperformed other algorithms. SRCNN has the potential to act as an effective tool to generate higher resolution ACU images due to its flexibility.
LOWER TYPE DIMENSIONS OF SOME MORAN SETS
Authors: YANG JIAOJIAO
Published: May 2019

In this paper, we discuss the lower type dimensions for some Moran sets. On one hand, for Moran set [Formula: see text] with [Formula: see text], we prove that [Formula: see text], where the supremum is taken over all quasi-Lipschitz mappings [Formula: see text]. On the other hand, we obtain the lower spectrum formula for homogeneous Moran sets. In the proof a lower spectrum formula for a large class of fractal sets is established.
A REVISIT TO α-FRACTAL FUNCTION AND BOX DIMENSION OF ITS GRAPH
Authors: VERMA S. , VISWANATHAN P.
Published: May 2019

One of the tools offered by fractal geometry is fractal interpolation, which forms a basis for the constructive approximation theory for nondifferentiable functions. The notion of fractal interpolation function can be used to obtain a wide spectrum of self-referential functions associated to a prescribed continuous function on a compact interval in [Formula: see text]. These fractal maps, the so-called [Formula: see text]-fractal functions, are defined by means of suitable iterated function system which involves some parameters. Building on the literature related to the notion of [Formula: see text]-fractal functions, the current study targets to record the continuous dependence of the [Formula: see text]-fractal function on parameters involved in its definition. Furthermore, the paper attempts to study the box dimension of the graph of the [Formula: see text]-fractal function.
DISTINGUISHING BETWEEN SIERPINSKI TRIANGLE CONSTRUCTIONS
Authors: ETTESTAD DAVID , CARBONARA JOAQUIN
Published: May 2019

There are several methods given for constructing the Sierpinski Triangle (ST). In particular, the ST can be created as a countably infinite intersection of contained figures, or as the countably infinite union of triangles. At first glance they both appear to create the same object. In this paper, we show that they are not the same. In addition, we analyze and compare with the previous two methods, a third method of constructing the ST which entails generating a countable number of points using an algorithm.
Three-Dimensional Mechanical Modeling of Magnet-Controlled Transfer Printing
Authors: Zhang Xiaofei , Linghu Changhong , Song Jizhou
Published: May 2019

The recently developed magnet-controlled transfer printing is valuable to develop advanced engineering systems due to its ability to tune the interfacial adhesion strength continuously and rapidly. A three-dimensional analytical model based on the energy method is developed for the magnet-controlled transfer printing. The predicted interfacial adhesion strengths agree well with experiments. A scaling law is established for the normalized interfacial adhesion strength, which depends on only four non-dimensional parameters: the normalized stamp size, the normalized stamp height, the normalized work of adhesion, and the normalized magnetic pressure. The influences of the non-dimensional parameters on the adhesion strength are fully investigated. This study provides a theory to guide the design of stamp and selection of the magnetic pressure to enable a successful magnet-controlled transfer printing.
Nonlinear Thermo-Mechanical Stability Analysis of Eccentrically Spiral Stiffened Sandwich Functionally Graded Cylindrical Shells Subjected to External Pressure
Authors: Nam Vu Hoai , Phuong Nguyen Thi , Doan Cao Van , Trung Nguyen Thoi
Published: May 2019

A new analytical approach to investigate the nonlinear buckling and postbuckling of the sandwich functionally graded circular cylindrical shells reinforced by ring and stringer or spiral stiffeners subjected to external pressure is presented in this paper. By employing the Donnell shell theory, the geometrical nonlinearity in Von Kármán sense and developed Lekhnitskii’s smeared stiffener technique, the governing equations of sandwich functionally graded circular cylindrical shells are derived. Resulting equations are solved by applying the Galerkin method to obtain the explicit expression of critical buckling external pressure load and postbuckling load–deflection curve. Effects of spiral stiffeners, thermal environment, external pressure, and geometrical parameters on nonlinear buckling behavior of sandwich functionally graded circular cylindrical shells are shown in numerical results.
Asymmetrically Dynamic Coupling Hysteresis in Piezoelectric Actuators: Modeling Identification and Experimental Assessments
Authors: Zhang Zijian , Dong Yangyang
Published: May 2019

An asymmetrically dynamic coupling hysteresis (ADCH) model is proposed as an extension of the Prandtl–Ishlinskii (PI) model to characterize the hysteretic nonlinearities in piezoelectric actuators (PEAs). When subject to two-input: dynamic excitation and external loads. In this model, the developed asymmetrically one-side play operator helps to represent the saturation, nonlinearity, and centrally asymmetric properties of PEAs employed inverse hyperbolic envelope functions. The dynamic threshold functions are put in place to characterize the width of rate-dependent hysteresis property. Introductions of continuously coupled density functions are beneficial to the cross-coupled hysteresis behaviors of external load/excitation voltage-to-expansion. Besides, the proposed ADCH model is verified to satisfy indeed the wiping-out property and equal vertical chords property, which means that it can be regarded as well-suited in modeling the complicated hysteresis nonlinearity of PEAs. Furthermore, this paper also tackles the identification issue of the proposed ADCH model by using a global research method, which possesses satisfactory accuracy without strict requirements for the initially iterative value.
A Conversation with Theda Skocpol
Authors: Skocpol Theda , Schickler Eric
Published: May 2019

An interview with Theda Skocpol took place at Harvard University in December 2017. Professor Skocpol is the Victor S. Thomas Professor of Government and Sociology at Harvard University. Skocpol is the author of numerous books and articles well known in political science and beyond, including States and Social Revolutions, Protecting Soldiers and Mothers, Diminished Democracy: From Membership to Management in American Civic Life, and The Tea Party and the Remaking of Republican Conservatism (the latter coauthored with Vanessa Williamson). Skocpol has served as President of the American Political Science Association and the Social Science History Association. Among her honors, she is an elected member of the American Academy of Arts and Sciences, the American Philosophical Society, and the National Academy of Sciences, and she was awarded the Johan Skytte Prize in Political Science. She was interviewed by Eric Schickler, the Jeffrey & Ashley McDermott Professor of Political Science at the University of California, Berkeley. The following is an edited transcript; a video of the entire interview can be viewed at https://www.annualreviews.org/r/theda-skocpol .
Partisan Bias in Surveys
Authors: Bullock John G. , Lenz Gabriel
Published: May 2019

If citizens are to hold politicians accountable for their performance, they probably must have some sense of the relevant facts, such as whether the economy is growing. In surveys, Democrats and Republicans often claim to hold different beliefs about these facts, which raises normative concerns. However, it is not clear that their divergent survey responses reflect actual divergence of beliefs. In this review, we conclude that partisan divergence in survey responses is often not due to sincere, considered differences of belief that fall along party lines—but determining what it is due to is difficult. We review the evidence for possible explanations, especially insincere responding and congenial inference. Research in this area is still nascent, and much more will be required before we can speak with precision about the causes of partisan divergence in responses to factual questions.
Effects of an Applied Load on the Chloride Penetration of Concrete with Recycled Aggregates and Recycled Powder
Authors: Ma Zhiming , Duan Zhenhua , Ba Guangzhong
Published: May 2019

Recycled aggregate (RA) and recycled powder (RP) are the primary products of the reclamation of construction and demolition (C&D) wastes, and the question of how to use them to prepare recycled aggregate concrete (RAC) and recycled powder concrete (RPC) has been a hot topic in the construction industry in China. As concrete structures are frequently subjected to the effects of both applied loads and chloride attacks, it is necessary to examine their effects on both RAC and RPC, which have received little consideration in previous investigations. In this study, RAC and RPC were firstly prepared by using RA and RP, respectively, to replace natural coarse aggregate and cement by weight. For each type of recycled concrete, sustained load and repeated load tests were then conducted, followed by a chloride diffusion experiment after unloading. The results indicated that the chloride penetration increased with the loading degree as well as the repeated load cycles. As the RP used in this study has high fineness and activity, the chloride penetration of RPC was lower than that of natural concrete, while the opposite result was found in RAC. Besides, the correlation between the chloride diffusivity and the imposed loading damage was also established in this study.
Giant Vulvar Condylomata: Two Cases and a Review of the Literature
Authors: Gungor Ugurlucan Funda , Yasa Cenk , Demir Omer , Dural Ozlem , Yavuz Ekrem , Akhan Suleyman Engin
Published: May 2019

Introduction. Giant vulvar condyloma is usually associated with the HPV subtypes 6 and 11 and is characterized by excessive growth of verrucous lesions on the genitals and/or perianal region. It may be observed in sexually inactive as well as sexually active women. Immunosuppression plays an important role in the development of the disease. Patients and Methods. We report two cases of giant vulvar condyloma together with the review of the literature. Results. One case was a 21-year old sexually inactive woman with a history of Type 1 Diabetes. Second case was a 20-year-old sexually active woman with a rapidly progressing disease and cervical dysplasia. Both cases were operated; all the condylomatous structures were resected with preservation of the anatomy and clitoral innervation and blood flow. Skin and subcuticular dehiscence was the only complication encountered in the first case. Conclusion. Main treatment of giant vulvar condyloma is surgical resection with maintenance of the vulvar anatomy. Preservation of especially the clitoral innervation as much as possible is very important.