bluuebunny/crossref_metadata_2025 huggingface dataset:
A Radix-16 Booth Multiplier Based on Recoding Adder with Ultra High Power Efficiency and Reduced Complexity for Neuroimaging
Authors: Sureshbabu J. , Saravanakumar G.
Published: January 2020

In the current medical developments the neuro imaging plays a vital role in the study of a human brain related disorders. The accuracy of the brain study is mainly dependent on the images created from the scanners at a rapid speed. In achieving this we need a high speed and low power
consuming scanners. The current scenario in VLSI design, the scanners highly rely on a high speed Digital Signal Processor (DSP), which generally depends on the speed of a multiplier. Multipliers are considered as a more complex component when compared with adders. The current techniques provide
greater access to high-speed multipliers which are designed with less area that consume low power. The major constraints to be considered for an efficient multiplier design are propagation time delay and power dissipation, especially during the ideal time. An approximate recoding adder is
proposed to reduce the existing booth multiplier's immensity. It increases the accuracy and reduces complexity through this technique; however, it has an issue with Power Delay Product (PDP) and power dissipation. To solve this problem, the proposed system is designed with a power gating based
16 × 16 bit Booth multiplier based on approximate recoding adder. It decreases the power dissipation and minimizes the length and width of the partial products for speeding up the multiplication process. The results obtained from the simulation show that the designed power gating based
Radix multiplier circuits achieves better PDP, average power and area. The achieved results are compared with a Radix based multiplier, power gating CLA based multiplier and CLA based multiplier.
Research on Applying Musculoskeletal Ultrasound Technology to Real-Time Medical Diagnosis of Sports Injuries
Authors: Tang Lixia
Published: January 2020

The objective of the paper is to explore the application of musculoskeletal ultrasound technology to a real-time medical diagnosis of sports injuries. The Color Doppler Ultrasound Diagnosis Instrument was applied to inspect the injured parts of the athletes. The athletes were classified
and diagnosed from the perspectives of bones, joints, muscles, tendons, ligaments, skin, and subcutaneous tissues. The proportions of tendon injuries and ligament injuries were higher, which were 41% and 34% respectively, while the proportions of bone injuries and joint injuries were lower.
In general, knee injuries of athletes occupied 71.3%, while the ankle injuries occupied 22.5%. The results showed that the musculoskeletal ultrasound technology could obtain the injuries accurately and instantly in real-time, which helped the doctor make correct diagnosis and improved the
speed of the next step of rehabilitation treatments given by physicians, proving the superior function of musculoskeletal ultrasound technology in sports injuries and the high value of application in sports events.
Research on the Effect of Repairing Anterior Teeth with All-Ceramic Veneer Based on CT Images
Authors: Liu Shuang , Yan Hui , Gao Yuehang
Published: January 2020

IPS e.maxPress all-ceramic materials have good physical and chemical properties, biocompatibility, light transmission similar to natural teeth and excellent aesthetic properties, so they are widely used in clinical practice. In this study, the anterior porcelain veneer was made by using
IPS e.maxPress hot-pressed casting ceramic under the guidance of DSD software aesthetic design, and its clinical aesthetic repair effect and success rate were evaluated, which provided a useful reference for clinical aesthetic restoration work. The original data was obtained by using the medical
image method; the DICOM data obtained by CT scanning was input into the reverse engineering software for image processing and data optimization by using the reverse technique to obtain the real tooth and mandible model. The 3D modeling software is used to establish the implant model and the
associated tissue model, and the assembly is completed. The finite element software is introduced, the contact type between the tissues is set, and the clinical simulation results are compared to analyze the simulation results. Practice provides a better surgical solution.
Study on Sensitivity and Accuracy of Diagnosis of Intracranial Aneurysms Based on 256-Slice Spiral CT Angiography
Authors: Wang Weiping , Niu Simei , Meng Xiangfu , Li Youjie
Published: January 2020

Objective: To investigate the value of 256-slice spiral CT angiography in the diagnosis and postoperative evaluation of patients with intracranial aneurysms. Methods: A total of 62 patients with intracranial aneurysms diagnosed by neurosurgery in our hospital were randomly
collected from 2017.03–2018.11. The MSCTA was performed by labeling intravenous non-ionic contrast agent (iodosyls alcohol). The obtained image was imageprocessed at Sun's stand-alone workstation (Philip256iCT). Observe the position, shape, size of the aneurysm, the relationship between
the neck and the artery and the structure of the skull base, and compare with the intraoperative findings to understand the anastomosis between the preoperative and intraoperative. Postoperatively, 28 cases were reviewed, and the surgical results, the patency of the arterial artery, and the
presence or absence of aneurysm residual were confirmed. Results: Sixty-two patients with intracranial aneurysms were diagnosed with MSCTA and DSA. A total of 66 aneurysms and multiple aneurysms were found. Of these, 32 patients underwent direct operative MSCTA and 43 underwent craniotomy.
Endovascular interventional therapy. The location, shape, size, relationship between the neck and the parental artery of the aneurysm and the DSA performance were basically consistent with MSCTA. No false positive results were found. Postoperative examination of MSCTA in 28 cases, all developed
well, the arterial artery was well patency, no residual aneurysm was seen. Conclusion: MSCTA can accurately display the location, shape and size of the aneurysm, the relationship between the neck and the artery and the structure of the skull base. It can be used as an important tool
for clinical diagnosis and treatment of aneurysm imaging. An important method for post-review and follow-up.
Twenty-First-Century Climate Change Hot Spots in the Light of a Weakening Sun
Authors: Spiegl Tobias , Langematz Ulrike
Published: January 2020

Satellite measurements over the last three decades show a gradual decrease in solar output, which can be indicative as a precursor to a modern grand solar minimum (GSM). Using a chemistry–climate model, this study investigates the potential of two GSM scenarios with different magnitude to counteract the climate change by projected anthropogenic greenhouse gas (GHG) emissions through the twenty-first century. To identify regions showing enhanced vulnerability to climate change (hot spots) and to estimate their response to a possible modern GSM, a multidimensional metric is applied that accounts for—in addition to changes in mean quantities—seasonal changes in the variability and occurrence of extreme events. We find that a future GSM in the middle of the twenty-first century would temporarily mitigate the global mean impact of anthropogenic climate change by 10%–23% depending on the GSM scenario. A future GSM would, however, not be able to stop anthropogenic global warming. For the GHG-only scenario, our hot-spot analysis suggests that the midlatitudes show a response to rising GHGs below global average, while in the tropics, climate change hot spots with more frequent extreme hot seasons will develop during the twenty-first century. A GSM would reduce the climate change warming in all regions. The GHG-induced warming in Arctic winter would be dampened in a GSM due to the impact of reduced solar irradiance on Arctic sea ice. However, even an extreme GSM could only mitigate a fraction of the tropical hot-spot pattern (up to 24%) in the long term.
A Subjective and Objective Evaluation of Model Forecasts of Sumatra Squall Events
Authors: Sun Xiangming , Huang Xiang-Yu , Gordon Chris , Mittermaier Marion , Beckett Rebecca , Cheong Wee Kiong , Barker Dale , North Rachel , Semple Allison
Published: January 2020

Sumatra squalls are important rain-bearing weather systems that affect Singapore and southern Peninsular Malaysia. The performance of forecasts for 63 past squall events is evaluated using a subjective evaluation by forecasters and an objective evaluation based on the fractions skill score (FSS). The purpose of this study is to investigate whether an objective procedure can reproduce the main results of the subjective evaluation. A convection permitting version of the Met Office (UKMO) Unified Model (UM), configured for a limited domain in the southern region of the South China Sea, is used with two driving global deterministic models: the UM and the European Centre for Medium-Range Weather Forecasts (ECMWF) model. Subjective and objective evaluation scoring methods for the two limited-area forecasts of the UM are compared, and it is shown that the objective procedure can reasonably emulate the scores produced by the forecasters in the context of parameters that are of direct relevance to the forecast process. This indicates that automated objective verification methods may be a reasonable alternative to resource intensive subjective evaluations for some cases. The robustness of the objective results is investigated using 7 months of data, and issues of statistical significance are considered.
Substance Use Among Adolescents and Young Adults With Type 1 Diabetes: Discussions in Routine Diabetes Care
Authors: Bento Samantha P. , Campbell MaryJane S. , Soutullo Olivia , Cogen Fran R. , Monaghan Maureen
Published: January 2020

Pediatric health care providers are in a unique position to discuss the health implications of alcohol, tobacco, and drug use with adolescents and young adults (AYAs) with type 1 diabetes (T1D). This study evaluated the frequency of self-reported substance use and associated demographic and clinical characteristics in a sample of AYAs with T1D and patient-provider discussions of substance use in T1D care. Sixty-four AYAs completed questions about substance use from the Youth Risk Behavior Survey (YRBS). Corresponding diabetes clinic visits were audio-recorded, transcribed, and reviewed to examine substance use discussions. A total of 56.3% of AYAs reported ever engaging in substance use; 40.6% reported substance use within the past 30 days. Five AYAs had discussions about substance use during their most recent diabetes clinic visit. Substance use should be proactively addressed by pediatric health care providers and AYAs should be encouraged to raise questions related to substance use during clinic visits.
Adapting Pediatric Medical Homes for Youth in Foster Care: Extensions of the American Academy of Pediatrics Guidelines
Authors: Espeleta Hannah C. , Bakula Dana M. , Sharkey Christina M. , Reinink Jennifer , Cherry Amanda , Lees Julie , Shropshire Deborah , Mullins Larry L. , Gillaspy Stephen R.
Published: January 2020

This article provides recommendations for adapting the pediatric medical home (PMH) model for health care needs of youth in foster care. Recommendations are based on key informant interviews regarding experiences at an established PMH for youth in foster care. Major clinic recommendations include expanding the PMH framework to include proficiency in Medicaid billing, promoting true interdisciplinary care teams, improving care accessibility via phone consultation, providing a stable place for medical records to be housed, delivering services throughout stages of the child welfare case, incorporating all family members, and implementing trauma-informed practice. Preliminary evidence suggests that the PMH model of care may be ideal for addressing the complex and often underserved needs of youth in foster care and their families. The present recommendations provide a logistical framework for establishing a clinic that thoughtfully considers the unique needs of this population. Future research is needed to examine best practices for implementation.
Proximity of Gun Stores to High Schools and Student Gun Carrying
Authors: Zhang Gary , Nakamoto Jonathan , Wendt Staci
Published: January 2020

Although research has examined various correlates of weapon and gun carrying at school and among adolescents, it has yet to consider the relationship between gun stores around schools and the carrying of guns at school. This study uses data from the 2015–2016 California Healthy Kids Survey, the California Department of Education, and geocoded data on public high schools and gun stores in Orange County, California, to examine the association between proximity of gun stores to schools and the carrying of guns by high school students. Using geographic information system analysis and hierarchical logistic regression, results indicate that the proximity of gun stores to schools is significantly associated with self-reported gun carrying at school. Implications for policy and practice are discussed.
A Rare Case of Dapsone Hypersensitivity Syndrome and Leukemoid Reaction With Coexisting Hepatitis E in a Pediatric Patient
Authors: Babu Tirin , Panachiyil George Mathew , Ramesh Sneha , Vasudev Prajwala Hassan , Ravi Mandyam Dhati , Chandrashekhar Channanayaka
Published: January 2020

Dapsone is extensively used for a variety of infectious, immunological, and hypersensitivity disorders. Dapsone can cause several adverse effects, the most serious being dapsone hypersensitivity syndrome (DHS), which is potentially fatal. DHS is characterized by triad of eruptions, fever, and organ involvement (including liver, kidney, hematological system, etc.). DHS can develop several weeks to as late as 6 months after treatment initiation with dapsone. Here, we report a case of DHS and leukemoid reaction with coexisting hepatitis E in a 10-year-old girl. Three weeks prior to the current admission, she was treated with dapsone (1 mg/kg/day in two divided doses) for 8 days by a local doctor for lichen nitidus. She was managed successfully for DHS with intravenous (IV) steroids followed by the oral steroid. This case is being reported to highlight the importance to ensure timely diagnosis of DHS and its appropriate management. Patients started on dapsone for various clinical conditions need to be observed carefully for the development of the DHS. If this occurs, DHS can be mistaken for the progression of the primary disease. If dapsone is not withdrawn, it could have deleterious and potentially fatal effects due to major organ dysfunction.
Static, Dynamic, and Cognitive Fit of Exosystems for the Human Operator
Authors: Stirling Leia , Kelty-Stephen Damian , Fineman Richard , Jones Monica L. H. , Daniel Park Byoung-Keon , Reed Matthew P. , Parham Joseph , Choi Hyeg Joo
Published: January 2020

Objective

To define static, dynamic, and cognitive fit and their interactions as they pertain to exosystems and to document open research needs in using these fit characteristics to inform exosystem design.

Background

Initial exosystem sizing and fit evaluations are currently based on scalar anthropometric dimensions and subjective assessments. As fit depends on ongoing interactions related to task setting and user, attempts to tailor equipment have limitations when optimizing for this limited fit definition.

Method

A targeted literature review was conducted to inform a conceptual framework defining three characteristics of exosystem fit: static, dynamic, and cognitive. Details are provided on the importance of differentiating fit characteristics for developing exosystems.

Results

Static fit considers alignment between human and equipment and requires understanding anthropometric characteristics of target users and geometric equipment features. Dynamic fit assesses how the human and equipment move and interact with each other, with a focus on the relative alignment between the two systems. Cognitive fit considers the stages of human-information processing, including somatosensation, executive function, and motor selection. Human cognitive capabilities should remain available to process task- and stimulus-related information in the presence of an exosystem. Dynamic and cognitive fit are operationalized in a task-specific manner, while static fit can be considered for predefined postures.

Conclusion

A deeper understanding of how an exosystem fits an individual is needed to ensure good human–system performance. Development of methods for evaluating different fit characteristics is necessary.

Application

Methods are presented to inform exosystem evaluation across physical and cognitive characteristics.
Improving the performance of silicon solar cell by optimizing metallization
Authors: Sangi Abdur Rashid , Qayoom Abdul , Qadir Abdul , Abdalla Ahmed N , Ali Rehan
Published: January 2020

Solar energy exploitation through photovoltaic technology has demonstrated a sustainable way for curbing energy needs and cutting environmental issues happening due to emissions of carbon dioxide, CO2 from the usage of non-renewable energy resources. The purpose of this study was to reduce metallization by choosing optimal metallization on silicon photovoltaic wafer. Using numerical study, the effects of the number of busbars, fingers, and soldering/probe points were analyzed and also the study of the size of busbar and finger was carried out to find the optimal value for each which assures better performance. It is revealed that increasing the number and size of busbars, fingers, and probe points result in increasing fill factor, however, the efficiency of the device is limited to a number which provides the best optimal performance in terms of efficiency, whereas increasing the size (width) of the parameter result in a decrease in efficiency increasing shading factor. The optimal value of prescribed parameters was recorded as 4, 82, and 20 numbers of busbars, fingers, and probe points, respectively, while an optimal value of the width of busbar and finger is found as 0.5 mm and 60 µm, respectively. These values attained efficiency and fill factor above 20% and 80%, respectively. This study finds a realistic method to further diminish the metallization, improve the performance, and reduce the cost of often used industrial silicon photovoltaic cells.
A fuzzy neural network model to determine axial strain measured by a long-period fiber grating sensor
Authors: Hu Xingliu , Si Haifei , Shen Hao , Yu Zhenzhong
Published: January 2020

The paper reports an adaptive-network-based fuzzy inference system for the measurement of axial strain using long-period fiber grating sensors. The long-period fiber grating sensor supports optical resonances, which are sensitive to the change of axial strain. The axial strain can be quantified based on the wavelength shift and amplitude changes of the optical resonance. To improve the accuracy of axial strain quantification, this paper proposes the adaptive-network-based fuzzy inference system model. The adaptive-network-based fuzzy inference system model is trained using the strain data measured with long-period fiber grating sensors. The parameters of the membership functions used in the adaptive-network-based fuzzy inference system are set adaptively. In the adaptive-network-based fuzzy inference system–based method, the maximum relative error was found to be 1.5%, which is about one-ninth of that when the data fitting method was used. The R-squared statistics using the adaptive-network-based fuzzy inference system model is 0.9872, while that using the linear fitting algorithm is 0.8815. Compared with the conventional data fitting methods, the proposed approach is highly adaptive and versatile with the capability of improving the accuracy of strain quantification.
Interactions between institutional logics and cultural dynamics in the public–private integration process
Authors: Thelisson Anne-Sophie , Meier Olivier
Published: January 2020

This article underlines the specificities of public–private mergers by presenting the interactions between the institutional logics at stake and the cultural dynamics during the integration process of a public–private merger. The article presents a longitudinal case study of a public–private merger of two listed French companies over two years. Our study completes and enriches Schultz’s model by showing its dynamic nature and highlighting the crucial role of the state as a trigger for the interactions between institutional logics and cultural dynamics.

Points for practitioners

By highlighting the interactions between cultural dynamics and institutional logics, we trace how cultural dynamics influence the decision-making process and how institutional logics influence integration by becoming dominant. We demonstrate how the state influences the interactions between these forces during the integration process.
Socio-Economic Impacts of 1918–19 Influenza Epidemic in Punjab
Authors: Ojo Olusola Bamidele
Published: January 2020

The 1918–19 influenza epidemic arguably remains the worst natural disaster in the annals of colonial India. The scourge of the 1918–19 influenza in Punjab eclipsed the significant malaria epidemics of 1908 and the Bubonic plague catastrophe of the first decade of the 20th century. Over 800,000 people died from the outbreak between October and November 1918. This article examines the social and economic impacts of the 1918–19 influenza outbreak in Punjab. It argues that the scarcity of everyday food items as well as an escalation in the prices of staple foodstuffs were direct consequences of the epidemic. This study discovered that massive influenza mortalities triggered severe disruptions in the agricultural activities and public services in Punjab. Other studies had focused mainly on the spread and mortality of the epidemic in the public domains of colonial India. However, this study illuminates the socio-economic effects of an outbreak from a regional perspective. A focus on Punjab, the colonial capital of Northern India, affords us a rare privilege to gauge how epidemics influence the socio-economic spaces on a provincial basis.
Examining Contextual Differences in Participant Characteristics and During-Program Occurrences With Drug Court Program Completion
Authors: Shannon Lisa M. , Jones Afton Jackson , Newell Jennifer , Nash Shondrah , Nichols Elizabeth
Published: January 2020

The study purpose was to compare individuals participating in rural and urban drug courts to examine factors associated with program completion. Secondary data (participant assessment; drug court Management Information System) as well as conviction information from a statewide database were examined for a sample of drug court participants ( N = 534). Based on multivariate analysis, for rural participants, two variables were significantly associated with increased program completion: age and outpatient treatment. Conversely, for rural participants, the number of felony/misdemeanor convictions before drug court and receiving an incarceration sanction during drug court were associated with program non-completion. For urban participants, gender and age were associated with increased odds of completion, whereas marital status, education, and past 30-day cocaine use were associated with program non-completion. Findings suggest contextual differences in participant characteristics and during-program occurrences, which ultimately influenced program completion. Understanding contextual factors has important implications for program planning and implementation.
Tribal Development Disparities in Odisha: An Empirical Analysis
Authors: Dungdung Kiran , Pattanaik B. K.
Published: January 2020

The well-known phenomenon of tribal disadvantage in India requires constant monitoring to ensure diligent attention to equitable protection of tribal people’s right to life. This article, based on an analysis of primary data collected from 400 households in eight different tribal communities in Odisha, charts the differential progress of Odisha tribals by establishing a Tribal Development Index. Such data identify significant development disparities and confirm the existence of a ‘creamy layer’, constituted of more developed individuals and families also among India’s tribals. While many households in these eight communities still lack basic amenities, notable differences regarding food security, landholding, income and overall development were identified, supporting arguments for devising more sophisticated differential forms of intervention.
Central nervous system variations and abnormalities in anhidrotic ectodermal dysplasia (AED): neuroimaging findings
Authors: Dusak Abdurrahim , Hafizoglu Demet , Kilic Sara Sebnem , Yazıcı Zeynep
Published: January 2020

Background

Anhidrotic ectodermal dysplasia (AED) is a rare, mostly X-linked recessive genodermatosis, characterized by congenital defects of ectodermal derivative structures as the central nervous system (CNS) is primarily ectodermal in origin.

Purpose

To evaluate CNS variations and abnormalities in AED.

Material and Methods

A retrospective analysis was made of the neurological and neuroimaging findings of 17 children (12 boys, 5 girls; median age = 8 years; age range = 2–14 years) diagnosed with AED in our pediatric clinics during 2008–2016. The pattern of CNS variation and abnormalities were evaluated by comparing of these findings with an age- and gender-matched healthy control group with no family history.

Results

Of the 17 AED cases identified on the basis of neuroimaging findings, 6 (35.3%) were seen to be normal. Associated CNS variation and abnormalities including cavum septum pellucidum (35.3%), callosal dysgenesis (11.8%), prominent Virchow–Robin spaces (64.7%), cortical sulcal dilation (41.1%), mega cisterna magna (35.3%), focal cortical dysplasia (11.8%), and delayed myelination (58.8%) were observed in 11 (64.7%) children with AED.

Conclusion

AED suggests a spectrum of CNS variation and abnormalities, presenting with neurological and neuroimaging findings, demonstrated in the embryonic surface- and neuro-ectoderm derived structures. The results of this study suggest that CNS variation and abnormalities might be associated with AED.
Aquaporin-2 expression in the kidney and urine is elevated in rats with monocrotaline-induced pulmonary heart disease
Authors: Ouyang Shao , Chen Wei , Zeng Gaofeng , Lei Changcheng
Published: January 2020

Objective

Little is known about how renal aquaporin-2 (AQP2) expression is affected by right heart failure caused by pulmonary heart disease (PHD). Therefore, we examined the expression of AQP2 in a rat model of PHD induced by monocrotaline (MCT).

Methods

After 4 weeks of treatment, urine and blood samples were collected from sham-treated and MCT-treated rats. Plasma arginine vasopressin (AVP) levels were measured by radioimmunoassay, and kidney Aqp2 mRNA expression was detected by reverse transcription (RT)-PCR. Kidney AQP2 protein expression was quantified by immunohistochemistry and western blotting assays. The concentration of urine AQP2 was determined by indirect enzyme-linked immunosorbent assay.

Results

We successfully established an animal model of MCT-induced PHD in rats. MCT-treated rats had significantly higher mRNA and protein levels of AQP2 in their kidney tissue. Following MCT treatment, rats also had markedly increased concentrations of both urine AQP2 and plasma AVP.

Conclusions

AQP2 expression was significantly increased in the kidney tissues and urine of rats with PHD induced by MCT. Our findings suggest that the evaluation of AQP2 expression contributes to an early diagnosis of PHD, and may also be an important reference to improve PHD therapeutics.
Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association
Authors: Green Daniel W. , Sidharthan Sreetha , Schlichte Lindsay M. , Aitchison Alexandra H. , Mintz Douglas N.
Published: January 2020

Background:

Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tubercle caused by repetitive strain and chronic avulsion from the patellar tendon. No widely accepted anatomic risk factors have been associated with OSD.

Purpose:

To determine if OSD is associated with increased posterior tibial slope (PTS).

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Forty knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients 10 to 15 years of age with a clinical diagnosis of OSD and available lateral radiograph and magnetic resonance imaging (MRI) were eligible. Age- and sex-matched patients with a history of knee pain but no evidence of OSD on clinical examination and without significant pathology on lateral radiograph and MRI were included in the control group. PTS was defined as the angle between a reference line perpendicular to the proximal anatomic axis and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral radiographs by 2 blinded investigators. Interrater reliability of PTS measurements was evaluated using intraclass correlation coefficient (ICC). The independent samples t test was used to compare PTS between the OSD and control knees.

Results:

The mean age was 12.6 ± 1.6 years and 51% (37/72) of the knees were from male youth. There were no differences in age, sex, and laterality of knees between the OSD and control groups. The mean PTS was significantly higher in the OSD group (12.23°± 3.58°) compared with the control group (8.82°± 2.76°; P < .001). The ICC was 0.931 (95% CI, 0.890-0.957), indicating almost perfect interrater reliability.

Conclusion:

This study identifies an association between OSD and increased PTS. The clinical implications of this finding have not yet been elucidated. It may be speculated that in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS.
Pulmonary artery pressure may be a predictor of closed aortic valve in patients managed by venoarterial extracorporeal membrane oxygenation
Authors: Yamaguchi Shogo , Sawamura Akinori , Okumura Takahiro , Kato Hiroo , Oishi Hideo , Arao Yoshihito , Haga Tomoaki , Kuwayama Tasuku , Yokoi Tsuyoshi , Hiraiwa Hiroaki , Kondo Toru , Morimoto Ryota , Murohara Toyoaki
Published: January 2020

In the management of venoarterial extracorporeal membrane oxygenation, some patients present persistently closed aortic valve. However, little is known about the variables that contribute to persistently closed aortic valve. We investigated the factors that could predict persistently closed aortic valve at the time of venoarterial extracorporeal membrane oxygenation initiation. We investigated 17 patients who presented closed aortic valve immediately after the introduction of venoarterial extracorporeal membrane oxygenation. Patients who presented closed aortic valve 24 h after introduction of venoarterial extracorporeal membrane oxygenation were defined as the Closed-AV group (n = 8), while those whose aortic valve remained opened after 24 h were defined as the Open-AV group (n = 9). All patients were managed by concomitant use of intra-aortic balloon pumping. At baseline, there were no significant differences between mean arterial blood pressure, central venous pressure, and left ventricular ejection fraction. However, Closed-AV group had significantly lower mean pulmonary artery pressure and pulmonary artery pulse pressure compared to those of Open-AV group (mean pulmonary artery pressure: 15 ± 6 mmHg vs 25 ± 8 mmHg, p = 0.01; pulmonary artery pulse pressure: 3 ± 2 mmHg vs 8 ± 3 mmHg, p < 0.01). Logistic regression analyses revealed that the lower mean pulmonary artery pressure and pulmonary artery pulse pressure had the predictive value of closed aortic valve within 24 h after venoarterial extracorporeal membrane oxygenation initiation (mean pulmonary artery pressure: odds ratio = 0.78, 95% confidence interval = 0.58–0.95, p < 0.01; pulmonary artery pulse pressure: odds ratio = 0.18, 95% confidence interval = 0.01–0.61, p < 0.01). Lower mean pulmonary artery pressure and pulmonary artery pulse pressure values could predict persistent closed aortic valve 24 h after venoarterial extracorporeal membrane oxygenation initiation. Left ventricular preload derived from right heart function may have a major impact on aortic valve status.
Hemoperfusion with Cytosorb in pediatric patients with septic shock: A retrospective observational study
Authors: Bottari Gabriella , Guzzo Isabella , Marano Marco , Stoppa Francesca , Ravà Lucilla , Di Nardo Matteo , Cecchetti Corrado
Published: January 2020

Objective:

To determine the clinical effect of continuous hemoperfusion with Cytosorb associated with standard Continuous Renal Replacement Therapy on hemodynamics and on clinically relevant outcome parameters in children with septic shock.

Design:

Retrospective analysis.

Setting:

Pediatric intensive care unit.

Patients:

Eight consecutive children with septic shock who received hemoperfusion with Cytosorb while on Continuous Renal Replacement Therapy.

Interventions:

Continuous hemoperfusion with Cytosorb (adsorber was changed every 24 h).

Measurements and main results:

Vasoactive-Inotropic Score was measured before and after the extracorporeal blood purification treatment. Bedside refractory septic shock score was calculated before the onset of the extracorporeal blood purification treatment. Time course of cytokines interleukin-6, interleukin-10, and tumor necrosis factor–alpha was measured at Time 0, then every 12 h until the end of blood purification treatment (72 or 96 h). Pediatric intensive care unit survival in our cohort was 90%. Median bedside refractory septic shock score was 2.1. Patients showed improved Vasoactive-Inotropic Score following blood purification (pre: 40.00 post: 8.89 p = 0.0076). Measurement of cytokines level showed a significant reduction of interleukin-6 plasma levels (7977.27–210.18 pg/mL, p = 0.0077) and interleukin-10 plasma levels (from 687.19 to 36.95 pg/mL, p = 0.0180). In those patients with detectable tumor necrosis factor–alpha plasma level, its reduction was not significant ( p = 0.138). The median removal ratio was 80% for interleukin-6, 90% for interleukin-10, and 29% for tumor necrosis factor–alpha.

Conclusion:

The use of Cytosorb in combination with Continuous Renal Replacement Therapy as blood purification strategy in pediatric septic shock is associated with a rapid hemodynamic stabilization in the first 48 h of treatment and a significant reduction of interleukin-6 and interleukin-10.
Nonlinear static modeling of a tip-tilt-piston micropositioning stage comprising leaf-spring flexure hinges
Authors: Chen Guozhen , Liu Pinkuan , Ding Han
Published: January 2020

Nonlinear static modeling is crucial for the design of stages with large travel ranges. However, few studies have investigated complex spatial compliant mechanisms. The present study proposes an optimization algorithm based on substructure constraint conditions to formulate the nonlinearity of the force–displacement characteristic of a tip-tilt-piston stage comprising leaf-spring flexure hinges. First, the nonlinear force–displacement characteristics of the compound basic parallelogram mechanism are derived using an optimization algorithm based on two constraint conditions (I and II). Second, the nonlinear static modeling of the tip-tilt-piston stage is conducted based on the modeling results of the compound basic parallelogram mechanism. The stage is divided into three parts, and force analyses are conducted for all three parts. The vertical displacement of the compound basic parallelogram mechanism in part 1 and the rotational angle of the rotational plate in part 2 are calculated. Subsequently, the force–displacement characteristics of the tip-tilt-piston stage are obtained based on a third constraint condition (III). A comparison of the finite element analysis results and the theoretical calculation indicates less than 4% errors. In the experimental tests conducted on the proposed stage and four compound basic parallelogram mechanisms, the displacements were evidently larger than those calculated using the finite element analysis. Therefore, a weight coefficient of the axial force w is introduced in the theoretical calculation to solve the problem of the large deviations between the experimental results and the finite element analysis results. When w is set to 1, the theoretical results are in good agreement with the finite element analysis results; when w is set to 0.05 for the tip-tilt-piston stage and 0.15 for compound basic parallelogram mechanisms, the theoretical results are consistent with the experimental results (less than 8.5% errors).
Mycoplasma genitalium and antimicrobial resistance in Europe: a comprehensive review
Authors: Fernández-Huerta Miguel , Barberá María J , Serra-Pladevall Judit , Esperalba Juliana , Martínez-Gómez Xavier , Centeno Cristina , Pich Oscar Q , Pumarola Tomàs , Espasa Mateu
Published: January 2020

Antibiotic resistance in Mycoplasma genitalium has been emerging in Europe. Also, discrepancies on the management and treatment of sexually transmitted infections may have distinctly influenced the prevalence of antimicrobial resistance among European countries. This comprehensive review of the literature published between 2012 and 2018 updates antimicrobial resistance data in M. genitalium in Europe. Overall, macrolide resistance is rapidly increasing in this region, where many countries are exceeding 50%. The limited data regarding fluoroquinolone resistance estimate a prevalence of 5% (interquartile range, 5–6%). The study supports the need to conduct representative and well-defined surveillance on antimicrobial resistance in M. genitalium at both local and European levels. Also, further investigations on new promising antibiotics are required to fight against M. genitalium that may soon become untreatable.
On powerful exact nonrandomized tests for the Poisson two-sample setting
Authors: Wellek Stefan
Published: January 2020

In the case of two independent samples from Poisson distributions, the natural target parameter for hypothesis testing is the ratio of the two population means. The conditional tests which have been derived for this class of problems already in the 1940s are well known to be optimal in terms of power only when randomized decisions between hypotheses are admitted at the boundary of the respective rejection regions. The major objective of this contribution is to show how the approach used by Boschloo in 1970 for constructing a powerful nonrandomized version of Fisher’s exact test for hypotheses about the odds ratio between two binomial parameters can successfully be adapted for the Poisson case. The resulting procedure, which we propose to term Poisson-Boschloo test, depends on some cutoff for the observed total number of events, the variable upon which conditioning has to be done. We show that for any fixed specific alternative, this cutoff can be chosen in such a way that the resulting nonrandomized test falls short in power of the randomized UMPU test only by a negligible amount. Thus, sample size calculation for the Poisson-Boschloo test can be carried out nearly exactly by means of the same computational procedure as has to be used for the randomized UMPU test. Since the power of the latter is accessible to elementary computational tools, this result makes approximate methods of sample size calculation for the Poisson-Boschloo test dispensable. It is furthermore shown how the construction of a Poisson-Boschloo type test extends to the case that interest is in establishing equivalence in the strict, two-sided sense rather than noninferiority. Although proceeding to two-sided equivalence considerably complicates the construction, comparing the resulting test procedure in terms of power with the exact randomized UMPU test leads essentially to the same conclusions as in the noninferiority case.
Three Mindsets of Entrepreneurial Leaders
Authors: Subramaniam Ramnarayan , Shankar Raj Krishnan
Published: January 2020

Discontinuous change is becoming the norm. This has consequences for how organisations are managed and led. Strategic entrepreneurship—the simultaneous practice of advantage-seeking behaviour and opportunity-seeking behaviour—has been proposed as a solution. But practice of strategic entrepreneurship confronts challenges requiring a special type of leadership for its successful implementation—entrepreneurial leadership. People who display such leadership behaviours are called entrepreneurial leaders. We know little about such individuals. We purposively studied three different types of organisations that renewed themselves under such leaders and inductively arrived at three unique mindsets—purpose-oriented, people-oriented and learning-oriented—which help us unpack one aspect of what makes a leader entrepreneurial. We contribute to the entrepreneurial leadership literature by contributing a more nuanced view to mindsets of such leaders which is an important cognitive filter. Our findings also contribute to the literature on strategic entrepreneurship by indicating how leaders with certain combination of mindsets are better at implementing renewal. We advance practice by enabling organisations better identify and develop mindsets among potential leaders who can take on entrepreneurial roles. Limitations and future research are discussed.
Education, Religion and Gender: The Sikh Kanya Mahavidyalaya in Punjab
Authors: Bassi Tripti
Published: January 2020

Schools are truly ‘microcosms of society’ since they reflect the larger dynamics of society. Women’s position in society also got replicated in their low participation in education among other fields. This article contextualises women’s education in the nineteenth-century Punjab. It briefly discusses approaches followed by various stakeholders like the Christian missionaries, the British and the social reformers in addressing this issue. Somehow, religious education remained intertwined with women’s education. The article seeks to demonstrate how religious socialisation happens through certain school processes and practices generating religious identities mediated by notions of gender. Established during the late nineteenth century, the Sikh Kanya Mahavidyalaya in Ferozepur started in a local Gurdwara but later emerged as a significant institution of girls’ education in Punjab. It nurtured ‘obedient’ and ‘religiously-oriented’ Sikh girls who then transmitted those values to the family and larger society. That is how it also cultivated a favourable environment for the schooling of girls. Based on ethnographic fieldwork, the article seeks to explore the dynamics of Sikh identities that not only get constructed but also get established within a school setting. Factors like religion and gender intersect to create a complex web influencing the realm of education.
A Randomized Controlled Trial Study of Transforming Impossible into Possible (TIP) Policy Experiment in South Korea
Authors: Hong Philip Young P. , Choi Sangmi , Hong Rana
Published: January 2020

Purpose:

This randomized controlled trial (RCT) study examined the efficacy of the Transforming Impossible into Possible (TIP) program for low-income, low-skilled jobseekers in the Self-Sufficiency Program (SSP) in South Korea.

Method:

A total of 169 participants in SSP regional centers were randomly assigned to the intervention group (104 participants) and the wait-list control group (65 participants). Employment hope, perceived employment barriers, economic self-sufficiency (ESS), self-esteem and self-efficacy were measured at two time points, and data were analyzed using a paired sample t-test and an analysis of covariance (ANCOVA).

Results:

The TIP intervention group showed statistically significant increase in employment hope, ESS, self-esteem, and self-efficacy. The ANCOVA result indicated significant pre–post score differences in these variables between the TIP and the control groups.

Discussion:

TIP program can be effective in increasing psychological capital for low-income and low-skilled jobseekers. Further research ought to replicate the current RCT study to determine its application to other populations.
Teaching Operations Management With Virtual Reality: Bringing the Factory to the Students
Authors: Netland Torbjørn H. , von Dzengelevski Oliver , Maghazei Omid , Brown Karin
Published: January 2020

Recent developments in virtual reality (VR) technologies offer new opportunities for teaching management courses. The objective of this article is to present one way to use VR to teach operations management. In partnership with a global manufacturer, we integrate virtual environments of the manufacturers’ real factories in a course assignment. The assignment was used in two graduate operations management courses. Theoretically, we draw on the concept of immersion. To evaluate the effects of VR on students’ learning experiences, we use focus groups and a survey. We find that VR can be implemented cost-efficiently in operations management courses and present one way to do it. Considering effectiveness, we find that students generally perceive that VR improves their learning experience. The presented VR assignment provides students a guided discovery learning, which is active. However, we also find several limitations with the current technology, which can be overcome in future implementations. Teachers can use the idea and findings presented here to innovate their own teaching by the means of readily available and low-cost VR technologies.
Geographic-Level Association of Contemporary Changes in Localized and Metastatic Prostate Cancer Incidence in the Era of Decreasing PSA Screening
Authors: Yang Daniel X. , Makarov Danil V. , Gross Cary P. , Yu James B.
Published: January 2020

Decreased prostate-specific antigen screening since 2008 has generated much concern, including report of recent increase in metastatic prostate cancer incidence among older men. Although increased metastatic disease was temporally proceeded by decreased screening and decreased localized prostate cancer at diagnosis, it is unclear whether the 2 trends are geographically connected. We therefore used the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database to assess geographic-specific associations between changes in localized (2008-2011) and later changes in metastatic prostate cancer incidence (2012-2015). We examined trends from 200 health-care service areas (HSAs) within SEER 18 registries. While on average for each HSA, localized incidence decreased by 27.4 and metastatic incidence increased by 2.3 per 100 000 men per year, individual HSA-level changes in localized incidence did not correlate with later changes in metastatic disease. Decreased detection of localized disease may not fully explain the recent increase in metastatic disease at diagnosis.
Association of Functional Polymorphism in Protein Tyrosine Phosphatase Nonreceptor 22 (PTPN22) Gene with Vitiligo
Authors: Huraib Ghaleb Bin , Al Harthi Fahad , Arfin Misbahul , Aljamal Abdulrahman , Alrawi Abdulqader Saeed , Al-Asmari Abdulrahman
Published: January 2020

The protein tyrosine phosphatase nonreceptor 22 (PTPN22) is associated with susceptibility to autoimmune diseases. The functional polymorphism in PTPN22 at 1857 is a strong risk factor for vitiligo susceptibility in Europeans; however, controversy exits in other populations. Present study was aimed to determine whether the PTPN22 C1857T polymorphism confers susceptibility to vitiligo in Saudi Arabians. Genomic DNA was extracted and amplified using tetra primer amplification-refractory mutation system polymerase chain reaction (ARMS-PCR) method. The frequencies of allele T and genotype CT of PTPN22 C1858T polymorphism were significantly higher, whereas those of allele C and genotype CC were lower in patients as compared with controls ( P < 0.0001). The genotype TT was absent in both the patients and controls. It is concluded that PTPN22 C1858T polymorphism is strongly associated with vitiligo susceptibility. However, additional studies are warranted using large number of samples from different ethnicities and geographical areas.