bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Lateral Wandering of Automated Vehicles to Reduce Hydroplaning Potential and to Improve Pavement Life
Authors: Zhou Fujie , Hu Sheng , Chrysler Susan T. , Kim Yangwoo , Damnjanovic Ivan , Talebpour Alireza , Espejo Alejandro
Published: June 2019

The deployment of automated vehicles (AVs) has many potential benefits, such as reductions in congestion and emissions, and safety improvements. However, two notable aspects of AVs are their impact on roadway hydroplaning and pavement life. Since most AVs are programmed to follow a set path and maintain a lateral position in the center of the lane, over time, significant rutting will occur in asphalt surfaced pavements. This study measured AV lateral wandering patterns and compared them with human driven vehicles. Both wandering patterns could be modeled with a normal distribution but have significantly different standard deviations. AVs have a standard deviation for the lateral traffic wander pattern at least three times smaller than human driven vehicles. The influences of AVs with smaller lateral wandering on pavement rutting and fatigue life were analyzed with the Texas Mechanistic-Empirical Flexible Pavement Design system. The research discovered that AVs would shorten pavement fatigue life by 20%. Additionally, pavement rut depths (RD) increased by 13% and reached critical values of the RD 30% earlier. Deeper ruts formed more quickly leading to thicker water films on wet roads, and consequently, a much higher risk of hydroplaning. The research also calculated maximum tolerable RDs at different hydroplaning speeds. AVs have a much smaller tolerable RD human driven vehicles because of a greater water film in the rutted wheel path. This research thus proposed an optimal AV lateral wandering pattern: a uniform distribution. A uniformly distributed lateral wandering pattern for AVs prolongs pavement fatigue life, reduces pavement RD, and decreases hydroplaning potential.
Development of Urban Road Order Index Based on Driving Behavior and Speed Variation
Authors: Yao Ying , Zhao Xiaohua , Zhang Yunlong , Ma Jianming , Rong Jian , Bi Chaofan , Wang Yujing
Published: June 2019

This study uses driving behavior and speed variation data from navigation software to propose a traffic order index (TOI) for evaluating the order of traffic on urban roads. Based on the significance analysis of driving behaviors and speed variation under different road types and congestion levels, the TOI calculation method is proposed by using the order of preference by similarity to ideal solution (TOPSIS) method. Through a case study of an urban area in Beijing, the distribution of TOI under different road types and congestion levels is described, and the hourly and daily TOI heat maps are generated to show changes in TOI for urban roads during different periods. The relationships between TOI, congestion index (CI) and crash data were explored. A nonlinear relationship of TOI and CI was discovered, and roads with more crashes or longer crash durations were associated with a lower level of traffic order. The TOI could help traffic management departments better understand the order of traffic on roads, reveal causes of the poor level of traffic order in some roads, and more reasonably dispatch traffic police to handle traffic crashes.
Thermal buckling and postbuckling of CNT-reinforced composite cylindrical shell surrounded by an elastic medium with tangentially restrained edges
Authors: Hieu Pham Thanh , Van Tung Hoang
Published: June 2019

Buckling and postbuckling behavior of thin composite cylindrical shells reinforced by carbon nanotubes (CNTs), surrounded by elastic media and exposed to uniform temperature rise, are investigated in this article. CNTs are reinforced into isotropic matrix phase through uniform distribution or functionally graded distributions across the thickness direction. Material properties are assumed to be temperature dependent, and effective elastic moduli of CNT-reinforced composite are determined according to extended rule of mixture. Formulations are based on the classical thin shell theory taking Von Karman–Donnell nonlinearity, surrounding elastic media and elastic constraints of boundary edges into consideration. Multi-term solutions of deflection and stress function are assumed to satisfy simply supported boundary condition, and Galerkin method is applied to obtain nonlinear relation of thermal load and deflection. An iteration algorithm is used to determine buckling temperatures and postbuckling paths. Numerical examples are given to analyze the effects of volume fraction and distribution type of CNTs, geometrical parameters, degree of tangential edge constraint, buckling mode, and surrounding elastic media on the buckling temperatures and postbuckling strength of thermally loaded nanocomposite cylindrical shells.
The Joint Dynamics of Liquidity and Volatility Across Small- and Large- index Indian Funds
Authors: Kulshrestha Kriti , Bhaduri Saumitra N.
Published: June 2019

The article explores the relationship between volatility and liquidity, as there is a change in market capitalisation (cap). Using three regimes of volatility, identified by the threshold vector auto-regression method, the results show that volatility affects liquidity differently for the three volatility regimes during the two periods (crisis and post-crisis) of study. The results show that there is inconsistency in how volatility affects liquidity across the Indian large-, mid- and small-cap indices.

JEL Classification: G1 G17
Zinc overload in weaned pigs: tissue accumulation, pathology, and growth impacts
Authors: Burrough Eric R. , De Mille Carson , Gabler Nicholas K.
Published: June 2019

Zinc oxide (ZnO) is commonly fed to pigs at pharmacologic concentrations (2,000–3,000 ppm) for the first 3 wk post-weaning to increase growth and reduce enteric bacterial disease. The safety of this high-dose treatment is assumed based upon lower bioavailability of ZnO compared to other common forms of Zn in feed; however, limited data are available regarding the specific serum and tissue concentrations of Zn expected in animals experiencing overload following feeding of excessive ZnO. Fifty-five 3-wk-old pigs were divided into 5 groups receiving various concentrations of ZnO (0–6,000 ppm) for 3 wk. Pigs receiving 6,000 ppm ZnO had higher mean pancreatic Zn concentrations ( p < 0.001) compared to other treatments, and higher pancreatic Zn concentrations were associated with pancreatic acinar cell apoptosis ( p < 0.0001). Hepatic Zn concentrations were highest for pigs receiving 6,000 ppm ZnO (mean ± SEM; 729 ± 264 ppm) and significantly higher than all other groups ( p < 0.0001), with controls having concentrations <60 ppm. Similarly, serum Zn was highest in pigs receiving 6,000 ppm ZnO (4.81 ± 2.31 ppm) and significantly higher than all groups (controls, <1 ppm). Additionally, as pigs became overloaded with Zn, there were significant reductions in serum Cu and both serum and hepatic Se. Hepatic and serum Zn concentrations >500 ppm and >2 ppm, respectively, are indicative of Zn overload, and dietary trace mineral analysis is warranted if expected inclusion rates are ≤3,000 ppm ZnO.
Loop-mediated isothermal amplification–fluorescent loop primer assay for the genotyping of a single nucleotide polymorphism at position 2254 in the viral DNA polymerase gene of equid alphaherpesvirus 1
Authors: Tsujimura Koji , Bannai Hiroshi , Nemoto Manabu , Kokado Hiroshi
Published: June 2019

We developed a loop-mediated isothermal amplification (LAMP)–fluorescent loop primer (FLP) assay for genotyping the A/G2254 single nucleotide polymorphism (SNP) in the viral DNA polymerase gene of species Equid alphaherpesvirus 1 (EHV-1), which is associated with the neuropathogenic potential of this virus. In addition to the use of regular LAMP primers to amplify the target region, a 5’-FAM–labeled backward loop primer (FLB) and 3’-dabcyl–labeled quencher probe (QP) were designed for annealing curve analysis of the amplification product. The QP, which contacts the FLB, is located at the SNP site and has the A2254 allele. LAMP reactions were performed at 63°C for 40 min, and the subsequent annealing curve analyses were accomplished within 20 min. The LAMP-FLP assay could clearly differentiate A2254 and G2254 genotypes according to the difference in the annealing temperature of the QP between the 2 genotypes. Good agreement between the LAMP-FLP and the real-time PCR for genotyping of this SNP was observed in the detection of EHV-1 in equine clinical samples. The newly developed assay is a simple and rapid method for detecting and differentiating EHV-1 strains with A2254 and G2254 polymorphisms and would be suitable for clinical use.
What Constitutes Risk of Future Maltreatment Among Young Mothers? An Examination of Child Protection Investigations in Ontario, Canada
Authors: King Bryn , Fallon Barbara , Goulden Ami , O’Connor Carolyn , Filippelli Joanne
Published: June 2019

Despite younger maternal age being a risk factor for child welfare involvement, the literature on decision making once young mothers are investigated for child protection concerns is limited. This article examines characteristics and decision making related to investigating workers’ determinations that young children of adolescent and young adult mothers are at risk of future maltreatment. Using a provincially representative data set, this study found that children of young mothers were more likely to be deemed at risk of future maltreatment than those of adult mothers, and this assessment was also related to more intensive child welfare involvement. Among young mothers, a risk determination was strongly associated with maternal mental health concerns and socioeconomic circumstances. Practice and policy shifts should address the need for timely and effective material and emotional supports.
An Oral Health-Related Quality of Life Comparison Between Adults With Unilateral Cleft Lip and Palate and Class III Malocclusion
Authors: Barros Leandro Almeida Nascimento , Jesuino Flávia Aline Silva , de Paiva João Batista , Rino-Neto José , Valladares-Neto José
Published: June 2019

Objective:

To compare oral health-related quality of life (OHRQoL) before treatment of adults with unilateral cleft lip and palate (UCLP) and surgical Class III malocclusion, and to consider if clefts needing different orthodontic treatment protocols could influence people’s self-perception.

Design:

Cross sectional.

Setting:

Cleft Lip and Palate Center and Clinic of Orthognathic Surgery from a School of Dentistry.

Participants:

A sample of adults with repaired nonsyndromic UCLP (n = 52) which was age- and sex-matched with a noncleft Class III malocclusion sample seeking orthognathic surgery (n = 51). In turn, the cleft group was subdivided according to treatment planning into nonsurgical orthodontic and surgical orthodontic approaches.

Main Outcome Measure:

The whole sample was assessed using the short-form oral health impact profile (OHIP-14), with higher scores indicating a poorer OHRQoL. Statistical comparisons were performed with Mann-Whitney U and Kruskal-Wallis tests, and effect size. Bonferroni adjustment was used for post hoc tests ( P < .017).

Results:

The OHIP-14 scores of the UCLP and Class III groups were significantly different ( P = .001, η2 = 0.108), and higher in Class III. The largest commitment was in the physical disability, physical pain, and psychological disability domains. In addition, no differences were found when the UCLP treatment planning was considered.

Conclusion:

Surgical Class III malocclusion have a poorer OHRQoL when compared to patients with UCLP, irrespective of whether they are treated surgically or orthodontically. Therefore, the greater commitment of OHRQoL appears to be influenced by the etiology of Class III, and not by treatment plan.
Total Ankle Arthroplasty Survival and Risk Factors for Failure
Authors: Escudero Mario I. , Le Vu , Barahona Maximiliano , Symes Michael , Wing Kevin , Younger Alastair , Veljkovic Andrea , Penner Murray
Published: June 2019

Background:

Total ankle arthroplasty (TAA) is an increasingly selected treatment for end-stage ankle arthritis; however, failure and revision of the tibial and talar components remains an issue. Although multiple risk factors have been shown to contribute to early component revision, no study has looked at combining such risk factors into a predictive model that could potentially decrease revision rates and improve implant survival. This study aimed to develop a predictive model for TAA failure based on patient characteristics, patient-reported outcomes (PROs), and immediate postoperative radiographs.

Methods:

A retrospective review of a single-site ankle arthritis database was conducted. All patients with current-generation ankle replacements including the Hintegra and Infinity prostheses implanted between 2004 and 2015 and with complete postoperative radiographs taken between 6 and 12 weeks postoperatively were included. Eight coronal and sagittal radiographic parameters were assessed and performed twice by 2 independent orthopedic surgeons on included TAAs. These radiographic parameters were then analyzed in association with patient demographics and PRO. Advanced statistical methods including survival analysis were used to construct a predictive model for TAA survival. A total of 107 patients were included and analyzed with a median clinical follow-up of 49 months (minimum 24 months).

Results:

A predictive model was created, with 4 parameters identified as being statistically associated with TAA metal-component revision: diabetes mellitus, poor baseline Ankle Osteoarthritis Scale (AOS) score, excessively dorsiflexed talar component, and an anteriorly/posteriorly translated talus relative to the tibial axis. The presence of 3 parameters predicted TAA survival of 0.60 whereas presence of all 4 parameters predicted survival of only 0.13 in the period studied.

Conclusion:

Our predictive model is based on a combination of patient factors, PROs, and radiographic TAA alignment. We believe it can be used by surgeons to predict failure in their TAA patients, thereby optimizing postoperative outcomes by improving patient selection and modifiable outcome-specific parameters.

Level of Evidence:

Level III, retrospective cohort study using prospectively collected data.
Patients at Risk for Exceeding CJR Cost Targets After Total Ankle Arthroplasty
Authors: Goltz Daniel E. , Ryan Sean P. , Howell Claire B. , Bolognesi Michael P. , Seyler Thorsten M. , Adams Samuel B.
Published: June 2019

Background:

The Comprehensive Care for Joint Replacement (CJR) model includes total ankle arthroplasty (TAA), under which a target reimbursement is established. Whether this reimbursement is sufficient to cover average cost remains unknown. We hypothesized that a substantial number of TAAs still exceed cost targets, and that risk factors associated with exceeding the target cost could be identified preoperatively.

Methods:

Two hundred two primary TAAs performed at a single tertiary referral center under the CJR model from June 2013 to May 2017 were retrospectively reviewed. Patient demographics, comorbidities, outcomes, and costs were extracted from the electronic medical record using a validated structured query language (SQL) algorithm. A comparison cohort of 2084 CJR total hip arthroplasty (THA) and total knee arthroplasty (TKA) cases performed during the same period was also reviewed.

Results:

Twenty TAAs (10%) exceeded the target cost of care, significantly fewer than CJR THAs/TKAs (29%) performed during the same period ( P < .0001). These patients did not differ significantly in age, sex, body mass index, number of Elixhauser comorbidities, or the American Society of Anesthesiologists score. The average cost for these patients was $17 338 higher than those who did not exceed the target cost, and they were less likely to be married or have a partner (45% vs 79%, P = .001). Non-Caucasian status also reached significance ( P < .0001). Those exceeding the target cost had a significantly longer length of stay (2.6 vs 1.5 days, P < .0001) and were more likely to be discharged to either skilled nursing or a rehabilitation facility (60% vs 1%, P < .0001).

Conclusion:

Even high-volume TAA centers still exceed target costs in up to 10% of cases, with length of stay, discharge location, and readmissions driving many of these events. Potential risk factors for excess cost include marital/partner status and non-Caucasian ethnicity, but further work is needed to clarify their effects and whether other risk factors exist.

Level of Evidence:

Level III, comparative study.
Through Reflective Lenses: Enhancing Students’ Perceptions of Their Media Writing Skills
Authors: Leggette Holli R. , Redwine Tobin , Busick Brytann
Published: June 2019

Many national reports have documented students’ writing deficiencies and the need to develop rigorous writing curricula that moves the needle forward in training young professionals to write. The quasi-experimental study described herein explains the effect reflection had on journalistic writing students’ media writing self-perception scores. We found that students who participated in metacognitive reflection exercises after each major journalistic writing assignment scored significantly higher on the writing self-efficacy construct and the overall media writing self-perceptions scale. Reflection was one way the students in the study began to perceive themselves as media writers and transform from novices to professionals.
Implementation of the New York City Policy Restricting Sales of Flavored Non-Cigarette Tobacco Products
Authors: Brown Elizabeth M. , Rogers Todd , Eggers Matthew E. , Cavazos Michelle L. , O’Brien Maureen S. , McCrae Tarsha , Farley Shannon M. , Schroth Kevin R. J.
Published: June 2019

Flavored tobacco products appeal to youth, and jurisdictions have implemented policy interventions to reduce youth tobacco initiation. This study reviews the process, challenges, and compliance monitoring of a flavored tobacco sales restriction. New York City (NYC) passed a policy restricting the sale of flavored non-cigarette tobacco products in 2009. To describe the policy’s passage, legal defense, implementation, and enforcement, we conducted stakeholder interviews, reviewed legislative and legal records, and analyzed administrative data on retailer inspections and violations. Extensive public and policy maker education efforts preceded this policy. Barriers included opposition to the policy’s passage and a tobacco manufacturer’s lawsuit that sought to halt the law’s implementation and to establish that NYC lacked the authority to restrict the sale of flavored products. The city implemented the flavored tobacco policy as intended and it withstood legal challenges. NYC integrated enforcement into the city’s retailer compliance monitoring infrastructure, and the violation rate is low. Our investigation of NYC’s experience with flavored tobacco policy implementation and enforcement can provide policy makers and health professionals with insights relevant to policy implementation, expand understanding of the potential impact of these kinds of policies, and inform compliance monitoring efforts.
Linearization of Median Genomes Under the Double-Cut-and-Join-Indel Model
Authors: Avdeyev Pavel , Jiang Shuai , Alekseyev Max A
Published: June 2019

Reconstruction of the median genome consisting of linear chromosomes from three given genomes is known to be intractable. There exist efficient methods for solving a relaxed version of this problem, where the median genome is allowed to have circular chromosomes. We propose a method for construction of an approximate solution to the original problem from a solution to the relaxed problem and prove a bound on its approximation error. Our method also provides insights into the combinatorial structure of genome transformations with respect to appearance of circular chromosomes.
Psychological resilience is linked to motor strength and gait endurance in early multiple sclerosis
Authors: Klineova Sylvia , Brandstadter Rachel , Fabian Michelle T , Sand Ilana Katz , Krieger Stephen , Leavitt Victoria M , Lewis Christina , Riley Claire S , Lublin Fred , Miller Aaron E , Sumowski James F
Published: June 2019

Background:

Psychologically resilient persons persist despite obstacles and bounce back after adversity, leading to better outcomes in non-neurologic populations. It is unknown whether psychological resilience relates to objective functional outcomes in multiple sclerosis (MS).

Objective:

To determine whether psychological resilience explains differential objective cognitive and motor functioning in persons with early MS.

Methods:

Psychological resilience was assessed in 185 patients with early MS and 50 matched healthy controls with the Connors-Davidson Resilience Scale (CDRS-10). Subjects completed the MS Functional Composite (MSFC) and a comprehensive neurobehavioral evaluation. Correlations assessed links between CDRS-10 and MSFC, motor indices (Total, Fine Motor, Gross Motor), and cognitive indices (Total, Cognitive Efficiency, Memory).

Results:

Higher CDRS-10 among patients was linked to better MSFC and motor outcomes (but not cognition), with the most robust relationships for gross motor function (grip strength, gait endurance). Findings were independent of mood and fatigue. CDRS-10 was unrelated to MS disease burden. CDRS-10 was also specifically linked to motor outcomes in healthy controls.

Conclusion:

Functional outcomes vary across persons with MS, even when disease burden and neurologic disability are low. These findings identify high psychological resilience as a non-disease-specific contributor to motor strength and endurance, which may explain differential outcomes across patients.
When restorative justice meets the Good Lives Model: Contributing to a criminology of trust
Authors: Walgrave Lode , Ward Tony , Zinsstag Estelle
Published: June 2019

The Good Lives Model and restorative justice, although both innovative practices with a number of common traits, interests and aims, have been developing in parallel or even at odds with each other for a number of years. As a consequence, they have rarely been examined as possibly complementary and of use to each other. In this article we aim to explore these innovative practices individually and to look at how they might work together to address the harm in a positive and constructive way for all stakeholders. We examine the possibilities of how a new approach to criminology, a criminology of trust, could be further developed through their lens and their possible complementarity.
Is There a Role for Desensitization in Intestinal Transplantation?
Authors: Santeusanio Andrew D. , Moon Jang , Nair Vinay , Iyer Kishore R.
Published: June 2019

Human leukocyte antigen allosensitization prior to transplant can increase the risk of early graft loss and prolong waitlist times for intestinal transplant candidates. Desensitization offers a potential therapeutic option to reduce the quantity of preformed antibodies prior to organ allocation and facilitate transplantation with a more immunologically compatible donor allograft. However, there remains a paucity of data to guide the use of desensitization in the setting of intestinal transplantation. As a result, in this review we evaluate the existing literature supporting the role of desensitization therapy in intestinal transplant, describe our own experience with the implementation of a risk-stratified desensitization protocol, and finally explore barriers and unanswered questions that continue to limit the widespread adoption of desensitization as a management strategy for highly sensitized intestinal transplant candidates.
Apathy and Disinhibition Related to Neuropathology in Amnestic Versus Behavioral Dementias
Authors: Borges Letizia G. , Rademaker Alfred W. , Bigio Eileen H. , Mesulam M-Marsel , Weintraub Sandra
Published: June 2019

Objectives:

Investigating the frequency of apathy and disinhibition in patients clinically diagnosed with dementia of the Alzheimer type (DAT) or behavioral variant frontotemporal dementia (bvFTD) with neuropathology of either Alzheimer disease (AD) or frontotemporal lobar degeneration (FTLD).

Methods:

Retrospective data from 887 cases were analyzed, and the frequencies of apathy and disinhibition were compared at baseline and longitudinally in 4 groups: DAT/AD, DAT/FTLD, bvFTD/FTLD, and bvFTD/AD.

Results:

Apathy alone was more common in AD (33%) than FTLD (25%), and the combination of apathy and disinhibition was more common in FTLD (43%) than AD (14%; P < .0001). Over time, apathy became more frequent in AD with increasing dementia severity (33%-41%; P < .006).

Conclusions:

Alzheimer disease neuropathology had the closest association with the neuropsychiatric symptom of apathy, while FTLD was most associated with the combination of apathy and disinhibition. Over time, the frequency of those with apathy increased in both AD and FTLD neuropathology.
Exploring the Use of Complementary and Alternative Medicine in Cancer Patients
Authors: Jones Ellen , Nissen Lisa , McCarthy Alexandra , Steadman Kathryn , Windsor Carol
Published: June 2019

In Australia, it is estimated that around 17% to 87% of cancer patients have used one form of complementary therapy during their cancer treatment. There are numerous reasons and contributing factors for cancer patients to consider using complementary and alternative medicine (CAM). CAM information and products are readily available. However, the level of evidence to support the benefits of use in the cancer setting is limited, and the associated adverse effects and interactions with conventional medicine may not be fully studied. Besides, not all health professionals favor the concept of integrative health approaches, or have the confidence in dealing with CAM due to a lack of knowledge and standardization of practices. A thematic review of the literature was performed on the main contributing factors to cancer patients’ use of CAM, as well as the current issues that may be encountered by the patients and health professionals.
High-flow nasal cannula oxygen therapy to treat acute respiratory failure in patients with acute exacerbation of idiopathic pulmonary fibrosis
Authors: Vianello Andrea , Arcaro Giovanna , Molena Beatrice , Turato Cristian , Braccioni Fausto , Paladini Luciana , Vio Stefania , Ferrarese Silvia , Peditto Piera , Gallan Federico , Saetta Marina
Published: June 2019

Background:

Some patients with idiopathic pulmonary fibrosis (IPF) develop acute exacerbation (AE-IPF) leading to severe acute respiratory failure (ARF); despite conventional supportive therapy, the mortality rate remains extremely high. The aim of this study was to assess how a treatment algorithm incorporating high-flow nasal cannula (HFNC) oxygen therapy affects the short-term mortality of patients with AE-IPF who develop ARF.

Method and design:

A retrospective cohort analysis was conducted.

Patients and interventions:

The study consisted of 17 patients with AE-IPF admitted to a respiratory intensive care unit (RICU) for ARF managed using a treatment algorithm incorporating HFNC. The outcome measure was mortality rate during their stay in the RICU.

Results:

Implementation of the treatment algorithm led to a successful outcome in nine patients and to a negative one in eight patients (47.1%) who died within 39 days of being admitted to the RICU. The survival rate was 70.6% (±0.1 %) at 15 days, 52.9% (±0.1%) at 30 days, 35.3% (±0.1%) at 90 days, and 15.6% (±9.73 %) at 365 days. Overall, 4 out of 10 patients who did not respond to conventional oxygen therapy showed a satisfactory response to HFNC.

Conclusions:

Short-term mortality fell to below 50% when a treatment algorithm incorporating HFNC was implemented in a group of patients with AE-IPF admitted to a RICU for ARF. Patients not responding to conventional oxygen therapy seemed to benefit from HFNC. The reviews of this paper are available via the supplementary material section.
Numerical simulation modeling of the irreversible electroporation treatment zone for focal therapy of prostate cancer, correlation with whole-mount pathology and T2-weighted MRI sequences
Authors: Scheltema Matthijs J. , O’Brien Tim J. , van den Bos Willemien , de Bruin Daniel M. , Davalos Rafael V. , van den Geld Cees W.M. , Laguna Maria P. , Neal Robert E. , Varkarakis Ioannis M. , Skolarikos Andreas , Stricker Phillip D. , de Reijke Theo. M. , Arena Christopher B. , de la Rosette Jean
Published: June 2019

Background:

At present, it is not possible to predict the ablation zone volume following irreversible electroporation (IRE) for prostate cancer (PCa). This study aimed to determine the necessary electrical field threshold to ablate human prostate tissue in vivo with IRE.

Methods:

In this prospective multicenter trial, patients with localized PCa were treated with IRE 4 weeks before their scheduled radical prostatectomy. In 13 patients, numerical models of the electrical field were generated and compared with the ablation zone volume on whole-mount pathology and T2-weighted magnetic resonance imaging (MRI) sequences. Volume-generating software was used to calculate the ablation zone volumes on histology and MRI. The electric field threshold to ablate prostate tissue was determined for each patient.

Results:

A total of 13 patients were included for histological and simulation analysis. The median electrical field threshold was 550 V/cm (interquartile range 383–750 V/cm) for the software-generated histology volumes. The median electrical field threshold was 500 V/cm (interquartile range 386–580 V/cm) when the ablation zone volumes were used from the follow-up MRI.

Conclusions:

The electrical field threshold to ablate human prostate tissue in vivo was determined using whole-mount pathology and MRI. These thresholds may be used to develop treatment planning or monitoring software for IRE prostate ablation; however, further optimization of simulation methods are required to decrease the variance that was observed between patients.
A case of Crimean-Congo haemorrhagic fever imported in Greece: Contact tracing and management of exposed healthcare workers
Authors: Maltezou Helena C , Papa Anna , Ventouri Sarantoula , Tseki Charikleia , Pervanidou Danai , Pavli Androula , Panagopoulos Periklis , Markatou Philothei , Gavana Elpida , Maltezos Efstratios
Published: June 2019

Background:

Nosocomial transmission is a major mode of infection of Crimean-Congo haemorrhagic fever (CCHF). In May 2018, a patient with CCHF was hospitalised in Greece.

Objective:

Our aim was to present the management of healthcare workers (HCWs) to the CCHF case.

Methods:

Contact tracing, risk assessment and follow-up of exposed HCWs were performed. Testing (RT-PCR and/or serology) was offered to contacts. Post-exposure prophylaxis (PEP) with ribavirin was considered for high-risk exposures.

Results:

Ninety-one HCWs were exposed to the case. Sixty-six HCWs were grouped as high-risk exposures. Ribavirin PEP was offered to 29 HCWs; seven agreed to receive prophylaxis. Forty-one HCWs were tested for CCHF infection; none was found positive. Gaps in infection control occurred.

Discussion:

CCHF should be considered in patients with compatible travel history and clinical and laboratory findings. Early clinical suspicion and laboratory confirmation are imperative for the implementation of appropriate infection control measures. Ribavirin should be considered for high-risk exposures. Infection control capacity for highly pathogenic agents should increase.
Identification of CSPG4 as a promising target for translational combinatorial approaches in osteosarcoma
Authors: Riccardo Federica , Tarone Lidia , Iussich Selina , Giacobino Davide , Arigoni Maddalena , Sammartano Federica , Morello Emanuela , Martano Marina , Gattino Francesca , Maria Raffaella De , Ferrone Soldano , Buracco Paolo , Cavallo Federica
Published: June 2019

Background:

Osteosarcoma (OSA) is a highly metastatic pediatric bone tumor. Adjuvant chemotherapy and surgical resection represent standard treatments; however, the prognosis is still poor. Effective strategies are urgently needed. Chondroitin sulfate proteoglycan (CSPG)4 is a transmembrane proteoglycan with a low expression in normal tissues but high expression in several solid tumors, where it plays a central tumorigenic role. Therefore, it represents a promising therapeutic target. The high homology between human and canine CSPG4 and the recognized translational power of canine tumors as preclinical models for human malignancies prompted us to evaluate CSPG4 expression and the consequences of its immune-targeting for both human and canine OSA treatment.

Methods:

We analyzed CSPG4 overexpression in human and canine OSA samples and its significance for the survival of OSA patients. We exploited functional in vitro experiments to assess the antitumor potential of CSPG4 immune-targeting.

Results:

CSPG4 is overexpressed in OSA and has possible clinical implications as suggested by an evident correlation between CSPG4 overexpression and a shorter survival for both OSA-affected humans and dogs. The potential of CSPG4 immune-targeting for OSA treatment came from the ability of anti-CSPG4 monoclonal antibodies and sera, derived from human-CSPG4-DNA vaccinated canine patients, to significantly inhibit human and canine CSPG4-positive OSA cell proliferation, migration, and osteospheres generation. Moreover, CSPG4 immune-targeting has been shown to potentiate the effect of doxorubicin.

Conclusions:

Overall, these results provide the rationale to investigate the CSPG4 immune-targeting as a promising weapon for the treatment of CSPG4-positive OSA canine patients, to be successfully translated to a human setting.
Prostate abscess: A comprehensive review of the literature
Authors: Ridgway Alexander J , Luk Angus Chin-On , Pearce Ian
Published: June 2019

Prostate abscess (PA) is a rare but serious infection of the prostate gland. Traditionally a complication of urethral gonococcal infection, the majority of PAs are now seen in the older or immunosuppressed populations, in men with existing prostatic disease, or those who have undergone recent instrumentation of the lower urinary tract. Aetiological organisms are diverse, often with non-specific presentations posing a diagnostic challenge. Multiple management options have been described, however no consensus exists on what is the best practice. This comprehensive review examines the literature surrounding this condition in detail, with a focus on diagnostic and surgical treatment options. Recommendations for practice are made where appropriate. This article aims to edge towards a national guideline for the management of PA and inspire more research in the field.

Level of evidence - 3a
A systematic review of the accuracy of the digital rectal examination as a method of measuring prostate gland volume
Authors: Christie David RH , Windsor Jane , Sharpley Christopher F
Published: June 2019

Objective:

There are many important clinical scenarios in which estimates of the volume of the prostate gland can have an influence on clinical decisions. The digital rectal examination is the simplest and most readily available method for measuring it. It is commonly performed numerous times every day by practising urologists and radiation oncologists. The prostate gland volume is the most studied parameter arising from it. Although reported in many heterogeneous studies, the accuracy of the digital rectal examination in measuring the volume has never been reviewed. Our aim was to conduct the world’s first systematic review.

Methods:

Articles from the literature were included if they compared the digital rectal examination with more accurate measures including fluid displacement after radical prostatectomy and transrectal ultrasound measurements.

Results:

Nineteen articles describing 7891 patients were reviewed and summarised. Wide variations were noted but most studies provided correlation coefficients that lay between 0.3 and 0.7. For those studies that did not involve special training in volume estimation or were not conducted by a urologist with a special interest in the correlation, the coefficients were below 0.6. For eight studies that analysed the estimated volume as a categorical variable, concordance was described using a variety of statistical tests but was generally high.

Conclusions:

The reported correlations were weak to moderate strength indicating that the digital rectal examination may not be accurate enough when quantitative measurements are required. However, enlargement of the prostate was detectable with high levels of concordance, indicating that the digital rectal examination is effective for that purpose.

Level of evidence:

Not applicable for this multicentre audit.
Female urethral diverticulum with large calculus: Presentation and management
Authors: Bhatt Manish , Pandey Himanshu , Jain Pritesh , Gupta Prateek
Published: June 2019

Level of evidence: Not applicable for this multicentre audit
Is the qSOFA more reliable than SIRS in detecting post-operative PCNL patients requiring escalation of care?
Authors: Small Robert P , Hendry Jane L , McKay Alastair C , McPhee Arthur S , Jones Gareth E
Published: June 2019

Aims

Percutaneous nephrolithotomy is known to have a significant risk of sepsis and traditionally the systemic inflammatory response score has been used to identify post-operative patients requiring higher levels of care. Recently, the quick Sepsis Related Organ Failure Assessment score has been developed as a rapid and easy tool to assess patients likely to deteriorate from sepsis. We aim to evaluate the quick Sepsis Related Organ Failure Assessment system against the established systemic inflammatory response score criteria in identifying patients at risk of intensive care unit admission following percutaneous nephrolithotomy.

Patients and Methods

A retrospective review of 157 patients undergoing percutaneous nephrolithotomy between May 2015 and November 2018 at our institution was performed. Patient demographics of age, sex and American Society of Anesthesiologists’ score were collected. Quick Sepsis Related Organ Failure Assessment and systemic inflammatory response scores were calculated at 24 hours and 7 days post-operatively. Primary outcome was admission to an intensive care unit. Specificity, sensitivity, positive and negative predictive values were calculated for the systemic inflammatory response and quick Sepsis Related Organ Failure Assessment scores.

Results

Of 157 patients undergoing percutaneous nephrolithotomy, eight (5.1%) and 52 (33.1%) scored positively for quick Sepsis Related Organ Failure Assessment and systemic inflammatory response score criteria within 24 hours. Quick Sepsis Related Organ Failure Assessment scoring had a higher specificity (98.7%: 95% confidence interval 98.6–98.7%) and positive predictive value (75.0: 95% confidence interval 74.0–75.0%) than systemic inflammatory response score criteria (69.5%: 95% confidence interval 69.3–69.7%), (11.5%; 95% confidence interval 1.2–11.8%) in predicting intensive care unit admission following percutaneous nephrolithotomy. Quick Sepsis Related Organ Failure Assessment correlated strongly with intensive care unit admission and overall length of stay, whereas systemic inflammatory response score correlated weakly with both parameters.

Conclusion

Quick Sepsis Related Organ Failure Assessment demonstrated a statistically significant improvement in predicting intensive care unit admission and overall length of stay versus systemic inflammatory response score criteria following percutaneous nephrolithotomy. Further multi-centre studies are required to validate these findings, which are the first to be published in a urology-specific patient population.

Level of Evidence:

4
Avoiding antibiotics in the management of recurrent UTIs in women: What are our options?
Authors: Yang Bob , Blick Christopher , Foley Steve
Published: June 2019

Urinary tract infections are one of the most common infections worldwide, accounting in the United Kingdom for 1–3% of all medical consultations. Fifty per cent of women will experience one episode of urinary tract infection in their lifetimes and of these, up to 30% will develop recurrent urinary tract infections. Such women often rely on long-term low dose antibiotics.

Level of evidence: Not applicable for this multicentre audit.
The spectacle of pain in the experience: A study in rugby stadiums
Authors: Dubreuil Clément , Dion Delphine
Published: June 2019

This research focuses on understanding how the spectacle of pain contributes to the spectators’ experience. Based on an abductive approach and a 3-year mixed and longitudinal data collection in stadiums, this work identifies four functions of the pain spectacle and details its modalities and progressiveness. This research on rugby matches contributes to the literature on experience and pain. First, it deepens the understanding of the ambivalence of experiences. It shows that the negative dimensions of experience are valued by a moral and normative system. Second, this research contributes to a deeper understanding of the attractiveness of pain, by showing its association with symbolic content. Third, it introduces the concept of domesticating violence in the face of pain. The spectacle of a rugby match is part of nature/culture dialectic, with, on the one hand, a pseudo-primitive violence and, on the other hand, a sophisticated set of codes and rules. Recommendations for administrators and opportunities for future research are also presented.
Relationship Between Innovation and Performance in Private Companies: Systematic Literature Review
Authors: Bach Tatiana Marceda , Dalazen Luciano Luiz , da Silva Wesley Vieira , Ferraresi Alex Antonio , da Veiga Claudimar Pereira
Published: June 2019

This article conducts a systematic literature review (SLR) on the relationship between innovation and performance in private companies. The research corpus was based on research protocol systematization. Dissemination of knowledge was examined in two stages: the summary of general corpus characteristics, and the content analysis performed according to the categories that emerged via the study’s themes. Relationships among authors, co-citations, keywords, and centrality statistics were identified through algorithms for optimizing standard graph layout. This study discusses the results of this relationship for improving the competitiveness of enterprises. The relationships among the authors of the corpus constitute relationships between isolated groups with little connectivity, low density, and a formation of distinct communities. The categories of analysis emerged in the study themes, as well as the techniques adopted to measure the relationships between innovation and private company performance. In the analyzed studies, innovation initiatives converge. Overall, they contribute to improvements in company performance. In the scientific field, initiatives for developing innovations have enhanced the performance of private companies. A key theoretical contribution of this article is in identifying the research corpus on the relationship between innovation and performance in private companies. The practical contribution of this study lies in offering evidence produced by studies that can help decision making regarding the creation of strategies and policies focused on competitiveness. The differences in the evidence found in the literature highlight the importance of the outcome of this study and indicate the need for future research in an effort to better understand the phenomenon.
Repurposing the (Super)Crip: Media Representations of Disability at the Rio 2016 Paralympic Games
Authors: McGillivray David , O’Donnell Hugh , McPherson Gayle , Misener Laura
Published: June 2019

Mega-events attract ever larger media audiences, and the 2016 Rio Paralympics were no exception. As audiences grow, media coverage extends to ever more varied domains, which are themselves then colonised by an increasing range of discourses. One of main discourses to develop since the early 2000s has been that of the so-called supercrip, one which challenges the notion of “impairment” often connected with disability by foregrounding the para-athletes’ triumph over adversity, celebrating instead their courage, grit, and perseverance leading to athletic success and personal and increasingly national prestige. In this article, we analyse the continuing importance of the supercrip discourse in coverage of the Rio Paralympics but also move on to highlight its tactical alignment with other—both competing and complementary—discourses of nationalism, sexualisation, militarisation, and celebritisation. We analyse textual and visual manifestations of these discourses using both critical discourse analysis and Foucauldian discourse analysis. We conclude by paying particular attention to the increasing visibility of discourses which, while acknowledging the potentially positive role of the supercrip discourse in focussing on athletic success, repurpose that discourse by foregrounding instead the day-to-day experiences of belittling misrepresentation and neglect, including political neglect.
Social Feedback Modulates Neural Response Associated With Cognitive Bias in Individuals Expressing Anxious Symptoms
Authors: Thompson Khalil , King Kendrick , Nahmias Eddy , Fani Negar , Kvaran Trevor , Tone Erin B. , Turner Jessica A.
Published: June 2019

Background

Social anxiety is characterized by a tendency to overestimate the likelihood of negative outcomes and consequences before, during, and after interpersonal interactions with social partners. Recent evidence suggests that a network of brain regions critical for perspective-taking, threat appraisal, and uncertainty resolution may function atypically in those prone to social anxiety. In this study, we used functional magnetic resonance imaging to examine neural activity in specific regions of interest in a sample of young adults who endorsed high or low levels of social anxiety.

Methods

We recruited 31 college student volunteers (age: 18–28 years), categorized as having high or low anxiety based on their Liebowitz Social Anxiety Scale-Self Report scores. These participants were each scanned while playing the iterated Prisoner’s Dilemma game with three computerized confederates, two of whom they were deceived to believe were human co-players. This study focuses on data collected during play with the presumed humans. Regions of interest were defined for the temporoparietal junction, anterior midcingulate, and dorsomedial prefrontal cortex. Average weighted mean blood-oxygen-level-dependent signals for each subject were extracted and analyzed using mixed design analyses of variance to detect group differences in activation during decision-making, anticipation, and appraisal of round outcomes during the game.

Results

Behavior analysis revealed that the high-anxiety group was more likely to defect than the low-anxiety group. Neuroimaging analysis showed that the high-anxiety group exhibited elevated blood-oxygen-level-dependent activity relative to the low-anxiety group in all three regions during the social feedback appraisal phase but not during decision-making or the anticipation of interaction outcomes.

Conclusions

These findings provide evidence that some behaviors linked to cognitive biases associated with social anxiety may be mediated by a network of regions involved in recognizing and processing directed social information. Future investigation of the neural basis of cognition and bias in social anxiety using the prisoner’s dilemma and other economic-exchange tasks is warranted. These tasks appear to be highly effective, functional magnetic resonance imaging-compatible methods of probing altered cognition and behavior associated with anxiety and related conditions.