bluuebunny/crossref_metadata_2025 huggingface dataset:
Heat Transfer Augmentation in a Divergent Duct with Angled Ribs
Authors: Ahn SooWhan , Lee MyungSung
Published: January 2017

Heat transfer characteristics in the rectangular divergent duct with parallel angled ribs are experimentally compared with the straight smooth circular duct. The ribs with four different parallel angles ([Formula: see text], 45[Formula: see text], 60[Formula: see text], and 90[Formula: see text]) are glued on the duct’s two opposite walls as well as on the duct’s one sided wall only, respectively. The 0.72[Formula: see text]-inclined walls are installed at the two opposite walls of the rectangular divergent duct. The test section of 1000[Formula: see text]mm long has the cross section of [Formula: see text][Formula: see text]mm2 at inlet and [Formula: see text][Formula: see text]mm2 at exit. The ribbed walls are manufactured with a rib height [Formula: see text][Formula: see text]mm and the ratio of rib spacing ([Formula: see text]) to height([Formula: see text]) [Formula: see text] 10. The main findings are summarized that the increase in the dimensionless Nusselt number for the flow attack angles can be seen in the order of 90[Formula: see text], 30[Formula: see text], 60[Formula: see text], and 45[Formula: see text] at the two opposite ribbed divergent wall ducts, in addition, the average Nusselt number in the divergent rectangular duct with two opposite ribbed walls is somewhat greater than in the ribbed straight cross-sectional rectangular duct.
Implicit Visual Learning
Authors: Liu Yan , Liu Yang , Zhong Shenghua , Wu Songtao
Published: January 2017

According to consciousness involvement, human’s learning can be roughly classified into explicit learning and implicit learning. Contrasting strongly to explicit learning with clear targets and rules, such as our school study of mathematics, learning is implicit when we acquire new information without intending to do so. Research from psychology indicates that implicit learning is ubiquitous in our daily life. Moreover, implicit learning plays an important role in human visual perception. But in the past 60 years, most of the well-known machine-learning models aimed to simulate explicit learning while the work of modeling implicit learning was relatively limited, especially for computer vision applications. This article proposes a novel unsupervised computational model for implicit visual learning by exploring dissipative system, which provides a unifying macroscopic theory to connect biology with physics. We test the proposed Dissipative Implicit Learning Model (DILM) on various datasets. The experiments show that DILM not only provides a good match to human behavior but also improves the explicit machine-learning performance obviously on image classification tasks.
Generating API Call Rules from Version History and Stack Overflow Posts
Authors: Azad Shams , Rigby Peter C. , Guerrouj Latifa
Published: January 2017

Researchers have shown that related functions can be mined from groupings of functions found in the version history of a system. Our first contribution is to expand this approach to a community of applications and set of similar applications. Android developers use a set of application programming interface (API) calls when creating apps. These API calls are used in similar ways across multiple applications. By clustering co-changing API calls used by 230 Android apps across 12k versions, we are able to predict the API calls that individual app developers will use with an average precision of 75% and recall of 22%. When we make predictions from the same category of app, such as Finance, we attain precision and recall of 81% and 28%, respectively.

Our second contribution can be characterized as “programmers who discussed these functions were also interested in these functions.” Informal discussions on Stack Overflow provide a rich source of information about related API calls as developers provide solutions to common problems. By grouping API calls contained in each positively voted answer posts, we are able to create rules that predict the calls that app developers will use in their own apps with an average precision of 66% and recall of 13%.

For comparison purposes, we developed a baseline by clustering co-changing API calls for each individual app and generated association rules from them. The baseline predicts API calls used by app developers with a precision and recall of 36% and 23%, respectively.
Harmony Generation Driven by a Perceptually Motivated Tonal Interval Space
Authors: Bernardes Gilberto , Cocharro Diogo , Guedes Carlos , Davies Matthew E. P.
Published: January 2017

We present D'accord, a generative music system for creating harmonically compatible accompaniments of symbolic and musical audio inputs with any number of voices, instrumentation, and complexity. The main novelty of our approach centers on offering multiple ranked solutions between a database of pitch configurations and a given musical input based on tonal pitch relatedness and consonance indicators computed in a perceptually motivated Tonal Interval Space. Furthermore, we detail a method to estimate the key of symbolic and musical audio inputs based on attributes of the space, which underpins the generation of key-related pitch configurations. The system is controlled via an adaptive interface implemented for Ableton Live, MAX, and Pure Data, which facilitates music creation for users regardless of music expertise and simultaneously serves as a performance, entertainment, and learning tool. We perform a threefold evaluation of D'accord, which assesses the level of accuracy of our key-finding algorithm, the user enjoyment of generated harmonic accompaniments, and the usability and learnability of the system.
Stimulating Creative Partnerships in Human-Agent Musical Interaction
Authors: Brown Andrew R. , Gifford Toby , Voltz Bradley
Published: January 2017

Musical duets are a type of creative partnership with a long history of artistic practice. What can they tell us about creative partnerships between a human and a computer? To explore this question, we implemented an activity-based model of duet interaction in software designed to support musical metacreation and investigated the experience of performing with it. The activity-based model allowed for the application of reflexive interactive processes, previously used in dialogic interaction, to a synchronous musical performance context. The experience of improvising with the computational agent was evaluated by expert musicians, who reported that interactions were fun, engaging, and challenging, despite some obvious limitations in the musical sophistication of the software. These findings reinforce the idea that even simple metacreative systems can stimulate creative partnerships and, further, that creative human-machine duet partnerships may well produce, like human-human duet partnerships, more than the sum of their parts.
Chopping a Chebyshev Series
Authors: Aurentz Jared L. , Trefethen Lloyd N.
Published: January 2017

Chebfun and related software projects for numerical computing with functions are based on the idea that at each step of a computation, a function
f
(
x
) defined on an interval [
a
,
b
] is “rounded” to a prescribed precision by constructing a Chebyshev series and chopping it at an appropriate point. Designing a chopping algorithm with the right properties proves to be a surprisingly complex and interesting problem. We describe the chopping algorithm introduced in Chebfun Version 5.3 in 2015 after many years of discussion and the considerations that led to this design.
Why Data Deletion Fails? A Study on Deletion Flaws and Data Remanence in Android Systems
Authors: Shu Junliang , Zhang Yuanyuan , Li Juanru , Li Bodong , Gu Dawu
Published: January 2017

Smart mobile devices are becoming the main vessel of personal privacy information. While they carry valuable information, data erasure is somehow much more vulnerable than was predicted. The security mechanisms provided by the Android system are not flexible enough to thoroughly delete sensitive data. In addition to the weakness among several provided data-erasing and file-deleting mechanisms, we also target the Android OS design flaws in data erasure, and unveil that the design of the Android OS contradicts some secure data-erasure demands. We present the data-erasure flaws in three typical scenarios on mainstream Android devices, such as the
data clearing flaw
,
application uninstallation flaw
, and
factory reset flaw
. Some of these flaws are inherited data-deleting security issues from the Linux kernel, and some are new vulnerabilities in the Android system. Those scenarios reveal the data leak points in Android systems. Moreover, we reveal that the data remanence on the disk is rarely affected by the user’s daily operation, such as file deletion and app installation and uninstallation, by a real-world data deletion latency experiment. After one volunteer used the Android phone for 2 months, the data remanence amount was still considerable. Then, we proposed
DataRaider
for file recovering from disk fragments. It adopts a file-carving technique and is implemented as an automated sensitive information recovering framework.
DataRaider
is able to extract private data in a raw disk image without any file system information, and the recovery rate is considerably high in the four test Android phones. We propose some mitigation for data remanence issues, and give the users some suggestions on data protection in Android systems.
Stop It, and Be Stubborn!
Authors: Valmari Antti
Published: January 2017

This publication discusses how automatic verification of concurrent systems can be made more efficient by focusing on
always may-terminating systems
. First, making a system always may-terminating is a method for meeting a modelling need that exists independently of this publication. It is illustrated that without doing so, non-progress errors may be lost. Second, state explosion is often alleviated with stubborn, ample, and persistent set methods. They use expensive cycle or terminal strong component conditions in many cases. It is proven that for many important classes of properties, if the systems are always may-terminating, then these conditions can be left out.
Sparse Matrix-Vector Multiplication on GPGPUs
Authors: Filippone Salvatore , Cardellini Valeria , Barbieri Davide , Fanfarillo Alessandro
Published: January 2017

The multiplication of a sparse matrix by a dense vector (SpMV) is a centerpiece of scientific computing applications: it is the essential kernel for the solution of sparse linear systems and sparse eigenvalue problems by iterative methods. The efficient implementation of the sparse matrix-vector multiplication is therefore crucial and has been the subject of an immense amount of research, with interest renewed with every major new trend in high-performance computing architectures. The introduction of General-Purpose Graphics Processing Units (GPGPUs) is no exception, and many articles have been devoted to this problem.

With this article, we provide a review of the techniques for implementing the SpMV kernel on GPGPUs that have appeared in the literature of the last few years. We discuss the issues and tradeoffs that have been encountered by the various researchers, and a list of solutions, organized in categories according to common features. We also provide a performance comparison across different GPGPU models and on a set of test matrices coming from various application domains.
ImproteK
Authors: Nika Jérôme , Chemillier Marc , Assayag Gérard
Published: January 2017

This article focuses on the introduction of control, authoring, and composition in human-computer music improvisation through the description of a guided music generation model and a reactive architecture, both implemented in the software ImproteK. This interactive music system is used with expert improvisers in work sessions and performances of idiomatic and pulsed music and more broadly in situations of structured or composed improvisation. The article deals with the integration of temporal specifications in the music generation process by means of a fixed or dynamic “scenario” and addresses the issue of the dialectic between reactivity and planning in interactive music improvisation. It covers the different levels involved in machine improvisation: the integration of anticipation relative to a predefined structure in a guided generation process at a symbolic level, an architecture combining this anticipation with reactivity using mixed static/dynamic scheduling techniques, and an audio rendering module performing live re-injection of captured material in synchrony with a non-metronomic beat. Finally, it sketches a framework to compose improvisation sessions at the scenario level, extending the initial musical scope of the system. All of these points are illustrated by videos of performances or work sessions with musicians.
Glucose-dependent insulinotropic polypeptide promotes lipid deposition in subcutaneous adipocytes in obese type 2 diabetes patients: a maladaptive response
Authors: Thondam Sravan K. , Daousi Christina , Wilding John P. H. , Holst Jens J. , Ameen Gulizar I. , Yang Chenjing , Whitmore Catherine , Mora Silvia , Cuthbertson Daniel J.
Published: January 2017

Glucose-dependent insulinotropic polypeptide (GIP) beyond its insulinotropic effects may regulate postprandial lipid metabolism. Whereas the insulinotropic action of GIP is known to be impaired in type 2 diabetes mellitus (T2DM), its adipogenic effect is unknown. We hypothesized that GIP is anabolic in human subcutaneous adipose tissue (SAT) promoting triacylglycerol (TAG) deposition through reesterification of nonesterified fatty acids (NEFA), and this effect may differ according to obesity status or glucose tolerance. Twenty-three subjects categorized into four groups, normoglycemic lean ( n = 6), normoglycemic obese ( n = 6), obese with impaired glucose regulation (IGR; n = 6), and obese T2DM ( n = 5), participated in a double-blind, randomized, crossover study involving a hyperglycemic clamp with a 240-min GIP infusion (2 pmol·kg−1·min−1) or normal saline. Insulin, NEFA, SAT-TAG content, and gene expression of key lipogenic enzymes were determined before and immediately after GIP/saline infusions. GIP lowered NEFA concentrations in the obese T2DM group despite diminished insulinotropic activity (mean NEFA AUC0–4 h ± SE, 41,992 ± 9,843 µmol·l−1·min−1 vs. 71,468 ± 13,605 with placebo, P = 0.039, 95% CI: 0.31–0.95). Additionally, GIP increased SAT-TAG in obese T2DM (1.78 ± 0.4 vs 0.86 ± 0.1-fold with placebo, P = 0.043, 95% CI: 0.1–1.8). Such effect with GIP was not observed in other three groups despite greater insulinotropic activity. Reduction in NEFA concentration with GIP correlated with adipose tissue insulin resistance for all subjects (Pearson, r = 0.56, P = 0.005). There were no significant gene expression changes in key SAT lipid metabolism enzymes. In conclusion, GIP appears to promote fat accretion and thus may exacerbate obesity and insulin resistance in T2DM.
Informatics Metrics and Measures for a Smart Public Health Systems Approach: Information Science Perspective
Authors: Carney Timothy Jay , Shea Christopher Michael
Published: January 2017

Public health informatics is an evolving domain in which practices constantly change to meet the demands of a highly complex public health and healthcare delivery system. Given the emergence of various concepts, such as learning health systems, smart health systems, and adaptive complex health systems, health informatics professionals would benefit from a common set of measures and capabilities to inform our modeling, measuring, and managing of health system “smartness.” Here, we introduce the concepts of organizational complexity, problem/issue complexity, and situational awareness as three codependent drivers of smart public health systems characteristics. We also propose seven smart public health systems measures and capabilities that are important in a public health informatics professional’s toolkit.
Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality Improvement Interventions
Authors: Weiss Jennifer M. , Pickhardt Perry J. , Schumacher Jessica R. , Potvien Aaron , Kim David H. , Pfau Patrick R. , Jacobs Elizabeth A. , Smith Maureen A.
Published: January 2017

Aims. Colorectal cancer (CRC) screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system). We examined groups of primary care providers (PCPs) based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions.Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166PCPs; 39,430 patients eligible for CRC screening). Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups.Results. We found two distinct groups: (1) PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75) and (2) PCPs identifying no major barriers to screening (N=91). PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08).Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.
Modeling the Mechanisms of Clay Damage by Molecular Dynamic Simulation
Authors: Jin Luchao , Jamili Ahmad , Huang Liangliang , Perez Felipe
Published: January 2017

We carried out MD simulations to review the mechanisms of clay damage under hydration, the manners clays interact with water and cations, and the structures they form in between aluminosilicate sheets and offered an alternative explanation as to how clay structures become instable after certain water concentration. Water molecules form one, two, and sometimes three layers parallel to the clay surfaces. The cations already present in montmorillonites (the most representative of the smectites) or coming with low salinity water will either be adsorbed by the clay surfaces or become fully hydrated, detached from the surfaces, and located in the midst of the interlayer space between clay surfaces, while water molecules that do not hydrate the cations invade the clay structures, making them unstable. The driving force of this phenomenon happens to be the hydration energy of the cations in question.
The lncRNA H19 Promotes Cell Proliferation by Competitively Binding to miR-200a and Derepressing β-Catenin Expression in Colorectal Cancer
Authors: Yang Weiwei , Ning Ning , Jin Xiaoming
Published: January 2017

H19, a paternally imprinted noncoding RNA, has been found to be overexpressed in various cancers, including colorectal cancer (CRC), and may function as an oncogene. However, the mechanism by which H19 regulates CRC progression remains poorly understood. In this study, we aimed to assess H19 expression levels in CRC tissues, determine the effect of H19 on CRC proliferation, and explore the mechanism by which H19 regulates the proliferation of CRC. We measured H19 expression using qRT-PCR and analysed the effects of H19 on colon cancer cell proliferation via cell growth curve, cell viability assay, and colony formation assays. To elucidate the mechanism underlying these effects, we analysed the interactions between H19 and miRNAs and identified the target gene to which H19 and miRNA competitively bind using a series of molecular biological techniques. H19 expression was upregulated in CRC tissues compared with adjacent noncancerous tissues. H19 overexpression facilitated colon cancer cell proliferation, whereas H19 knockdown inhibited cell proliferation. miR-200a bound to H19 and inhibited its expression, thereby decreasing CRC cell proliferation. β-Catenin was identified as a target gene of miR-200a. H19 regulated β-catenin expression and activity by competitively binding to miR-200a. H19 promotes cell proliferation by competitively binding to miR-200a and derepressing β-catenin in CRC.
Improving the Complexity of the Lorenz Dynamics
Authors: Mareca María Pilar , Bordel Borja
Published: January 2017

A new four-dimensional, hyperchaotic dynamic system, based on Lorenz dynamics, is presented. Besides, the most representative dynamics which may be found in this new system are located in the phase space and are analyzed here. The new system is especially designed to improve the complexity of Lorenz dynamics, which, despite being a paradigm to understand the chaotic dissipative flows, is a very simple example and shows great vulnerability when used in secure communications. Here, we demonstrate the vulnerability of the Lorenz system in a general way. The proposed 4D system increases the complexity of the Lorenz dynamics. The trajectories of the novel system include structures going from chaos to hyperchaos and chaotic-transient solutions. The symmetry and the stability of the proposed system are also studied. First return maps, Poincaré sections, and bifurcation diagrams allow characterizing the global system behavior and locating some coexisting structures. Numerical results about the first return maps, Poincaré cross sections, Lyapunov spectrum, and Kaplan-Yorke dimension demonstrate the complexity of the proposed equations.
Data Link Layer Considerations for Future 100 Gbps Terahertz Band Transceivers
Authors: Lopacinski Lukasz , Brzozowski Marcin , Kraemer Rolf
Published: January 2017

This paper presents a hardware processor for 100 Gbps wireless data link layer. A serial Reed-Solomon decoder requires a clock of 12.5 GHz to fulfill timings constraints of the transmission. Receiving a single Ethernet frame on a 100 Gbps physical layer may be faster than accessing DDR3 memory. Processing so fast streams on a state-of-the-art FPGA (field programmable gate arrays) requires a dedicated approach. Thus, the paper presents lightweight RS FEC engine, frames fragmentation, aggregation, and a protocol with selective fragment retransmission. The implemented FPGA demonstrator achieves nearly 120 Gbps and accepts bit error rate (BER) up to 2e-3. Moreover, redundancy added to the frames is adopted according to the channel BER by a dedicated link adaptation algorithm. At the end, ASIC synthesis results are presented including detailed statistics of consumed energy per bit.
Scedosporium prolificansSeptic Arthritis and Osteomyelitis of the Hip Joints in an Immunocompetent Patient: A Case Report and Literature Review
Authors: Daniele Luca , Le Michael , Parr Adam Franklin , Brown Lochlin Mark
Published: January 2017

Scedosporium prolificans, also known asScedosporium inflatum, is a fungus widespread in soil, sewage, and manure. This species is highly virulent and is an emerging opportunistic pathogen found in penetrating injuries in immunocompromised patients. Here we report on an immunocompetent patient with bilateral hipS. prolificans-associated osteomyelitis and septic arthritis caused by intentional penetrating trauma. The condition was refractory to initial antimicrobial suppression and surgical irrigation and debridement. Successful outcome was achieved after incorporating a bilateral two-stage total-hip-arthroplasty with Voriconazole-loaded cement and spacer.
A Comparative Study on the Performance of LLR- and SNR-Based Hybrid Relaying Schemes
Authors: El-Mahdy Ahmed , Alexan Wassim
Published: January 2017

A comparative study on the theoretical bit error rate (BER) is presented for hybrid relaying schemes that toggle between adaptive decode-and-forward (ADF) and amplify-and-forward (AF) protocols, for a typical three-node wireless network. Toggling between the two forwarding protocols is based on the log-likelihood ratio (LLR) or the signal-to-noise ratio (SNR) of the received signal at the relay node. Closed-form expressions for the probability of error are presented, as well as the expressions of the proposed schemes’ gains over classical ADF and AF protocols. Comparisons are carried out among the two schemes and other hybrid schemes found in the literature. Moreover, the impact of relay location on the probability of error is investigated.
Rheological Method for Alpha Test Evaluation of Developing Superplasticizers’ Performance: Channel Flow Test
Authors: Kim Jae Hong , Lee Jin Hyun , Shin Tae Yong , Yoon Jin Young
Published: January 2017

Advance in high-range water-reducing admixture revolutionizes the workability and constructability of conventional vibrated concrete as well as self-consolidating concrete. Its need from construction fields has increased, and consequently a variety of new-type polycarboxylates, base polymers for the admixture, are being formulated in these days. Synthesizing new polymers needs a quick, but reliable, test to evaluate its performance on concrete. The test is also asked for selecting the best applicable brand of them before a test concrete will be mixed. This paper proposes a “channel flow test” and its usage for the purpose. The proposed procedure for the test includes the mix proportion of a test mortar, the test method, and rheological interpretation of the test results.
A Cost Effective Route Guidance Method for Urban Areas Using Histograms
Authors: El-Sayed Hesham , Thandavarayan Gokulnath , Hawas Yasser
Published: January 2017

Analysing shortest path for real time traffic environment is crucial with dynamic updating. VANET technology can be used for analysing traffic but generates a huge amount of data to be exchanged, which demands more processing power and resources. In this paper, a new histogram-based route guidance algorithm (HBA) has been proposed based on light weight processing. The proposed algorithm enables selecting the shortest path between any source and destination using the histogram models, which capture the higher order distribution function of the number vehicles in every lane. Furthermore, the histogram model is used to estimate the traffic delays at intersections and roundabouts. The data entity collection through sensors used for histogram modelling is presented in detail. The experimental results show that the proposed algorithm provides a good prediction of road traffic status and a better solution for the congestion problem in the urban areas.
Thwarting Nonintrusive Occupancy Detection Attacks from Smart Meters
Authors: Man Dapeng , Yang Wu , Xuan Shichang , Du Xiaojiang
Published: January 2017

Occupancy information is one of the most important privacy issues of a home. Unfortunately, an attacker is able to detect occupancy from smart meter data. The current battery-based load hiding (BLH) methods cannot solve this problem. To thwart occupancy detection attacks, we propose a framework of battery-based schemes to prevent occupancy detection (BPOD). BPOD monitors the power consumption of a home and detects the occupancy in real time. According to the detection result, BPOD modifies those statistical metrics of power consumption, which highly correlate with the occupancy by charging or discharging a battery, creating a delusion that the home is always occupied. We evaluate BPOD in a simulation using several real-world smart meter datasets. Our experiment results show that BPOD effectively prevents the threshold-based and classifier-based occupancy detection attacks. Furthermore, BPOD is also able to prevent nonintrusive appliance load monitoring attacks (NILM) as a side-effect of thwarting detection attacks.
Phishing Detection: Analysis of Visual Similarity Based Approaches
Authors: Jain Ankit Kumar , Gupta B. B.
Published: January 2017

Phishing is one of the major problems faced by cyber-world and leads to financial losses for both industries and individuals. Detection of phishing attack with high accuracy has always been a challenging issue. At present, visual similarities based techniques are very useful for detecting phishing websites efficiently. Phishing website looks very similar in appearance to its corresponding legitimate website to deceive users into believing that they are browsing the correct website. Visual similarity based phishing detection techniques utilise the feature set like text content, text format, HTML tags, Cascading Style Sheet (CSS), image, and so forth, to make the decision. These approaches compare the suspicious website with the corresponding legitimate website by using various features and if the similarity is greater than the predefined threshold value then it is declared phishing. This paper presents a comprehensive analysis of phishing attacks, their exploitation, some of the recent visual similarity based approaches for phishing detection, and its comparative study. Our survey provides a better understanding of the problem, current solution space, and scope of future research to deal with phishing attacks efficiently using visual similarity based approaches.
Physicians’ Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis
Authors: Zhao Yongdong , Dedeoglu Fatma , Ferguson Polly J. , Lapidus Sivia K. , Laxer Ronald M. , Bradford Miranda C. , Li Suzanne C.
Published: January 2017

Background/Purpose. Understanding the practices of pediatric rheumatologists in diagnosing and treating chronic nonbacterial osteomyelitis (CNO) can provide important information to guide the development of consensus treatment plans. The objectives of this study were to determine physicians’ approaches to (1) diagnosing and monitoring CNO, (2) ordering a bone biopsy, and (3) making treatment decisions. Methods. A survey was distributed among members of the Childhood Arthritis and Rheumatology Research Alliance using a web-based questionnaire. Results. 121 of 277 (41%) attending physician members completed the survey. Plain radiographs (89%) were most commonly used followed by regional MRI (78%), bone scintigraphy (43%), and whole-body MRI (36%). The top three reasons for performing a biopsy were constitutional findings (66%), unifocal bone lesions (64%), and nocturnal bone pain (45%). Nearly all responders (95%) prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) as initial therapy. For patients who failed NSAID treatment, methotrexate (67%), tumor necrosis factor inhibitors (65%), and bisphosphonates (46%) were the next most commonly used treatments. The presence of a spinal lesion increased the use of bisphosphonate treatment. Conclusion. The diagnostic approach and disease activity monitoring for CNO varied among surveyed physicians. Our survey findings provided important background for the development of consensus treatment plans for CNO.
Management of Venous Thromboembolism in Patients with Hereditary Antithrombin Deficiency and Pregnancy: Case Report and Review of the Literature
Authors: Refaei Mohammad , Xing Lydia , Lim Wendy , Crowther Mark , Boonyawat Kochawan
Published: January 2017

Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50–90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels.Methods. A review of the literature was conducted for studies on prophylaxis and management of VTE in pregnant patients with hereditary AT deficiency. The search involved a number of electronic databases, using combinations of keywords as described in the text. Only English language studies between 1946 and 2015 were included.Conclusion. Antithrombin concentrate is indicated in pregnant women with hereditary AT deficiency who develop VTE despite being on therapeutic dose anticoagulation. Expert opinion suggests AT concentrate should be used concomitantly with therapeutic dose anticoagulation. However, further high-quality studies on the dose and duration of treatment in the postpartum period are required. Use of AT concentrate for prophylaxis is controversial and should be based on individual VTE risk stratification.
The Effect of Diagnostic Imaging on Surgical Treatment Planning in Diseases of the Thymus
Authors: Ottlakan Aurel , Borda Bernadett , Morvay Zita , Maraz Aniko , Furak Jozsef
Published: January 2017

Accurate imaging of the thymus is essential in the diagnosis and surgical treatment of both neoplastic and nonneoplastic conditions. Imaging of the thymus is a rather complex task, which affects both initial diagnosis and further surgical treatment planning. Imaging techniques include a wide armamentary of possibilities, from the most frequently used computed tomography (CT) to 18-fluorodeoxyglucose positron emission tomography- (18-FDG-PET-) CT and chemical shift magnetic resonance imaging (CS-MRI). In cases where surgical treatment is involved diagnostic imaging is of pivotal importance, not only in distinguishing benign from malignant disease but also in making a way among subtypes of thymic conditions. The article presents a current review of the advantages and backdrops of different imaging techniques used in the diagnosis of benign and malignant thymic conditions, with emphasis on differential imaging of thymic hyperplasia (TH), ectopic thymic tissue (ETT), and thymic epithelial tumors (TETs), with special attention to the importance of MR imaging according to the new TNM classification of thymic epithelial tumors.
A Narrowing Diagnosis: A Rare Cause of Adult Croup and Literature Review
Authors: Patel Jayshil J. , Kitchin Emily , Pfeifer Kurt
Published: January 2017

Croup or laryngotracheitis is rare in adults. We present a case of an otherwise healthy young woman that presented in the winter with 3 days of increasing dyspnea, cough, and fever. She was hemodynamically stable but was found to have a barking cough, paradoxical abdominal breathing, and stridor. Chest radiograph revealed subglottic narrowing. Respiratory viral nucleic acid amplification testing was positive for respiratory syncytial virus. The patient was treated with nebulized epinephrine, dexamethasone, and a helium-oxygen mixture. Stridor resolved immediately after starting the helium-oxygen mixture. Within 72 hours, the patient made a complete clinical recovery without the need for escalation of care. Prehospital discharge chest radiograph demonstrated resolution of subglottic narrowing.
East Meets West: Synergy through Diversity
Authors: Hager Stefan , Dai Jingzhang , Fischer Volker , Lüthke Folkert , Staudinger Anton
Published: January 2017

The TCM hospital Bad Kötzting is historically the first inpatient facility in Germany with an emphasis on Traditional Chinese Medicine (TCM). The clinic's specialty is the multimodal treatment of somatic complaints in conjunction with acute psychological or psychiatric comorbidity. Most patients present with clinical problems of a high degree of chronicity and complexity. Over the past 25 years the treatment concept of the hospital has developed from a strictly TCM approach to a multimodal combination of TCM, psychosomatic medicine, and lifestyle medicine. This article outlines the admission and intake procedures and describes the process of determining the TCM diagnoses and treatment protocols. A typical case study illustrates this process in more details. Then, we present the various components of the psychotherapeutic and psychoeducational programs, including innovative approaches to lifestyle medicine. In conclusion, the treatment program at the TCM hospital Bad Kötzting has developed into a multimodal approach that synergistically intertwines diverse therapies drawn from Eastern and Western traditions, effectively combining the best approaches of both contexts.
Quality Control and Complication Screening Programme of Chinese Medicinal Drugs at the First German Hospital of Traditional Chinese Medicine - A Retrospective Analysis
Authors: Melchart Dieter , Hager Stefan , Dai Jingzhang , Weidenhammer Wolfgang
Published: January 2017

Background: The use of drugs derived from plants is a cornerstone of Traditional Chinese Medicine (TCM). Yet, too little is known about risk and safety of Chinese medicinal drugs (CMD). Therefore, the TCM hospital Bad Kötzting has developed a quality control and complication screening programme in order to ensure a safe administration of TCM drugs to their patients. Methods: All Chinese medicinal drugs delivered to the hospital between September 1, 2012 and December 31, 2013 entered the quality control program and were screened for microbial contamination, aflatoxin, pesticides and heavy metals. A routinely applied complication screening programme monitored liver enzymes in all patients. Case causality assessment by CIOMS scale and identification of admitted herbs were conducted. Additionally, side effects of patients were identified by a routinely performed web-based documentation system. Results: In 5 of 23 investigated samples (21.7%) the initial testing showed microbial contamination (2), pesticide (2) and heavy metals (1). The drugs were tested for authenticity and adulterations, respectively. All 994 patients (mean age 52.6 years; 72.6% female) admitted were available for analysis. 448 (45.1%) of all patients reported having perceived at least one side effect of treatment. They experienced mainly gastrointestinal symptoms (13.6%), neurovegetative symptoms (10.8 %), temporary deteriorations of pain (8.8%), diarrhoea (5.9%), nausea (1.6%) and vomiting (0.5%). Further, 6 patients with a more than 2-fold elevation (compared to maximum normal value or elevated admission values) of ALT were found in the systematic laboratory control with a non-conclusive causality assessment for TCM-drugs. Conclusion: Approximate incidence rates and analysed drugs associated with liver damage revealed a low rate of liver injury. Patients should be informed of the gastrointestinal symptoms caused by and potential hepatotoxicity of TCM herbs.
Quality Profiling at the TCM Hospital Bad Kötzting - Examples from an Ongoing Systematic Patient Documentation
Authors: Weidenhammer Wolfgang , Melchart Dieter
Published: January 2017

Background: Quality profiling is practiced at the TCM hospital Bad Kötzting since its establishment 25 years ago. The profiling comprises assessment of treatment effectiveness andsafety, structural features, staff qualification as well as diagnostic and therapeutic processes. Findings regarding patients, intervention and outcome profiles are presented by appropriate examples. Methods: Data of each in-patient were systematically collected by physicians and via self-reports at admission, discharge and follow-up. Over the years the system was adjusted several times resulting in a data pool of about 19,000 in-patients by end of 2014. Results: Patients are 52 years old on average, 70% are female, and suffering from the main complaint since 7 years (median). The diagnostic spectrum changed over the years according to the development towards a psychosomatic focus. For TCM acupuncture therapy 222 different acupoints were used in 7.7 different localisations on average per individual treatment. The mean intensity of the main complaint decreased clinically relevant (Cohen's d = 1.11 at discharge and 0.93 at follow-up). After the hospital stay the number of days of sick leave declined from 51.3 days by 40% per patient and year. Depressive disorders as most common mental illness decreased significantly decreased significantly at discharge (ICD symptom rating; Cohen's d = -1.01). 29.8% of patients met the criteria for a metabolic syndrome diagnosis according to the International Diabetes Federation (IDF). In this group of cases, triglycerides, cholesterol and blood glucose improved markedly at discharge. Discussion: The presented quality control measures clearly contribute to an enhanced transparency in terms of a comprehensive quality profile. The findings from various outcome parameters indicate that patients benefit from the treatment.
Surfactant Need by Gestation for Very Preterm Babies Initiated on Early Nasal CPAP: A Danish Observational Multicentre Study of 6,628 Infants Born 2000-2013
Authors: Wiingreen Rikke , Greisen Gorm , Ebbesen Finn , Petersen Jesper Padkær , Zachariassen Gitte , Henriksen Tine Brink , Mølholm Hansen Bo
Published: January 2017

Background: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but few studies provide data on this. Since the 1990s, the first approach to respiratory support to preterm infants in Denmark has been early nCPAP combined with surfactant administration by the INSURE method by which the infant is intubated and surfactant administration is followed by rapid extubation to nCPAP if possible. Objectives: To investigate how often surfactant was administered in preterm infants with a gestational age below 34 weeks treated with early nCPAP as a first approach to respiratory support. Methods: An observational multicentre study including all inborn infants with a gestational age below 34 weeks admitted to 1 of the 4 level 3 neonatal intensive care units in Denmark in the period from 2000 to 2013. Results: A total of 6,628 infants were included in this study. We found that surfactant was administered in 1,056 of 1,799 (59%; 95% CI: 57-61%), in 821 of 2,864 (29%; 95% CI: 27-31%), and in 132 of 1,796 (7%; 95% CI: 6-8%) of the infants with a gestational age from 24 to 27, 28 to 31, and 32 to 33 weeks and 6 days, respectively. Conclusions: A large proportion of preterm infants treated with early nCPAP as the first approach to respiratory support was never treated with surfactant.
Use of Transcutaneous Bilirubin to Determine the Need for Phototherapy in Resource-Limited Settings
Authors: Olusanya Bolajoko O. , Emokpae Abieyuwa A.
Published: January 2017

Background: Routine and timely determination of total serum bilirubin (TSB) remains a challenge in many resource-limited countries with substantial burden of severe neonatal hyperbilirubinemia. Limited evidence exists on the potential usefulness of transcutaneous bilirubin (TcB) to identify infants who may require phototherapy based on possible treatment criteria in such settings. Objective: To compare the number of infants requiring phototherapy across different TSB criteria and determine the predictive performance of TcB under each criterion. Methods: Infants with paired TcB and TSB measurements in a maternity hospital in Lagos, Nigeria, were assessed for phototherapy based on TSB criteria by the American Academy of Pediatrics (AAP), National Institute for Health and Clinical Excellence (NICE) UK, and World Health Organization (WHO), and an absolute threshold of ≥12 mg/dL. The predictive performance of TcB across treatment criteria was evaluated with receiver operating curve analysis. Results: A total of 1,011 infants with a mean TcB of 10.54 ± 3.19 (range: 2.7-19.9) mg/dL and TSB of 9.63 ± 2.61 (range: 0.3-19.5) mg/dL were assessed. Some 60 (5.9%) infants required phototherapy by 1 or more TSB criteria, with TSB ≥12 mg/dL identifying 55 (91.7%) and AAP 27 (45%) of these infants. All infants identified by the NICE and WHO criteria were equally detected by the AAP criterion. TcB showed negative predictive values of 99.0-99.9%, and positive predictive values of 7.7-15.5% across all criteria. Conclusions: The number of infants requiring phototherapy varies significantly across treatment criteria. TcB may be useful in identifying infants who do not require phototherapy, but may also identify a high proportion of false positives that is burdensome in resource-limited settings.
Bioresorbable Vascular Scaffolds for the Treatment of Chronic Total Occlusions
Authors: Mitomo Satoru , Naganuma Toru , Fujino Yusuke , Kawamoto Hiroyoshi , Basavarajaiah Sandeep , Pitt Michael , Yin Wei-Hsian , Tresukosol Damras , Colombo Antonio , Nakamura Sunao
Published: January 2017

Background—

There are only limited studies reporting clinical outcomes after bioresorbable vascular scaffold (BVS; Absorb; Abbott Vascular, Santa Clara, CA) implantation for coronary chronic total occlusions (CTO). The aim of this study was to evaluate the real-world feasibility and safety of BVS implantation for the treatment of CTO.

Methods and Results—

We retrospectively evaluated CTO cases treated with BVS from a multicenter registry. The primary end point was target lesion failure defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization. From September 2012 to November 2015, 65 patients with CTO were successfully treated with BVS. The mean age of patients was 60.8±11.0 years; 89.2% were male and 40.0% diabetic. The mean ejection fraction was 57.7±10.8%. The mean reference vessel diameter and CTO lesion length were 3.0±0.4 and 20.2±3.0 mm, respectively. The mean number of BVS deployed per patient was 1.8±0.7, of which mean diameter and total length were 3.0±0.4 and 47.6±19.9 mm, respectively. Postdilatation with noncompliant balloons (mean diameter 3.3±0.3 mm) was performed at high pressures (18.6±5.3 atm) in all cases. Intravascular ultrasound (n=34) or optical coherence tomography (n=31) was performed in all cases. During the follow-up period (median: 453 days, 25th and 75th percentiles: 230 and 703), there were no occurrences of target lesion failure or scaffold thrombosis.

Conclusions—

BVS implantation for the treatment of CTO seems feasible and safe. Appropriate lesion preparation, high-pressure postdilatation, and the use of intravascular imaging are recommended to obtain the best possible final result.
Lookit (Part 2): Assessing the Viability of Online Developmental Research, Results From Three Case Studies
Authors: Scott Kimberly , Chu Junyi , Schulz Laura
Published: January 2017

To help address the participant bottleneck in developmental research, we developed a new platform called “Lookit,” introduced in an accompanying article (Scott & Schulz, 2017 ), that allows families to participate in behavioral studies online via webcam. To evaluate the viability of the platform, we administered online versions of three previously published studies involving different age groups, methods, and research questions: an infant ( M = 14.0 months, N = 49) study of novel event probabilities using violation of expectation, a study of two-year-olds’ ( M = 29.2 months, N = 67) syntactic bootstrapping using preferential looking, and a study of preschoolers’ ( M = 48.6 months, N = 148) sensitivity to the accuracy of informants using verbal responses. Our goal was to evaluate the overall feasibility of moving developmental methods online, including our ability to host the research protocols, securely collect data, and reliably code the dependent measures, and parents’ ability to self-administer the studies. Due to procedural differences, these experiments should be regarded as user case studies rather than true replications. Encouragingly, however, all studies with all age groups suggested the feasibility of collecting developmental data online and the results of two of three studies were directly comparable to laboratory results.