bluuebunny/crossref_metadata_2025 huggingface dataset:
Rotor structure design of permanent magnet synchronous generator by topology optimization method using GA
Authors: Mizuno Shota , Ishikawa Takeo , Kurita Nobuyuki
Published: August 2016

This paper proposes a topology optimization method and rotor structure designs for a permanent magnet synchronous generator based on this method. These described designs enable high output power and less permanent magnet volume. The topology optimization method is a genetic algorithm that considers the clusters and cleaning procedure of material. The optimized rotor has a structure in which the magnet is moved in the direction of rotation, and the output power of the optimized rotor is larger than that of the Prius type generator, in spite of less PM volume.
Research on strategies to improve measurement of coating thickness in hemispherical steel shells for an inclined eddy current sensor
Authors: Zhang Dongli , Wu Meixian , Li Hongmei , Chen Zhenmao , Li Yong , Xie Shejuan
Published: August 2016

The thickness of anti-corrosive layer coated in the inner surface of steel oil containers is very important to prevent the containers from corrosion. To make the measurement accurate, some effective means are needed, especially for the eddy current sensor inclining or deviating over the curved inner surface of the containers. By using an electromagnetic field simulation method with high accuracy, the distorted signals and the measure precision of lift-off were analyzed. Then, some correction measures were proposed according to the characteristics of testing signals due to the sensor's inclination or deviation. Simulation results confirmed their effectiveness for enhancing the measure precision. The conclusions can give an effective theoretical guide to the centering and verticality controlling of the sensor in practice.
An efficient approach to the construction of motion graphs
Authors: Zhao Minghua , Yuan Yongqin , Shi Zhenghao , Zhao Jinwei , Wang Yinghui
Published: August 2016

A novel approach to the construction of motion graphs based on a new similarity measurement method is proposed in this paper. The main contributions of this paper are: i) to improve the accuracy of motion similarity computing, a new similarity measurement method is presented which combines frame distance based on dynamic time warping (DTW) with uniform warping window and motion distance based on motion features; ii)to avoid illogical jump of standard motion graph, a new automatic construction strategy of motion graphs based on similarity of motion clips is proposed, transition points of which are matched based on the path with the minimum cost and motions are synthesized based on motion transition points. Experimental results based on the CMU MoCap human motion database show that the proposed method can confirm the logical correctness and naturalness in the junction of two human locomotion sequences and its efficiency is two or three times faster than the standard motion graph.
Practical and privacy-preserving information retrieval from a database table
Authors: Di Crescenzo Giovanni , Cook Debra L. , McIntosh Allen , Panagos Euthimios
Published: August 2016

We study the problem of privately performing database queries (i.e., keyword searches and conjunctions over them), where a server provides its own database for a client’s query-based access. We propose a cryptographic model for the study of such protocols, by expanding previous well-studied models of keyword search and private information retrieval to incorporate a more practical data model: a time-varying, multi-attribute and multiple-occurrence database table.

Our first result is a 2-party private database retrieval protocol. This is the first protocol that preserves query and data privacy on such a practical data model. Like all previous work in private information retrieval and keyword search, this protocol still satisfies server time complexity linear in the database size.

Our main result is a private database retrieval protocol in a 3-party model where encrypted data is outsourced to a third party (i.e., a cloud server), satisfying highly desirable privacy and efficiency properties; most notably: (1)  no unintended information is leaked to clients or servers, and only minimal ‘access pattern’ information is leaked to the third party; (2) for each query, all parties run in time only logarithmic in the number of database records; (3) the protocol’s runtime is practical for real-life applications, as shown in our implementation where we achieve response time that is only a small constant slower than commercial non-private protocols like MySQL. This is the first protocol that achieves privacy of database and query content with practical performance.

Finally, we show a second private database retrieval protocol in the 3-party model for which we can show that no unintended information is leaked to an adversary corrupting both clients and third parties, at an only constant additional performance overhead cost.
Context-aware security: Linguistic mechanisms and static analysis
Authors: Bodei Chiara , Degano Pierpaolo , Galletta Letterio , Salvatori Francesco
Published: August 2016

Adaptive systems improve their efficiency by modifying their behaviour to respond to changes in their operational environment. Also, security must adapt to these changes and policy enforcement becomes dependent on the dynamic contexts. We study these issues within [Formula: see text], (the core of) an adaptive declarative language proposed recently. A main characteristic of [Formula: see text] is to have two components: a logical one for handling the context and a functional one for computing. We extend this language with security policies that are expressed in logical terms. They are of two different kinds: context and application policies. The first, unknown a priori to an application, protect the context from unwanted changes. The others protect the applications from malicious actions of the context, can be nested and can be activated and deactivated according to their scope. An execution step can only occur if all the policies in force hold, under the control of an execution monitor. Beneficial to this is a type and effect system, which safely approximates the behaviour of an application, and a further static analysis, based on the computed effect. The last analysis can only be carried on at load time, when the execution context is known, and it enables us to efficiently enforce the security policies on the code execution, by instrumenting applications. The monitor is thus implemented within [Formula: see text], and it is only activated on those policies that may be infringed, and switched off otherwise.
SQLiDDS: SQL injection detection using document similarity measure
Authors: Kar Debabrata , Panigrahi Suvasini , Sundararajan Srikanth
Published: August 2016

SQL injection attack has been a major security threat to web applications for over a decade. Now a days, attackers use automated tools to discover vulnerable websites from search engines and launch attacks on multiple websites simultaneously. Being extremely heterogeneous in nature, accurate run-time detection of SQL injection attacks, particularly those previously unseen, is still a challenge using regular-expression or parse-tree matching techniques suggested in the literature. In this paper, we present a novel approach for real-time detection of SQL injection attacks by applying document similarity measure on run-time queries after normalizing them into sentence-like form. The proposed approach acts as a database firewall and can protect multiple web applications using the database server. With additional inputs from human expert, the system can also become more robust over time. We implemented the approach in a tool named SQLiDDS and the experimental results are very encouraging. The approach can effectively detect all types of SQL injection attacks and previously unseen attacks with substantial accuracy yet negligible impact on overall performance of web applications. The tool was built with PHP and tested on web applications built with PHP and MySQL, but it can be adapted to other platforms with minimal changes.
Toxicological Characterization of Exon Skipping Phosphorodiamidate Morpholino Oligomers (PMOs) in Non-human Primates
Authors: Carver Michael P. , Charleston Jay S. , Shanks Courtney , Zhang Jianbo , Mense Mark , Sharma Alok K. , Kaur Harjeet , Sazani Peter
Published: August 2016

Background: Phosphorodiamidate morpholino oligomers (PMOs) are a class of exon skipping drugs including eteplirsen, which has shown considerable promise for treatment of the degenerative neuromuscular disease, Duchenne musculardystrophy (DMD).

Objective: Toxicity studies in non-human primates (NHPs) of 12 weeks duration with two new PMOs for DMD, SRP-4045 and SRP-4053, along with results from a chronic study in NHPs of 39 weeks duration for eteplirsen, are described here.

Methods: PMOs were administered once-weekly by bolus intravenous (IV) injections to male NHPs. Endpoints evaluated included plasma exposures, clinical observations, body weight/food consumption, eye exams, electrocardiograms, male reproductive hormones/endpoints, complement alternative pathway, clinical pathology, urinalysis, and macroscopic/light microscopic pathology.

Results: Findings in these studies were limited to the kidneys, with a common presentation of tubular basophilia, vacuolation, and/or minimal degeneration that was considered non-adverse. No necrosis, glomerular lesions, or effects on renal function tests such as serum creatinine or urea nitrogen were observed, suggesting that PMO-related kidney findings are not likely to develop into frank nephrotoxicity. There were no adverse effects on other potential target organs after repeated IV injections at the highest dose levels tested, 320 mg/kg.

Conclusions: Nonclinical results in NHPs for these three PMOs, together with the excellent clinical safety established for eteplirsen to date, suggest that once-weekly IV administration of PMOs for lifetime durations at therapeutic doses will be well tolerated by patients with DMD.
Increasing Role of Titin Mutations in Neuromuscular Disorders
Authors: Savarese Marco , Sarparanta Jaakko , Vihola Anna , Udd Bjarne , Hackman Peter
Published: August 2016

The TTN gene with 363 coding exons encodes titin, a giant muscle protein spanning from the Z-disk to the M-band within the sarcomere. Mutations in the TTN gene have been associated with different genetic disorders, including hypertrophic and dilated cardiomyopathy and several skeletal muscle diseases.

Before the introduction of next generation sequencing (NGS) methods, the molecular analysis of TTN has been laborious, expensive and not widely used, resulting in a limited number of mutations identified. Recent studies however, based on the use of NGS strategies, give evidence of an increasing number of rare and unique TTN variants. The interpretation of these rare variants of uncertain significance (VOUS) represents a challenge for clinicians and researchers.

The main aim of this review is to describe the wide spectrum of muscle diseases caused by TTN mutations so far determined, summarizing the molecular findings as well as the clinical data, and to highlight the importance of joint efforts to respond to the challenges arising from the use of NGS. An international collaboration through a clinical and research consortium and the development of a single accessible database listing variants in the TTN gene, identified by high throughput approaches, may be the key to a better assessment of titinopathies and to systematic genotype– phenotype correlation studies.
Developmental Milestones and Quality of Life Assessment in a Congenital Myotonic Dystrophy Cohort
Authors: Prasad Madhavi , Hicks Rhiannon , MacKay Melissa , Nguyen Cam-Tu , Campbell Craig
Published: August 2016

Background: Congenital myotonic dystrophy (CDM) is a neuromuscular disorder caused by a CTG triplet repeat expansion in the DMPK gene. In addition to the expected motor delay, affected children often have significant developmental disability in language and cognitive realms, which ultimately impacts on quality of life.

Objective: In a prospective cohort of children with CDM to 1) present the profile of language and motor developmental milestones, and 2) describe their early childhood health related quality of life (HRQOL).

Methods: A five year cohort study of eligible incident cases of CDM was performed via the Canadian Pediatric Surveillance Program (CPSP). Consenting subjects were then followed from infancy in a prospective cohort study. Caregivers were contacted every 3 months for the first year of life, and then twice yearly in order to obtain data concerning language skills, motor development and parent proxy HRQOL from the PedsQL and Infant and Toddler Quality of life (ITQOL) questionnaires.

Results: Milestones were achieved at later ages in patients when compared to healthy children. Girls appeared to be more delayed than boys in both language and motor skills. HRQOL scores remained stable in this cohort, for both the PedsQL and ITQOL.

Conclusions: Understanding developmental milestones and quality of life are important parameters when judging a child’s overall health. For CDM patients delineating developmental milestones and QOL have important clinical care and research implications.
Similar Efficacy from Specific and Non-Specific Mineralocorticoid Receptor Antagonist Treatment of Muscular Dystrophy Mice
Authors: Lowe Jeovanna , Floyd Kyle T. , Rastogi Neha , Schultz Eric J. , Chadwick Jessica A. , Swager Sarah A. , Zins Jonathan G. , Kadakia Feni K. , Smart Suzanne , Gomez-Sanchez Elise P. , Gomez-Sanchez Celso E. , Raman Subha V. , Janssen Paul M.L. , Rafael-Fortney Jill A.
Published: August 2016

Background: Combined treatment with an angiotensin-converting enzyme inhibitor and a mineralocorticoid receptor (MR) antagonist improved cardiac and skeletal muscle function and pathology in a mouse model of Duchenne muscular dystrophy. MR is present in limb and respiratory skeletal muscles and functions as a steroid hormone receptor.

Objective: The goals of the current study were to compare the efficacy of the specific MR antagonist eplerenone with the non-specific MR antagonist spironolactone, both in combination with the angiotensin-converting enzyme inhibitor lisinopril.

Methods: Three groups of n = 18 dystrophin-deficient, utrophin-haploinsufficient male mice were given chow containing: lisinopril plus spironolactone, lisinopril plus eplerenone, or no drug, from four to 20 weeks-of-age. Eighteen C57BL/10 male mice were used as wild-type controls. In vivo measurements included cardiac magnetic resonance imaging, conscious electrocardiography, and grip strength. From each mouse in the study, diaphragm, extensor digitorum longus, and cardiac papillary muscle force was measured ex vivo, followed by histological quantification of muscle damage in heart, diaphragm, quadriceps, and abdominal muscles. MR protein levels were also verified in treated muscles.

Results: Treatment with specific and non-specific MR antagonists did not result in any adverse effects to dystrophic skeletal muscles or heart. Both treatments resulted in similar functional and pathological improvements across a wide array of parameters. MR protein levels were not reduced by treatment.

Conclusions: These data suggest that spironolactone and eplerenone show similar effects in dystrophic mice and support the clinical development of MR antagonists for treating skeletal muscles in Duchenne muscular dystrophy.
Roles of Cognitive Status and Intelligibility in Everyday Communication in People with Parkinson’s Disease: A Systematic Review
Authors: Barnish Maxwell S. , Whibley Daniel , Horton Simon M.C. , Butterfint Zoe R. , Deane Katherine H.O.
Published: August 2016

Background: Communication is fundamental to human interaction and the development and maintenance of human relationships and is frequently affected in Parkinson’s disease (PD). However, research and clinical practice have both tended to focus on impairment rather than participation aspects of communicative deficit in PD. In contrast, people with PD have reported that it is these participation aspects of communication that are of greatest concern to them rather than physical speech impairment.

Objective: To systematically review the existing body of evidence regarding the association between cognitive status and/or intelligibility and everyday communication in PD.

Methods: Five online databases were systematically searched in May 2015 (Medline Ovid, EMBASE, AMED, PsycINFO and CINAHL) and supplementary searches were also conducted. Two reviewers independently evaluated retrieved records for inclusion and then performed data extraction and quality assessment using standardised forms. Articles were eligible for inclusion if they were English-language original peer-reviewed research articles, book chapters or doctoral theses investigating the associations between at least one of cognitive status and level of intelligibility impairment and an everyday communication outcome in human participants with PD.

Results: 4816 unique records were identified through database searches with 16 additional records identified through supplementary searches. 41 articles were suitable for full-text screening and 15 articles (12 studies) met the eligibility criteria. 10 studies assessed the role of cognitive status and 9 found that participants with greater cognitive impairment had greater everyday communication difficulties. 4 studies assessed the role of intelligibility and all found that participants with greater intelligibility impairment had greater everyday communication difficulties, although effects were often weak and not consistent.

Conclusions: Both cognitive status and intelligibility may be associated with everyday communicative outcomes in PD. The contribution of intelligibility to everyday communication appears to be of small magnitude, suggesting that other factors beyond predominantly motor-driven impairment-level changes in intelligibility may play an important role in everyday communication difficulties in PD.
Assessment of Nonmotor Fluctuations Using a Diary in Advanced Parkinson’s disease
Authors: Ossig Christiana , Sippel Daniel , Fauser Mareike , Gandor Florin , Jost Wolfgang H. , Ebersbach Georg , Storch Alexander
Published: August 2016

Background: Since previous studies aimed to study nonmotor symptom (NMS) fluctuations in direct conjunction with motor oscillations, there are no data available on the temporal context of NMS fluctuations and motor oscillations in advanced Parkinson’s disease (PD).

Objective: To evaluate circadian patterns and temporal connections of NMS and motor fluctuations in PD.

Methods: 15 controls, 17 non-fluctuating and 15 fluctuating PD patients completed two diaries by rating 4 key psychiatric (anxiety, depressive mood, inner restlessness, concentration/attention deficits), fatigue and 4 autonomic NMS (excessive sweating, sialorrhea, bladder urgency, dizziness) absent or present and motor function (Off, On with/without dyskinesia, and asleep) for every hour for 5 consecutive days.

Results: NMS Off state hours (hours with NMS rated as present) were less frequent compared to motor Off state hours and NMS On-Off-switches were less prevalent compared to those of the motor state. Off time and number of On-Off-switches of psychiatric NMS were moderately correlated with motor Off time and number of motor On-Off switches on the individual patient level. Changes in NMS state occurred largely independent of changes in motor states with concordance rates of only 26–43% of all NMS changes for psychiatric and 7–17% for autonomic NMS. In controls and non-fluctuating PD patients, there were no NMS state switches in concordance to motor state switches.

Conclusion: We provide first data on the temporal context of NMS fluctuations showing similar frequencies of psychiatric NMS Off, fatigue Off and motor Off times as well as their On-Off-fluctuations, but low concordance rates of NMS with motor On-Off-state switches. We found no evidence for NMS fluctuations in non-fluctuating PD patients. Our data implicate similar fluctuation patterns of mood NMS and motor function without close timing and/or different kinetics.
The Effects of Physical Activity in Parkinson’s Disease: A Review
Authors: Lauzé Martine , Daneault Jean-Francois , Duval Christian
Published: August 2016

Background: Physical activity (PA) is increasingly advocated as an adjunct intervention for individuals with Parkinson’s disease (PD). However, the specific benefits of PA on the wide variety of impairments observed in patients with PD has yet to be clearly identified.

Objective: Highlight health parameters that are most likely to improve as a result of PA interventions in patients with PD.

Methods: We compiled results obtained from studies examining a PA intervention in patients with PD and who provided statistical analyses of their results. 868 outcome measures were extracted from 106 papers published from 1981 to 2015. The results were classified as having a statistically significant positive effect or no effect. Then, outcome measures were grouped into four main categories and further divided into sub-categories.

Results: Our review shows that PA seems most effective in improving Physical capacities and Physical and cognitive functional capacities. On the other hand, PA seems less efficient at improving Clinical symptoms of PD and Psychosocial aspects of life, with only 50% or less of results reporting positive effects. The impact of PA on Cognitive functions and Depression also appears weaker, but few studies have examined these outcomes.

Discussion: Our results indicate that PA interventions have a positive impact on physical capacities and functional capacities. However, the effect of PA on symptoms of the disease and psychosocial aspects of life are moderate and show more variability. This review also highlights the need for more research on the effects of PA on cognitive functions, depression as well as specific symptoms of PD.
Apathy in Mild Parkinson’s Disease: Neuropsychological and Neuroimaging Evidence
Authors: Alzahrani Hamad , Antonini Angelo , Venneri Annalena
Published: August 2016

Background: Apathy is one of the most common neuropsychiatric symptoms in Parkinson’s disease (PD). Few studies have investigated the cognitive and neuroanatomical correlates of apathy in PD, and those which have done so have not controlled for the presence of other neuropsychiatric comorbidities.

Objective: To explore the cognitive and neuroanatomical correlates of apathy in PD at a mild disease stage.

Methods: Sixty-five PD patients and 24 healthy controls participated in this study. Patients underwent extensive neuropsychological screening, neuropsychiatric assessment using the Neuropsychiatric Inventory, structural MRI scanning, and neurological examination. Voxel-based independent t-test analyses were used to assess the differences in grey and white matter volumes between the sample groups with/without apathy/neuropsychiatric symptoms.

Results: Patients with apathy had lower grey matter volume in several brain areas including the left insula, left inferior/middle/medial frontal gyrus, right anterior cingulate, and the left superior temporal gyrus. Significant impairments were found in tests assessing executive functions, and a trend-level significant difference was observed in long term memory tests in patients with apathy, when compared with patients without apathy.

Conclusions: Apathy was associated with greater levels of atrophy in the frontal and temporal cortex, and anterior cingulate, as well as overall lower level of cognitive performance, particularly in executive function and memory skills. Apathy appears to be associated with cognitive impairments in PD, therefore, treatment of this symptom might mitigate its effects on cognitive performance in this clinical population.
Health and Social Service Access Among Family Caregivers of People with Parkinson’s Disease
Authors: Olsson Yvonne , Clarén Lena , Alvariza Anette , Årestedt Kristofer , Hagell Peter
Published: August 2016

Background: Being a family caregiver for a person with Parkinson’s disease (PD) can negatively impact health and wellbeing, but it appears less clear to what extent caregivers’ health/social service needs are met.

Objective: We explored the extent to which PD family caregivers experience sufficient access to health/social services, as compared to age-matched controls; and the associations between this and demographic and health-related variables.

Methods: A cross-sectional survey of 66 PD family caregivers and 79 age-matched control subjects including the SF-36 health survey, the Nottingham Health Profile Sleep section (NHP-Sleep), and questions regarding contacts with various health/social related services and whether these were perceived as sufficient.

Results: People reporting insufficient access ( n = 29) were more often PD family caregivers than controls (83% vs. 37%), did more often have a disease of their own (79% vs. 46%), and reported poorer health according to the SF-36 and the NHP-Sleep. Being a PD family caregiver (OR, 8.90), reporting more pain (OR, 1.02) and having an own disease (OR, 3.46) were independently associated with insufficient health/social service access.

Conclusions: Our results imply that those in greatest need for health/social services (i.e., those with poorer health, an own disease, and who are PD family caregivers) are those whose health/social service needs are least met. Larger studies are needed for firmer conclusions and regarding how unmet health/social service needs impacts caregiver health and wellbeing. Health/social service providers should not only focus on patients but also consider their family members’ needs.
Impulse Control Disorders in Parkinson’s Disease are Associated with Alterations in Reward-Related Cortical Oscillations
Authors: Carriere Nicolas , Bourriez Jean-Louis , Delval Arnaud , Derambure Philippe , Defebvre Luc , Dujardin Kathy
Published: August 2016

Background: Impulse control disorders (ICDs) in Parkinson’s disease (PD) are related to treatment with dopamine agonists, which is thought to deregulate the dopaminergic mesolimbic pathway and impair reward evaluation. EEG studies in healthy controls (HCs) have suggested that the increase in theta power observed after negative outcome is a marker of reward processing.

Objective: To compare outcome-locked, event-related spectral perturbation in a gambling task in PD patients with and without ICDs and in HCs.

Methods: Twelve PD patients with ICDs, 12 PD patients without ICDs and 14 HCs underwent EEG while performing a gambling task. The groups were compared in terms of (i) the peak EEG power in the theta (4–7 Hz), alpha (8–14 Hz) and beta (15–30 Hz) frequency bands between 200 and 500 ms after the outcome, and (ii) time-frequency plots at Fz, FCz and Cz.

Results: Positive outcomes were associated with greater theta power than negative outcomes in patients without ICDs and in HCs, but not in patients with ICDs. Patients with ICDs and HCs displayed greater theta power following unexpectedly high outcomes. HCs displayed greater beta power following high amplitude than low amplitude outcomes, whereas patients with ICD showed the opposite pattern.

Conclusions: In PD, ICDs are associated with (i) weaker modulation of frontocentral theta power by reward valence, (ii) greater frontocentral theta power following unexpected, high outcomes, and (iii) a reversal of the effect of risk on beta oscillations. These observations are consistent with an impairment in prediction error computation in the medial prefrontal cortex.
Pathophysiological Concepts and Treatment of Camptocormia
Authors: Margraf N.G. , Wrede A. , Deuschl G. , Schulz-Schaeffer W.J.
Published: August 2016

Camptocormia is a disabling pathological, non-fixed, forward bending of the trunk. The clinical definition using only the bending angle is insufficient; it should include the subjectively perceived inability to stand upright, occurrence of back pain, typical individual complaints, and need for walking aids and compensatory signs (e.g. back-swept wing sign). Due to the heterogeneous etiologies of camptocormia a broad diagnostic approach is necessary. Camptocormia is most frequently encountered in movement disorders (PD and dystonia) and muscles diseases (myositis and myopathy, mainly facio-scapulo-humeral muscular dystrophy (FSHD)). The main diagnostic aim is to discover the etiology by looking for signs of the underlying disease in the neurological examination, EMG, muscle MRI and possibly biopsy. PD and probably myositic camptocormia can be divided into an acute and a chronic stage according to the duration of camptocormia and the findings in the short time inversion recovery (STIR) and T1 sequences of paravertebral muscle MRI. There is no established treatment of camptocormia resulting from any etiology. Case series suggest that deep brain stimulation (DBS) of the subthalamic nucleus (STN-DBS) is effective in the acute but not the chronic stage of PD camptocormia. In chronic stages with degenerated muscles, treatment options are limited to orthoses, walking aids, physiotherapy and pain therapy. In acute myositic camptocormia an escalation strategy with different immunosuppressive drugs is recommended. In dystonic camptocormia, as in dystonia in general, case reports have shown botulinum toxin and DBS of the globus pallidus internus (GPi-DBS) to be effective. Camptocormia in connection with primary myopathies should be treated according to the underlying illness.
Effect of patient safety incident review and reflection in an extended morbidity and mortality meeting
Authors: Mehta Saurabh , Singh Harvinder Pal , Dias Joseph J.
Published: August 2016

BACKGROUND: We modified the departmental mortality and morbidity (M&M) meetings to evaluate whether patient safety incident review as a part of this meeting was associated with reduced patient safety incidents.

METHOD: A pilot programme of peer review of patient safety incidents (PSI) supported by education relevant to that event and follow-on action plan was introduced as a part of an extended morbidity and mortality meeting in a university hospital orthopaedic department. The pilot programme was conducted over six months (January 2012–June 2012). This programme involved junior and senior doctors including consultants although multidisciplinary groups were invited to attend. We investigated PSI rate/1000 hospital admissions for trauma and elective surgery, which were collected prospectively and independently between Jan 2011 to June 2013. We noted if the incident was caused by a medical or a nursing error and compared PSI rates.

RESULTS: Rates of PSI (33/1000) were 7.8 times higher in trauma cases (80.2/1000) than in elective admissions (11.2/1000). There was 18% reduction in trauma and 27% reduction in planned elective admissions. The rate increased after the pilot programme finished but there was still a 7% reduction compared to the pre-pilot period. This study found a significant reduction in the PSI rate for medical error but no change in the rate of nursing error.

CONCLUSION: This continuous reflection, education and action process, where safety events are reviewed as a part of the extended morbidity and mortality meeting, is associated with reduction of patient safety incidents. We recommend that PSI reflection should be introduced in Mortality and Morbidity meetings with mandated attendance of the entire multidisciplinary health care team.
3D Printed Surgical Instruments Evaluated by a Simulated Crew of a Mars Mission
Authors: Wong Julielynn Y. , Pfahnl Andreas C.
Published: August 2016

INTRODUCTION: The first space-based fused deposition modeling (FDM) 3D printer became operational in 2014. This study evaluated whether Mars simulation crewmembers of the Hawai’i Space Exploration Analog and Simulation (HI-SEAS) II mission with no prior surgical experience
could utilize acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments FDM 3D printed on Earth to complete simulated surgical tasks.METHODS: This study sought to examine the feasibility of using 3D printed surgical tools when the primary crew medical officer is incapacitated
and the back-up crew medical officer must conduct a surgical procedure during a simulated extended space mission. During a 4 mo duration ground-based analog mission, five simulation crewmembers with no prior surgical experience completed 16 timed sets of simulated prepping, draping, incising,
and suturing tasks to evaluate the relative speed of using four ABS thermoplastic instruments printed on Earth compared to conventional instruments.RESULTS: All four simulated surgical tasks were successfully performed using 3D printed instruments by Mars simulation crewmembers
with no prior surgical experience. There was no substantial difference in time to completion of simulated tasks with control vs. 3D printed sponge stick, towel clamp, scalpel handle, and toothed forceps.DISCUSSION: These limited findings support further investigation into the creation
of an onboard digital catalog of validated 3D printable surgical instrument design files to support autonomous, crew-administered healthcare on Mars missions. Future work could include addressing sterility, biocompatibility, and having astronaut crew medical officers test a wider range of
surgical instruments printed in microgravity during actual surgical procedures.Wong JY, Pfahnl AC. 3D printed surgical instruments evaluated by a simulated crew of a Mars mission. Aerosp Med Hum Perform. 2016; 87(9):806–810.
Social, Occupational, and Cultural Adaptation During a 12-Month Wintering in Antarctica
Authors: Nicolas Michel , Bishop Sheryl L. , Weiss Karine , Gaudino Marvin
Published: August 2016

BACKGROUND AND METHODS: Life in isolated and confined environments (ICEs) is subject to important constraints which can generate psychosociologically impaired outcomes. This study investigated psychological, social, occupational, and cultural variables which are among the most
important determinants in adaptation to a one-year wintering in Antarctica for 13 international subjects.RESULTS: Our findings confirm and give further insight into the role of social (Cohesiveness, Social Support) and occupational (Implementation/Preparedness, Counterproductive
Activity, Decision Latitude, and Psychological Job Demands) dimensions of adaptation to ICEs. Relationships between various social and occupational dimensions studies reflected detrimental effects ranging from decrements in cohesiveness (ICE 1, M = 4.44; ICE 7, M = 3.33), social
support (ICE 2, M = 4.93; ICE 7, M = 4.28), and work performance (ICE 1, M = 4.33; ICE 6, M = 3.5), which differed across professional status and multicultural factors.DISCUSSION: These psychosocial issues have important implications for pre-mission selection
and training, monitoring and support of crews during the mission, and post-mission readaptation. Operational recommendations are suggested to improve adaptation, success, and well-being for long-duration ICE missions, e.g., to Mars and beyond.Nicolas M, Bishop SL, Weiss K, Gaudino M. Social,
occupational, and cultural adaptation during a 12-month wintering in Antarctica. Aerosp Med Hum Perform. 2016; 87(9):781–789.
Endovascular Treatment of a Severe Stroke Occurring in a Commercial Airplane Over the Sahara
Authors: Foerch Christian , Mayer Christoph A. , Berkefeld Joachim , You Se-Jong
Published: August 2016

BACKGROUND: The occurrence of an acute stroke syndrome during a long-distance flight demands critical decisions from the crew and attendant physicians. One in particular is whether the flight should be continued or be detoured to a nearby airport.CASE REPORT: We describe
a 42-yr-old woman who suffered from a severe stroke in a commercial airplane over the Sahara. The captain, together with a physician aboard and the next of kin, decided not to detour to north African or south European airports, but to continue flying to Frankfurt, Germany (final destination;
remaining flight time 4 h), where an efficient transfer infrastructure and an advanced medical standard were presumed. At the hospital, the patient was successfully treated by means of catheter-based mechanical thrombus extraction. The patient was free of neurological deficits at discharge.DISCUSSION:
The geographically unbalanced availability of complex but highly effective therapies such as mechanical recanalization in acute stroke challenges decision making in aviation medicine. In selected cases it might be beneficial to continue flying to cities with advanced medical standards instead
of deviating to nearby airports.Foerch C, Mayer CA, Berkefeld J, You S-J. Endovascular treatment of a severe stroke occurring in a commercial airplane over the Sahara. Aerosp Med Hum Perform. 2016; 87(9):825–829.
Association of Individual Characteristics with Teleoperation Performance
Authors: Pan Dan , Zhang Yijing , Li Zhizhong , Tian Zhiqiang
Published: August 2016

BACKGROUND: A number of space activities (e.g., extravehicular astronaut rescue, cooperation in satellite services, space station supplies, and assembly) are implemented directly or assisted by remote robotic arms. Our study aimed to reveal those individual characteristics which
could positively influence or even predict teleoperation performance of such a space robotic arm.METHODS: There were 64 male volunteers without robot operation experience recruited for the study. Their individual characteristics were assessed, including spatial cognitive ability,
cognitive style, and personality traits. The experimental tasks were three abstracted teleoperation tasks of a simulated space robotic arm: point aiming, line alignment, and obstacle avoidance. Teleoperation performance was measured from two aspects: task performance (completion time, extra
distance moved, operation slips) and safety performance (collisions, joint limitations reached). The Pearson coefficients between individual characteristics and teleoperation performance were examined along with performance prediction models.RESULTS: It was found that the subjects
with relatively high mental rotation ability or low neuroticism had both better task and safety performance (|r| = 0.212 ∼ 0.381). Subjects with relatively high perspective taking ability or high agreeableness had better task performance (r = −0.253; r = −0.249).
Imagery subjects performed better than verbal subjects regarding both task and safety performance (|r| = 0.236 ∼ 0.290). Compared with analytic subjects, wholist subjects had better safety performance (r = 0.300). Additionally, extraverted subjects had better task performance
(r = −0.259), but worse safety performance (r = 0.230).CONCLUSIONS: Those with high spatial cognitive ability, imagery and wholist cognitive style, low neuroticism, and high agreeableness were seen to have more advantages in working with the remote robotic arm.
These results could be helpful to astronaut selection and training for space station missions.Pan D, Zhang Y, Li Z, Tian Z. Association of individual characteristics with teleoperation performance. Aerosp Med Hum Perform. 2016; 87(9):772–780.
Loss of Consciousness During Single Sling Helicopter Hoist Rescue Resulting in a Fatal Fall
Authors: Biles Jessie , Garner Alan A.
Published: August 2016

INTRODUCTION: Although harness suspension trauma has been documented since the 1960s, especially in the mountaineering setting, there is little robust medical research into the area. Helicopter hoist rescue shares similar risks and is reserved for those cases that cannot be accessed
safely by other routes, where extrication may be hazardous or will take an unreasonable amount of time. The single sling or chest harness used for hoist rescue is a single harness around the upper torso and is easier and quicker to apply than a stretcher. However, the risks of a chest harness
need to be balanced against the patient’s condition, the environment, aircraft performance, and the urgency of the rescue.CASE REPORT: We report an adult male falling 80 ft to his death while being hoisted into a rescue helicopter for a likely fractured ankle. A single rescue
sling harness technique was used, but the patient became unconscious, slipped out of the harness, and fell. He had significant comorbidities, including cardiomyopathy, obstructive sleep apnea, morbid obesity, and diabetes.DISCUSSION: A decrease in cardiac output secondary to thoracic
compression was the presumed cause for his loss of consciousness and the potential physiological mechanisms and modifying factors are discussed. Further research into harness suspension trauma is required. Stretcher, double point harnesses, or rescue baskets are likely safer methods of hoisting,
especially in a medically compromised patient.Biles J, Garner AA. Loss of consciousness during single sling helicopter hoist rescue resulting in a fatal fall. Aerosp Med Hum Perform. 2016; 87(9):821–824.
Sleep and Fatigue Differences in the Two Most Common Types of Commercial Flight Operations
Authors: Reis Cátia , Mestre Catarina , Canhão Helena , Gradwell David , Paiva Teresa
Published: August 2016

BACKGROUND: Sleep and fatigue management is one of the main challenges in airline operations scheduling. Our aim was to compare the differences regarding fatigue, sleep, and labor specificities between the two most common types of flight, short/medium haul (SM-H) and long haul
(L-H), in a large sample of airline pilots.METHODS: A self-report questionnaire was developed, composed of socio-economic and labor questions, and psychological assessment scales for fatigue and sleep. Associations of these variables and type of flight were tested.RESULTS:
Of the total sample of Portuguese airline pilots (N = 435), 313 (72%) were from SM-H and 122 (28%) were from L-H. For SM-H, the values obtained for sleep complaints were 34.2%, daytime sleepiness 61.6%, and fatigue 93.0%. For L-H, 36.9%, 53.3%, and 84.4%, respectively. Looking at labor
variables, the differences between the two types of flights were evident, with SM-H pilots’ having statistically significant higher mean values of duty and flight hours, numbers of sectors, and early mornings. Only the mean number of night periods was higher in L-H pilots. All values
were reported for 28 consecutive scheduling days.CONCLUSION: Night periods and time-zone crossing may explain higher prevalence levels of sleep disturbances in L-H pilots. However, the values for daytime sleepiness were higher in SM-H pilots, which may be attributed to diminished
sleep caused by a combination of frequent early starts and long duty periods. Taking into account the large differences between the two types of flights, different regulatory limits should be considered by aviation authorities.Reis C, Mestre C, Canhão H, Gradwell D, Paiva T. Sleep
and fatigue differences in the two most common types of commercial flight operations. Aerosp Med Hum Perform. 2016; 87(9):811–815.
Metabolic Syndrome in Military Aircrew Using a Candidate Definition
Authors: Sharma Sanjiv , Chandrashekar AM , Singh Vishal
Published: August 2016

INTRODUCTION: Prevalence of metabolic syndrome (MetS) in the Indian population varies from 31.6 to 41.1%. Indians, without being conventionally obese, but inherently insulin resistant, have higher risk of developing cardiovascular diseases and diabetes. Since military aircrew,
belonging to the same ethnic pool, may reflect similar prevalence of MetS as the general Indian populace, this study was undertaken to find the prevalence of MetS among Indian military aircrew using one candidate definition.METHODS: In this cross sectional descriptive study, 210
military aircrew voluntarily participated. Besides demographic and lifestyle related details, their anthropometric measurements, including height, weight, waist circumference, hip circumference, and skin fold thickness were recorded. Body mass index and waist-to-hip ratio were deduced from
the recorded measurements. Resting heart rate and blood pressure were recorded and appropriate laboratory investigations were undertaken.RESULTS: Prevalence of MetS, as per chosen definition, was 33.3% (N = 70), which had moderate, fair, and slight agreement with NCEP ATP
III (k = 0.43), IDF (k = 0.27), and WHO (k = 0.15) definitions, respectively. Decadal prevalence of MetS was found to be highest in the fourth decade (46.8%), followed by the third decade (41.3%).CONCLUSION: Reported prevalence of MetS highlights an urgent need to define preventive
strategies to minimize loss of trained manpower among military aircrew. Flight surgeons have an important role to play to educate aircrew about modifying their lifestyle to reduce morbidity and mortality among themselves in the future.Sharma S, Chandrashekar AM, Singh V. Metabolic syndrome in military aircrew using a candidate definition. Aerosp Med Hum Perform. 2016; 87(9):790–794.
Adenosine Receptor Stimulation by Polydeoxyribonucleotide Improves Tissue Repair and Symptomology in Experimental Colitis
Authors: Pallio Giovanni , Bitto Alessandra , Pizzino Gabriele , Galfo Federica , Irrera Natasha , Squadrito Francesco , Squadrito Giovanni , Pallio Socrate , Anastasi Giuseppe P. , Cutroneo Giuseppina , Macrì Antonio , Altavilla Domenica
Published: August 2016

Activation of the adenosine receptor pathway has been demonstrated to be effective in improving tissue remodeling and blunting the inflammatory response. Active colitis is characterized by an intense inflammatory reaction resulting in extensive tissue damage. Symptomatic improvement requires both control of the inflammatory process and repair and remodeling of damaged tissues. We investigated the ability of an A2Areceptor agonist, polydeoxyribonucleotide (PDRN), to restore tissue structural integrity in two experimental colitis models using male Sprague-Dawley rats. In the first model, colitis was induced with a single intra-colonic instillation of dinitrobenzenesulfonic acid (DNBS), 25 mg diluted in 0.8 ml 50% ethanol. After 6 h, animals were randomized to receive either PDRN (8 mg/kg/i.p.), or PDRN + the A2Aantagonist [3,7-dimethyl-1-propargylxanthine (DMPX); 10 mg/kg/i.p.], or vehicle (0.8 ml saline solution) daily. In the second model, dextran sulfate sodium (DSS) was dissolved in drinking water at a concentration of 8%. Control animals received standard drinking water. After 24 h animals were randomized to receive PDRN or PDRN+DMPX as described above. Rats were sacrificed 7 days after receiving DNBS or 5 days after DSS. In both experimental models of colitis, PDRN ameliorated the clinical symptoms and weight loss associated with disease as well as promoted the histological repair of damaged tissues. Moreover, PDRN reduced expression of inflammatory cytokines, myeloperoxidase activity, and malondialdehyde. All these effects were abolished by the concomitant administration of the A2Aantagonist DMPX. Our study suggests that PDRN may represent a promising treatment for improving tissue repair during inflammatory bowel diseases.
Three-Class EEG-Based Motor Imagery Classification Using Phase-Space Reconstruction Technique
Authors: Djemal Ridha , Bazyed Ayad , Belwafi Kais , Gannouni Sofien , Kaaniche Walid
Published: August 2016

Over the last few decades, brain signals have been significantly exploited for brain-computer interface (BCI) applications. In this paper, we study the extraction of features using event-related desynchronization/synchronization techniques to improve the classification accuracy for three-class motor imagery (MI) BCI. The classification approach is based on combining the features of the phase and amplitude of the brain signals using fast Fourier transform (FFT) and autoregressive (AR) modeling of the reconstructed phase space as well as the modification of the BCI parameters (trial length, trial frequency band, classification method). We report interesting results compared with those present in the literature by utilizing sequential forward floating selection (SFFS) and a multi-class linear discriminant analysis (LDA), our findings showed superior classification results, a classification accuracy of 86.06% and 93% for two BCI competition datasets, with respect to results from previous studies.