bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of implants with superelastic behaviour for midface reconstruction
Authors: Wagner Maximilian E. H. , Rotsch Christian , Hanus Sibylle , Essig Harald , Grunert Ronny , Gellrich Nils-Claudius , Lichtenstein Jürgen
Published: March 2020

The proper reconstruction of midfacial defects is an ongoing challenge in the field of reconstructive surgery. One of the principal aims of adequate therapeutic and anatomical reconstruction was to guarantee good functional and aesthetical results. In this context, one of the most challenging areas as regards reconstruction of the facial skeleton is the orbit, which refers to the cavity or socket of the skull in which the eye and its appendages are situated. Today, computer-assisted surgery, particularly in combination with patient-specific implants, allows for the reconstruction of complex orbital defects with high precision. In this regard, in commercially available titanium implants, the final shape of the implant has to be determined before insertion; otherwise, not determining the final implant shape can sometimes result in considerable soft-tissue sequelae after implant placement. This problem can be addressed with the use of new material characteristics such as superelasticity in shape-memory alloys. This special type of nickel-titanium-alloy has already found utility in various medical disciplines. In this context, here, we propose to use shape-memory alloys for orbital reconstruction and combine their unique characteristics with the possibility of patient-specific shape-memory alloy implants. We experimented on a broad spectrum of implant geometries and finally achieved a shape that combines sufficient stiffness with superelastic properties. The combination of patient-specific shape and the special physical properties of shape-memory alloy implants can find utility in orbital reconstruction as well as various other surgical reconstructions.
Correlates of Infrequent Plain Water Intake Among US High School Students: National Youth Risk Behavior Survey, 2017
Authors: Park Sohyun , Onufrak Stephen , Cradock Angie , Patel Anisha , Hecht Christina , Merlo Caitlin , Blanck Heidi M.
Published: March 2020

Purpose:

To examine factors associated with frequency of plain water (ie, tap, bottled, and unflavored sparkling water) intake among US high school students.

Design:

Quantitative, cross-sectional study.

Setting:

The 2017 national Youth Risk Behavior Survey data.

Subjects:

US high school students with plain water intake data (N = 10 698).

Measures:

The outcome was plain water intake. Exposure variables were demographics, academic grades, and behavioral characteristics.

Analysis:

We used logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for factors associated with infrequent plain water intake (<3 vs ≥3 times/day).

Results:

Overall, 48.7% of high school students reported drinking plain water <3 times/day. Factors associated with infrequent plain water intake were younger age (≤15 years; aOR = 1.20, CI = 1.05-1.37); earning mostly D/F grades (aOR = 1.37, CI = 1.07-1.77); consuming regular soda 1 to 6 times/week (aOR = 1.92, CI = 1.67-2.20) or ≥1 time/day (aOR = 3.23, CI = 2.65-3.94), sports drinks 1 to 6 times/week (aOR = 1.30, CI = 1.14-1.49), milk <2 glasses/day (aOR = 1.51, CI = 1.31-1.73), fruits <2 times/day (aOR = 1.92, CI = 1.66-2.22), and vegetables <3 times/day (aOR = 2.42, CI = 2.04-2.89); and being physically active ≥60 minutes/day on <5 days/week (aOR = 1.83, CI = 1.60-2.08). Students with obesity were less likely to have infrequent water intake (aOR = 0.63, CI = 0.53-0.74).

Conclusions:

Infrequent plain water intake was associated with younger age, poor academic grades, poor dietary behaviors, and physical inactivity. These findings can inform intervention efforts to increase water intake to promote healthy lifestyles among adolescents.
Fatigue life analysis of double-row tapered roller bearing in a modern wind turbine under oscillating external load and speed
Authors: Zheng Jingyang , Ji Jinchen , Yin Shan , Tong Van-Canh
Published: March 2020

Fatigue life analysis of roller bearing is usually performed for bearings under constant rotating speed and invariant loading conditions. For the bearings used in offshore floating direct-drive wind turbines, they often experience oscillating motions with varying loading patterns, for which the standard fatigue life analysis is not valid due to the presence of fluctuating loads. This paper presents the fatigue life analysis of a double-row tapered roller bearing under oscillating external load and speed conditions, which is used to support the main shaft of a large modern direct-drive wind turbine. First, a comprehensive quasi-static model of the double-row tapered roller bearing is developed for determining the internal load distribution of rollers. The contact pressure of rollers is then studied using an iterative scheme based on the elastic contact model. After that, the formulation of basic rating life of the double-row tapered roller bearing with oscillating external load and speed is given to calculate the fatigue life. Numerical simulations are carried out to investigate the effects of the oscillating load and speed, angular misalignment, and internal clearance on the fatigue life of the bearing.
Delays in HIV and TB diagnosis and treatment initiation in co-infected patients in Colombia
Authors: Ríos-Hincapié Cielo Yaneth , Rojas Marcela , López Martha , Porras Alexandra , Luque Ricardo , Pelissari Daniele Maria , López Lucelly , Rueda Zulma Vanessa
Published: March 2020

We investigated the delays in the diagnosis of tuberculosis and/or HIV, their treatment initiation, and factors associated with each delay. All drug-susceptible tuberculosis cases diagnosed in 2014 and 2015 in Colombia, with a confirmed diagnosis of HIV were included. A total of 1909 patients were registered with tuberculosis/HIV co-infection. Seventy-nine percent of patients were men, 50% had sputum smear-negative tuberculosis, culture was done in 50% of cases, 68.5% had <200 CD4 cell count at diagnosis, and 35% had concurrent tuberculosis/HIV diagnosis. Delays in the tuberculosis diagnosis were identified in 54.8% of the patients, and delays in tuberculosis and HIV treatment initiation in 41.8% and 27.4%, respectively. The risk factors associated with delay in tuberculosis diagnosis were age between 15–34 and ≥45 years, and those patients who received tuberculin skin test. The risk factor associated with antiretroviral therapy initiation delay was previously-treated tuberculosis patients after failure. It is necessary to implement strategies for early detection and treatment initiation of HIV and to use rapid test for tuberculosis diagnosis in this population.
Performance of propensity score matching to estimate causal effects in small samples
Authors: Andrillon Anais , Pirracchio Romain , Chevret Sylvie
Published: March 2020

Propensity score (PS) matching is a very popular causal estimator usually used to estimate the average treatment effect on the treated (ATT) from observational data. However, opting for this estimator may raise some efficiency issues when the sample size is limited. Therefore, we aimed to evaluate the performance of propensity score matching in this context. We started with a motivating example based on a cohort of 66 children with sickle cell anemia who received either allogeneic bone-marrow transplant or chronic transfusion. We found substantial differences in the ATT estimate according to the model selected for propensity score estimation and subsequent matching. Then, we assessed the performance of the different propensity score matching methods and post-matching analyses to estimate the ATT using a simulation study. Although all selected propensity score matching methods were based of previous recommendations, we found important discrepancies in the estimation of treatment effect between them, underlining the importance of thorough sensitivity analyses when using propensity score matching in the context of small sample sizes.
Asymptotic permutation tests for coefficients of variation and standardised means in general one-way ANOVA models
Authors: Pauly Markus , Smaga Łukasz
Published: March 2020

Coefficients of variations are unit-free measures that can, for example, be used to compare the variability of different samples. To this end, we study inference methods for them as well as their reciprocal given by standardised means in general heterogeneous one-way ANOVA designs. As no specific model assumptions are made, a permutation method is proposed to guarantee good finite sample performance. Building on recent limit theorems for randomisation techniques, we prove that the permutation procedure is asymptotically correct in general and finitely exact when data is exchangeable. These results are fostered in extensive simulation studies and two illustrative data analyses.
Accuracy of B‐type natriuretic peptide in a multiethnic Asian population with acute dyspnea
Authors: Yeganeh Mojdeh , Jaweed Syed Saleem , Woei Kelvin Siew Shenq , Zakaria Mohd Idzwan bin , Loch Alexander
Published: March 2020

Background:

Optimal cut‐offs for B‐type natriuretic peptide (BNP) for the diagnosis of heart failure differ based on ethnicity. There are no data for Southeast Asian patients. We aimed to define the optimal cut‐off points and the strength of B‐type natriuretic peptide as a predictor of heart failure in Southeast Asian multiethnic population.

Methods:

Bedside B‐type natriuretic peptide (SOB panel (Biosite®)) was measured for patients (>50 years) presenting with dyspnea. Emergency physicians (blinded to B‐type natriuretic peptide result) assessed the probability of acute heart failure on a scale of 0%–100%. Heart failure diagnosis was adjudicated by two cardiologists.

Results:

In all, 43% (n = 87) of the 203 dyspneic patients (54.7% males, 453% females) had a final diagnosis of acute heart failure. B‐type natriuretic peptide values ranged from 3.2 to 4960 pg/mL (median, 189 pg/mL). Median B‐type natriuretic peptide values of patients with the final diagnosis of “acute heart failure,” “no acute heart failure but history of heart failure,” and “no heart failure” were 600, 301, and 68 pg/mL, respectively. The optimum cut‐off was 186 pg/mL. The receiver operating characteristic curve of the emergency physician's assessment of the probability of heart failure based on clinical assessment had an area under the curve of 85% (95% confidence interval: 80%–90%). Combining receiver operating characteristic curves of physician assessment and B‐type natriuretic peptide values yielded an area under the curve of 96% (95% confidence interval: 93%–98%). B‐type natriuretic peptide levels less than 100 pg/mL were the strongest predictor of heart failure (odds ratio: 26.36; confidence interval: 6.85–101.41), followed by upper lobe diversion and cardiomegaly.

Conclusion:

The accuracy of bedside B‐type natriuretic peptide was validated in a multiethnic Asian population. Optimum cut‐off is 186 pg/mL. A B‐type natriuretic peptide >100 pg/mL is the single strongest independent predictor of heart failure.
Isolated intraventricular conduction delay in fulminant myocarditis: A case report
Authors: Lo Yat Hei , Wong Yau Tak
Published: March 2020

Introduction:

Fulminant myocarditis is uncommon. Making the diagnosis in the emergency department is difficult due to the nonspecific clinical presentation and electrocardiogram results.

Case presentation:

A 58-year-old Chinese woman presented to an emergency department with dizziness and malaise for 2 days. She was hypotensive and afebrile. Initial electrocardiogram showed isolated nonspecific intraventricular conduction delay. Despite resuscitation, she rapidly deteriorated in the emergency department and eventually succumbed. Autopsy and histological examination of heart muscle found acute inflammatory cell infiltration and multifocal necrosis, suggestive of acute fulminant myocarditis.

Discussion:

There is a wide range of differential diagnosis of nonspecific intraventricular conduction delay. Clinical presentation of mycoarditis is also often non-specific. Rapid and accurate recognition of the condition is essential to save life.

Conclusion:

Fulminant myocarditis presenting with cardiogenic shock and isolated intraventricular conduction delay on electrocardiogram poses a diagnostic challenge as illustrated in this case report.
Optimal design and experimental evaluation of magneto-rheological mount applied to start/stop mode of vehicle powertrain
Authors: Deng Zhaoxue , Yang Qinghua , Yang Xuejiao
Published: March 2020

Magneto-rheological mount is one of the most effective vibration isolation devices for the vibration isolation system of vehicle powertrain. In this article, a flow type of magneto-rheological mount was proposed to control the vibration and the torque excitation of the engine when vehicle was in start/stop mode. A mathematical model for the flow type of magneto-rheological mount was formulated with consideration of the influence of current on magneto-rheological fluid viscosity and the relationship between liquid resistance effect and flow rate in damping gap. Then, a co-simulation optimal platform was developed by the Isight and the ANSYS, and the non-dominated sorting genetic algorithm II was used to optimize magnetic circuit. Subsequently, two prototypes of magneto-rheological mounts were manufactured according to the initial design and the optimal design model, and the dynamic performance test of magneto-rheological mount monomer and the vibration isolation performance test of the whole vehicle under start/stop mode were carried out, respectively. The experimental results showed that the controllability and the vibration isolation performance of the optimal design magneto-rheological mount were significantly improved compared with the initial design.
Do Writing Errors Bother Professionals? An Analysis of the Most Bothersome Errors and How the Writer’s Ethos is Affected
Authors: Gubala Carolyn , Larson Kara , Melonçon Lisa
Published: March 2020

This study asks whether grammatical and mechanical errors bother business professionals, which of these types of errors are most bothersome, and whether such errors affect perceptions of the writer and their ethos. We administered a 17-question survey to roughly 100 business professionals whose roles are not primarily writing and communication within organizations. The findings show that business professionals are bothered by these errors and that the level of bothersomeness has increased from previous studies. Additionally, the findings show that participants have clear views of writers who make errors and that the context of the error matters. The authors conclude by offering implications for technical and professional communication.
Safety of two-hour intermittent intravenous infusions of tacrolimus in the allogeneic hematopoietic stem cell transplantation unit
Authors: Bacopoulos Alexander JS , Ho Lina , Yang Anjie , Ng Pamela , Dara Celina , Loach David , Deotare Uday , Michelis Fotios V , Viswabandya Auro , Kim Dennis D , Lipton Jeffrey H , Messner Hans A , Thyagu Santhosh
Published: March 2020

At our institution, tacrolimus is used as a second-line agent for the prevention and treatment of graft-versus-host-disease in the allogeneic hematopoietic stem cell transplantation (HSCT) unit after patients have experienced a serious or intolerable adverse event to cyclosporine. As per our standard practice, tacrolimus is administered via 2-h intermittent IV infusions (IIVs) every 12 h rather than continuous IV infusion. Shorter infusion times are cautioned due to concerns of higher rates of nephrotoxicity, neurotoxicity and infusion-related reactions, although there is a paucity of data to support this claim. Our primary objective was to evaluate the safety of a 2-h IIV of tacrolimus in an adult HSCT population. We retrospectively reviewed the charts of 104 patients who received tacrolimus by IIV (3574 doses; median = 22, range 1–158, IQR = 28) from 2002 to 2016. Primary outcomes collected include rates of nephrotoxicity, neurotoxicity and infusion-related reactions. One (0.9%) grade 2 infusion-related reaction occurred and resolved without discontinuation of tacrolimus. Of 16 incidences (13.6%) of nephrotoxicity, all but 10 (8.5%) cases resolved. Precipitating factors for nephrotoxicity unrelated to tacrolimus were identified in all 10 cases. There were 41 incidences (35%) of neurotoxicity, of which, 8 (6.8%) were considered serious. All neurotoxicity reverted to baseline or resolved completely. We propose that a 2-h IIV of tacrolimus is a safe method of administration in the adult HSCT setting.
Patient and Physician Perspectives on Systemic Sclerosis–Associated Interstitial Lung Disease
Authors: Cheema Tariq J , Young Meilin , Rabold Erica , Barbieri Ashley N , Baldwin Nancy , Steen Virginia D
Published: March 2020

Systemic sclerosis–associated interstitial lung disease is challenging to diagnose and treat. Patients and physicians can perceive the disease differently and have different views on its management. Communication issues between them can lead to suboptimal disease management. Despite a clear need for improvement in the speed and accuracy of the diagnostic workup, the heterogeneity of clinical symptoms renders the process long and challenging. When considering treatment options, physicians may be more focused on the evidence supporting a particular treatment or on a patient’s pulmonary function test results, as opposed to the realities of the patient’s difficulties with symptoms or the psychosocial effects of systemic sclerosis–associated interstitial lung disease. Disease management plans should be determined by the patient’s own preferences and goals as well as the objective clinical situation. Health care providers must consider their patients as partners on a journey in which treatment decisions are reached jointly. This review will focus on the perspectives of physicians and patients in relation to the diagnosis and management of systemic sclerosis–associated interstitial lung disease. Similarities and differences in these perspectives will be identified, and strategies for achieving optimal disease management will be proposed.
Charting the place of islands in criminology: On isolation, integration and insularity
Authors: Scott John , Staines Zoe
Published: March 2020

In this article, we seek to chart the place of islands in criminology with respect to both their place- and space-based attributes. We explore the possibilities of island criminology through the case of Pitcairn Island, which in 2004 formed the backdrop for a series of sensational sexual assault trials. The trials thrust the Island, its people, history and customs into the international spotlight, acting as a counter-narrative to the popular mythology of islands as idyllic paradises. This case study provides us with an opportunity to re-examine how fundamental concepts for understanding crime and regulation, such as social integration, community and belonging, and exclusion are practised in the often closed and bounded networks of island ecologies.
The boy in a dress: A spectre for our times
Authors: Gray Emily , Reimers Eva , Bengtsson Jenny
Published: March 2020

This article draws upon theories of gender, nation and haunting in order to examine what we term the spectre of the boy in a dress within two international contexts, Sweden and Australia. These two contexts have been chosen because, on the surface, they appear to be very different and yet as our analysis will reveal there are striking similarities around gender conformity discourse and nation, although they play out differently. We illustrate how the notion of the boy in a dress is drawn upon as a problematic figure within these two different socio-political contexts, and argue that this figure represents a ‘tipping point’ between the tolerance and intolerance of gender diversity within public and educational spaces. Two key moments will be analysed. In Australia, the recent (2017) postal survey on Marriage Equality saw a campaign run from a conservative right group, the Coalition for Marriage, that included a television commercial featuring a concerned mother stating that, ‘School told my son he could wear a dress to school if he likes’. In Sweden, in 2016, the department store Åhléns chose an image of a child of African heritage and indeterminate gender to be the face of their annual Lucia marketing. This caused significant controversy and sparked a ‘Jag är Lucia’ (I am Lucia) campaign featuring notable Swedish celebrities dressed as Lucia, including footballer Zlatan Ibrahimović. These critical incidents act as illustration of how the power of cisgender normativity intersects with notions about the nation, within educational spaces and public consciousness.
‘When I look in the bathroom mirror, I see all the women standing behind me’: An evaluation of a leadership development program for women in STEMM
Authors: Nash Meredith , Moore Robyn
Published: March 2020

Leadership development programs (LDPs) are one response to the under-representation of women in leadership positions. This article evaluates Homeward Bound, a 12-month LDP for women in Science, Technology, Engineering, Mathematics and Medicine (STEMM) fields that culminates in a three-week voyage to Antarctica. We evaluate the extent that the program supports key features of LDPs for women – including creating a safe, women-only environment, providing professional networking opportunities and using intersectional approaches. We argue that remote locations generate challenges that must be considered in LDP design and implementation. Findings are widely applicable and can inform LDPs in multiple contexts.
Interactions of the process parameters and mechanical properties of laser butt welds in thin high strength low alloy steel plates
Authors: Riofrío Patricio Gustavo , Capela Carlos Alexandre , Ferreira José AM , Ramalho Amilcar
Published: March 2020

High strength low alloy steels subjected to the thermomechanical control process present excellent strength–toughness combination, high strength/weight ratio, and weldability. Therefore, they are widely used in structural components, such as pressure vessels, oil/gas transportation pipes, lifting equipment, vehicles, shipbuilding and offshore industries, and in the automotive industry where low thickness (0.8–3 mm thickness) is of great importance. Usually, these steels are welded by conventional gas metal arc welding, which creates wide heat-affected zones, large residual stresses, and distortion in the welded parts. Laser welding is nowadays an alternative process to weld high strength low alloy steel parts due to its advantages. The aim of this work is to understand the effect of process parameters on defects, weld bead geometry, microstructure, and mechanical properties, namely hardness and tensile strength. We identify the main laser welding parameters and their influence on the weld bead geometry and defects, for a 3 mm thick high strength low alloy steel welded under a maximum power of 2 kW. A cross section of the weld seam was optimized achieving a good geometry without porosity. The threshold value of the heat input to achieve complete penetration was determined for different focus diameters. The microstructure, size, and hardness of the heat-affected zone and of the fusion zone are strongly influenced by the heat input. The values of the tensile strength achieved in butt welds were close to the base metal by an appropriate selection of the laser welding parameters and the heat input.
Dynamic embodied positionalities: The politics of class and nature through a critical ethnography of homelessness
Authors: Rose Jeff
Published: March 2020

Researchers’ subjective positionalities are often presented as explanatory factors in the interpretation and analyses of ethnographic experiences. In geographic and anthropological ethnographies, positionalities are often benignly disclosed to readers under the auspices of being better able to understand specific subjective backgrounds, or the lenses, through which researchers engage with participants, places, and the overall subject matter. While positionality statements have become standard in qualitative research, there is not sustained development of the dynamic nature of positionality as way to better understand, analyze, and theorize through a research project. To contextualize this methodological argument, I draw from ethnographic engagement with a community of individuals facing homelessness who reside in tents and other rudimentary structures in a public municipal park. My own dynamic positionalities are positioned as both a lens through which I understand the “Hillside residents” and also evolving analytical tools that complicate assumed understandings of class and relationships to nature.
Ethnic penalty and occupational mobility in the Italian labour market
Authors: Avola Maurizio , Piccitto Giorgio
Published: March 2020

The article examines the occupational mobility of immigrants in Italy in a double perspective. First, this work compares immigrants and natives in order to understand whether, and to what extent, in a country characterized overall by low social mobility, natives and migrants have the same chances for improving their social position, or the latter are disadvantaged on an ethnic basis that affects their career (research question 1). Then, the article investigates what are the factors (referring to immigrants’ human capital, socio-cultural assimilation process and ethnic network) fostering occupational mobility among immigrants (research question 2). We conduct an ordinary least squares analysis on microdata from two retrospective cross-sectional surveys, for natives and migrants, with the same sample design, questionnaire structure and variable classification, thereby allowing the comparison of results. The empirical findings confirm that intra-generational occupational mobility in Italy is overall very limited but that geographical origin is a significant factor influencing upward mobility. Thus, the existence of an ethnic penalty is confirmed. Furthermore, among migrants, high human capital improves (short-range) upward mobility, while the socio-cultural assimilation process only partly leads to economic assimilation. Conversely, the recourse to the ethnic network acts as a trap in low-qualified occupational careers, hindering an improvement of socio-economic position.
Professional or authentic motherhood? Negotiations on the identity of the birth mother in the context of foster care
Authors: Weitz Ylva Spånberger , Karlsson Marie
Published: March 2020

This article explores birth parents’ negotiations on the identity of the birth mother in three narratives about shared parenthood in foster care. The article draws on data from an interview study exploring the views of 16 birth parents on their experiences of foster care and non-resident parenthood. Through a position analysis, the authors show how the identity of the birth mother is negotiated in light of the moral discourse on intensive mothering. In these stories, birth mothers are positioned as authentic mothers holding a unique, emotional and life-long bond with their children. In contrast, foster mothers are positioned as professional mothers carrying out the formal activities of everyday care. Birth parents re-negotiate the moral discourse on intensive mothering by downplaying the importance of everyday care. The article thus adds to our knowledge on how non-resident mothers find different ways of constructing a sense of mothering, when they are not able to take part in the everyday care of their children. An understanding of such processes is important for social work practice to handle the challenges that may occur in relationships between foster parents and birth parents and thereby to support a more collaborative approach of shared parenthood.
Evaluation of EndoAnchor Aortic Wall Penetration After Thoracic Endovascular Aortic Repair
Authors: Reyes Valdivia Andrés , Busto Suárez Sara , Duque Santos África , Zanabili Al-Sibbai Ahmad Amer , Gandarias Zúñiga Claudio , Chaudhuri Arindam
Published: March 2020

Purpose: To analyze aortic wall penetration of Heli-FX EndoAnchors after use in seal zones in the aortic arch or descending thoracic aorta during thoracic endovascular aortic repair (TEVAR). Materials and Methods: From May 2014 to May 2019, 25 patients (mean age 70.5±10 years; 16 women) were treated with TEVAR and adjunctive use of the Heli-FX device in 3 academic vascular surgery departments. Computed tomography scans were retrospectively reviewed to determine the location [arch or descending thoracic aorta (DTA)] of the EndoAnchors and the adequacy of aortic wall penetration, defined as adequate (≥2 mm), partial (<2 mm), or inadequate wall penetration (including loss). Endoleaks, reinterventions, and mortality were assessed. Results: A total of 161 EndoAnchors were deployed (median 7 per patient, range 4–9). Twenty-two EndoAnchors were place in the arch (zones 0–2) and 139 in the DTA (zones 3–5). A larger proportion of arch deployments (27%) had suboptimal penetration compared with the DTA (6.5%; p<0.005), resulting in a 91% adequate wall penetration rate for the series overall. Three EndoAnchors were lost (and only 1 retrieved) in 3 different patients, with no additional morbidity; thus, an overall deployment success rate of 88% was achieved. At a mean follow-up of 16.6±14 months, 4 patients required 5 (successful) reinterventions, including one for a type Ia endoleak treated with chimney TEVAR. One patient died 10 months after treatment due to endograft infection, without an opportunity for surgical correction. Conclusion: EndoAnchors have a higher risk of maldeployment in the arch, though this may be attributable to the small learning curve experience in this location. The best aortic wall penetration for this series was in the DTA, where EndoAnchors proved useful for distal endograft fixation during TEVAR.
Applicability of the Zenith Inner Branched Arch Endograft
Authors: Burke Christopher R. , Kratzberg Jarin A. , Yoder Anthony D. , Steele Natasha Z. , Aldea Gabriel S. , Sweet Matthew P.
Published: March 2020

Purpose: To evaluate the clinical and anatomical features of patients with arch pathology to better understand the applicability of the Zenith inner branched arch endograft (IBAE). Materials and Methods: A retrospective review was performed of 60 consecutive patients (mean age 62.5 years; 42 men) who presented with nonruptured aortic arch pathology at a single institution between 2009 and 2016. Patients were stratified into standard (no previous cardiac surgery, <80 years old, and no significant medical comorbidity), high (previous cardiac surgery or significant comorbidity), or prohibitive risk (turned down for operative intervention) for operative intervention. Anatomical measurements of the aorta were obtained on computed tomography scans; anatomical suitability was based on the device’s instructions for use. Results: Overall, 27 (45%) patients had anatomy amenable to treatment with the existing IBAE. Inadequate proximal seal length and large ascending aortic diameters were the primary reasons for anatomical unsuitability. Shortening the inner curve seal zone from 25 to 15 mm and increasing the proximal seal zone diameter from 38 to 42 mm increased anatomical suitability to include 49 (82%) patients. Of these, 31 were in the high-risk cohort and 7 were deemed prohibitive risk; therefore, IBAE would have been strongly considered in these 38 patients. Conclusion: Based on anatomical criteria alone, nearly half of patients with aortic arch pathology have anatomy suitable to the Zenith IBAE in its current design. Arch branch vessel anatomy was not a limitation of the device. From a clinical standpoint, if endovascular repair were reserved for those at high or prohibitive risk for open repair, approximately 30% of patients would likely benefit from the IBAE in its current form.
The Rose and the Cactus: The Lived and Unanswered Callings of Manya Sklodowska (Marie Curie) and Mileva Marić (Einstein)
Authors: Bento Regina F. , Sauerbronn Fernanda F. , Sauerbronn João Felipe R.
Published: March 2020

This article examines the role of calling in the lives of two women: Marie Curie (born “Manya Sklodowska,” in Poland, 1867; died in France, 1934) and Mileva Einstein (born “Mileva Marić” in Serbia, 1875; died in Switzerland, 1948). We explore how the lives of these two women unfolded as they went through the crucibles of sensing, pursuing, and answering or missing their callings.
An Unmodulated Very-Low-Voltage Electrosurgical Technology Creates Predictable and Ultimate Tissue Coagulation: From Experimental Data to Clinical Use
Authors: Watanabe Yusuke , Fuchshuber Pascal , Homma Takafumi , Bilgic Elif , Madani Amin , Hiki Naoki , Cammack Ivor , Noji Takehiro , Kurashima Yo , Shichinohe Toshiaki , Hirano Satoshi
Published: March 2020

Objective. We analyzed the underlying principles of an unmodulated very-low-voltage (VLV) mode, designated as “soft coagulation” in hemostasis, and demonstrate its clinical applications. Summary Background Data. While the advantage of the VLV mode has been reported across surgical specialties, the basic principle has not been well described and remains ambiguous. Methods. Characteristics of major electrosurgical modes were measured in different settings. For the VLV mode, the tissue effect and electrical parameters were assessed in simulated environments. Results. The VLV mode achieved tissue coagulation with the lowest voltage compared with the other modes in any settings. With increasing impedance, the voltage of the VLV mode stayed very low at under 200 V compared with other modes. The VLV mode constantly produced effective tissue coagulation without carbonization. We have demonstrated the clinical applications of the method. Conclusions. The voltage of the VLV mode consistently stays under 200 V, resulting in tissue coagulation with minimal vaporization or carbonization. Therefore, the VLV mode produces more predictable tissue coagulation and minimizes undesirable collateral thermal tissue effects, enabling nerve- and function-preserving surgery. The use of VLV mode through better understanding of minimally invasive way of using electrosurgery may lead to better surgical outcomes.
Fabric defect detection using the improved YOLOv3 model
Authors: Jing Junfeng , Zhuo Dong , Zhang Huanhuan , Liang Yong , Zheng Min
Published: March 2020

To improve the detection rate of defect and the fabric product quality, a higher real-time performance fabric defect detection method based on the improved YOLOv3 model is proposed. There are two key steps: first, on the basis of YOLOv3, the dimension clustering of target frames is carried out by combining the fabric defect size and k-means algorithm to determine the number and size of prior frames. Second, the low-level features are combined with the high-level information, and the YOLO detection layer is added on to the feature maps of different sizes, so that it can be better applied to the defect detection of the gray cloth and the lattice fabric. The error detection rate of the improved network model is less than 5% for both gray cloth and checked cloth. Experimental results show that the proposed method can detect and mark fabric defects more effectively than YOLOv3, and effectively reduce the error detection rate.
Study on composite spinning oil for polyester bulked continuous filament with high efficiency
Authors: Gou Ming-xia , Chen Ge-xin , Meng Xu , Wang Jin-mei , Zhao Pei-qing
Published: March 2020

The special spinning oil for modified polyester bulked continuous filament was prepared using compound technology. The mixture of smoothing agent, emulsifier, collecting agent, and antistatic agent at certain proportions shows synergistic effect, which improves the usability of spinning oil on the whole. According to the use of different components, polyoxyethylene ether, polyether, and white oil spinning oil are synthesized, respectively. The basic performances of self-made spinning oil are better than those of a commercially available spinning oil, and its production rate can reach 93%.
Degradation of basalt fiber–reinforced polymer bars in seawater and sea sand concrete environment
Authors: Sharma Suraksha , Zhang Daxu , Zhao Qi
Published: March 2020

Although numerous experimental and analytical investigations on the environmental effects on basalt fiber–reinforced polymer bars were carried out, degradation of the basalt fiber–reinforced polymer bar in seawater and sea sand concrete environment has been insufficiently analyzed. This work presents two distinct numerical approaches, degradation rate–based approach and diffusion-based approach, to investigate the durability of basalt fiber–reinforced polymer bars in seawater and sea sand concrete solution subjected to various temperatures (32°C, 40°C, 48°C, and 55°C). The degradation of the material was quantified using a simplified two-dimensional model of a homogenized basalt fiber–reinforced polymer bar in COMSOL Multiphysics software. Fickian diffusion provides basis for modeling diffusion-based approach. The findings from both the approaches suggested that the basalt fiber–reinforced polymer bar becomes more susceptible to degradation as the exposure temperature increases and results in greater geometrical deformities. The comparisons of experimental data, analytical solutions, and numerical results showcase that the present numerical models can predict the degradation of a basalt fiber–reinforced polymer bar in a seawater and sea sand concrete environment.
Minimum-jerk trajectory planning pertaining to a translational 3-degree-of-freedom parallel manipulator through piecewise quintic polynomials interpolation
Authors: Lu Song , Ding Bingxiao , Li Yangmin
Published: March 2020

This article aims to present a minimum-jerk trajectory planning approach to address the smooth trajectory generation problem of 3-prismatic-universal-universal translational parallel kinematic manipulator. First, comprehensive kinematics and dynamics characteristics of this 3-prismatic-universal-universal parallel kinematic manipulator are analyzed by virtue of the accepted link Jacobian matrices and proverbial virtual work principle. To satisfy indispensable continuity and smoothness requirements, the discretized piecewise quintic polynomials are employed to interpolate the sequence of joints’ angular position knots which are transformed from these predefined via-points in Cartesian space. Furthermore, the trajectory planning problem is directly converted into a constrained nonlinear multi-variables optimization problem of which objective function is to minimize the maximum of the joints’ angular jerk throughout the whole trajectory. Finally, two typical application simulations using the reliable sequential quadratic programming algorithm demonstrate that this proposed minimum-jerk trajectory planning approach is of explicit feasibility and appreciable effectiveness.
Clinical research nursing and factors influencing success: a qualitative study describing the interplay between individual and organisational leadership influences and their impact on the delivery of clinical research in healthcare
Authors: Tinkler Linda , Robinson Lisa
Published: March 2020

Background

Clinical research delivery is a term increasingly used to describe the work undertaken to implement studies which explore and test prevention, diagnosis and treatment in healthcare. Such studies range from multi-site clinical trials to single site observational projects. Whilst widely acknowledged as fundamental to effective healthcare, clinical research is complex to deliver and is met with challenges in the busy clinical environment. The perceptions and experiences of Clinical Research Nurses, whose work is central to this agenda, have emerged as important, yet frequently overlooked insights in relation to the potential success of research delivery. Increased understanding of these insights is essential to address the barriers and maximise facilitators to success in clinical research.

Aim

To better understand how the perceptions and experiences of Clinical Research Nurses relate to potential for success in research delivery.

Methods

Seven focus groups and two one-to-one interviews (27 participants) were conducted in a large tertiary North East England National Health Service Foundation Trust between March and June 2017.

Results

Clinical Research Nurses’ described perceptions and experiences of working to co-ordinate and deliver a range of research as individuals, within their teams, throughout the wider organisation, and beyond. Two key elements situated within an overarching theme of leadership emerged as likely to impact on how successfully they were able to practise: • the individual (self-leadership). • the organisation (leadership culture).

Conclusions

The framework emerging from this study illustrates a complex interplay between personal attributes and organisational culture, mediated by national strategies and targets associated with the clinical research agenda. When situated within the concept of leadership, it broadens the potential for understanding the underlying issues and increases the range of possible support mechanisms to improve experiences for Clinical Research Nurses. Framing the challenges in this way contributes new knowledge to the dialogue surrounding clinical research delivery.
Synthesis, biological evaluation, and molecular docking of ((4-([1,2,4]triazolo[4,3-b][1,2,4,5]tetrazin-6-yl) piperazin-1-yl)methyl) benzohydrazide derivatives
Authors: Wu Xiaoyu , Xu Feng , Yang Zhenzhen , Ke Zhonglu , Shi Lei , Ye Can , Yan Qidong , Zhang Shijie
Published: March 2020

A series of ((4-([1,2,4]triazolo[4,3- b][1,2,4,5] methyl) benzo-hydrazide derivatives was designed, synthesized, and evaluated for their inhibition activities against five tumor cells and c-Met kinase in vitro. These compounds were fully characterized by 1H NMR, 13C NMR, MS, and elemental analysis. Antitumor experiments indicated that some compounds exhibited significant inhibition activities against A549 and Bewo. Especially, the IC50 values of 5f (12 μM), 5h (7.1 μM), 6a (8.4 μM), and 6d (9.2 μM) demonstrated better antitumor activities against A549 than the positive agent cisplatin (13.3 μM), and the IC50 value of 6a (5.2 μM) exhibited better antitumor activity against Bewo than cisplatin (7.7 μM).
Multicap to improve adherence after acute coronary syndromes: results of a randomized controlled clinical trial
Authors: Mariani Javier , Rosende Andrés , De Abreu Maximiliano , Gonzalez Villa Monte Gabriel , D’Imperio Heraldo , Antonietti Laura , Lemonnier Gabriela , de Bonis Alejandra , Tajer Carlos
Published: March 2020

Background:

Adherence to treatment after a myocardial infarction (MI) is poor, even in the early postinfarction period. Combining evidence-based drugs into a multicap could improve adherence in this population. No previous randomized trial assessing fixed-dose combination therapy has included patients early after a MI. We aimed to assess if a multicap containing four secondary prevention drugs increases adherence to treatment at 6 months after MI hospitalization. The study was designed as a randomized, parallel, open-label, controlled trial.

Methods:

Patients were randomized within 7 days of a MI to either multicap or control group. The multicap group received a capsule containing aspirin, atenolol, ramipril, and simvastatin. The control group received each drug in separate pills. The primary outcome was adherence at 6 months. We also measured blood pressure, heart rate, serum cholesterol levels, C-reactive protein, and platelet aggregation.

Results:

The study was stopped prematurely when 100 patients were included for futility. At 6 months, 92 (95.8%) patients were adherent to medical treatment: 98.0% in the multicap group and 93.5% in the control group [relative risk (RR) 1.05; 95% confidence interval (CI) 0.96–1.14; p = 0.347]. There were no differences between groups in systolic blood pressure ( p = 0.662), diastolic blood pressure ( p = 0.784), heart rate ( p = 0.533), total cholesterol ( p = 0.760), LDL-c ( p = 0.979), C-reactive protein ( p = 0.399), or in the proportion of patients with adequate platelet aggregation inhibition ( p = 0.600).

Conclusions:

The study did not find any improvement in the adherence at 6 months after a MI with a multicap-based strategy (Multicap for Increase Adherence After Acute Myocardial Infarction; [ ClinicalTrials.gov identifier: NCT02271178]).
Tyrosine kinase inhibitors and immunotherapy combinations in renal cell carcinoma
Authors: Rassy Elie , Flippot Ronan , Albiges Laurence
Published: March 2020

The treatment landscape of metastatic renal cell carcinoma (mRCC) has been transformed with the advent of antiangiogenics, notably tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor receptor (VEGFR), and immune checkpoint inhibitors (ICIs). Both treatment options have improved outcomes of patients and modified the natural history of mRCC. Clinical investigations have focused on evaluating combination regimens containing ICIs and VEGFR-directed TKIs. Namely, the combinations of axitinib plus pembrolizumab (KEYNOTE-426) and axitinib plus avelumab (JAVELIN RENAL 101) have shown improved outcomes compared with sunitinib in treatment-naïve patients with mRCC. In this review, we discuss the clinical data of single-agent TKIs and ICIs in mRCC and the rationale for the combination ICIs and TKIs based on preclinical and clinical evidence. We also explore the current challenges for regimen selection and development of predictive biomarkers.
Does the Lag Time Between Injury and Treatment Affect Recovery of Infraorbital Nerve Disturbances in Zygomaticomaxillary Complex Fractures?
Authors: Tabrizi Reza , Neamati Majid , Rajabloo Sara , Latifi Fatemeh
Published: March 2020

Study Design:

A cross-sectional study.

Objective:

Neurosensory disturbances (NSDs) of the infraorbital nerve (ION) are common following orbito-zygomaticomaxillary complex (ZMC) fractures. This study aimed to evaluate the effect of lag time between injury and treatment on recovery of NSDs of the ION following open reduction internal fixation.

Methods:

Subjects who had ZMC fracture and paresthesia were studied. The lag time between injury and treatment was considered as the predictive factor. The level of NSDs according to the brush test and two-point discrimination (TPD) test and self-reported NSD were the outcomes of this study. Self-reported NSD was quantified using a visual analog scale.

Results:

Forty patients were studied. The lag time between injury and treatment had a significant correlation with the result of the TPD test and the self-reported level of NSD. In 73.6% of patients who had NSD following ZMC fracture, every 1-day delay in treatment increased the incidence of self-reported paresthesia by 0.44.

Conclusions:

It seems, a delay in treatment of ZMC fractures increased the risk of NSD.