bluuebunny/crossref_metadata_2025 huggingface dataset:
Leiomyomatosis peritonealis disseminata: a rare disease with a difficult diagnosis
Authors: Martins Jordão Daniel , Santos Pereira João , Furtado Emanuel , Ferrão Isabel Cristina
Published: July 2019

Leiomyomatosis peritonealis disseminata(LPD) is a rare condition, characterised by the proliferation of peritoneal smooth muscle nodules. LPD is a benign disease with a low rate of malignant degeneration. We describe the case of a 46-year-old, asymptomatic, woman presenting with a mass on the left renal hilum, identified by ultrasound. A CT scan showed three nodules near the left kidney, a mass anterior to the vena cava and bilateral iliac nodules. Biopsy revealed a mesenchymal low-grade tumour. The patient underwent a left nephrectomy and excision of the other masses. The histological diagnosis revealed smooth muscle nodular proliferation with no malignant features, compatible with LPD. The differential diagnosis between LPD and metastatic leiomyosarcoma is sometimes very difficult because they are clinically very similar and even on histology the diagnosis can be tricky. Treatment is conservative in most cases, with surgical excision reserved for high-risk patients.
Outcome of peripheral iridotomy in subjects with uveitis
Authors: Betts Thomas David , Sims Joanne L , Bennett Sonya L , Niederer Rachael L
Published: July 2019

Background/aims

Peripheral iridotomy (PI) may be required in subjects with uveitis to manage iris bombe, seclusio pupillae and primary angle closure glaucoma. The aim of this study was to identify risk factors for failure of both laser and surgical PIs in patients with uveitis and determine survival durations.

Methods

Retrospective study of subjects with a history of uveitis undergoing yttrium-aluminium-garnet (YAG) laser or surgical PI at Auckland District Health Board over an 11-year period. Failure of PI was defined as loss of patency or recurrence of iris bombe. A mixed effects shared frailty model was constructed with PI nested within eyes nested within patients, to examine time to failure.

Results

131 PIs were performed in 52 eyes of 39 subjects during the study period (111 YAG PIs and 20 surgical PIs). Median age at time of PI was 46.6 years and 60.5% of subjects were female. HLAB27 positive uveitis was the most common diagnosis (25.6% of subjects). Median survival time was 70 days for YAG PI and 11.0 years for surgical PI. On multivariate analysis, younger age at time of PI (HR 0.933, p<0.001) and iris bombe (HR 2.180, p=0.046) were associated with risk of failure. Surgical PI was associated with a lower risk of failure (HR 0.151, p<0.001) compared with YAG PI. Glaucoma developed in 19 eyes (36.5%), of which 13 required glaucoma surgery.

Conclusion

Surgical PI had longer survival than YAG PI, and should be considered in subjects presenting with iris bombe and in young subjects with uveitis.
The global scale and implications of delivering multiple interventions through integrated child health events
Authors: Kamatsuchi Mahoko , Gheorghe Adrian , Balabanova Dina
Published: July 2019

Introduction

Delivering child health services through integrated child health events (ICHEs) has been a useful and popular strategy implemented in many in low-income and middle-income countries (LMICs) to accelerate the reduction of child mortality. The study aims to portray the scope of ICHEs and examine the association between the number of child health-nutrition interventions and types of ICHE packages delivered through these campaigns with vitamin A supplementation (VAS) and measles vaccination.

Methods

Secondary data analysis was conducted using Unicef global campaign database (1999–2010), where 597 ICHEs from 76 countries were analysed. Panel random effects regression models were used to explore the association between the number of interventions and coverage for VAS and measles vaccination, and non-parametric Kruskal-Wallis test to explore the association between different intervention packages and VAS coverage.

Results

An average of 100 ICHEs were conducted per year between 2005 and 2010, highest in sub-Saharan Africa (60%). By 2010, 40 ICHEs out of 66 (60%) across 24 countries delivered 5 or more interventions during 1 ICHE. No statistically significant effect of the number of ICHE interventions on VAS coverage was found (−0·76, p=0·185). There was a small significant effect on measles coverage (−1·81, p=0·057), which was not robust to model specifications removing outlier observations with measles coverage lower than 40%. The Kruskal-Wallis test did not suggest a significant association between different intervention packages and VAS coverage at 5% significance level (p=0·07).

Conclusion

ICHEs were found to be a widely used strategy to deliver essential child health-nutrition interventions in LMICs. ICHEs appear to represent a commonly used platform with the capacity to incorporate multiple interventions without compromising coverage of some key interventions as VAS and measles vaccination. More research is required to better understand what operational factors may affect the coverage outcomes delivered together through ICHEs.
Formative mixed-method multicase study research to inform the development of a safer sex and healthy relationships intervention in further education (FE) settings: the SaFE Project
Authors: Young Honor , Turney Catherine , White James , Lewis Ruth , Bonell Christopher
Published: July 2019

Objectives

Sexual health includes pleasurable, safe, sexual experiences free from coercion, discrimination and violence. In the UK, many young people’s experiences fall short of this definition. This study aimed to inform the development of a safer sex and healthy relationships intervention for those aged 16–19 years studying in further education (FE) settings.

Design

A formative mixed-method multicase study explored if and how to implement four components within a single intervention.

Setting

Six FE settings in England and Wales and one sexual health charity participated between October and July 2015.

Participants

Focus groups with 134 FE students and 44 FE staff, and interviews with 11 FE managers and 12 sexual health charity staff, first explored whether four candidate intervention components were acceptable and could have sustained implementation. An e-survey with 2105 students and 163 staff then examined potential uptake and acceptability of components shortlisted in the first stage. Stakeholder consultation was then used to refine the intervention.

Intervention

Informed by a review of evidence of effective interventions delivered in other settings, four candidate intervention components were identified which could promote safer sex and healthy relationships among those aged 16–19 years: 1) student-led sexual health action groups; 2) on-site sexual health and relationships services; 3) staff safeguarding training about sexual health and relationships and 4) sex and relationships education.

Results

On-site sexual health and relationships services and staff safeguarding training about sexual health and relationships were key gaps in current FE provision and welcomed by staff, students and health professionals. Sex and relationships education and student-led sexual health action groups were not considered acceptable.

Conclusions

The SaFE intervention, comprising on-site sexual health and relationships services and staff safeguarding training in FE settings, may have potential promoting sexual health among FE students. Further optimisation and refinement with key stakeholders is required before piloting via cluster randomised controlled trial.
Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach
Authors: Wilson Andrew , Baker Richard , Bankart John , Banerjee Jay , Bhamra Ran , Conroy Simon , Kurtev Stoyan , Phelps Kay , Regen Emma , Rogers Stephen , Waring Justin
Published: July 2019

Aim

To examine system characteristics associated with variations in unplanned admission rates in those aged 85+.

Design

Mixed methods.

Setting

Primary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.

Participants

A total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis.

Results

In general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission.

Conclusions

Health and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions.
Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
Authors: Nakabe Takayo , Sasaki Noriko , Uematsu Hironori , Kunisawa Susumu , Wimo Anders , Imanaka Yuichi
Published: July 2019

Objective

The purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.

Design

A cross-sectional online survey.

Participants

4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.

Primary outcome measures

Informal care costs and out-of-pocket payments for long-term care (LTC) services.

Results

From 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.

Conclusion

This study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.
Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study)
Authors: Bana Marika , Ribi Karin , Kropf-Staub Susanne , Zürcher-Florin Sabin , Näf Ernst , Manser Tanja , Bütikofer Lukas , Rintelen Felix , Peters Solange , Eicher Manuela
Published: July 2019

Introduction

Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients’ symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses.

Methods and analysis

This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness—Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients’ accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses’ fidelity of providing the intervention as intended, and patients’ safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis.

Ethics and dissemination

The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017–00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences.

Trial registration number

NCT03649984; Pre-results.
The extent of public awareness, understanding and use of the Global Solar UV index as a worldwide health promotion instrument to improve sun protection: protocol for a systematic review
Authors: Lehmann Maria , Heinitz Maria , Uter Wolfgang , Pfahlberg Annette B , Gefeller Olaf
Published: July 2019

Introduction

(Over)exposure to ultraviolet radiation is a major risk factor for skin cancer. The Global Solar Ultraviolet Index (UVI) was introduced by the WHO and partner organisations in 1995 as a simple measure of the intensity of solar UV radiation, providing guidance for the population to use appropriate sun protective measures. Little is known about the impact of the UVI on actual sun protection behaviour. Our systematic review aims to assess global levels of awareness, understanding and use of the UVI as prerequisites for the preventive effectiveness of this public health tool.

Methods and analysis

Systematic searches will be performed in 10 electronic literature databases including Medline, Scopus and Web of Science–Core Collection, two clinical trials registries and at least two grey literature databases (OpenGrey, Bielefeld Academic Search Engine). Additional literature sources will be retrieved using hand search of reference lists of included studies and snowballing methods. We will include studies with all types of quantitative study designs and participants reporting on at least one outcome in the three main categories (i) awareness, (ii) understanding and (iii) use of the UVI. We will assess the risk of bias within studies with an abbreviated version of the AXIS tool, designed specifically for cross-sectional studies. As we expect large heterogeneity in outcomes, we will conduct a narrative synthesis of results instead of a meta-analysis.

Ethics and dissemination

Ethical approval and patient consent are not required as this is a systematic review based on published studies. The results of this study will be published in an international peer-reviewed journal.

Prospero registration number

CRD42018093693.
Patient reporting of complications after surgery: what impact does documenting postoperative problems from the perspective of the patient using telephone interview and postal questionnaires have on the identification of complications after surgery?
Authors: Woodfield John , Deo Priya , Davidson Ann , Chen Tina Yen-Ting , van Rij Andre
Published: July 2019

Objectives

To identify the frequency of postoperative complications, including problems identified by patients and complications occurring after discharge from hospital. To identify how these impact on quality of life (QoL) and the patient’s perception of the success of their treatment.

Design

Data from three prospective sources: surgical audit, a telephone interview (2 weeks after discharge) and a patient-focused questionnaire (2 months after surgery) were retrospectively analysed.

Setting

Dunedin Hospital, Dunedin, New Zealand.

Participants

Of the 500 patients, 100 undergoing each of the following types of surgeries: anorectal, biliary, colorectal, hernia and skin.

Primary and secondary outcome measures

The primary outcomes were complications and the 36-item Short Form Health Survey (SF-36). Secondary outcomes included the patient’s ratings of their treatment and a questionnaire-derived patient satisfaction score.

Results

226 patients reported a complication; there were 344 separate complications and 411 reports of complications (16% of complications were reported on more than one occasion). The audit, telephone interview and questionnaire captured 12.6%, 36.3% and 51% of the 411 reports, respectively. Patients with complications had a lower SF-36 Physical Composite Summary (PCS) score (48.5 vs 43.9, p=0.021) and a lower Patient Satisfaction Score (85.6 vs 74.6, p<0.001). Rating of information received, care received, symptoms experienced, QoL and satisfaction with surgery were all significantly worse for patients with complications. On linear regression analysis, surgical complications, American Society of Anaesthesiologists score and age all made a similar contribution to the SF-36 PCS score, with standardised beta coefficients between 0.19 and 0.21.

Conclusions

Following surgery, over 40% of patients experienced complications. The QoL and satisfaction score were significantly less than for those without complications. The majority of complications were diagnosed after discharge from hospital. Taking more notice of the patient perspective helps us to identify problems, to understand what is important to them and may suggest ways to improve perioperative care.
How should health policy and practice respond to the increased genetic risk associated with close relative marriage? results of a UK Delphi consensus building exercise
Authors: Salway Sarah , Yazici Edanur , Khan Nasaim , Ali Parveen , Elmslie Frances , Thompson Julia , Qureshi Nadeem
Published: July 2019

Objectives

(1) To explore professional and lay stakeholder views on the design and delivery of services in the area of consanguinity and genetic risk. (2) To identify principles on which there is sufficient consensus to warrant inclusion in a national guidance document. (3) To highlight differences of opinion that necessitate dialogue. (4) To identify areas where further research or development work is needed to inform practical service approaches.

Design

Delphi exercise. Three rounds and one consensus conference.

Setting

UK, national, web-based and face-to-face.

Participants

Recruitment via email distribution lists and professional networks. 42 participants with varied professional and demographic backgrounds contributed to at least one round of the exercise. 29 people participated in statement ranking across both rounds 2 and 3.

Results

Over 700 individual statements were generated in round 1 and consolidated into 193 unique statements for ranking in round 2, with 60% achieving 80% or higher agreement. In round 3, 74% of statements achieved 80% or higher agreement. Consensus conference discussions resulted in a final set of 148 agreed statements, providing direction for both policy-makers and healthcare professionals. 13 general principles were agreed, with over 90% agreement on 12 of these. Remaining statements were organised into nine themes: national level leadership and coordination, local level leadership and coordination, training and competencies for healthcare and other professionals, genetic services, genetic literacy, primary care, referrals and coordination, monitoring and evaluation and research. Next steps and working groups were also identified.

Conclusions

There is high agreement among UK stakeholders on the general principles that should shape policy and practice responses in this area: equity of access, cultural competence, coordinated inter-agency working, co-design and empowerment and embedded evaluation. The need for strong national leadership to ensure more efficient sharing of knowledge and promotion of more equitable and consistent responses across the country is emphasised.
Psychosomatic subjects and the agencies of addiction
Authors: Weinberg Darin
Published: July 2019

Addiction science and public policy have for some time been articulated in conformity with a broader antinomy in Western thought between biological reductionism and liberal voluntarism. Hence, mainstream debates have concerned whether and how addiction might be understood as a disease in the biomedically orthodox sense of anatomical or physiological pathology or whether and how addiction might be understood as a voluntary choice of some kind. The fact that those who staff these debates have appeared either unable or unwilling to consider alternatives to this antinomy has resulted in a rather unhappy and intransigent set of intellectual anomalies both on the biomedical and the social scientific sides of this divide. Perhaps more importantly, it has also resulted in a striking isolation of scientific debates themselves from the vicissitudes of therapeutically caring for those putatively suffering from addictions both within and outside clinical settings. After briefly demonstrating the conformity of debates in addiction science with the broader antinomy between biological reductionism and liberal voluntarism and the anomalies that thereby result, this article considers the scientific and therapeutic benefits of a psychosomatic framework for the understanding of both self-governing subjects and the experience of a loss of self-control to agencies of addiction.
Two-party quantum private comparison protocol with maximally entangled seven-qubit state
Authors: Ji ZhaoXu , Zhang HuanGuo , Fan PeiRu
Published: July 2019

Quantum private comparison (QPC), whose security is based on some laws of quantum mechanics (e.g. quantum noncloning theorem and Heisenbergs uncertainty principle), allows [Formula: see text] parties who do not trust each other to judge whether their secret data are the same while maintaining data privacy. In this paper, we investigate the utility of the maximally entangled seven-qubit state for QPC, and we propose a new protocol which enables two parties to compare their secret data with each other for equality without disclosing their secret data. In our protocol, single particle measurements and Bell-basis measurements are employed, both of which can be implemented with current technologies. In addition to quantum measurements, our protocol does not use other quantum technologies such as entanglement swapping and unitary operations. A semi-honest third-party who assists two parties in implementing the protocol is assumed in our protocol. Furthermore, we use the entanglement correlations of the maximally entangled seven-qubit state and collaborative computing between parties for privacy protection, and we use quantum key distribution (QKD) to ensure the security of the cooperative computing when two parties are in different locations. What is more, we show that the security towards both outsider and insider attacks can be guaranteed.
New Technology Acceptance Model Based on Innovation Characteristics with AHP–TOPSIS Approach
Authors: Oturakci Murat
Published: July 2019

In this study, a new technology acceptance model (TAM) based on the characteristics that are adapted from Innovation Diffusion Theory (IDT) with integrated multi-criteria decision-making (MCDM) method is developed in order to explain students’ acceptance of information system. New TAM is developed based on 650 students of a public university of Turkey. In the study, first, five innovation characteristics are prioritized with the Analytical Hierarchy Method (AHP) and independent variables of TAM are formed with the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) technique with using AHP results as the criteria weights. With the obtained results, explaining the intention to use by more than 50% shows that integrated TAM is an applicable and flexible model.
Prediction of Bone Quality of Remodeling Trabeculae Using Multi-Scale Stress Analyses with a Homogenization Technique Reflecting Material Anisotropy
Authors: Tawara Daisuke , Nagura Ken
Published: July 2019

High stress in osteoporotic bone that leads to fracture is related to time-dependent changes of bone quality, which is defined by the trabecular structure and the material anisotropy derived from biological apatite (BA) crystallite orientation, with loss of bone mass. To assess and estimate the relativity of variation with time of bone quality, bone mass and fracture risk for the same subject in the future, prediction of remodeling and change in stress distribution in bone is necessary. We established a computational framework with multi-scale stress analyses and remodeling simulations. Then, using healthy and osteoporotic pig’s trabeculae, stress analyses of their remodeled tissue considering BA orientation were performed. The homogenized stiffness in the direction which had adapted to the mechanical environment was high even though bone mass decreased. The relationship between the present percentage of the high stress and the decrease of bone density was not proportional in the osteoporotic remodeling process, but it increased more when the bone mass decreased. These findings suggest that future fracture risk could be detected in more detail by time-dependent variance of bone quality, and the relationship between bone mass, bone quality, and fracture risk could be potentially elucidated by our computational frameworks.
Novel Insight into High-Order Numerical Manifold Method Using Complex Fourier Element Shape Functions in Statics and Dynamics
Authors: Malekzadeh M. , Hamzehei-Javaran S. , Shojaee S.
Published: July 2019

In this paper, the high-order numerical manifold method (HONMM) with new complex Fourier shape functions is developed for the simulation of elastostatic and elastodynamic problems. NMM uses two separate covers which give it the ability to analyze continuous and discontinuous problems in a unified way. The new shape functions are derived using constant and linear complex Fourier shape functions. These shape functions are able to satisfy exponential and trigonometric function fields in addition to polynomial ones, unlike classic Lagrange shape functions. Compared to the Lagrange shape functions, the proposed shape functions show much more accurate results with fewer degrees of freedom. The superiority of the proposed method over the conventional HONMM in static analysis is demonstrated through a special beam example. As cases of dynamic analysis, four free and forced vibration problems are illustrated. The results of the HONMM with the use of constant and linear complex Fourier shape functions are compared with the classic HONMM results and available analytical and other numerical solutions. The results show that the proposed method, even with less number of elements, is more accurate than the classic HONMM.
Synthesis, growth mechanism and effect of sputtering pressure on 3D ZnO nanostructures with trunk-branch nanorods
Authors: Liu Yangsi , Gao Wei
Published: July 2019

Three-dimensional (3D) ZnO nanostructures, hierarchical nanorods with trunks and branches, were synthesized via a multi-step growth method. The ZnO trunk-branch nanorods are immobilized on glass substrates and their fabrication technologies include the deposition of ZnO seed crystals by magnetron sputtering and the hydrothermal growth of ZnO nanorods without any directing agents. The sputtering pressure for the deposition of ZnO seed crystals was varied and the corresponding effect on the morphology and microstructure of 3D ZnO nanostructures was characterized by various spectroscopic and microscopic techniques. The growth mechanism of ZnO trunk-branch nanorods was discussed and their optical property was also explored. The multi-level constructions of ZnO nanorods would benefit their photo-related functional applications.
Subarachnoid Hemorrhage and Prostatic Involvement in Granulomatosis with Polyangiitis – An Atypical Presentation
Authors: Chu Raymond Bak Hei , Wong Priscilla Ching Han , Wai Joey Ka Ming , Yap Florence Hiu Yi
Published: July 2019

Granulomatosis with Polyangiitis (GPA) is a form of Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. We report a case of a 56-year-old man with GPA who first presented with acute urinary retention, and then developed pulmonarycavitating lesions and subarachnoid hemorrhage (SAH). The SAH was due to a ruptured right vertebral artery aneurysm, whichwas subsequently embolized. The patient initially had a good response to immunosuppressive therapy but later succumbed due to fulminant sepsis. SAH is a rare complication of GPA and usually not associated with a detectable aneurysm. Our patient is thesecond case in the literature where an aneurysm had been detected on angiography and the first case where examination of the culprit aneurysm revealed features of vasculitis.
Trace evidence examination using laboratory and synchrotron X-ray diffraction techniques
Authors: Raven Mark D. , Fitzpatrick Robert W. , Self Peter G.
Published: July 2019

In a 2007 homicide in Western Australia, small (<0.5 mm diameter) red brick fragments and soil were identified on the victim's clothing (mainly bra), body (mainly hair) and vehicle. A comparative study of the mineralogy and morphology of the red brick fragments with red bricks from the paved area in front of the victim's house was undertaken by traditional laboratory X-ray diffraction (XRD) using low background Si wafer holders and a 0.5 mm focusing monocapillary attachment. Whilst significant similarities were observed between the two datasets, peak overlaps and poor resolution prevented a specific provenance to be determined. Additional analyses using the superior intensity and resolution of synchrotron XRD that was conducted at the Australian Synchrotron quantified the mineralogy of polycrystalline minerals (cristobalite and mullite) in the small brick fragments. These data established that the brick fragments could not be distinguished from the driveway bricks and were clearly shown to be different to a range of other possible sources.

The trial was before a judge only and he concluded that the mineralogy data from the small brick fragments on the victim's clothing and the bricks from her front driveway indicated that she was initially attacked in her front yard and not at Kings Park where her body was buried.
Memory-Augmented Dialogue Management for Task-Oriented Dialogue Systems
Authors: Zhang Zheng , Huang Minlie , Zhao Zhongzhou , Ji Feng , Chen Haiqing , Zhu Xiaoyan
Published: July 2019

Dialogue management (DM) is responsible for predicting the next action of a dialogue system according to the current dialogue state and thus plays a central role in task-oriented dialogue systems. Since DM requires having access not only to local utterances but also to the global semantics of the entire dialogue session, modeling the long-range history information is a critical issue. To this end, we propose MAD, a novel memory-augmented dialogue management model that employs a memory controller and two additional memory structures (i.e., a slot-value memory and an external memory). The slot-value memory tracks the dialogue state by memorizing and updating the values of semantic slots (i.e., cuisine, price, and location), and the external memory augments the representation of hidden states of traditional recurrent neural networks by storing more context information. To update the dialogue state efficiently, we also propose slot-level attention on user utterances to extract specific semantic information for each slot. Experiments show that our model can obtain state-of-the-art performance and outperforms existing baselines.
A Rapid Penetration Trajectory Optimization Method for Hypersonic Vehicles
Authors: Yan Binbin , Liu Ruifan , Dai Pei , Xing Muzeng , Liu Shuangxi
Published: July 2019

The evasion maneuver problem of hypersonic vehicles differs from those of ballistic missiles and other traditional weapons, showing distinctive properties including expansive maneuver range and weak maneuverability. How to avoid the disadvantage of low available overload and ensure follow-up tasks are the main concerns of the hypersonic penetration. This paper presents a penetration trajectory optimization algorithm for an air-breathing hypersonic vehicle, where the prerequisite penetration condition is analyzed and control costs are chosen as an objective function to minimize the fuel consumption and maneuver range. This paper focuses on how to formulate the complex, highly constrained nonconvex penetration problem to be a sequence of easily solved second-order cone programming through a combination of successive linearization and relaxation techniques. Innovation lies in the raising of the penetration angle and the relaxation technique of nonlinear and nonconvex elements. Various numerical simulations are conducted to verify the validity of penetration condition and to demonstrate that the proposed method is effective and has a good computational performance irrespective of initial guesses.
Fifty-Two-Week Results of Clinical and Imaging Assessments of a Patient with Rheumatoid Arthritis Complicated by Systemic Sclerosis with Interstitial Pneumonia and Type 1 Diabetes despite Multiple Disease-Modifying Antirheumatic Drug Therapy That Was Successfully Treated with Baricitinib: A Novel Case Report
Authors: Fujita Yuya , Nawata Masao , Nagayasu Atsushi , Someya Kazuki , Saito Kazuyoshi , Tanaka Yoshiya
Published: July 2019

Baricitinib is a Janus kinase 1/2 (JAK1/2) inhibitor used in the treatment of rheumatoid arthritis. A 71-year-old woman with rheumatoid arthritis complicated by systemic sclerosis and type 1 diabetes that were resistant to multiple disease-modifying antirheumatic drugs started treatment with baricitinib. After baricitinib administration, the disease activity of her rheumatoid arthritis was attenuated from the early stage of treatment, and the effect was maintained for up to 52 weeks. In addition, the skin sclerosis in systemic sclerosis showed an improvement. Regarding the influence on type 1 diabetes, the required daily dose of insulin and hemoglobin A1c (HbA1c) levels decreased. To date, no studies have demonstrated the effectiveness of baricitinib on systemic sclerosis or type 1 diabetes. We report that baricitinib was effective for systemic sclerosis and type 1 diabetes, as well as for rheumatoid arthritis, for up to 52 weeks.
Telbivudine Treatment during Late Pregnancy Prevents Mother-to-Child Transmission of Hepatitis B Virus: A Retrospective Study
Authors: Cai Mengzhi , Hao Yanli , Zhong Jianxin , Yao Wei , Cao Xia , Gu Guifang , Qin Gang
Published: July 2019

Purpose. To investigate the efficacy of telbivudine (LdT) in blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) during late pregnancy. Methods. A total of 651 pregnant women aged 18-40 in Nantong Third People’s Hospital and Hospital affiliated to Nantong University with positive hepatitis B surface antigen (HBsAg) and HBV DNA were enrolled between January 2011 and December 2015. Patients with HBV DNA≥106 copies/mL (n=251) received LdT during late pregnancy according to the patients’ will, while 136 high viral patients with HBV DNA≥106 copies/mL who did not take LdT therapy and 268 low viral patients with HBV DNA<106 copies/mL served as the controls. Results. At 7 months and 1 year postpartum, the basal HBV DNA serum level of treated patients declined significantly (P<0.001), while no obvious decline was observed in the untreated high viraemic controls (P<0.05) and untreated low viraemic controls (P<0.05). Only 1 infant (0.4%) in LdT group was HBsAg positive at 7 months, while 14 (5.2%) were in the untreated low viraemic controls (P<0.001) and 15 (11.0%) were in untreated high viraemic controls (P<0.001). Conclusion. For pregnant women with HBV DNA≥106 copies/mL, the use of LdT during late pregnancy could effectively reduce the MTCT rate of HBV.
In VitroAntioxidant andIn VivoLipid-Lowering Properties ofZingiber officinaleCrude Aqueous Extract and Methanolic Fraction: A Follow-Up Study
Authors: Bekkouch Oussama , Harnafi Mohamed , Touiss Ilham , Khatib Saloua , Harnafi Hicham , Alem Chakib , Amrani Souliman
Published: July 2019

Over the past decades, cardiovascular diseases have become the leading cause of death all over the world, and among these diseases there is atherosclerosis caused mainly by an increase in plasmatic cholesterol levels and by strong oxidation caused by free radicals. For these reasons and others, we explored in this report the hypolipidemic and the antioxidant effects ofZingiber officinalecrude aqueous and methanolic extract. The hypolipidemic study was carried out in high-fat-fed mice model. Animals were subdivided into four groups and were orally treated with the aqueous extract once daily for twelve weeks at two doses: 250 and 500 mg/Kg. During the treatment, the body weight, total cholesterol, triglycerides, and high-density lipoproteins have been defined every four weeks. The antioxidant activity has been studied using radical scavenging activity,β-carotene bleaching, reducing power assay, and the TBARs tests. The daily oral administration of the extracts for twelve weeks significantly improved the lipid profile in a dose-dependent manner, from the first until the twelfth week, and also showed a significant antioxidant effect. These findings may be potentially contributive to the validation of the medicinal use ofZ. officinaleto treat hyperlipidemia and cardiovascular complications.
Transcapillary Refilling Rate and Its Determinants during Haemodialysis with Standard and High Ultrafiltration Rates
Authors: Mitsides Nicos , Pietribiasi Mauro , Waniewski Jacek , Brenchley Paul , Mitra Sandip
Published: July 2019

Background: Achieving euvolaemia using ultrafiltration (UF) during haemodialysis (HD) without inducing haemodynamic instability presents a major clinical challenge. Transcapillary refill is a key factor in sustaining the circulating blood volume (BV) during UF, which is in turn predicted by the rate of refilling. However, absolute plasma refilling rate (PRR), its determinants and variability with UF rate (UFR), have not been reported in the literature. Method: We studied paired HD sessions (n = 48) in 24 patients over 2 consecutive mid-week HD treatments. Plasma refilling was measured using real-time, minute-by-minute relative BV changes obtained from the integrated BV monitoring device during UF. A fixed bolus dilution approach at the start of HD was used to calculate absolute BV. The first control HD session was undertaken with a standard UFR required to achieve the prescribed target weight, while during the second study session, a fixed (high) UFR (1 L/h) was applied, either in the first (n = 12 patients) or in the final hour (n = 12 patients) of the HD session. Participants’ had their hydration status measured pre- and post-HD using multifrequency bioimpedance (BIS). Blood pressure was measured at 15-min intervals and blood samples were collected at 7 intervals during HD sessions. Results: The mean PRR during a standard 4-hr HD session was 4.3 ± 2.0 mL/kg/h and varied between 2 and 6 mL/kg/h. There was a mean time delay of 22 min (range 13.3–35.0 min) for onset of plasma refilling after the application of UF irrespective of standard or high UFRs. The maximum refilling occurred during the second hour of HD (mean max PRR 6.8 mL/kg/h). UFR (beta = 0.60, p < 0.01) and BIS derived pre-HD overhydration index (beta = 0.44, p = 0.01) were consistent, independent predictors of the mean PRR (R2 = 0.49) in all HD sessions. At high UFRs, PRR exceeded 10 mL/kg/h. The total overall plasma refill contribution to UF volume was not significantly different between standard and high UF. During interventions no significant haemodynamic instability was observed in the study. Conclusion:We describe absolute transcapillary refilling rate and its profile during HD with UF. The findings provide the basis for the development of UF strategies to match varying PRRs during HD. An approach to fluid removal, which is tailored to patients’ refilling rates and capacity, provides an opportunity for more precision in the practice of UF.
ДІАГНОСТИКА ТА КОРЕКЦІЯ МАГНІЄВОГО ДЕФІЦИТУ У ВАГІТНИХ ІЗ ОБТЯЖЕНИМ ГІНЕКОЛОГІЧНИМ АНАМНЕЗОМ
Authors: Andriichuk T. P. , Senchuk A. Ya. , Martynova D. A.
Published: July 2019

Мета дослідження – виокремлення пацієнток із клінічними ознаками дефіциту магнію серед вагітних із групи ризику розвитку прееклампсії і вивчення ефективності застосування в них препаратів магнію для профілактики прееклампсії.

Матеріали та методи. Нами здійснені обстеження і комплексна пероральна магнієва профілактика пізнього гестозу у 100 вагітних (I група) із групи ризику виникнення цього ускладнення вагітності. Результати порівнювали із даними спостереження за 50-ма вагітними (II група) з групи ризику виникнення прееклампсії, яким до профілактичного комплексу пероральні препарати магнію не додавали. Контрольну групу (КГ) склали 50 здорових жінок із фізіологічним перебігом вагітності. Наявність дефіциту магнію визначали за результатами вивчення даних опитування, зафіксованих у розробленій нами анкеті для дослідження дефіциту магнію у вагітних. Магнієву монопрофілактику прееклампсії здійснювали такими препаратами:

Магнію оксид легкий 342 мг і магнію карбонат легкий 670 мг, що відповідає 365 мг іонів Mg++ – по 1 шипучій таблетці на добу переривчастими курсами – у 10–12; 22–26; 30–32 тижні вагітності.

Мікрогранульований порошок магнію оксид, 535 мг, що відповідає 300 мг магнію і магнію оксиду легкого 403,0–435,2 мг, що відповідає іонам магнію 243 мг. Препарати призначали з 10 тижнів протягом усієї вагітності по 1 таблетці 1 раз на добу.

Результати дослідження та їх обговорення. Результати профілактичного застосування пероральних препаратів магнію показали високу ефективність, нешкідливість і гарну переносимість запропонованої терапії порівняно із загальноприйнятими підходами (протокол МОЗ). У групі вагітних, які використовували препарати магнію (I група), значно меншою була частота загрози переривання вагітності та плацентарної дисфункції. Ефективність профілактики прееклампсії становила 96,0 % у I групі і тільки 68,0 % у групі пацієнток, яким профілактика прееклампсії здійснювалась за протоколом (II група).

Висновки. Визначено, що пацієнтки із групи ризику розвитку прееклампсії потребують призначення препаратів магнію, корекції способу життя та харчування. Профілактичний прийом препаратів магнію пацієнтками з групи ризику розвитку прееклампсії є високоефективним, нешкідливим і гарно переноситься. Ефективність профілактики прееклампсії становить 96,0 %.
ОСОБЛИВОСТІ ПЕРЕБІГУ МУКОВІСЦИДОЗУ В ДІТЕЙ ТЕРНОПІЛЬСЬКОЇ ОБЛАСТІ
Authors: Boyarchuk O. R. , Kosovska V. O. , Kosovska T. M.
Published: July 2019

Мета дослідження – встановити особливості клінічного перебігу муковісцидозу в дітей Тернопільської області.

Матеріали та методи. Проведено ретроспективний аналіз історій хвороб 15 дітей Тернопільської області, хворих на муковісцидоз. Оглянуто 5 дітей під час їх перебування у стаціонарі.

Результати дослідження та їх обговорення. Ідеальними можна вважати виявлення хворих на муковісцидоз під час неонатального скринінгу і початок лікування одразу ж після встановлення діагнозу навіть за відсутності клінічних проявів. Діагноз муковісцидозу в усіх пацієнтів підтверджено в Західноукраїнському спеціалізованому дитячому медичному центрі. При дослідженні генотипу було виявлено різні види мутацій, але найчастіше траплялась мутація F508del/F508del. Ми ви­значили, що більшість дітей досягла десятирічного віку. Час встановлення діагнозу муковісцидозу був різний: до 1 року – в 2 дітей (13,3 %), від 2 до 5 років – у 5 дітей (33,3 %), від 5 до 10 років – у 8 дітей (53,4 %). Встановлено, що, чим пізніше у хворого діагностують захворювання, тим тяжчий його перебіг і нижча ефективність лікування. У цих дітей відмічали багаторазові рецидиви запальних процесів у бронхах – у 10 хворих (66,6 %), додаткових пазухах носа – в 5 (33,3 %), порушень функції підшлункової залози – у 15 (100,0 %), розвиток резистентності патогенної мікрофлори до антибіотиків – у 15 (100,0 %). Тому в цих дітей лікування ускладнювалось і, відповідно, ефективність його знижувалась. Майже в половини пацієнтів, а саме у 7 (46,6 %), внаслідок тривалої гіпоксії виявлено деформацію пальців і нігтів у вигляді «барабанних паличок» та «годинникових скелець». Легеневу гіпертензію діагностовано в 4 пацієнтів (26,6 %). Деформацію грудної клітки (бочкоподібна, розширена в передньо-задньому розмірі) відмічено в 7 дітей (46,6 %). Холестатичний гепатит виявлено в 5 хворих (33,3 %). Порушення толерантності до глюкози діагностовано у 2 дітей (13,3 %).

Висновки. У структурі хворих на муковісцидоз дітей Тернопільської області переважають дівчатка та мешканці сільської місцевості. На сьогодні більша частина дітей області з муковісцидозом (53,3 %) досягла віку старше 10 років. У дітей нашого регіону переважає мутація F508del/F508del (66,7 %). У більшості дітей (53,4 %) захворювання було діагностовано після 5 років. У дебюті хвороби найчастіше спостерігали затяжні обструктивні бронхіти (66,7 %) та порушення функції підшлункової залози (100,0 %). Серед ускладнень переважали кісткові деформації, ознаки хронічної гіпоксії та висока частота інфікування золотистим стафілококом (73,3 %) і синьогнійною паличкою (46,7 %). Необхідно збільшити настороженість щодо діагностики муковісцидозу на ранніх стадіях для покращення якості й подовження тривалості життя дітей.
ХАРАКТЕРИСТИКА ДІЯЛЬНОСТІ НЕОНАТОЛОГІЧНОЇ СЛУЖБИ РІВНЕНСЬКОГО ОБЛАСНОГО ПЕРИНАТАЛЬНОГО ЦЕНТРУ
Authors: Klishch O. V. , Pavlyshyn H. A.
Published: July 2019

Мета дослідження – оцінити основні показники діяльності неонатологічної служби Рівненського обласного перинатального центру впродовж останніх років.

Матеріали та методи. Проведено ретроспективний статистичний аналіз динаміки основних показників роботи відділення інтенсивної терапії новонароджених Рівненського обласного перинатального центру, таких,  як народжуваність, захворюваність, неонатальна смертність, за період 2016–2018 рр.

Результати дослідження та їх обговорення. Аналіз народжуваності в Рівненському обласному перинатальному центрі свідчить про зниження її рівня в області, при цьому кількість передчасно народжених дітей не зменшується, становлячи 8,7–8,9 %. Показники неонатальної смертності як в області, так і в перинатальному центрі знижуються. У структурі смертності переважають гіпоксично-ішемічні ураження нервової системи, уроджені вади розвитку, внутрішньоутробні інфекції, глибока морфофункціональна незрілість. Уроджені вади серця, не сумісні з життям або в поєднанні з множинними вадами розвитку, переважають у структурі смертності від уроджених вад розвитку. В Рівненському обласному перинатальному центрі рівень виживання немовлят, народжених з екстремально малою масою тіла, має стабільну тенденцію до збільшення – від 25 % у 2016 р. до 40 % у 2018 р. У структурі захворюваності переважають неонатальна енцефалопатія, уроджені вади розвитку, інфекційна патологія.

Висновок. Оцінка основних показників роботи неонатологічної служби Рівненського обласного перинатального центру впродовж останніх років розкриває переваги і труднощі в діяльності неонатологічної служби в області.