bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on rotating speed measurement method of turbodrill based on tilt sensor
Authors: Chuan Wu , Guojun Wen , Lei Han
Published: July 2020

The rotating speed of turbodrill is a key parameter for adjusting the drilling process, which needs to be measured in real time. Based on this, a new rotating speed measurement method used in downhole turbodrill based on the tilt sensor is proposed in this paper. The basic principle is that a periodic signal will be generated by the tilt sensor along with the turbodrill, and then the rotating speed can be obtained by using fast Fourier transform to analyze the output data. Test results show that the measurement error is related to the inclination angle of the borehole, that is, this method cannot be used when the inclination angle is less than 0.4 degrees, while the measurement error is less than 3.5% when the inclination angle is more than 0.4 degrees, which meets the practical requirements. Compared with traditional methods, this method will not be interfered by mud, geological conditions and downhole vibration, and it is also a non-contact measurement method, which is very suitable for downhole environment.
Investigation of deformation and degradation response of geogrid-reinforced ballast based on model track tests
Authors: Hussaini Syed Khaja Karimullah , Sweta Kumari
Published: July 2020

A series of large-scale cyclic tests was conducted using process simulation test ( PST) apparatus to capture the influence of loading frequency ( f) on the deformation and degradation behavior of ballast with and without geogrids. Fresh granite ballast and subballast having mean particle diameter ( D50) of 42 mm and 3.5 mm, respectively and five geogrids of different aperture shapes and sizes were used in this study. The tests were conducted at f ranging from 10 to 40 Hz and up to 250,000 load cycles. The test results from the laboratory investigations confirmed that the deformation and degradation behavior of ballast is highly influenced by loading frequency ( f). Moreover, the results showed that geogrid reinforcement stabilizes ballast by reducing the extent of lateral spreading ( ld) and vertical settlement ( Sv) and by minimizing particle breakage ( BBI). The inclusion of geogrids also reduces the extent of vertical settlement in subballast layer ( Svsb). In addition, the extent of volumetric ( εv) and shear strains ( εs) including void ratio ( ef) and density ( γbf) were found to be highly influenced by f. It is further seen that lateral spread and vertical settlement reduction index ( LSRI and VSRI) of all the geogrids decreases with the increase in f. Moreover, it is revealed that with the decrease in LSRI, the extent of Sv and BBI increases. A correlation is developed between the deformations ( ld and Sv) and interface efficiency factor ( α). The effectiveness of geogrid in keeping the ballast in place is evaluated in terms of a new parameter ‘geogrid efficiency factor ( Gef)’. The value of Gef for geogrids used is found to vary from 0.02 to 0.27. It is further shown that Gef under cyclic loading conditions is a function of the interface efficiency factor ( α) evaluated under direct shear conditions.
Correlates of inconsistent condom use and drug use among men having sex with men in Poland: a cross-sectional study
Authors: Piersiala Krzysztof , Krajewski Joanna , Dadej Daniela , Loroch Anna , Czerniak Witold , Rozpłochowski Błażej , Kierepa Agata , Mozer-Lisewska Iwona
Published: July 2020

The number of new human immunodeficiency virus (HIV) diagnoses is rising in many parts of Europe. We sought to evaluate the rising prevalence of new HIV diagnoses in Poland, where the majority of newly-diagnosed HIV cases are men having sex with men (MSM). This study aims to measure the prevalence of condom use and drug use and to identify risk factors for contracting sexually transmitted infections (STIs) among MSM in Poland by distributing an anonymous online survey aimed toward MSM. Among the 1438 participants who completed valid surveys, those with low education level and greater than 100 prior sexual partners showed the highest odds for inconsistent condom use (adjusted odds ratio [aOR] 3.027, 2.044, respectively). Participants who identified themselves as heterosexuals, with multiple sexual partners and living in big cities showed the highest odds for drug use (aOR 4.869, 3.305, 1.720, respectively). This study identifies groups at the highest risk of HIV/STIs and provides valuable information for public health experts to develop targeted STI prevention campaigns.
External validation of STONE, modified STONE, and CHOKAI scores for the diagnosis of ureteral stones in the Turkish population
Authors: Acar Yahya Ayhan , Uysal Emin
Published: July 2020

Background:

Scoring systems seem to be effective in the management of patients with uncomplicated ureteral stones. However, their efficiency may differ by population.

Objectives:

We aimed to validate STONE, modified STONE, and CHOKAI scores for the diagnosis of ureteral stones in the Turkish population.

Methods:

We conducted a retrospective chart review between 01 February 2018 and 30 November 2018, in an academic emergency department. Demographics, laboratory findings, and radiologic tests of patients with flank pain were obtained. Computed tomography was used as the gold standard for the diagnosis of ureteral stones. STONE, modified STONE, and CHOKAI scores were calculated for each patient. The performance of the scoring systems was compared in terms of their specificity, sensitivity, positive likelihood ratio, negative likelihood ratio, negative predictive value, and positive predictive value.

Results:

A total of 157 patients were included in the study. The mean age was 38.47 ± 14.87 years, and 103 (65.6%) of the patients were males. The prevalence of ureteral stones was 84.0%, 88.9%, and 85.0% in the high-risk patients and 12%, 9.4%, and 22.7% in the low-risk patients for the STONE, modified STONE, and CHOKAI scores, respectively. Area under the curve values for the STONE, modified STONE, and CHOKAI scores were 0.776 (p = 0.001; 0.692–0.860 95% confidence interval), 0.825 (p < 0.001; 0.749–0.901 95% confidence interval), and 0.869 (p < 0.001; 0.806–0.932 95% confidence interval), respectively. The specificity and sensitivity values of STONE, modified STONE, and CHOKAI scores for the diagnosis of ureteral stones were 64.71, 71.70; 70.59, 87.74; and 66.67, 90.57, respectively.

Conclusion:

The CHOKAI score displayed the best performance compared to STONE and modified STONE in diagnosing ureteral stones in the Turkish population.
Multiple jobs? The prevalence, intensity and determinants of multiple jobholding in Canada
Authors: Glavin Paul
Published: July 2020

While traditional labour market estimates indicate that there has been little change in the proportion of workers holding multiple jobs in North America, survey instrument deficiencies may be hiding more substantial growth driven by the gig economy. To address this possibility, I test a broader measure of multiple jobholding to examine its prevalence in the Canadian workforce based on two national studies of workers (2011 Canadian Work Stress and Health Study and 2019 Canadian Quality of Work and Economic Life Study). Almost 20% of workers in 2019 reported multiple jobholding – a rate that is three times higher than Statistics Canada estimates. While multivariate analyses reveal that the multiple jobholding rate in 2019 was 30% higher than in the 2011 Canadian Work Stress and Health Study, multiple jobholders in 2019 were less likely to report longer work hours in secondary employment. Analyses also revealed that having financial difficulties is consistently associated with multiple jobholding in 2011 and 2019. Collectively, these findings suggest that while the spread of short-term work arrangements has facilitated Canadians’ secondary employment decisions, for many workers these decisions may reflect underlying problems in the quality of primary employment in Canada, rather than labour market opportunity. I discuss the potential links between multiple jobholding, the gig economy and employment precariousness.

JEL Code: J21
The Effectiveness and Impact of Action Learning on Business Graduates’ Professional Practice
Authors: Perusso Andre , van der Sijde Peter , Leal Rafael , Blankesteijn Marlous
Published: July 2020

The organizational world has long recognized action learning (AL) as an invaluable tool for managerial development. However, AL’s popularity among organizations did not translate into its adoption by business schools. A lack of evidence on what competencies AL fosters in students and whether these competencies transfer to practice has limited its wider acceptance. We address this issue by examining the learning outcomes of an undergraduate business program that has been using AL as a central didactical feature for the past 10 years. Based on a qualitative cross-sectional study following five alumni cohorts, results show that AL fosters the development of knowledge (theoretical and practical), skills (communication and collaboration), and attitudes (self-knowledge and self-efficacy); competencies graduates transferred to practice years after completing the program. Although management education has been continually criticized for its inability to provide undergraduates with the competencies necessary for practice, our study shows that AL contributes to narrowing this relevance gap. It also expands our understanding of the effectiveness and impact of AL beyond executive training to include undergraduate education, thus informing and inviting educators to consider AL as an alternative to expand their teaching practices.
Submucous Cleft Palate Repair in Patients With 22q11.2 Deletion Syndrome
Authors: Fleming Jenna , Morrell Noelle , Zavala Hanan , Chinnadurai Siva , Roby Brianne Barnett
Published: July 2020

Objective:

To determine whether surgical intervention for submucous cleft palate (SMCP) is more common in children with 22q11.2 deletion syndrome (22q DS) compared to children without 22q DS.

Design:

Retrospective chart review.

Setting:

Tertiary pediatric hospital and 22q11.2 DS specialty clinic.

Participants:

One hundred forty-two children seen at the tertiary hospital or clinic during a 20-year period (June 1999-June 2019) with documented SMCP with and without 22q DS.

Main Outcome Measure:

Percentage of children with SMCP with and without 22q DS requiring surgical intervention for velopharyngeal insufficiency.

Results:

Patients with 22q DS had a significantly higher frequency of SMCP repair than those without 22q DS (89.7% vs 32.0%, P < .001, χ2 = 37.75). The odds of requiring SMCP repair were 18.6 times higher in those with 22q DS compared to those without (odds ratio = 18.6, CI = 6.1-56.6).

Conclusions:

This study provides new evidence suggesting patients with 22q DS require SMCP surgical repair for velopharyngeal insufficiency at a significantly higher rate than those without 22q DS. As the majority of patients with 22q DS with SMCP require surgical intervention, future prospective studies looking at early versus late repair of SMCP in patients with 22q DS are needed to guide the surgical repair timeline in this population.
College Grieving: Normalizing the Pain of Leaving and of Staying Behind
Authors: Gold Joshua M. , Beasley Elizabeth
Published: July 2020

The transition to college, however enacted, is viewed as a time of joyous discovery and self-exploration for the launched young adult. For the family, this transition may allow for pride in parental accomplishment and perhaps relief as the young adult departs the family home. However, in both circumstances, there is an undercurrent of loss and perhaps unexpressed grieving. If unacknowledged and unresolved, these feelings may cause the student to question readiness for college and personal maturity, perhaps spiraling into depression or substance abuse and culminating in withdrawal or dismissal. At home, the challenge of reimaging family daily life and parental connection may lead to either overinvolvement or distancing, deflecting but not resolving the accompanying family pain. This article will explain the normative process of “freshman grief,” integrate the concepts of this loss through the lens of narrative counseling, and offer suggestions for mental health workers in secondary schools and on college campuses to help students and families anticipate, process, and resolve this time of bereavement in the midst of the excitement of the first year ( n = 175).
Design and test of a torsional vibration absorber in series with a planetary gearset
Authors: Jurmu Luke , Robinette Darrell , Blough Jason , Gehringer Mark
Published: July 2020

Traditional vibration absorbers have not often been a practical solution for attenuating low frequency drivetrain modes of vibration because of the combination of the large mass and inertia and/or low stiffness, required to tune to the desired frequency. With the goal of reducing the inertia and size of a torsional vibration absorber, a unique vibration absorber was developed. Using a planetary gearset, the effective inertia of the absorber was increased without changing its physical mass, and a torsional mode below 30 Hz was successfully attenuated with physically realizable inertia and stiffness parameters. By reducing the tuned mass, the total volume claimed by the vibration absorber and planetary gearset was up to three times less than an equivalent traditional vibration absorber. A lumped parameter torsional model was developed to determine the optimal configuration of the planetary gearset input, output, and absorber inertia as well as a method to predict the optimal tuning frequency of the planetary torsional vibration absorber. A drivetrain dynamometer setup which emulates a two-degree-of-freedom torsional system was used to experimentally test and validate the performance of two planetary torsional vibration absorber prototypes built based upon the results of the lumped parameter model. The dynamometer setup was designed to have a first torsional mode around 20 Hz in which the planetary torsional vibration absorber was designed to attenuate. Based upon the experimental results of the planetary torsional vibration absorber, a reduction of over 20 dB was achieved.
Preoperative Functional Platelet Number Is Inversely Associated With 30-Day Mortality After Cardiac Surgery: A Retrospective Cohort Study
Authors: Ghosal Soutik , Trivedi Jaimin , Barlowe Daniel , Zhao Lei , Ji Xiaolin , Slaughter Mark S. , Kong Maiying , Huang Jiapeng
Published: July 2020

Background. We hypothesize that preoperative functional platelet number (platelet count multiplied by platelet aggregation percentage) are associated with 30-day mortality after cardiac surgery. Methods. We linked our preoperative testing database with the STS (Society of Thoracic Surgeon) database to form a study cohort of 1390 patients who had cardiac surgeries between January 2008 and December 2013. Preoperative tests of platelet count and platelet aggregation were routinely performed on all cardiac surgical patients within 24 hours before entering the operating room. Multiple logistic regression models were used to determine whether functional platelet number are associated with 30-day mortality, modified composite major adverse cardiocerebral events, postoperative renal failure or requirement for new renal replacement therapy, and reoperation for bleeding. Log-linear models were used to examine whether functional platelet numbers are associated with hospital length of stay and intensive care unit length of stay. Results. Functional platelet number had an inverse association with 30-day mortality, and each 50 × 109/L increase in functional platelet number resulted in decreased 30-day mortality (odds ratio of 0.767 with 95% confidence interval = 0.591-0.996). For secondary outcomes, functional platelet number was neither associated with major adverse cardiocerebral event nor length of stay. However, we found that each 50 × 109/L increase in functional platelet number was associated with decreased reoperations for bleeding (odds ratio of 0.778 with 95% confidence interval = 0.636-0.951). Conclusions. The preoperative functional platelet number had significant associations with 30-day mortality after cardiac surgery. Functional platelet number could be used to guide timing of cardiac surgery, especially as more and more patients are receiving antiplatelet medications nowadays.
Changes in Gut Microbiome Associated With Co-Occurring Symptoms Development During Chemo-Radiation for Rectal Cancer: A Proof of Concept Study
Authors: González-Mercado Velda J. , Henderson Wendy A. , Sarkar Anujit , Lim Jean , Saligan Leorey N. , Berk Lawrence , Dishaw Larry , McMillan Susan , Groer Maureen , Sepehri Farrah , Melkus Gail D’Eramo
Published: July 2020

Purpose:

To examine a) whether there are significant differences in the severity of symptoms of fatigue, sleep disturbance, or depression between patients with rectal cancer who develop co-occurring symptoms and those with no symptoms before and at the end of chemotherapy and radiation therapy (CRT); b) differences in gut microbial diversity between those with co-occurring symptoms and those with no symptoms; and c) whether before-treatment diversity measurements and taxa abundances can predict co-occurrence of symptoms.

Methods:

Stool samples and symptom ratings were collected from 31 patients with rectal cancer prior to and at the end of (24–28 treatments) CRT. Descriptive statistics were computed and the Mann-Whitney U test was performed for symptoms. Gut microbiome data were analyzed using R’s vegan package software.

Results:

Participants with co-occurring symptoms reported greater severity of fatigue at the end of CRT than those with no symptoms. Bacteroides and Blautia2 abundances differed between participants with co-occurring symptoms and those with no symptoms. Our random forest classification (unsupervised learning algorithm) predicted participants who developed co-occurring symptoms with 74% accuracy, using specific phylum, family, and genera abundances as predictors.

Conclusion:

Our preliminary results point to an association between the gut microbiota and co-occurring symptoms in rectal cancer patients and serves as a first step in potential identification of a microbiota-based classifier.
Oral Probiotic Bifidobacterium Longum Supplementation Improves Metabolic Parameters and Alters the Expression of the Renin-Angiotensin System in Obese Mice Liver
Authors: Machado Amanda S. , Oliveira Janaína R. , Lelis Deborah de F. , de Paula Alfredo M. B. , Guimarães André L. S. , Andrade João M. O. , Brandi Igor V. , Santos Sérgio H. S.
Published: July 2020

Background:

Obesity and non-alcoholic fatty liver disease (NAFLD) have been increasing at an alarming rate worldwide. Bifidobacterium longum (BL), a common member of the human gut microbiota, has important health benefits through several mechanisms.

Objectives:

We evaluated the BL supplementation effects on body metabolism and renin-angiotensin components hepatic expression in mice fed a high-fat diet.

Methods:

Thirty-two male mice were divided into four groups: standard diet + placebo (ST), standard diet + Bifidobacterium longum (ST + BL), high-fat diet + placebo (HFD) and high-fat diet + Bifidobacterium longum (HFD + BL). Following the obesity induction period, the ST + BL and HFD + BL groups were supplemented with Bifidobacterium longum for 4 weeks. Then, body, biochemical, histological and molecular parameters were evaluated.

Results:

HFD + BL mice had a significant decrease in adipose tissue mass and blood glucose levels, as well as a significant reduction in blood glucose during an intraperitoneal glucose tolerance test. The treatment also resulted in reduced levels of total cholesterol and hepatic fat accumulation. Moreover, we observed an increase in angiotensin converting enzyme 2 (ACE2) and Mas receptor (MASR) expression levels in BL-treated obese mice.

Conclusions:

These data demonstrate that BL may have the potential to prevent obesity and NAFLD by modulating the mRNA expression of renin-angiotensin system components.
Medium-term tamponade with vitrectomy and perfluorodecalin for the management of complex retinal detachments
Authors: Chehade Luke K , Guo Brad , Chan Weng , Gilhotra Jaqjit
Published: July 2020

Purpose:

To describe the clinical presentation, anatomical and visual outcome of a series of patients in our department with complex retinal detachments, managed with vitrectomy and perfluorodecalin (PFD) for medium-term tamponade.

Study design:

Retrospective case series.

Methods:

Retrospective analysis of the medical records of all patients in the last 6 years presenting with complex retinal detachment managed with vitrectomy where PFD was used as a medium-term tamponade.

Results:

A total of 85 eyes in 85 patients were included in the study, with a mean follow-up period of 16.0 ± 2.67 months (range 3–59). About 26 detachments presented with associated PVR-C, and 10 had giant retinal tears. The location of the retinal detachment was inferior in 40% of cases, and total in 18.9% of cases. Anatomical success, defined as retinal reattachment at 12 months, was achieved in 98.8% of cases, and there was a mean improvement in BCVA of logMAR 0.64 ± 0.20, which was statistically significant ( p < 0.001, paired t-test 6.23). Of the 41 phakic eyes included in the study, 20 underwent cataract surgery within the follow-up period.

Conclusion:

In this case series, we have demonstrated a 98.8% anatomical success and significant improvement in BCVA, with no reports of retinal toxicity. Medium-term tamponade PFD appears to be an efficacious and safe technique for management of a variety of complex retinal detachments, including those secondary to GRT, the presence of PVR-C, inferior location, tractional, traumatic, and re-detachments.
The use of topical cyclosporine A 0.05% as treatment for primary alacrimia in Allgrove syndrome
Authors: Botella García Jéssica , Lázaro-Rodríguez Víctor , de la Paz Maria Fideliz
Published: July 2020

Introduction:

The purpose is to report a case on the use of cyclosporine A 0.05% for primary alacrimia in Allgrove syndrome or triple A syndrome (alacrimia, achalasia, and adrenal insufficiency).

Case description:

A 37-year-old man with achalasia treated surgically 11 years ago presented with sensation of a foreign body, irritation, and intermittent ocular redness for several years. Ophthalmological examination revealed bulbar hyperemia, Oxford grade 4 corneal staining, anisocoria, and optic atrophy. The patient was initially treated with washing with serum and lubricants. Due to the persistence of symptoms, treatment with cyclosporine A 0.05% was started observing a clinical improvement with a decrease in the symptoms caused by tear deficiency.

Conclusion:

It is important to emphasize the relevance of establishing an early diagnosis through a complete multidisciplinary clinical examination and a study of adrenal function. The treatment of dry eye in these patients is difficult to manage, with topical immunomodulators such as cyclosporine A as a good alternative when lubricants are insufficient. To our knowledge this is the first case of subjective and objective improvement of dry eye using cyclosporine A 0.05% in a case of alacrimia in triple A syndrome. Allgrove syndrome presentation does not always manifest with the classic triad and some symptoms may be not present at the time of diagnosis. Ophthalmologist and pediatrician should consider this syndrome in patients with symptoms as complex as lack of growth, crying without tears, and convulsions.
Outcome of Everolimus-Based Therapy in Hormone-Receptor-Positive Metastatic Breast Cancer Patients After Progression on Palbociclib
Authors: Dhakal Ajay , Antony Thomas Roby , Levine Ellis G , Brufsky Adam , Takabe Kazuaki , Hanna Matthew G , Attwood Kristopher , Miller Austin , Khoury Thaer , Early Amy P , Soniwala Saif , O’Connor Tracy , Opyrchal Mateusz
Published: July 2020

Background:

Despite the approval of mTOR inhibitor everolimus and CDK4/6 inhibitors in the management of hormone-receptor-positive HER2 non-amplified metastatic breast cancer (HR+ HER2-MBC), the optimal sequence of therapy is unclear. There are no clinical data on efficacy of everolimus in HR+ HER2-MBC after cancer progresses on CDK4/6 inhibitors.

Objective:

The objective of this study is to find the efficacy of everolimus in HR+ HER2-MBC after they progress on a CDK4/6 inhibitor palbociclib.

Methods:

This is a retrospective, 2-institute review of HR+ HER2-MBC from Jan 2015 to March 2018 treated with everolimus after progression on palbociclib. Primary end point was median progression-free survival (PFS), secondary end points objective response rate (ORR), clinical benefit ratio (CBR), and overall survival (OS).

Results:

Out of 41 women with median age 61 years (33, 87) enrolled, 66% had received adjuvant systemic therapy, 61% had visceral disease, and 95% had prior nonsteroidal aromatase inhibitors. About 83% women had 3 or more chemotherapy or hormonal therapies prior to everolimus. Kaplan-Meier estimates showed a median PFS of 4.2 months (95% confidence interval [CI]: 3.2-6.2). The median OS was 18.7 months (95% CI 9.5 to not reached). Objective response rate and CBR were both 17.1%.

Conclusion:

Everolimus was associated with modest PFS and ORR in HR+ HER2-MBCs postprogression on palbociclib.
The performance of Cu-based friction material in dry clutch engagement
Authors: Koranteng Kingsford , Shaahu Joseph-Shaahu , Chengnan Ma , Li Heyan , Yi Yun-Bo
Published: July 2020

An enhanced Cu-based friction material was prepared by the powder metallurgy techniques and proposed for use in the dry clutch system. The friction characteristics and wear rate of this friction material sliding against 65Mn steel are obtained using Universal Material Tester-5. The friction pairs were subjected to two operating variables, which are sliding speed and temperature. The effect of these variables during the engagement process of the friction pairs is investigated. Knowing the normal applied force and dimension of the clutch disc, the dynamic friction coefficient was translated to friction torque capacity with time. It was found that instability can be excited at low operational conditions when the resulting friction coefficient is high. At 25 ℃, the dynamic friction torque oscillates with time likewise at 400 ℃. Generally, a more stable friction torque is obtained when the sliding speed is varied compared to varying the temperatures. Moreover, the influence of the operating temperatures and sliding speeds on thermal buckling and thermoelastic instability of the friction disc is the second consideration in this work. The onset of thermoelastic instability occurs when the sliding speed exceeded 200 r/min and the results for the growth rate of hot spots were found to agree well with the critical speed of the system. Also, thermal buckling was highly dependent on the temperature difference between the inner and outer radius of the friction disc.
Surfacing disciplinarity: Citation as a site for integrative learning
Authors: Russell Emily , Littler Lucy , Chick Nancy
Published: July 2020

Despite nearly ubiquitous general education requirements for students to take courses across disciplines, disciplinarity itself is often invisible to students and taken for granted by professors. We argue that surfacing these divisions and demystifying academic structures is, paradoxically, a key step in educating students toward the crossing of intellectual borders. In this article, we engage current Scholarship of Teaching and Learning to discuss the challenges both faculty and students face in navigating multidisciplinary general education programs, and we offer a practical resource for facilitating such integrative learning and pedagogy. This resource, a two-page handout outlining the disciplinary values behind the research processes and citation practices across several academic domains, can be used in a variety of settings—including classrooms and professional development workshops—for both student and faculty audiences, to achieve multiple purposes, including teaching and learning disciplinarity; demystifying disciplinary writing conventions; and assignment-, course-, or curricular redesign.
Beyond typologies, beyond optimization: Exploring novel structural forms at the interface of human and machine intelligence
Authors: Saldana Ochoa Karla , Ohlbrock Patrick Ole , D’Acunto Pierluigi , Moosavi Vahid
Published: July 2020

This article presents a computer-aided design framework for the generation of non-standard structural forms in static equilibrium that takes advantage of the interaction between human and machine intelligence. The design framework relies on the implementation of a series of operations (generation, clustering, evaluation, selection, and regeneration) that allow to create multiple design options and to navigate in the design space according to objective and subjective criteria defined by the human designer. Through the interaction between human and machine intelligence, the machine can learn the nonlinear correlation between the design inputs and the design outputs preferred by the human designer and generate new options by itself. In addition, the machine can provide insights into the structural performance of the generated structural forms. Within the proposed framework, three main algorithms are used: Combinatorial Equilibrium Modeling for generating of structural forms in static equilibrium as design options, Self-Organizing Map for clustering the generated design options, and Gradient-Boosted Trees for classifying the design options. These algorithms are combined with the ability of human designers to evaluate non-quantifiable aspects of the design. To test the proposed framework in a real-world design scenario, the design of a stadium roof is presented as a case study.
Optimization and physical performance evaluation of electrospun nanofibrous mats of PLA, PCL and their blends
Authors: Sharma Deepika , Satapathy Bhabani K
Published: July 2020

The optimization of process parameters such as applied voltage, orifice diameter, solvent system, and solvent ratio for electrospinning of neat polymers, polylactic acid (PLA) and poly (є-caprolactone) (PCL), to obtain uniform, randomly oriented nanofibers with minimum diameter variation and beaded structures has been critically discussed. The paper focuses on establishing a sequential optimization technique for arriving at a common set of electrospinning process parameters for individual polymers, such as, applied voltages, orifice diameters, solvent mixtures, solvent ratios, to be used in the fabrication of electrospun nanofibrous mats (ENMs) of blended polymers. In this study, the effect of variation of applied voltages, orifice diameters, solvent mixtures, solvent ratios, PLA/PCL blending ratios, solution concentration of blends and flow rate were reported via morphological analysis of electrospun nanofibers. The set of optimal process parameters obtained for both PLA and PCL were adopted for the fabrication of ENMs based on the PLA/PCL blends. The paper further deliberates on the physical performance of PLA/PCL based ENMs in acidic, basic and neutral release media. Thus, the study establishes a hierarchical processing optimization route for designing blended ENMs by following a set of variable electrospinning process parameters.
The Damaged Spinal Cord Is a Suitable Target for Stem Cell Transplantation
Authors: Curt Armin , Hsieh Jane , Schubert Martin , Hupp Markus , Friedl Susanne , Freund Patrick , Huber Evenline , Pfyffer Dario , Sutter Reto , Jutzeler Catherine , Wüthrich Rudolf P. , Min Kan , Casha Steve , Fehlings Michael G. , Guzman Raphael
Published: July 2020

Background. Given individuals with spinal cord injury (SCI) approaching 2 million, viable options for regenerative repair are desperately needed. Human central nervous system stem cells (HuCNS-SC) are self-renewing, multipotent adult stem cells that engraft, migrate, and differentiate in appropriate regions in multiple animal models of injured brain and spinal cord. Preclinical improved SCI locomotor function provided rationale for the first-in-human SCI clinical trial of HuCNS-SC cells. Evidence of feasibility and long-term safety of cell transplantation into damaged human cord is needed to foster translational progression of cellular therapies. Methods. A first-ever, multisite phase I/IIa trial involving surgical transplantation of 20 million HuCNS-SC cells into the thoracic cord in 12 AIS A or B subjects (traumatic, T2-T11 motor-complete, sensory-incomplete), aged 19 to 53 years, demonstrated safety and preliminary efficacy. Six-year follow-up data were collected (sensory thresholds and neuroimaging augmenting clinical assessments). Findings. The study revealed short- and long-term surgical and medical safety (well-tolerated immunosuppression in population susceptible to infections). Preliminary efficacy measures identified 5/12 with reliable sensory improvements. Unfortunately, without thoracic muscles available for manual muscle examination, thoracic motor changes could not be measured. Lower limb motor scores did not change during the study. Cervical cord imaging revealed, no tumor formation or malformation of the lesion area, and secondary supralesional structural changes similar to SCI control subjects. Interpretation. Short- and long-term safety and feasibility support the consideration of cell transplantation for patients with complete and incomplete SCI. This report is an important step to prepare, foster, and maintain the therapeutic development of cell transplantation for human SCI.
Factionalism in Southeast Asia: Types, Causes, and Effects
Authors: Hicken Allen , Tan Netina
Published: July 2020

In this article we present an overview of the arguments contained in the articles of this special issue. We first catalogue the varieties or types of factionalism present across Southeast Asia—namely, programmatic, clientelistic, and personalist/charismatic. We then explore the question of why the degree and type of factionalism varies across countries, across time, and across parties. We first focus on differences between factionalism in governing and opposition parties, arguing that factionalism across dominant and opposition parties differs in terms of the origin, type, and effect. We find that the more competitive the party system the more likely it is that factional patterns between the parties within a given polity will converge. We then review the relative power of socio-structural and institutional explanations of factionalism, and place the greatest weight on the role of patronage, party size, and the degree of party centralization. Finally, we turn our attention to common strategies for curbing factionalism across our cases and conclude by examining the consequences of factionalism.
The Limits of “Populism”: How Malaysia Misses the Mark and Why That Matters
Authors: Weiss Meredith L.
Published: July 2020

Politics in Malaysia seems ripe for a populist upsurge. Parties assume fairly exclusive, ethnic boundaries, inviting insider–outsider pandering. Personalities loom large. Economic inequality is among the highest in the region. Regardless, the extent to which Malaysian politics might be understood as “populist” rather than merely polarised, illiberal, and prone to particularism is dubious. I argue that Malaysian politics is neither populist nor likely to veer that way. However, the case offers a useful test of the boundaries between populism and personalisation of politics, the extent to which appeals designed to maximise popular support suffice to code a polity as populist, and which specific illiberal features facilitate or preclude populism. This examination thus clarifies a messy concept by exploring how populism might develop or falter in a multi-party, parliamentary, and hybrid rather than democratic regime – suggesting the relative reach of institutional rather than personalistic or zeitgeist-related explanations.
Subchronic Toxicity Assessment of Phytolacca americana L. (Phytolaccaceae) in F344 Rats
Authors: Han Hyoung-Yun , Han Kang-Hyun , Ahn Jun-Ho , Park Se-Myo , Kim Soojin , Lee Byoung-Seok , Min Byung-Sun , Yoon Seokjoo , Oh Jung-Hwa , Kim Tae-Won
Published: July 2020

Phytolacca americana L. is traditionally used in Korea, Japan, and China as a diuretic, antibacterial, antiviral, anticancer, and anti-inflammatory agent, and also in the treatment of hepatitis B, psoriasis, edema, and rheumatism. In this study, we evaluated the subchronic toxicity of an aqueous extract of P. americana (PAAE) in male and female F344 rats. The rats were orally administered PAAE (0, 500, 1000, and 2000 mg/kg body weight) once daily for 13 weeks. Mortality rate, body weight, food consumption, and organ weights were measured and assessed. Additionally, ophthalmological, hematological, and histopathological parameters were evaluated. Urinalysis and necropsy were also performed. The clinical chemistry values for potassium in the treated female groups (500, 1000, and 2000 mg/kg/ body weight/day) were higher than those in the control. Further, the relative weights of the kidneys in the treated female groups (1000 and 2000 mg/kg/ body weight/day) were higher than those in the control. However, these changes were not consistent in either sex, and no abnormalities were found in the corresponding pathological findings. Thus the results showed no adverse effects in all the parameters assessed. The findings show that after 13 weeks of treatment, the “no-observed-adverse-effect level” of PAAE is 2000 mg/kg body weight in both male and female F344 rats under the experimental conditions applied. Although treatment-related adverse effects were not seen, potassium-level changes in the blood should be examined to establish the safety profile of PAAE after long-term treatment.
A rare case of a non-neural granular cell tumor presenting as an enlarging right chest wall nodule in a 4-year-old male and review of the literature
Authors: Shahabi Ali , Hastings Hope , Winfield Harry , Khiyami Amer
Published: July 2020

Non-neural granular cell tumor was first described in 1991 as an unusual primitive, polypoid variant of the conventional granular cell tumor. To date, this neoplasm remains a rare entity and the cell of origin is uncertain. While the histological features are similar to the conventional granular cell tumor, it represents a distinct entity that is negative for S100 and lacks true nerve sheath differentiation. Here, we describe a case of a 4-year-old male who presented with a painless, soft nodule on his right chest wall that was slowly increasing in size. The mass was excised and sent for pathologic analysis. Microscopic examination reveals spindle and epithelioid cells with vesicular nuclei and prominent granular eosinophilic cytoplasm. Immunohistochemical analysis shows negative staining for S100 and AE1/AE3/PCK26 but is positive for CD68. A diagnosis of a non-neural granular cell tumor was made. We report a rare and diagnostically challenging case in a pediatric patient.
Clinical Outcomes After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Clinical Outcomes Consensus Group
Authors: Svantesson Eleonor , Hamrin Senorski Eric , Webster Kate E. , Karlsson Jón , Diermeier Theresa , Rothrauff Benjamin B. , Meredith Sean J. , Rauer Thomas , Irrgang James J. , Spindler Kurt P. , Ma C. Benjamin , Musahl Volker , the Panther Symposium ACL Injury Clinical Outcomes Consensus  , Fu Freddie H. , Ayeni Olufemi R. , Della Villa Francesco , Della Villa Stefano , Dye Scott , Ferretti Mario , Getgood Alan , Järvelä Timo , Kaeding Christopher C. , Kuroda Ryosuke , Lesniak Bryson , Marx Robert G. , Maletis Gregory B. , Pinczewski Leo , Ranawat Anil , Reider Bruce , Seil Romain , van Eck Carola , Wolf Brian R. , Yung Patrick , Zaffagnini Stefano , Hao Zheng Ming
Published: July 2020

A stringent outcome assessment is a key aspect of establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. To establish a standardized assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, Pennsylvania, USA, in June 2019. The aim was to establish a consensus on what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used, and at what follow-up time those outcomes should be assessed. The group reached consensus on 9 statements by using a modified Delphi method. In general, outcomes after ACL treatment can be divided into 4 robust categories: early adverse events, patient-reported outcomes (PROs), ACL graft failure/recurrent ligament disruption, and clinical measures of knee function and structure. A comprehensive assessment after ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained reinjuries, validated knee-specific PROs, and health-related quality of life questionnaires. In the midterm to long-term follow-up, the presence of osteoarthritis should be evaluated. This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment.
Chlamydia trachomatisduring pregnancy and childhood asthma-related morbidity: a population-based prospective cohort
Authors: van Meel Evelien R. , Attanasi Marina , Jaddoe Vincent W.V. , Reiss Irwin K.M. , Moll Henriëtte A. , de Jongste Johan C. , Duijts Liesbeth
Published: July 2020

Introduction

Chlamydia trachomatisis the most commonly reported sexually transmitted disease and although infection during pregnancy is associated with neonatal complications, long-term respiratory consequences are unknown. We aimed to determine whetherC. trachomatisinfection during pregnancy is associated with asthma-related symptoms across childhood

Methods

This study among 2475 children and their mothers was embedded in a population-based prospective cohort study. Maternal urine samples were tested forC. trachomatisinfection during pregnancy. Questionnaires provided information on childhood physician-attended lower respiratory tract infections and wheezing, and current asthma at age 10 years. Lung function was measured by spirometry at age 10 years.

Results

The prevalence ofC. trachomatisinfection during pregnancy was 3.2% (78 out of 2475).C. trachomatisinfection during pregnancy was not associated with lower respiratory tract infections until age 6 years, but was associated with a higher odds of wheezing in children until age 10 years (OR 1.50 (95% CI 1.10–2.03)).C. trachomatisinfection during pregnancy was associated with an increased odds of asthma (OR 2.29 (95% CI 1.02–5.13)), and with a lower forced expiratory volume in 1 s/forced vital capacity and forced expiratory flow at 75% of forced vital capacity (z-score difference −0.28 (95% CI −0.52– −0.04) and −0.24 (95% CI −0.46– −0.01), respectively) in children at age 10 years. The observed associations were only partly explained by mode of delivery, gestational age at birth or birthweight.

Conclusions

C. trachomatisinfection during pregnancy is associated with increased odds of wheezing, asthma and impaired lung function. The causality of the observed associations and potential underlying mechanisms need to be explored.
High rifampicin-resistant TB cure rates and prevention of severe ototoxicity after replacing the injectable by linezolid in early stage of hearing loss
Authors: Souleymane Mahamadou Bassirou , Piubello Alberto , Lawan Ibrahim Mamane , Hassane-Harouna Souleymane , Assao-Neino Mourtala Mohamed , Soumana Alphazazi , Hamidou-Harouna Zelika , Gagara-Issoufou Assiatou , Ortuño-Gutiérrez Nimer , Roggi Alberto , Schwoebel Valerie , Mamadou Saïdou , Lynen Lutgarde , De Jong Bouke , Van Deun Armand , Decroo Tom
Published: July 2020

The short treatment regimen (STR) achieves a >80% cure in rifampicin-resistant tuberculosis (RR-TB) patients. However, ototoxicity induced by the injectable is a concern. This is the first study to evaluate the replacement of injectables by linezolid in patients with audiometry abnormalities at baseline or during the treatment.

We conducted a retrospective cohort study of all RR-TB patients started on the STR between 2016 and June, 2019, in Niger. Patients underwent audiometry every 2 months in 2016 and every month since 2017.

Of 195 patients, 16.9% (33 out of 195) received linezolid from the start (n=17), or switched from injectables to linezolid during treatment (n=16), based on audiometry abnormalities. In 2016, two patients developed severe ototoxicity despite switching to linezolid. Since 2017, no patient developed severe hearing loss or complete deafness. Severe haematological toxicity was observed in 18.1% (six out of 33) of patients on linezolid, none of which was life threatening. The use of linezolid was associated with severe but manageable adverse events (hazard ratio 8.9, 95% CI 2.5–31.5; p=0.001). A total of 90.9% (30 out of 33) of patients on a linezolid-containing STR were cured, and none experienced treatment failure. Three died, but not due to adverse events.

Baseline and monthly audiometry monitoring and using linezolid after detection of hearing abnormalities appears effective to prevent severe ototoxicity, while keeping high treatment success and manageable adverse events.
Derivation and validation of a clinical prediction rule for thrombolysis-associated major bleeding in patients with acute pulmonary embolism: the BACS score
Authors: Jara-Palomares Luis , Jiménez David , Bikdeli Behnood , Muriel Alfonso , Rali Parth , Yamashita Yugo , Morimoto Takeshi , Kimura Takeshi , Le Mao Raphael , Riera-Mestre Antoni , Maestre Ana , Moustafa Fares , Monreal Manuel
Published: July 2020

Background

Improved prediction of the risk of major bleeding in patients with acute pulmonary embolism (PE) receiving systemic thrombolysis is crucial to guide the choice of therapy.

Methods

The study included consecutive patients with acute PE who received systemic thrombolysis in the RIETE registry. We used multivariable logistic regression analysis to create a risk score to predict 30-day major bleeding episodes. We externally validated the risk score in patients from the COMMAND VTE registry. In addition, we compared the newly created risk score against the Kuijer and RIETE scores.

Results

Multivariable logistic regression identified four predictors for major bleeding: recent major bleeding (3 points), age >75 years (1 point), active cancer (1 point) and syncope (1 point) (BACS). Among 1172 patients receiving thrombolytic therapy in RIETE, 446 (38%) were classified as having low risk (none of the variables present, 0 points) of major bleeding according to the BACS score, and the overall 30-day major bleeding rate of this group was 2.9% (95% CI 1.6–4.9%), compared with 44% (95% CI 14–79%) in the high-risk group (>3 points). In the validation cohort, 51% (149 out of 290) of patients were classified as having low risk, and the overall 30-day major bleeding rate of this group was 1.3%. In RIETE, the 30-day major bleeding event rates in the Kuijer and RIETE low-risk strata were 5.3% and 4.4%, respectively.

Conclusions

The BACS score is an easily applicable aid for prediction of the risk of major bleeding in the population of PE patients who receive systemic thrombolysis.