bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality is increased in patients with rheumatoid arthritis or diabetes compared to the general population – the Nord-Trøndelag Health Study
Authors: Houge Ingrid Sæther , Hoff Mari , Thomas Ranjeny , Videm Vibeke
Published: February 2020

Persons with rheumatoid arthritis (RA) or diabetes have increased risk of cardiovascular disease (CVD) and higher death rates compared to the general population. This study used data from the population-based Nord-Trøndelag Health Study (HUNT) and the Norwegian Cause of Death registry to compare all-cause mortality rates for RA or diabetes patients to the general population. We used Cox regression with age as time variable, adjusting for sex, smoking, body mass index, hypertension, total cholesterol, creatinine and previous CVD. To achieve proportional hazards, an interaction term with an age group variable (≤75 years or >75 years) was included for diabetes, smoking and previous CVD. Median follow-up was 18.1 years. Mortality occurred for 123 (32%) of the RA patients, 1,280 (44%) of the diabetes patients, 17 (52%) of the patients with both diseases and 11,641 (18%) of the controls. Both diseases were associated with statistically significantly increased mortality rates. The hazard ratio (HR) for RA was 1.24 (95% CI: 1.03-1.44). The HR of diabetes was 1.82 (1.60-2.04) for individuals ≤75 years old and 1.49 (1.39-1.59) for individuals >75 years. Diabetes had a significantly higher HR for death than RA for participants ≤75 years, but not significantly different for participants >75 years.
Performance improvement in electrospun InGaZnO nanofibres field-effect-transistors using low thermal budget microwave calcination and Ar/O2 mixed-plasma surface treatment
Authors: Cho Seong-Kun , Cho Won-Ju
Published: February 2020

In this study, we present a low thermal budget microwave annealing (MWA) method for calcination of electrospun In-Ga-ZnO (IGZO) nanofibres and demonstrate an improvement in the performance of IGZO nanofibre field-effect transistors (FETs) by Ar/O2 mixed-plasma surface treatment. The IGZO nanofibres were fabricated by electrospinning method and calcined using MWA method. This process allowed for a significant reduction in the heat treatment temperature and time. Subsequently, plasma surface treatment using various ratios of Ar/O2 gas mixtures was carried out. The surface morphology and chemical composition of MWA-calcined and plasma-treated IGZO nanofibres were studied by SEM and XPS analysis. In order to investigate the effects of MWA calcination combined with Ar/O2 mixed-plasma treatment on the electrical properties and the reliability of nanofibres-based transistors, IGZO nanofibres FETs were fabricated and applied to resistor-loaded inverters. Our results show that the O2 plasma treatment significantly improves the performance of IGZO nanofibres FETs and the resistor-loaded inverters based on IGZO nanofibres FETs, whereas Ar plasma treatment degrades the performance of these devices. The instability tests using positive bias temperature stress (PBTS) and negative bias temperature stress (NBTS) revealed that the O2 plasma treatment contributed to the stability of IGZO nanofibres FETs. Our results suggest that the MWA calcination combined with the Ar/O2 mixed-plasma surface treatment is a promising technique for the fabrication of high performance IGZO nanofibres FETs with low thermal budget processes.
The use of auxetic materials in tissue engineering
Authors: Mardling Paul , Alderson Andrew , Jordan-Mahy Nicola , Le Maitre Christine Lyn
Published: February 2020

A number of biological tissues have been shown to behave in an auxetic manner, defined by having a negative poissons ratio. Thus mimicking this environment has a number of potential applications especially in tissue engineering.
Cross-ecosystem nutrient subsidies in Arctic and alpine lakes: implications of global change for remote lakes
Authors: Burpee Benjamin T. , Saros Jasmine E.
Published: February 2020

Environmental change is continuing to affect the flow of nutrients, material and organisms across ecosystem boundaries. In this review, we synthesize current knowledge of cross-ecosystem nutrient subsidies between Arctic and alpine lakes and their surrounding terrain, cryosphere, and atmosphere.
Investigation of dielectric constants of water in a nano-confined pore
Authors: Zhu Haochen , Yang Fengrui , Zhu Yunjie , Li Aihua , He Wenzhi , Huang Juwen , Li Guangming
Published: February 2020

Investigation of dielectric properties in a silica hydrophilic pore with two water reservoirs.
Revealing electronic features governing hydrolysis of cephalosporins in the active site of the L1 metallo-β-lactamase
Authors: Levina Elena O. , Khrenova Maria G. , Astakhov Andrey A. , Tsirelson Vladimir G.
Published: February 2020

Combination of QM/MM and modern bonding descriptors explains different reactivity of cephalosporins in the active site of the L1 metallo-β-lactamase.
Correction: Formamide-assisted one-step synthesis of BiOCOOH and Bi/BiOCOOH micro-/nanostructures with tunable morphologies and composition and their photocatalytic activities
Authors: Zhou Hui , Kalwar Kaleemullah , Shen Ming , Zhong Songtao , Yao Yufeng
Published: February 2020

Correction for ‘Formamide-assisted one-step synthesis of BiOCOOH and Bi/BiOCOOH micro-/nanostructures with tunable morphologies and composition and their photocatalytic activities’ by Ming Shen et al., CrystEngComm, 2020, DOI: 10.1039/c9ce01960j.
Third-generation ionic liquids with N-alkylated 1,4-diazabicyclo[2.2.2]octane cations and pelargonate anions
Authors: Turguła Anna , Stęsik Konrad , Materna Katarzyna , Klejdysz Tomasz , Praczyk Tadeusz , Pernak Juliusz
Published: February 2020

Novel ionic liquids with cations based on alkyl derivatives of 1,4-diazabicyclo[2.2.2]octane (DABCO) and an anion derived from naturally occurring pelargonic acid possessed double biological functions: herbicidal and deterrent activity.
Direct cyanidation of silver sulfide by heterolytic C–CN bond cleavage of acetonitrile
Authors: Das Biraj , Saikia Pinku , Sharma Mukesh , Baruah Manash J. , Roy Subhasish , Bania Kusum K.
Published: February 2020

Herein, we report the cleavage of the C–CN bond of acetonitrile, catalyzed by vanadium pentoxide, for the direct cyanidation of silver sulfide.
Alendronate/folic acid-decorated polymeric nanoparticles for hierarchically targetable chemotherapy against bone metastatic breast cancer
Authors: Chen Shih-Hong , Liu Te-I , Chuang Cheng-Lin , Chen Hsin-Hung , Chiang Wen-Hsuan , Chiu Hsin-Cheng
Published: February 2020

Through hierarchically targeting bone matrix and tumor cells, PTX-carrying ALN/FA-nanoparticles substantially accumulate in bone metastases and improve mice survival rate.
Substituent steric effect boosting phosphorescence efficiency of PtCu2 complexes
Authors: Wang Zhao-Yi , Wang Jin-Yun , Zhang Li-Yi , Yang Ming , Zhang Xu , Chen Zhong-Ning
Published: February 2020

Introducing sterically hindered 2-methyl groups to phenyl rings in triphosphine ligands gives rise to a significant red-shift of the emission and dramatic increase of phosphorescence efficiency in PtCu2 acetylide complexes.
A lanthanide MOF immobilized in PMMA transparent films as a selective fluorescence sensor for nitroaromatic explosive vapours
Authors: Moscoso Francisco G. , Almeida José , Sousaraei Ahmad , Lopes-Costa Tânia , Silva Ana M. G. , Cabanillas-Gonzalez Juan , Cunha-Silva Luís , Pedrosa José M.
Published: February 2020

A selective luminescent sensor was fabricated by simply mixing a Tb(iii)-based MOF with polymethylmetahacrylate enabling to detect sub-ppb range of nitroaromatic vapours.
Calculation of 3D transient Eddy current by the face‐smoothed finite element–boundary element coupling method
Authors: Wang Yangyang , Jiang Xingliang
Published: February 2020

To calculate the distribution of the magnetic field and eddy current density on the surface of an aluminium plate, a method that couples the face‐smoothed finite element method (FS‐FEM) to the boundary element method (BEM) is proposed in this study. This method combines the advantages of the FS‐FEM and BEM, which can rapidly and accurately calculate the distributions of vertical magnetic field and eddy current field on the surface of an aluminium plate. The structural parameters and material properties of the coil and aluminium plate are considered. An accurate three‐dimensional calculation model is established. Then, the vertical magnetic field and eddy current field distributions are calculated in this study. In the case of the same grid density, compared with the finite element–boundary element coupling algorithm, the simulation results show that the FS‐FEM and the boundary element coupling method have obvious advantage in improving the calculation accuracy. The maximum relative error between the calculated results and measured results is only 4%. The proposed method in this study is available for reference to the transient open‐domain eddy current field analysis.
Real‐time agent‐based control of plug‐in electric vehicles for voltage and thermal management of LV networks: formulation and HIL validation
Authors: García Veloso César , Rauma Kalle , Fernández Orjuela Julián , Rehtanz Christian
Published: February 2020

Ensuring a stable and reliable operation of current and future distribution networks represents a major challenge for system operators aggravated by the global proliferation of plug‐in electric vehicles (PEVs). While the introduction of a controlled charging process would be advantageous to minimise the impacts PEVs cause in the system, a suitable, efficient and ready to be implemented solution is still missing. The present work addresses this issue by proposing a smart charging management solution capable to simultaneously combat the main network impacts derived from the energy needs of the vehicles. This is done by means of an agent‐based hierarchical real‐time algorithm which combines a local decentralised nodal voltage management with a centralised thermal control conceived to minimise the impact upon participating users. The effectiveness of the proposed system is tested both using a simulation environment considering multiple PEV penetration levels and employing commercially available charging stations and cars through hardware‐in‐the‐loop simulations. The results reveal how all network violations are successfully attenuated by peak shaving the total aggregated charging demand and ensuring a correct system operation for all penetration scenarios while inflicting no impact on the participating users.
Transient stability assessment combined model framework based on cost‐sensitive method
Authors: Wang Huaiyuan , Chen Qifan , Zhang Baohui
Published: February 2020

The real‐time transient stability assessment (TSA) is critical for emergency control of power systems. Accurate and fast TSA can provide an important basis for post‐fault control of power systems. At present, the accuracy of the evaluation model based on machine learning is very high, but there are still some misjudgements in the results. In order to build a high‐accuracy evaluation model, a novel frame based on the cost‐sensitive method is proposed. Firstly, a deep belief network (DBN) is applied to build a TSA frame. The DBN is effectively trained by means of pre‐training and fine tuning. Secondly, two models with the opposite preference are constructed based on the cost‐sensitive method. Based on the output results of the two models, the deterministic or uncertain evaluation results are obtained. The samples that may be misclassified are divided into uncertain evaluation results. Thus, the accuracy of the deterministic evaluation results can be improved greatly. Through this design, the practicability of the evaluation model based on machine learning is greatly improved. The effectiveness of the proposed scheme is verified by the simulation results in the IEEE‐39 bus system and a realistic regional system.
Descriptive statistical approach for the assessment of the output of a virtual power plant in a secondary distribution network
Authors: Palanichamy Ponraj , Samuel Arul Daniel , Murali Venkatakirthiga
Published: February 2020

Virtual power plants (VPPs) of secondary distribution network have come into existence due to the installation of generators in the premises of domestic consumers and the recent legislative emphasis on net‐zero energy operation. A predetermined operation of VPP as required by a system operator is possible only when its power output is assessed beforehand. A simple approach for assessment based on load profiling using descriptive statistical parameters such as z‐scores of the load data is proposed in this study. The proposed method collates historical customer data according to seasons, days of the week and specified time‐intervals of the day. Then, z‐scores are computed for each of the historical load and generator data. The calculated z‐scores are subsequently grouped into specified clusters. The grouped data in each of the clusters are then employed to predict the VPP output. Demonstration of the assessment of VPP output using available Pecan street data is presented to validate the proposed approach.
Multilevel inverter with improved basic unit structure for symmetric and asymmetric source configuration
Authors: Hamidi Muhammad Najwan , Ishak Dahaman , Zainuri Muhammad Ammirrul Atiqi Mohd , Ooi Chia Ai
Published: February 2020

An improved multilevel inverter (MLI) topology using a new basic unit structure with a reduced number of components is proposed in this study. Its single compact module is made up of two basic units connected to the left and right sides of a packed H‐bridge. The topology produces 9‐Level output when operated symmetrically and 17‐Level output when operated asymmetrically. Identical magnitude of DC sources is used for the symmetrical operation, while non‐identical magnitudes in a trinary sequence are used for the asymmetrical operation. The low‐frequency modulation scheme is applied for the switching control where the switching angles are pre‐calculated. The mathematical formulations for the switching are also considered to reduce the total harmonic distortion (THD) at the output. The proposed topology is also found to be superior in terms of the required number of switches per output level and total blocking voltage compared to conventional and recently reported MLIs. With these merits, real‐time installation of the proposed topology will potentially require lesser space and become cheaper. The feasibility of the proposed topology is validated for its 9‐Level and 17‐Level operations through experimental verification on output characteristics, THD, blocking voltage, power‐sharing and efficiency.
Synthesis and characterisation of zeolite LTA with sheet structure
Authors: Wang Peng , Sun Qi
Published: February 2020

This work reports a simple and effective method for the rapid synthesis of zeolite Linde Type A (LTA) with sheet structure from kaolin. X‐ray diffraction results confirm the purity and crystallinity of the synthesised zeolite LTA with sheet structure. Transmission electron microscopy images clearly show the sheet‐like structure of the synthesised zeolite LTA. The selected area electron diffraction pattern indicates that the crystal structure type of the synthesised zeolite LTA with sheet structure is the body‐centred cube. Meanwhile, the elemental mapping confirms the coexistence and uniform distribution of Si, Al, O and Na elements in the lamellar structure of the synthesised zeolite LTA. In addition, N2 adsorption–desorption technique indicates that the surface area of the synthesised zeolite LTA with sheet structure increases up to 39.7994 m2 ·g−1, a much higher value than that of zeolite LTA.
Erbium‐doped barium titanate/hydroxyapatite composites with enhanced piezoelectric and biological properties
Authors: Wu Cong , Tang Yufei , Zhao Kang , Jiao Mengzhen , Wu Zixiang
Published: February 2020

Shortening the period of bone repair based on BaTiO3/hydroxyapatite(HA) composites with osteoconductivity and osteoinductivity is important. However, when the piezoelectric properties of composites are matched with natural bone, the content of non‐degradable BaTiO3 needs to reach 90%, which may not conducive to clinical application. The barium titanate content in the composite was reduced by doping Er3+ into the BaTiO3 of BaTiO3/HA composites with enhanced piezoelectric properties. The piezoelectric constant and compressive strength of composites increased with the increase of Er3+ ‐doped barium titanate (BTEr) content. Appropriate piezoelectric stimulation can promote the growth of osteoblasts. 70% BTEr/30% HA is more beneficial to the proliferation of osteoblasts than 70% BaTiO3/30% HA.
Editorial
Authors: Saftoiu Adrian
Published: February 2020

As a dynamic journal, now indexed in PubMed/Medline, Ultrasound International
Open continued in 2019 with important original articles, reviews and case
presentations.
Terminalia chebula – Samoo Thai
Authors: Burri Josef , Uehleke Bernhard
Published: February 2020

Terminalia chebula Retz. aus der Familie der Combretaceae, ist im deutschsprachigen Raum unter den Namen chebulische Myrobalane oder Schwarze Myrobalane bekannt und im Englischen als myrobalan. Der 20–30 m hohe Laubbaum ist in ganz Süd- und Südostasien bis in den Süden und Südwesten Chinas verbreitet. Für therapeutische Zwecke finden vor allem die rund 3 cm großen Steinfrüchte Verwendung Abb. 1. In der Regel werden sie getrocknet. Dabei schrumpfen sie zusammen und gleichen dann Walnüssen; deshalb taucht gelegentlich auch die Bezeichnung „Myrobalan-Nuss“ auf.
Factors associated with complete clearance of difficult common bile duct stones after temporary biliary stenting followed by a second ERCP: a multicenter, retrospective, cohort study
Authors: Jang Dong Kee , Lee Sang Hyub , Ahn Dong Won , Paik Woo Hyun , Lee Jae Min , Lee Jun Kyu , Ryu Ji Kon , Kim Yong-Tae
Published: February 2020

Background Although temporary endoscopic biliary stenting is considered effective for difficult common bile duct (CBD) stones, few studies have investigated the optimal conditions for complete stone clearance at the second endoscopic retrograde cholangiopancreatography (ERCP) after temporary biliary stenting. We aimed to evaluate factors associated with complete clearance.

Methods Patients with difficult CBD stones (a large [≥ 20 mm] or multiple [≥ 3 sized ≥ 15 mm] CBD stones) were retrospectively enrolled from three institutions. Patients who underwent temporary biliary stenting at the first ERCP were analyzed. Double-pigtail plastic stents (7 or 10 Fr) were placed with the proximal ends above the stones. Complete clearance rate and stone size reduction at the second ERCP, and factors associated with complete clearance were evaluated using univariate and multivariate analyses.

Results 85 patients were enrolled (mean age 74.5 years [SD 11.3]; 47 women). Stone size and CBD diameter significantly decreased during the interval. The overall complete stone clearance rate was 64.7 % (55/85) at the second ERCP. The mean stone size reduction was 5.6 mm (SD 6.8). In multivariate analysis, complete clearance rate was significantly lower in male patients, in patients aged > 80 years, and in stones > 25 mm initially, but was significantly higher when 7-Fr stents were placed and stone size was reduced by > 5 mm.

Conclusion Use of 7-Fr rather than 10-Fr plastic stents was beneficial for complete clearance of difficult CBD stones after temporary biliary stenting; older male patients as well as patients with initial stones > 25 mm had a lower clearance rate.
Mortality, Morbidity, and Prognostic Factors in the Surgical Resection of Brain Metastases: A Contemporary Cohort Study
Authors: Picarelli Helder , Oliveira Marcelo de Lima , Marta Gustavo Nader , Solla Davi J. Fontoura , Teixeira Manoel Jacobsen , Figueiredo Eberval Gadelha
Published: February 2020

Objective Despite advances in systemic therapy and radiotherapy (RT), neurosurgical resection (NSR) remains a mainstay of the treatment of brain metastases (BMs). Although it is unequivocal in instances of diagnostic doubt, radioresistance, and risk of death due to neurologic causes, NSR may be controversial in other situations. Many aspects related to NSR have not yet been well established, and the primary prognostic indices were proposed only in the last decade. This study evaluates the survival and the morbidity, causes of death, prognostic factors, and the impact of RT in patients with BMs treated by NSR in the current era.

Methods A total of 200 patients with BMs who were treated by NSR were evaluated sequentially and followed prospectively. We used logistic regression and Cox regression models to identify independent factors associated with mortality at 4 weeks and at 1 year, respectively. Clinical features, morbidity, recurrence, and causes of death were also studied.

Results Lung cancer was the most prevalent cancer (36.5%); the median Karnofsky Performance Status (KPS) score was 60. Total resection was achieved in 89%, and adjuvant RT was applied in 63% of the cases. The rates of surgical mortality, morbidity, and mortality at 4 weeks were 1.5%, 17%, and 7.5%, respectively. Systemic infections were the leading cause of death in 62.5% of the cases. The median survival was 5 months, and 34.5% of patients lived > 1 year. The postoperative KPS (KPSpo) score remained unchanged or improved in 94.5% of the cases. In the multivariate analysis, a KPSpo score ≥ 80 and the application of adjuvant RT were associated with a lower risk of death at 12 weeks and at 1 year. Interestingly, the variables of primary tumor site, number of BMs, and presence of carcinomatous meningitis were not significant.

Conclusion Morbidity and mortality were high, a third of the patients lived > 1 year, and the KPS score improved or remained unchanged in most cases. Prognostic indices and health conditions were important predictive factors, but the KPSpo score and adjuvant RT were independent variables for survival at 12 weeks and at 1 year. Therefore, new studies are needed to assess the influence of new therapies and specific molecular profiles.
Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors
Authors: dos Santos Pâmela Antoniazzi , Madi José Mauro , da Silva Emerson Rodrigues , Vergani Daiane de Oliveira Pereira , de Araújo Breno Fauth , Garcia Rosa Maria Rahmi
Published: February 2020

Objective To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul.

Materials and Methods A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group.

Results The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56–6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR] = 2.19; 95%CI: 1.42–3.37; p < 0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR = 3.01; 95%CI: 1.97–4.61; p < 0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR = 1.84; 95%CI: 1.25–2.71; p = 0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables.

Conclusion In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.
Experiencia de embolización de la arteria renal previa a nefrectomía
Authors: Arboleda-Gómez Diego Alejandro , Lopera-Valle Johan Sebastián , Rueda-Cárdenas Luisa Fernanda , Vergara-Cadavid Juliana Andrea , Hidalgo-Oviedo José Miguel
Published: February 2020

Objetivo Describir la evolución perioperatoria de pacientes sometidos a nefrectomía con y sin embolización de la arteria renal (EAR) prequirúrgica, en un hospital de alta complejidad de Medellín, Colombia.

Materiales y Métodos Observacional descriptivo retrospectivo; se incluyeron pacientes de 18–90 años con diagnóstico de tumor renal, sometidos a nefrectomía con y sin EAR prequirúrgica. Las variables cualitativas se expresaron por medio de frecuencias y proporciones, y las cuantitativas mediante medidas de tendencia central y dispersión.

Resultados Se incluyeron 71 pacientes con una media de edad de 58,1 (DE: 10,6) años, 41 eran mujeres y el 69% tenía diagnóstico de carcinoma de células claras. La media del volumen de sangrado intraoperatorio fue de 540,8 cc, y 19,7% requirió transfusión. El tiempo quirúrgico promedio fue de 2,6 horas y el 38% presentó alguna complicación, con una mortalidad total del 4,2%. Al observar comparativamente los pacientes con EAR (15 pacientes) versus aquellos sin ella (56 pacientes), se identificó un mayor volumen de sangrado intraoperatorio y la necesidad de transfusión en los primeros.

Conclusión Los pacientes sometidos a EAR presentaron un mayor volumen de sangrado, mayor frecuencia de transfusión y complicaciones postoperatorias, siendo necesario un consenso sobre su real pertinencia terapéutica.
Subdural Hematoma Complicating Ventriculoperitoneal Shunts: An Algerian Centers Experience
Authors: Assoumane Ibrahim , Al-Zekri M. , Khelifa A. , Touati N. , Lagha N. , Sidi Said A. , Morsli A.
Published: February 2020

Introduction Subdural hematoma can occur as a complication of a ventriculoperitoneal shunt (VPS), and it should be considered in any patient who present a shunt dysfunction or who does not show the expected recovery after revision of a shunt. Computed tomography (CT) scan is a quick and easy way of detecting subdural hematoma.

Materials and Methods We conduct a retrospective study of 17 patients. All of them are admitted for a subdural hematoma on a VPS. The diagnosis in 13 cases is made by CT scan; three cases by brain MRI.

Results We operated 16 patients and the evacuation of the hematoma with revision of the shunt was performed; we used an adjustable shunt for three patients and endoscopic third ventriculostomy in one case. The operative outcomes were favorable in 12 patients; there were 4 recurrences, 2 of which required evacuation of the hematoma through a bone flap.

Conclusion The subdural hematoma is a complication observed during the surgical treatment of the hydrocephalus and can be a serious issue. We suggest that a brain CT scan should be routinely performed in symptomatic patients with VPS.
Robotic-Assisted DIEP Flap Harvest for Autologous Breast Reconstruction: A Comparative Feasibility Study on a Cadaveric Model
Authors: Bustos Samyd S. , Manrique Oscar J. , Mohan Anita T. , Nguyen Minh-Doan , Martinez-Jorge Jorys , Forte Antonio J. , Terzic Andre
Published: February 2020

Background The deep inferior epigastric perforator (DIEP) flap is the most common perforator flap for microsurgical breast reconstruction. Contrary to the conventional open approach, robotic-assisted DIEP flap harvest intends to preserve ARS integrity, thereby reducing the morbidity. We assessed the feasibility and compared performance outcomes of a robotic, cadaveric training model for DIEP flap harvest using two approaches: transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP).

Methods A robotics system (da Vinci Xi) was applied in conjunction with a cadaveric training model. Ports were placed in the abdominal wall to triangulate each DIEP flap. Surgical time and technical characteristics were recorded. Values were analyzed and compared.

Results Eight female cadavers (16 hemi-DIEP flaps) were dissected: 50% TAPP and 50% TEP approaches. Mean harvest time was 56 minutes (range: 48–74 minutes) and 65 minutes (range: 60–83 minutes) for TAPP versus TEP groups, respectively (p < 0.05). Mean pedicle dissection time was 36 minutes (range: 25–40 minutes) and 39 minutes (range: 30–42 minutes) for TAPP versus TEP groups, respectively (p > 0.05). Intra-abdominal contents were manipulated twice on average in the TAPP group versus 0 times in the TEP group (p < 0.05). One TAPP case had an injury to the bowel, and one TEP case was converted to conventional open due to pneumoperitoneum.

Conclusion Robotic-assisted DIEP flap harvest represents a technological enhancement for advanced regenerative plastic surgery. Our model demonstrated both TAPP and TEP are feasible, with TEP less invasive, preserving the posterior rectus sheath, and decreasing complication risks. However, there is a steeper and longer learning curve for TEP.
X-ray diffractive imaging of controlled gas-phase molecules reveals the molecular structure of 2,5-diiodothiophene
Authors: Frank Jodi Ackerman
Published: February 2020

Researchers used the ultrafast imaging method to determine the molecule's structure in its equilibrium state.
Rain, rain, gone away: decreased growing-season rainfall for the dryland cropping region of the south-west of Western Australia
Authors: Scanlon Timothy T. , Doncon Greg
Published: February 2020

The shift in Indian Ocean sea surface temperatures in 1976 led to a change in rainfall for the broad-scale winter annual grain cropping and pasture region in the south-west of Western Australia (the WA wheatbelt). Agriculture in the eastern part the WA wheatbelt was particularly sensitive to the change in rainfall because it is a marginal area for agronomic production, with low rainfall before changes in sea surface temperature. A second shift in sea surface temperature occurred in 2000, but there has been no analysis of the resulting impact on rainfall in the eastern WA wheatbelt. An analysis of rainfall pre- and post-2000 was performed for sites in the eastern WA wheatbelt in three groups: 19 sites in the west, 56 central, and 10 east. The analysis found a decline in growing-season rainfall (i.e. April–October), especially during May–July, post-2000. Rainfall declines of 49.9 mm (west group), 39.1 mm (central group) and 28.0 mm (east group) represented respective losses of 20.1%, 17.4% and 14.2% of growing-season rainfall. Increases in out-of-season rainfall in the respective groups of 31.0, 33.6, and 50.7 mm (57.8%, 60.8% and 87.6%) meant that annual rainfall changes were smaller than growing-season losses. The west and central groups lost 17.5 and 6.16 mm annual rainfall, whereas the east group gained 15.6 mm. Analysis of wheat yield indicated reductions of 13.5% (west) and 9.90% (central) in the eastern WA wheatbelt; the small group of east sites had a potential yield gain of 8.9% arising from the increased out-of-season rainfall. Further, increased out-of-season rainfall will exacerbate weed and disease growth over the summer fallow.
Improving Medical Students’ Attitude toward Patients with Substance use Problems through Addiction Medicine Education
Authors: Ayu Astri Parawita , van der Ven Margot , Suryani Eva , Puspadewi Natalia , Joewana Satya , Rukmini Elisabeth , de Jong Cor , Schellekens Arnt
Published: February 2020

Background: Patients with addiction often encounter negative attitudes from health care professionals, including medical doctors. Addiction medicine training might improve medical students’ attitudes toward patients with addiction problems and change the way they think about addiction. We evaluated the effect of comprehensive addiction medicine training on students’ attitudes and illness perceptions and explored which perceptions are most relevant for attitude development. Methods: In a quasi-experimental non-randomized study, fourth-year students ( n = 296) participated in either addiction medicine training (intervention) or one of three other blocks (control). We used the Medical Condition Regards Scale to measure attitudes and the Illness Perception Questionnaire Addiction version for perceptions. We analyzed the effect of the intervention using repeated measures MANOVA. The contribution of illness perception to attitude was explored in the intervention group using linear regression analysis. Results: Addiction medicine training improved students’ attitudes toward patients with addiction, compared to the control group. After the training, students expressed a less demoralized perception, a stronger perception of a coherent understanding of addiction, addiction as a cyclical condition, and attributed addiction more to psychological factors, compared to the control group. In the intervention group, attitude and emotional representation before training and illness coherence after the training were associated with attitude after the training. Conclusions: Addiction medicine training is effective in improving medical students’ attitudes toward patients with addiction and changing their illness perceptions of addiction. The development of an understanding of addiction might be particularly relevant for attitude improvement. These findings underscore the relevance of addiction medicine training as part of medical curricula and argue for including aspects related to attitude development in the curriculum.
Leaving the fish bowl: the ornamental trade as a global vector for freshwater fish invasions
Authors: Chan Farrah T. , Beatty Stephen J. , Gilles Allan S. , Hill Jeffrey E. , Kozic Sebastian , Luo Du , Morgan David L. , Pavia Richard T. B. , Therriault Thomas W. , Verreycken Hugo , Vilizzi Lorenzo , Wei Hui , Yeo Darren C. J. , Zeng Yiwen , Zięba Grzegorz , Copp Gordon H.
Published: February 2020

Despite its social and economic benefits, the trade in ornamental species (henceforth, ‘ornamental trade’) has become a major source of non-native fish introductions into freshwater ecosystems. However, the ornamental trade as a vector for introductions of non-native freshwater fishes is not well defined. We developed a framework incorporating elements of the biological invasion process and a typical ornamental fish trade supply chain to fill this gap. Records of non-native ornamental fishes introduced to freshwater environments of Australia, Belgium (Flanders), Canada (British Columbia), China (Guangdong), the Philippines, Poland, Singapore, the United Kingdom (England), and the United States of America (Florida) were reviewed to explore the pervasiveness of these introduced fishes in the wild. These regional case studies confirmed the prominence of the ornamental trade as a global vector for freshwater fish introductions beyond their natural range. Additionally, we examined freshwater fishes associated with the ornamental trade to identify ‘risky’ species that could establish in recipient regions based on climate match. All regions assessed were at risk of new fish introductions via the ornamental trade, with the number of ‘risky’ species ranging from seven to 256. Further, there appears to be taxonomic bias in the freshwater ornamental fish trade, with 74% of the species belonging to just 10 families (of 67). Current prevention and management approaches and associated polices, regulations and legislation on aquatic non-native species within assessed regions fit five general categories: import controls, risk assessment, whitelist, blacklist, and release ban. However, these prevention/management efforts may not be sufficient to reduce the invasion risk associated with the ornamental fish trade. Recommendations including species- and vector-based risk assessments, better recording of species import consignments, increased public education and industry engagement, and early detection and rapid response are discussed in this review.
The effect of TiN inclusions on the fracture mechanism of 20CrMnTi steel with lath martensite
Authors: Zhu Yong , Lu Ye-Mao , Huang Chao-Wen , Liang Yi-Long
Published: February 2020

This study aims to investigate the effect of TiN inclusions on the fracture mechanism of 20CrMnTi steel with martensite. Size of martensite packets, blocks and TiN inclusions were characterized, and the room-temperature tensile properties, impact toughness and fracture toughness were tested of 20CrMnTi steel quenched at different temperatures. The effects of TiN inclusions on the impact toughness and fracture toughness were investigated according to the Hall-Petch relationship. The results show that, TiN inclusions are high temperature stable phases which insoluble to the matrix, mostly squared in shape and dispersed. The impact toughness and fracture toughness of 20CrMnTi steel decrease with increasing sizes of the initial austenite grains, martensite packets and blocks as the quenching temperature increases. Interestingly, the TiN inclusions strongly affect the toughness of the 20CrMnTi steel in the fracture and the fine-grained sample has a better toughness. Under high-stress concentrations, TiN inclusion particles can initiate cleavage cracking.
Monolithic integration of display driver circuits and displays manufactured by screen printing
Authors: Andersson Ersman Peter , Zabihipour Marzieh , Tu Deyu , Lassnig Roman , Strandberg Jan , Åhlin Jessica , Nilsson Marie , Westerberg David , Gustafsson Göran , Berggren Magnus , Forchheimer Robert , Fabiano Simone
Published: February 2020

Here, we report all-screen printed display driver circuits, based on organic electrochemical transistors (OECTs), and their monolithic integration with organic electrochromic displays (OECDs). Both OECTs and OECDs operate at low voltages and have similar device architectures, and, notably, they rely on the very same electroactive material as well as on the same electrochemical switching mechanism. This then allows us to manufacture OECT-OECD circuits in a concurrent manufacturing process entirely based on screen printing methods. By taking advantage of the high current throughput capability of OECTs, we further demonstrate their ability to control the light emission in traditional light-emitting diodes (LEDs), where the actual LED addressing is achieved by an OECT-based decoder circuit. The possibility to monolithically integrate all-screen printed OECTs and OECDs on flexible plastic foils paves the way for distributed smart sensor labels and similar Internet of Things applications.
Factors associated with non-prescription of oral anticoagulant treatment in non-valvular atrial fibrillation patients with dementia: a CPRD–HES study
Authors: Besford Megan , Graham Sophie , Sammon Cormac , Mehmud Faisal , Allan Victoria , Alikhan Raza , Ramagopalan Sreeram
Published: February 2020

Dementia is a common comorbidity in patients with atrial fibrillation (AF) and treatment guidelines recommend oral anticoagulant (OAC) therapy for AF patients with dementia unless concordance cannot be ensured by the caregiver. Despite this, the literature reports a low prescribing of OAC treatment in these patients.

This study investigated possible factors associated with non-prescribing of OAC treatment in dementia patients newly diagnosed with non-valvular atrial fibrillation (NVAF) at age ≥ 65 years between 2013 and 2017 using the Clinical Practice Research Datalink and Hospital Episodes Statistics databases.

Of 1090 dementia patients newly diagnosed with NVAF, 693 (63.6%) patients did not have a prescription for an OAC in the year following their diagnosis. The likelihood of experiencing a thromboembolic event was high, with 97% of the population having a CHA2DS2-VASc score > 2; however, little difference in the presence of stroke risk factors was observed between the prescribed and non-prescribed groups. The presence of bleeding risk factors was high; only 28 (2.6%) of patients did not have a previous fall or a HAS-BLED bleeding risk factor. A history of falls [OR = 0.76, 95% confidence intervals (CIs) (0.58, 0.98)], previous major bleed [OR = 0.56, 95% CI (0.43, 0.73)] and care home residence [OR = 0.47, 95% CI (0.30, 0.74)] were associated with not having an OAC prescription.

The results suggest that dementia patients with NVAF and certain risk bleeding risk factors are less likely to be prescribed an OAC. Further work is needed to establish possible relationships between bleeding risk factors and other potential drivers of OAC prescribing.
Base Rates of Invalid Test Performance Across Clinical Non-forensic Contexts and Settings
Authors: Martin Phillip K , Schroeder Ryan W
Published: February 2020

Objective

Base rates of invalidity in forensic neuropsychological contexts are well explored and believed to approximate 40%, whereas base rates of invalidity across clinical non-forensic contexts are relatively less known.

Methods

Adult-focused neuropsychologists (n = 178) were surveyed regarding base rates of invalidity across various clinical non-forensic contexts and practice settings. Median values were calculated and compared across contexts and settings.

Results

The median estimated base rate of invalidity across clinical non-forensic evaluations was 15%. When examining specific clinical contexts and settings, base rate estimates varied from 5% to 50%. Patients with medically unexplained symptoms (50%), external incentives (25%–40%), and oppositional attitudes toward testing (37.5%) were reported to have the highest base rates of invalidity. Patients with psychiatric illness, patients evaluated for attention deficit hyperactivity disorder, and patients with a history of mild traumatic brain injury were also reported to invalidate testing at relatively high base rates (approximately 20%). Conversely, patients presenting for dementia evaluation and patients with none of the previously mentioned histories and for whom invalid testing was unanticipated were estimated to produce invalid testing in only 5% of cases. Regarding practice setting, Veterans Affairs providers reported base rates of invalidity to be nearly twice that of any other clinical settings.

Conclusions

Non-forensic clinical patients presenting with medically unexplained symptoms, external incentives, or oppositional attitudes are reported to invalidate testing at base rates similar to that of forensic examinees. The impact of context-specific base rates on the clinical evaluation of invalidity is discussed.
MRI and CT Assessment of Abdominal Tissue Composition in Patients After High-Intensity Focused Electromagnetic Therapy Treatments: One-Year Follow-Up
Authors: Kinney Brian M , Kent David E
Published: February 2020

Background

Several studies investigating high-intensity focused electromagnetic (HIFEM) treatments have recently been published. However, due to the novelty of the procedure, long-term data are still missing.

Objectives

The aim of this study was to evaluate changes in abdominal tissues on average 1 year after a series of HIFEM treatments, to determine the long-term durability of patients’ original body responses.

Methods

Magnetic resonance imaging (MRI) or computed tomography (CT) scanning were performed on 21 patients a mean of 332.6 [88.5] days after their original HIFEM treatment series. The scans were evaluated by a blinded radiologist for abdominal muscle thickness, subcutaneous fat changes, and abdominal separation. The results were compared with the MRI/CT-assisted measurements taken at baseline and 6-week follow-up. Correlations between collected data sets were calculated and tested. The incidence of any adverse events related to earlier treatments was monitored.

Results

When comparing the 1-year follow-up measurements with the baseline, the MRI/CT-assisted calculations revealed mean reductions of 14.63% (2.97 [2.11] mm) in fat, 19.05% (1.89 [0.88] mm) in muscle thickening, and 10.46% (1.96 [1.71] mm) in diastasis recti. All changes were significant (P < 0.05) and not related to weight fluctuations (P > 0.05). The baseline width of diastasis positively correlated with the degree of improvement at follow-up. No adverse events were reported.

Conclusion

The HIFEM-induced muscle hypertrophy, fat reduction, and reduction in abdominal separation were maintained 1-year posttreatment. This suggests long-term durability of the original bodily response, which needs to be verified by continuing follow-up of this group and by further studies.

Level of Evidence: 4
Predictors of itch and pain in the 12 months following burn injury: results from the Burns Registry of Australia and New Zealand (BRANZ) Long-Term Outcomes Project
Authors: Tracy Lincoln M , Edgar Dale W , Schrale Rebecca , Cleland Heather , Gabbe Belinda J ,   the BRANZ Adult Long-Term Outcomes Pilot Project participating sites and working party
Published: February 2020

Background

Itch and pain are common complaints of patients with burn injuries. This study aimed to describe the prevalence and predictors of itch and moderate to severe pain in the first 12 months following a burn injury, and determine the association between itch, moderate to severe pain, work-related outcomes, and health-related quality of life following a burn injury.

Methods

Burn patients aged 18 years and older were recruited from five Australian specialist burn units. Patients completed the 36-item Short Form Health Survey Version 2 (SF-36 V2), the Sickness Impact Profile (SIP) work scale, and a specially developed questionnaire relating to itch at 1, 6, and 12 months post-injury. Moderate to severe pain was defined as a score less than 40 on the bodily pain domain of the SF-36 V2. Multivariate mixed-effects regression models were used to identify patient and burn injury predictors of itch and moderate to severe pain.

Results

Three hundred and twenty-eight patients were included. The prevalence of itch decreased from 50% at 1 month to 27% at 12 months. Similarly, the prevalence of moderate to severe pain decreased from 23% at 1 month to 13% at 12 months. Compared to patients aged 18-34, the adjusted odds of experiencing any itch were 59% (95% CI: 0.20, 0.82) and 55% (95% CI: 0.22, 0.91) lower for patients aged between 35 and 49 and ≥ 50 years, respectively. Compared to patients aged 18-34, the adjusted odds of experiencing moderate to severe pain were 3.12 (95% CI: 1.35, 7.20) and 3.42 (95% CI: 1.47, 7.93) times higher for patients aged 35-49 and ≥ 50 years, respectively.

Conclusions

Less than 15% of patients reported moderate or severe pain at 12 months, while approximately one-quarter of the patients reported itch at the same period. The presence of moderate to severe pain was associated with a greater negative impact on health-related quality of life and work outcomes compared to itch. Further research is needed to improve our ability to identify patients at higher risk of persistent itch and pain who would benefit from targeted review and intervention studies.