bluuebunny/crossref_metadata_2025 huggingface dataset:
A Robust Incubator to Improve Access to Microbiological Culture in Low Resource Environments
Authors: Miller Andrew K. , Ghionea Simon , Vongsouvath Manivanh , Davong Viengmon , Mayxay Mayfong , Somoskovi Akos , Newton Paul N. , Bell David , Friend Michael
Published: December 2018

To help address the limitations of operating conventional microbiological culture incubators in low resource environments, a new incubator design was developed and tested to meet the requirements of operation in laboratories without reliable power (power outages up to 12 contiguous hours) or climate control (ambient indoor temperatures from 5 °C to 45 °C). The device is designed to enable adherence to incubation temperatures recommended for growth detection, identification, and drug susceptibility testing (DST) of human pathogenic bacteria. During power outages, stable temperatures are maintained in the device's internal sample compartment by employing phase change material (PCM) as a bi-directional thermal battery to maintain incubation temperature. Five prototypes were tested in a laboratory setting using environmental test chambers and programmable power supplies, and three were field tested in the Lao PDR in situations of intended use. The prototypes successfully held their temperature to within ±1 °C in both laboratory environmental chamber testing as well as during the field test. The results indicate that the device will maintain stable culture temperatures across periods of intermittent power supply, while enabling normal workflow of this could greatly increase the availability of microbiological culture for diagnosis and antimicrobial resistance (AMR) monitoring.
Topology Optimization of Planar Gear-Linkage Mechanisms
Authors: Yim Neung Hwan , Kang Seok Won , Kim Yoon Young
Published: December 2018

Topology optimization for mechanism synthesis has been developed for the simultaneous determination of the number and dimension of mechanisms. However, these methods can be used to synthesize linkage mechanisms that consist only of links and joints because other types of mechanical elements such as gears cannot be simultaneously synthesized. In this study, we aim to develop a gradient-based topology optimization method which can be used to synthesize mechanisms consisting of both linkages and gears. For the synthesis, we propose a new ground model defined by two superposed design spaces: the linkage and gear design spaces. The gear design space is discretized by newly proposed gear blocks, each of which is assumed to rotate as an output gear, while the linkage design space is discretized by zero-length-spring-connected rigid blocks. Another set of zero-length springs is introduced to connect gear blocks to rigid blocks, and their stiffness values are varied to determine the existence of gears when they are necessary to produce the desired path. After the proposed topology-optimization-based synthesis formulation and its numerical implementation are presented, its effectiveness and validity are checked with various synthesis examples involving gear-linkage and linkage-only mechanisms.
Experimental Study of Aerodynamic Damping of an Annular Compressor Cascade With Large Mean Incidences
Authors: Keerthi M. C. , Kushari Abhijit
Published: December 2018

This study addresses flutter that can occur in compressors when operating at high relative incidence. Studies are performed on a subsonic annular compressor cascade containing a sector of blades that can be subjected to controlled torsional oscillation. Measurements taken on the centrally located blade are used to study the unsteady surface pressures developed. Three large mean incidences are considered to characterize the aeroelastic performance. Aerodynamic damping is calculated for each test condition and its variation due to interblade phase angle (IBPA), reduced frequency, and incidence is studied. The source of stability or instability is traced to the nature of unsteady pressures. When the incidence is below the static-stall limit, an increasing incidence is found to exhibit aeroelastically more stable performance, whereas beyond the limit, the stability worsens. For the latter, the amount of improvement in stability by increasing reduced frequency is less compared to the former and its variation with IBPA is not as regular owing to the associated large uncertainty. The nonlinearity effects were found to be relatively higher for this case, especially from the aft region of the suction surface. It is also found that the phase of the local fluctuating pressure and its location on the chord has a decisive influence on the aerodynamic damping and its trends with respect to various parameters are discussed. The results are expected to be useful in the assessing aerodynamic damping trends in relation to the pressure phase variations in specific regions along the chord.
Size- and Temperature-Dependent Collision and Deposition Model for Micron-Sized Sand Particles
Authors: Yu Kuahai , Tafti Danesh
Published: December 2018

Sand ingestion and deposition in gas turbine engine components can lead to several operational hazards. This paper discusses a physics-based model for modeling the impact, deposition, and sticking of sand particles to surfaces. The collision model includes both normal and tangential components of impact. The normal collision model divides the impact process into three stages, the elastic stage, the elastic–plastic stage, and full plastic stage, and the recovery process is assumed to be fully elastic. The adhesion loss in the recovery stage is described using Timoshenko's model and Tsai's model, and shows that the two models are consistent under certain conditions. Plastic deformation losses of surface asperities are also considered for particle–wall collisions. The normal impact model is supplemented by an impulse-based tangential model, which includes both sliding and rolling frictions. Sand properties are characterized by size and temperature dependencies. The predicted coefficient of restitution (COR) of micron-sized sand particles is in very good agreement with experimental data at room temperature and at higher temperatures from 1073 K to 1340 K. The predicted COR decreases rapidly at temperatures above 1340 K. There is a strong interplay between the size-dependent properties of micron sand particles and the temperature dependency of yield stress on the collision and deposition characteristics. This is the first physics-based high temperature model including translation and rotation of micron-sized sand particles with sliding and rolling modes in the gas turbine literature.
Ultrasonographic features of superficial and nodular basal cell carcinoma
Authors: Khlebnikova Albina Nikolaevna , Molochkov Vladimir Alekseevich , Selezneva Elena Vladimirovna , Belova Lyubov Anatolevna , Bezugly Artur , Molochkov Anton Vladimirovich
Published: December 2018

Aim: To describe the ultrasonographic findings of surface and nodular basal cell skin cancer (BCC) using high frequency ultrasonography.Materials and methods: We examined 60 primary BCCs in different locations with the High Frequency Ultrasound (HFU) system DUB Skin Scanner using 75 MHz and 30 MHz probes. Epidermis, dermis, and depth of tumors spread in the region of interest (ROI) were measured. Visually unchanged, contralateral skin areas were examined as the control. Results: The surface BCC most often had elongated contours, clear margins and hypoechoic structure, while the nodular BCC had round or oval outlines and diffusely hypo-heterogeneous structure with clear margins. Sclerodermiform BCCs were visualized as hypoechoic areas of irregular shape penetrating in the dermis, with wavy fuzzy margins. The average thickness of the surface BCC in the US examination was 556.28±136.95 μ, the nodular BCC thickness was 2439.71±865.92 μ and the sclerodermiform thickness was 1500±325.33 μ. A statistically significant increase in the average thickness of tumors of the nodularand scleroderma forms was observed in comparison with the surface clinical variant (p<0.05). Hyperechoic inclusions were observed in 11% of the surface BCC’s and in the 100% of the nodular BCC’s. Their average number was 2±0.57 and 4±4.8, with the average area of 0.03±0.02 mm2 and 0.04±0.03 mm2 (p>0.05), respectively. In the surface BCC, they were mainly located along the periphery of the hypoechoic zones. In nodular BCC, the inclusions had a peripheral and combined (center and peripheral) distribution.Conclusions: Ultrasound allows differentiating BCC as diffuse-heterogeneous, hypoechoic, formations in the dermis with distinct contours. Depending on the clinical picture, they differ in form, depth of bedding, as well as in the quantitative ratio and distribution of the point hyperechoic structures in them.
Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography
Authors: Zheng Xiao-Zhi , Shi Yun-Yan , Chen Ke-Qi , Qiao Xiao-Ling , Wang Lian-You
Published: December 2018

Aims: To evaluate the feasibility of assessing regional myocardial perfusion using real-time myocardial contrast echocardiography (MCE) at rest for detecting coronary microcirculation abnormalities in methamphetamine abusers.Material and methods: Twenty-two male methamphetamine abusers (11 without chest pain, 11 with chest pain), free of ascertained coronary artery disease, were enrolled in this study. A control group of 22 age-matched male healthy participants was studied for comparison. Standard 2D, flow and tissue Doppler echo with measurements of cardiac morphologic and functional indicators,MCE with measurements of regional myocardial perfusion were performed, respectively.Results: Compared to healthy participants, methamphetamine abusers had higher blood pressure, greater left ventricular mass index and more impaired diastolic function, with preserved cardiac sizes and systolic function. Methamphetamine abusers with chest pain had a faster heart rate than those without chest pain and healthy participants. MCE in methamphetamine abusers, especially with chest pain, had significant longer contrast agent arrival times, less functional capillary blood volumes, slower microvascular flow velocities and less myocardial perfusion than healthy participants (p<0.05). Moreover, along with the increases of dosage and duration of use (from group A to group C, group A: 1-2 g/day, <2 years; group B: 2-3 g/day, 2-5 years; group C: >3 g/day, >5 years) the reductions in the myocardial perfusion indices were more significant (p<0.01). The cutoff value with 5.1 dB2/s of the myocardial perfusion at the left ventricular apex had a sensitivity of 87.5%, specificity of 75.2% and accuracy of 81.9% for differentiating methamphetamine abusers from normal subjects.Conclusions: Real-time MCE can effectively detect coronary microcirculation abnormalities in methamphetamine abusers at rest and myocardial perfusion is significantly reduced in methamphetamine abusers. This finding may be involved in the occurrence and development of cardiac damage.
Contrast-enhanced ultrasound performance in predicting blunt splenic injuries requiring only observation and monitoring
Authors: Tagliati Corrado , Argalia Giulio , Giuseppetti Gian Marco
Published: December 2018

Aims: To assess contrast enhanced ultrasound (CEUS) performance in the prediction of non-operatively managed blunt spleen injuries requiring only observation and monitoring during follow-up and to evaluate if CEUS accuracy was higher than conventional ultrasound (US) in this field.Material and methods: In 112 hemodynamic stable blunt spleen trauma patients, CEUS was performed for follow-up after computed tomography evaluation in the emergency department. CEUS and US performance were assessed considering as true negative cases patients that had not underwent interventional or surgical treatment during follow-up and were assessed as negative for splenic complications respectively by CEUS or US examinations.Results: CEUS showed sensitivity of 100%, specificity of 96.1%, positive predictive value of 69.2%, negative predictive value of 100.0% and accuracy of 96.4%. CEUS showed a significantly higher accuracy than conventional US (p=0.013).Conclusions: CEUS is a very useful imaging modality during follow-up of blunt splenic trauma non-operatively managed, allowing an efficientprediction of splenic injuries requiring only observation and monitoring during follow-up.
Abdominal ultrasound in paraneoplastic Pyoderma gangrenosum caused by renal carcinoma
Authors: Duca Ioana , Rusu Flaviu , Nicula Nicolae , Dumitrascu Dan Lucian
Published: December 2018

We present the case of a 60-year-old male patient, with refractory ulcers in the groin. Ultrasoundand CT showed a large vascularized tumor of the kidney with cystic parts and inhomogeneous dynamic behaviour. Histology demonstrated Pyoderma gangrenosum (ulcer) and well differentiated adenocarcinoma (kidney). Pyoderma gangrenosum appears as paraneoplastic manifestation in about 7% of cases, especially in lymphomas and tumors involving the digestive tract.Particularities of the case consisted in the accidental discovery of the renal tumor, in spite of the lack of urinary syndromes. The present case highlights the importance of tumor screening in patients with atypical antibiotic-refractory skin ulcers.
Extra-tunnel Compression Mimicking Tarsal Tunnel Syndrome: Ultrasound Imaging for a Plantar Ganglion Cyst
Authors: Chang Ke-Vin , Wu Wei-Ting , Özçakar Levent
Published: December 2018

We reported a 43-year-old man with right-foot numbness under the tentative diagnosis of tarsal tunnel syndrome. The initial ultrasound examination did not identify any remarkable findings at the level of the medial malleolus. Owing to the failure of conservative treatments, he was referred for US-guided injection of the tibial nerve. When tracking the entire course of the nerve, a ganglion cyst was observed on top of the tibial nerve, in proximity to the medial and lateral plantar branches. The symptom disappeared after surgical excision. The present case highlights the importance of sonoantomy and tracking of the entire course of affected nerve in peripheral nerve disorders and scout scanning prior to any perineural injections.
A stability-reversibility map unifies elasticity, plasticity, yielding, and jamming in hard sphere glasses
Authors: Jin Yuliang , Urbani Pierfrancesco , Zamponi Francesco , Yoshino Hajime
Published: December 2018

A stability-reversibility map unifies the response of amorphous solids to volume and shear deformations.
A quantum machine learning algorithm based on generative models
Authors: Gao X. , Zhang Z.-Y. , Duan L.-M.
Published: December 2018

We propose a quantum learning algorithm for a quantum generative model and prove its advantages compared with classical models.
Readout and control of the spin-orbit states of two coupled acceptor atoms in a silicon transistor
Authors: van der Heijden Joost , Kobayashi Takashi , House Matthew G. , Salfi Joe , Barraud Sylvain , Laviéville Romain , Simmons Michelle Y. , Rogge Sven
Published: December 2018

The controllable transition from charge to spin physics for a boron atom in silicon is an essential step to spin-orbit qubits.
Integrated photonic platform for quantum information with continuous variables
Authors: Lenzini Francesco , Janousek Jiri , Thearle Oliver , Villa Matteo , Haylock Ben , Kasture Sachin , Cui Liang , Phan Hoang-Phuong , Dao Dzung Viet , Yonezawa Hidehiro , Lam Ping Koy , Huntington Elanor H. , Lobino Mirko
Published: December 2018

An integrated optical chip is used for generating, manipulating, and detecting squeezed vacuum and two-mode entanglement.
Current-driven magnetization switching in ferromagnetic bulk Rashba semiconductor (Ge,Mn)Te
Authors: Yoshimi R. , Yasuda K. , Tsukazaki A. , Takahashi K. S. , Kawasaki M. , Tokura Y.
Published: December 2018

Current-driven switching of ferromagnetism is observed in a bulk material with Rashba-type spin-polarized band.
Engineering a light-responsive, quorum quenching biofilm to mitigate biofouling on water purification membranes
Authors: Mukherjee Manisha , Hu Yidan , Tan Chuan Hao , Rice Scott A. , Cao Bin
Published: December 2018

We engineered a light-responsive, quorum quenching biofilm and demonstrated its application in mitigating membrane biofouling.
New bounds on dark matter coupling from a global network of optical atomic clocks
Authors: Wcisło P. , Ablewski P. , Beloy K. , Bilicki S. , Bober M. , Brown R. , Fasano R. , Ciuryło R. , Hachisu H. , Ido T. , Lodewyck J. , Ludlow A. , McGrew W. , Morzyński P. , Nicolodi D. , Schioppo M. , Sekido M. , Le Targat R. , Wolf P. , Zhang X. , Zjawin B. , Zawada M.
Published: December 2018

The first Earth-scale quantum sensor network based on optical atomic clocks is looking for dark matter candidates.
Neutrophils: New insights and open questions
Authors: Ley Klaus , Hoffman Hal M. , Kubes Paul , Cassatella Marco A. , Zychlinsky Arturo , Hedrick Catherine C. , Catz Sergio D.
Published: December 2018

Neutrophils patrol the bloodstream and tissues to kill microbes and guide subsequent innate and adaptive immune responses.
Direct reprogramming of fibroblasts into antigen-presenting dendritic cells
Authors: Rosa Fábio F. , Pires Cristiana F. , Kurochkin Ilia , Ferreira Alexandra G. , Gomes Andreia M. , Palma Luís G. , Shaiv Kritika , Solanas Laura , Azenha Cláudia , Papatsenko Dmitri , Schulz Oliver , Reis e Sousa Caetano , Pereira Carlos-Filipe
Published: December 2018

Ectopic expression of transcription factors PU.1, IRF8, and BATF3 reprograms fibroblasts to dendritic cells.
Good things come in threes
Authors: Yona Simon , Mildner Alexander
Published: December 2018

Ectopic expression of PU.1, IRF8, and BATF3 reprograms mouse and human fibroblasts into dendritic cells. See related Research Article by

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The depth of mutational agony and the exuberance of tumoral T cell ecstasy predict checkpoint salvation
Authors: Guy Thomas V. , Pillai Shiv
Published: December 2018

Genomic biomarkers will help to elucidate which cancer patients will benefit from PD-1 blockade immunotherapy.
Enterovirus and parechovirus meningitis in infants younger than 90 days old in the UK and Republic of Ireland: a British Paediatric Surveillance Unit study
Authors: Kadambari Seilesh , Braccio Serena , Ribeiro Sonia , Allen David J , Pebody Richard , Brown David , Cunney Robert , Sharland Mike , Ladhani Shamez
Published: December 2018

Objectives

This study aimed to prospectively collect detailed clinical information for all enterovirus (EV) and human parechovirus (HPeV) meningitis cases in infants aged <90 days in the UK and Ireland.

Participants, design and setting

Prospective, active national surveillance during July 2014 to July 2015 through the British Paediatric Surveillance Unit. Reporting paediatricians completed questionnaires requesting information on clinical presentation, investigations, management and outcomes at hospital discharge and after 12 months.

Main outcome measures

To describe the clinical burden of EV and HPeV meningitis in infants aged <90 days.

Results

During the 13-month surveillance period, 703 cases (668 EV, incidence0.79/1,000 live- births; 35 HPeV, 0.04/1,000 live-births) were identified. The most common clinical presentations were fever (EV: 570/668(85%); HPeV: 28/35(80%)), irritability (EV: 441/668(66%); HPeV: 23/35(66%)) and reduced feeding (EV: 363/668(54%); HPeV 23/35(66%)). Features of circulatory shock were present in 27% (182/668) of EV and 43% (15/35) of HPeV cases. Overall, 11% (76/668) of EV and 23% (8/35) of HPeV cases required intensive care support. Nearly all cases (678/703, 96%) were confirmed by cerebrospinal fluid (CSF) PCR, with 52% (309/600) having normal CSF white cell count for age. Two infants with EV meningitis died (2/668, 0.3%) and four survivors (4/666, 0.6%) had long-term complications at 12 months’ follow-up. Infants with HPeV meningitis survived without sequelae. Overall 189 infants had a formal hearing test and none had sensorineural hearing loss.

Conclusion

The incidence of laboratory-confirmed EV/HPeV meningitis in young infants is more than twice that for bacterial meningitis. Less than 1% will develop severe neurological complications or die of their infection. Further studies are required to formally assess long-term neurodevelopmental sequelae.
Gender equality in the global health workplace: learning from a Somaliland–UK paired institutional partnership
Authors: Keynejad Roxanne C , Mekonnen Fikru Debebe , Qabile Aziza , Handuleh Jibril Ibrahim Moussa , Dahir Mariam Abdillahi , Haji Rabi Mariam Mohamed , Read Cathy , Adan Ismail Edna
Published: December 2018

Worldwide recognition of gender inequality and discrimination following the #MeToo movement has been slow to reach the field of global health. Although international institutions have begun to address gender, the perspectives of front-line global health workers remain largely undocumented, especially in regions not captured by large-scale surveys. Long-term collaborative relationships between clinicians and educators participating in paired institutional partnerships can foster cross-cultural dialogue about potentially sensitive subjects. King’s Somaliland Partnership (KSP) has linked universities and hospitals in Somaliland and London, UK, for health education and improvement, since 2000.We collaboratively developed an anonymous, mixed methods, online survey to explore workplace experiences among Somaliland and UK-based staff and volunteers. We adapted the Workplace Prejudice/Discrimination Inventory to address gender inequality, alongside qualitative questions. Somaliland (but not UK) women reported significantly more gender prejudice and discrimination than men (medians=43 and 31, z=2.137, p=0.0326). While front-line Somaliland workers described overt gender discrimination more frequently, UK respondents reported subtler disadvantage at systemic levels. This first survey of its kind in Somaliland demonstrates the potential of global health partnerships to meaningfully explore sensitive subjects and identify solutions, involving a range of multidisciplinary stakeholders. We propose priority actions to address pervasive gender inequality and discrimination, including wider engagement of academia with gender-focused research, institutional actions to address barriers, national prioritisation and nurturing of grassroots initiatives, through institutional partnerships and international networks. Without sustained, concerted intervention across all levels, gender inequality will continue to hinder progress towards the vision of good health for all, everywhere.
Patterns of performance and improvement in US Medicare’s Hospital Star Ratings, 2016–2017
Authors: Chatterjee Paula , Joynt Maddox Karen
Published: December 2018

Background

Publicly reported quality data can help consumers make informed choices about where to seek medical care. The Centers for Medicare and Medicaid Services developed a composite Hospital Compare Overall Star Rating for US acute-care hospitals in 2016. However, patterns of performance and improvement have not been previously described.

Objective

To characterise high-quality and low-quality hospitals as assessed by Star Ratings.

Design

We performed a retrospective cross-sectional study of 3429 US acute-care hospitals assigned Overall Star Ratings in both 2016 and 2017. We used multivariable logistic regression models to identify characteristics associated with receiving 4 or 5 stars.

Results

Small hospitals were more likely to receive 4 or 5 stars in 2016 (33% of small hospitals, 26% of medium hospitals and 21% of large hospitals, OR for medium 0.78, p=0.02, and for large, 0.61, p=0.003). Non-profit status (OR 1.37, p=0.01), midwest region (OR=2.30, p<0.001), west region (OR 1.30 in 2016, p=0.06) and system membership (OR 1.33, p=0.003) were associated with higher odds of achieving a higher Star Rating. Hospitals with the most Medicaid patients were markedly less likely to receive 4 or 5 stars (OR for highest quartile=0.32, p<0.001), and hospitals with the highest proportion of Medicare patients were somewhat less likely to do so (OR for highest quartile=0.68, p=0.01). These associations remained largely consistent over the first two years of reporting and were also associated with the highest likelihood of improvement.

Conclusions

Small hospitals with fewer Medicaid patients had the highest odds of performing well on Star Ratings. Further monitoring of these trends is needed as patients, clinicians and policymakers strive to use this information to promote high-quality care.
New generation of headgear for rugby: impact reduction of linear and rotational forces by a viscoelastic material-based rugby head guard
Authors: Ganly Mark , McMahon Jill Mary
Published: December 2018

Objectives

In the aim to develop a usable and wearable head guard for rugby that could reduce impact energy and lessen the likelihood of concussive and subconcussive injury during play, a combination of viscoelastic materials was employed to develop a guard with similar dimensions to those currently used in international rugby.

Methods

The head guard was tested for impact energy reduction following linear acceleration, using drop tests, as required by World Rugby. The head guard was also subjected to pendulum tests, allowing acceleration to be simultaneously measured on two headforms, as well as repeated impacts to mimic ageing and repeated use. Impact following rotational acceleration was determined at two impact locations and at three impact velocities.

Results

The viscoelastic head guard (N-Pro) was shown to reduce linear impacts by up to 75% in comparison to the use of a commercially available rugby head guard and repeated impacts did not impair the attenuation of impact energy. Rotational impact energy was also reduced by an average of 34% across three speeds and two sites of impact test sites, in comparison to tested bare headforms.

Conclusions

This heralds a new generation of soft-shelled headgear that could help reduce two primary risk factors in sports-induced mild traumatic brain injury: linear and rotational impacts to the head.
Muscle MRI in a large cohort of patients with oculopharyngeal muscular dystrophy
Authors: Alonso-Jimenez Alicia , Kroon Rosemarie H M J M , Alejaldre-Monforte Aida , Nuñez-Peralta Claudia , Horlings Corinne G C , van Engelen Baziel G M , Olivé Montse , González Laura , Verges-Gil Enric , Paradas Carmen , Márquez Celedonio , Garibaldi Matteo , Gallano Pía , Rodriguez Maria José , Gonzalez-Quereda Lidia , Dominguez Gonzalez Cristina , Vissing John , Fornander Freja , Eisum Anne-Sofie Vibæk , García-Sobrino Tania , Pardo Julio , García-Figueiras Roberto , Muelas Nuria , Vilchez Juan Jesús , Kapetanovic Solange , Tasca Giorgio , Monforte Mauro , Ricci Enzo , Gomez María Teresa , Bevilacqua Jorge Alfredo , Diaz-Jara Jorge , Zamorano Ivonne Ingrid , Carlier Robert Yves , Laforet Pascal , Pelayo-Negro Ana , Ramos-Fransi Alba , Martínez Amaia , Marini-Bettolo Chiara , Straub Volker , Gutiérrez Gerardo , Stojkovic Tanya , Martín María Asunción , Morís Germán , Fernández-Torrón Roberto , Lopez De Munaín Adolfo , Cortes-Vicente Elena , Querol Luis , Rojas-García Ricardo , Illa Isabel , Diaz-Manera Jordi
Published: December 2018

Background and objective

Oculopharyngeal muscular dystrophy (OPMD) is a genetic disorder caused by an abnormal expansion of GCN triplets within thePABPN1gene. Previous descriptions have focused on lower limb muscles in small cohorts of patients with OPMD, but larger imaging studies have not been performed. Previous imaging studies have been too small to be able to correlate imaging findings to genetic and clinical data.

Methods

We present cross-sectional, T1-weighted muscle MRI and CT-scan data from 168 patients with genetically confirmed OPMD. We have analysed the pattern of muscle involvement in the disease using hierarchical analysis and presented it as heatmaps. Results of the scans were correlated with genetic and clinical data.

Results

Fatty replacement was identified in 96.7% of all symptomatic patients. The tongue, theadductor magnusand thesoleuswere the most commonly affected muscles. Muscle pathology on MRI correlated positively with disease duration and functional impairment.

Conclusions

We have described a pattern that can be considered characteristic of OPMD. An early combination of fat replacement in the tongue,adductor magnusandsoleuscan be helpful for differential diagnosis. The findings suggest the natural history of the disease from a radiological point of view. The information generated by this study is of high diagnostic value and important for clinical trial development.
Ethical problems with ethnic matching in gamete donation
Authors: Maung Hane Htut
Published: December 2018

Assisted reproduction using donor gametes is a procedure that allows those who are unable to produce their own gametes to achieve gestational parenthood. Where conception is achieved using donor sperm, the child lacks a genetic link to the intended father. Where it is achieved using a donor egg, the child lacks a genetic link to the intended mother. To address this lack of genetic kinship, some fertility clinics engage in the practice of matching the ethnicity of the gamete donor to that of the recipient parent. The intended result is for the child to have the phenotypic characteristics of the recipient parents. This paper examines the philosophical and ethical problems raised by the policy of ethnic matching in gamete donation. I consider arguments for the provision of ethnic matching based on maximising physical resemblance and fostering ethnic identity development. I then consider an argument against ethnic matching based on the charge of racialism. I conclude that while the practice of ethnic matching in gamete donation could promote positive ethnic identity development in donor-conceived children from historically subjugated ethnic minorities, it also risks endorsing the problematic societal attitudes and assumptions regarding ethnicity that enabled such subjugation in the first place.
Off-label Medications Use in the Eastern Province of Saudi Arabia: The Views of General Practitioners, Pediatricians, and Other Specialists
Authors: AbuAlsaud Zainab , Alshayban Dhfer , Joseph Royes , Pottoo Faheem Hyder , Lucca Jisha Myalil
Published: December 2018

Background: Off-label drug prescribing remains a major pediatric health concern worldwide. The lack of studies in this vulnerable population causes many practitioners to prescribe drugs outside their license. This study aims to investigate and compare the current knowledge and views of general practitioners, pediatricians, and other specialists toward off-label pediatric prescribing. Methods: A descriptive, cross-sectional–based study conducted on a random sample of physicians who work in three different hospitals in the Eastern Province of Saudi Arabia. Results: Data were obtained from three hospitals, comprising a total of 160 practitioners. Overall, more than half of the participated practitioners (54%) were familiar with the definition of off-label prescribing. Thirty percentage of participated practitioners agreed that more than 10% of their prescribed medicines to children were off-labeled. A majority of participants expressed concerns over the efficacy (83%) and safety (92%) of off-label prescribing to children. Importantly, a noticeable proportion of the responders claimed that they sometimes observed an adverse drug reaction (n = 23; 20%) or treatment failure (n = 43; 37%) following off-label prescribing medicines to children. Only 46% participants have always informed the parents or guardian about the off-label prescription of medications to their children. Conclusion: A Large number of physicians are familiar with the concept of off-label prescribing of medicines to children in the Eastern Province of Saudi Arabia. Safety and efficacy are the main concerns of prescribing such medications. Policies toward improving pediatric clinical research and supporting the safety and efficacy of the drugs should be encouraged.
Writing Bennelong: The cultural impact of early Australian biofictions
Authors: Padmore Catherine , Gardiner Kelly
Published: December 2018

In 1941 Ernestine Hill published My Love Must Wait, a biographical novel based on the life of navigator Matthew Flinders. In the same year, Eleanor Dark published The Timeless Land, imagining the arrival of European settlers in the Sydney region from the perspectives of multiple historical figures. In this article we examine how each author represents the important figure of Bennelong, a man of the Wangal people who was kidnapped by Governor Phillip and who later travelled to England with him. While both works can be criticized as essentialist, paternalist or racist, there are significant differences in the ways each author portrays him. We argue that Dark’s decision to narrate some of her novel from the point of view of Bennelong and other Indigenous people enabled different understandings of Australian history for both historians and fiction writers. Dark’s “imaginative leap”, as critic Tom Griffiths has termed it, catalysed a new way of thinking about the 1788 invasion and early decades of the colonization of Australia. The unfinished cultural work undertaken by these novels continues today, as demonstrated by subsequent Australian novels which revisit encounters between Indigenous inhabitants and European colonists, including Thomas Keneally’s The Chant of Jimmie Blacksmith (1972), Richard Flanagan’s Wanting (2008), and Rohan Wilson’s The Roving Party (2011). Like Dark, these authors situate parts of their novels within the consciousness of Indigenous figures from the historical record. We analyse the diverse challenges and possibilities presented by these literary heirs of Eleanor Dark.
Seeding as Part of the Marketing Mix: Word-of-Mouth Program Interactions for Fast-Moving Consumer Goods
Authors: Dost Florian , Phieler Ulrike , Haenlein Michael , Libai Barak
Published: December 2018

Seeded marketing campaigns (SMCs) have become part of the marketing mix for many fast-moving consumer goods (FMCG) companies. In addition to making large investments in advertising and sales promotions, these firms now encourage seed agents or microinfluencers to discuss brands with friends and acquaintances to create further value. It is thus critical to understand how an FMCG seeding program interacts with traditional marketing tools when estimating the effectiveness of such efforts. However, the issue is still underexplored. The authors present the first empirical analysis of this question using a rich data set collected on four brands from various European FMCG markets. They combine advertising and sales promotion data from FMCG brand managers with sales and retail variables from market research companies as well as firm-created word-of-mouth variables from SMC agencies. The authors analyze the data using several approaches, confronting challenges of endogeneity and multicollinearity. They consistently find that firm-created word of mouth through SMC programs interacts negatively with all tested forms of advertising but positively with promotional activities. This phenomenon has significant implications for understanding the utility of SMCs and how they should be managed. The analysis implies that SMCs may increase total sales by approximately 3%–18% throughout the campaigns.
Urine pregnancy test (UPT) hCG negative molar pregnancy: a short report from Masanga/Sierra Leone
Authors: Gresnigt TM , Sikkema JM
Published: December 2018

In Masanga, Sierra Leone, a multigravid woman presented with a urine pregnancy test negative molar pregnancy. This can be explained by the ‘hook-effect’. In resource-poor settings where quantitative serum hCG cannot be determined, it is of paramount importance to remain vigilant of the diagnosis of molar pregnancy. Clinical judgement and sonography remain key in diagnosing molar pregnancy in district hospitals in low- and middle-income countries (LMICs), especially since their occurrence is much more common in these countries.
Quality of Life in Heterogeneous Anxiety Disorders: Changes Across Cognitive-Behavioral Treatments
Authors: Wilner Julianne G. , Dufour Steven , Kennedy Katherine , Sauer-Zavala Shannon , Boettcher Hannah , Farchione Todd J. , Barlow David H.
Published: December 2018

Quality of life is lower among individuals with anxiety disorders; however, this construct is rarely a focus in treatment research. This study explores changes in quality of life in a randomized, controlled trial of several cognitive-behavioral treatments (CBTs) for anxiety disorders. Adults with heterogeneous anxiety disorders ( N = 223) were randomly assigned to (a) unified protocol for transdiagnostic treatment of emotional disorders, (c) a single-disorder protocol targeting their principal diagnosis, or (c) a waitlist control condition, and assessed at baseline, posttreatment, and 6-month follow-up. At baseline, the sample evidenced deficits in quality of life, with no significant differences in quality of life across diagnoses or condition. Results suggest improved quality of life among participants in treatment, at similar rates across treatment condition and diagnostic category, and at levels significantly higher than the waitlist. Improvements were maintained through 6-month follow-up. This study supports CBT as effective in promoting quality of life.
Face validity of the youth Multiple Errands Test (yMET) in the community: A focus group and pilot study
Authors: Hanberg Vanessa L , MacKenzie Diane E , Versnel Joan
Published: December 2018

Introduction

During late adolescence and early adulthood, maturation of cognitive functions including executive functions are occurring. The multiple errands test is an assessment of real-world executive functions and, to date, non-virtual reality multiple errands test research has focused primarily on adults with acquired brain injury in hospital settings. There is poor evidence across multiple errands test studies for content and face validity and limited studies in the community. This study aimed to explore multiple errands test face validity for typically developing youth (age 16–24 years) and describe their community setting performance on a youth multiple errands test.

Methods

A youth focus group ( N = 5) was conducted to explore perceptions of the multiple errands test. From their input, the youth multiple errands test was developed and pilot tested ( N = 9) in a shopping mall.

Results

Two themes emerged from focus group analysis and limited changes, relevant to youth, were made to develop the youth multiple errands test. The focus group and pilot study found the youth multiple errands test was acceptable and cognitively challenging for youth, with older youth performing better than younger youth. Overall youth multiple errands test performance suggests similarities to healthy adults in previous studies.

Conclusion

Findings must be interpreted with caution since the sample was small, but preliminary results indicate that future studies with the youth multiple errands test are feasible and warranted.
Quantitative and Qualitative Assessment of the Posterior Medial Meniscus Anatomy: Defining Meniscal Ramp Lesions
Authors: DePhillipo Nicholas N. , Moatshe Gilbert , Chahla Jorge , Aman Zach S. , Storaci Hunter W. , Morris Elizabeth R. , Robbins Colin M. , Engebretsen Lars , LaPrade Robert F.
Published: December 2018

Background:

Meniscal ramp lesions have been defined as a tear of the peripheral attachment of the posterior horn of the medial meniscus (PHMM) at the meniscocapsular junction or an injury to the meniscotibial attachment. Precise anatomic descriptions of these structures are limited in the current literature.

Purpose:

To quantitatively and qualitatively describe the PHMM and posteromedial capsule anatomy pertaining to the location of a meniscal ramp lesion with reference to surgically relevant landmarks.

Study Design:

Descriptive laboratory study.

Methods:

Fourteen male nonpaired fresh-frozen cadavers were used. The locations of the posteromedial meniscocapsular and meniscotibial attachments were identified. Measurements to surgically relevant landmarks were performed with a coordinate measuring system. To further analyze the posteromedial meniscocapsular and meniscotibial attachments, hematoxylin and eosin and alcian blue staining were conducted on a separate sample of 10 nonpaired specimens.

Results:

The posterior meniscocapsular attachment had a mean ± SD length of 20.2 ± 6.0 mm and attached posteroinferiorly to the PHMM at a mean depth of 36.4% of the total posterior meniscal height. The posterior meniscotibial ligament attached on the PHMM 16.5 mm posterior and 7.7 mm medial to the center of the posterior medial meniscal root attachment. The meniscotibial ligament tibial attachment was 5.9 ± 1.3 mm inferior to the articular cartilage margin of the posterior medial tibial plateau. The posterior meniscocapsular attachment converged with the meniscotibial ligament at the most posterior point of the meniscocapsular junction in all specimens. Histological staining of the meniscocapsular and meniscotibial ligament PHMM attachments showed similar structure, cell density, and fiber directionality, with no qualitative difference in the makeup of their collagen matrices across all specimens.

Conclusion:

The anatomy of the area where a medial meniscal ramp tear occurs revealed that the 2 posterior meniscal attachments merged at a common attachment on the PHMM. Histological analysis validated a shared attachment point of the meniscocapsular and meniscotibial attachments of the PHMM.

Clinical Relevance:

The findings of this study provide the anatomic foundation for an improved understanding of the meniscocapsular and meniscotibial attachments of the PHMM, which may help provide a more precise definition of a meniscal ramp lesion.
Examining the Reliability of Scores From a Performance Assessment of Practice-Based Competencies
Authors: Roduta Roberts Mary , Alves Cecilia Brito , Werther Karin , Bahry Louise M.
Published: December 2018

The purpose of this study was to examine the reliability and sources of score variation from a performance assessment of practice competencies within an occupational therapy program. Data from 99 students who participated in a practical exam were examined. A generalizability analysis of analytic, total, and overall holistic scores was completed accounting for the nested design. The results demonstrated that rater pairs produced highly reliable (i.e., G > 0.93, ϕ > 0.90) overall holistic, total, and analytic scores. In all scoring scenarios, student variation accounted for the largest percentage of total variance with less variation attributable to raters. However, the interaction-error term accounted for the second most variation within the system. Findings from this study suggest possible differences in rater behavior raising questions for future research around the processes raters use to generate holistic versus analytic scores.
Protective Factors Associated With Fewer Generalized Anxiety Disorder Symptoms Among Women Exposed to Intimate Partner Violence
Authors: Schaefer Lauren M. , Howell Kathryn H. , Thurston Idia B. , Kaufman Caroline C. , Hasselle Amanda J.
Published: December 2018

Generalized anxiety disorder (GAD) has received minimal empirical attention in the context of intimate partner violence (IPV). Furthermore, factors related to lower levels of GAD symptoms in this population have received limited focus. This study evaluated the protective role of four forms of support, spiritual, family, friend, and community, in predicting levels of generalized anxiety among women who have experienced recent IPV. Participants included 116 women who were recruited from local agencies serving IPV-exposed individuals. Participants completed measures of IPV, GAD, stressful life events, spiritual support, social support, and community support during a 1-hr interview. Findings from a hierarchical multiple regression analysis indicated that after accounting for age, income, mental health service utilization, stressful life events, and severity of IPV, lower GAD symptoms were only associated with higher spiritual support (β = −0.20, p = .02) and community support (β = −0.25, p = .01), not friend or family support, F(9, 114) = 5.10; p < .001; R2 = .30. These findings indicate that alternative sources of support (i.e., spiritual and community) may be more accessible for IPV-exposed women, contributing to their association with reduced GAD symptomatology. The current study highlights the potential for spiritual and community support to serve a beneficial role above and beyond standard social support proffered by friends and family on symptoms of GAD. Results reinforce the examination of a broad range of multiple supports among women experiencing IPV. This thorough examination of different support systems may provide further insight into novel resources that can be strengthened among IPV-exposed populations.
A Study Into the Severity of Forensic and Civil Inpatient Aggression
Authors: Huitema Anneloes , Verstegen Nienke , de Vogel Vivienne
Published: December 2018

Aggressive incidents occur frequently in health care facilities, such as psychiatric care and forensic psychiatric hospitals. Previous research suggests that civil psychiatric inpatients may display more aggression than forensic inpatients. However, there is a lack of research comparing these groups on the incident severity, even though both frequency and severity of aggression influence the impact on staff members. The purpose of this study is to compare the frequency and severity of inpatient aggression caused by forensic and civil psychiatric inpatients in the same Dutch forensic psychiatric hospital. Data on aggressive incidents occurring between January 1, 2014, and December 31, 2017, were gathered from hospital files and analyzed using the Modified Overt Aggression Scale, including sexual aggression ( MOAS+). Multilevel random intercept models were used to analyze differences between forensic and civil psychiatric patients in severity of aggressive incidents. In all, 3,603 aggressive incidents were recorded, caused by 344 different patients. Civil psychiatric patients caused more aggressive incidents than forensic patients and female patients caused more inpatient aggression compared with male patients. Female forensic patients were found to cause the most severe incidents, followed by female civil psychiatric patients. Male forensic patients caused the least severe incidents. The findings have important clinical implications, such as corroborating the need for an intensive treatment program for aggressive and disruptive civil psychiatric patients, as well as emphasizing the importance of gender-responsive treatment.
Parental Corporal Punishment and Child Temperament: Independent and Interactive Predictors of Child Emotion Regulation in China
Authors: Wang Meifang , Wang Yuzhu , Wang Fang , Xing Xiaopei
Published: December 2018

The goal of this study was to simultaneously examine the independent and interactive effects of paternal and maternal corporal punishment, and child temperament on child emotion regulation over time in China. These links were assessed on a longitudinal study of 619 father–mother dyads and their children in primary schools (data collected in 2011 and 2014). Results showed an additive model where both parental corporal punishment and child temperament independently predicted child emotion regulation 3 years later. In addition, the effects of parental corporal punishment exhibited gender differences, with paternal corporal punishment predicting girls’ emotion regulation and both paternal and maternal corporal punishment predicting boys’ emotion regulation 3 years later. Moreover, the interactive effects of paternal and maternal corporal punishment and temperament on child emotion regulation were not found in the present study. These findings point to the importance of examining multiple factors within the family system to further understand the developmental process of child emotion regulation, particularly within the Chinese cultural context.