bluuebunny/crossref_metadata_2025 huggingface dataset:
Does insomnia modify the association between C-reactive protein and migraine? The Tromsø Study 2015–2016
Authors: Hagen Knut , Hopstock Laila A , Elise Eggen Anne , Mathiesen Ellisiv B , Nilsen Kristian Bernhard
Published: March 2019

Background

The relationship between high sensitivity C-reactive protein and migraine is unclear. The aim of this cross-sectional population-based study was to investigate the association between high sensitivity C-reactive protein and types of headache, and to evaluate the impact of insomnia on this association.

Methods

A total of 20,486 (63%) out of 32,591 invited, aged ≥40 years or older, participated in the seventh wave of the Tromsø study conducted in 2015–2016 and had valid information on headache, insomnia and high sensitivity C-reactive protein. The influence of insomnia on the association between questionnaire-based diagnoses of headache and elevated high sensitivity C-reactive protein defined as >3.0 mg/L was assessed using multiple logistic regression, estimating prevalence odds ratio with 95% confidence intervals.

Results

A total of 6290 participants (30.7%) suffered from headache during the last year. Among these, 1736 (8.5%) fulfilled the criteria of migraine, 991 (4.8%) had migraine with aura, 746 (3.6%) migraine without aura (3.8%), and 4554 (22.2%) had non-migrainous headache. In the final multi-adjusted analysis, elevated high sensitivity C-reactive protein was associated with headache (odds ratio 1.10, 95% confidence interval 1.01–1.20), migraine (odds ratio 1.17, 95% confidence interval 1.01–1.35), and migraine with aura (odds ratio 1.23, 95% confidence interval 1.01–1.53). No association was found between elevated high sensitivity C-reactive protein and migraine without aura or non-migrainous headache. The association between high sensitivity C-reactive protein and migraine was strongly dependent on insomnia status. Among individuals with insomnia, elevated high sensitivity C-reactive protein was associated with migraine (odds ratio 1.49, 95% confidence interval 1.02–2.17), and migraine with aura (odds ratio 1.59, 95% confidence interval 1.03–2.45), whereas no such relationship was found among those without insomnia.

Conclusions

In this cross-sectional study, participants with migraine, in particular migraine with aura, were more likely to have elevated high sensitivity C-reactive protein, evident only among those with insomnia.
The Role of Anterior Capsular Laxity in Hip Microinstability: A Novel Biomechanical Model
Authors: Johannsen Adam M. , Behn Anthony W. , Shibata Kotaro , Ejnisman Leandro , Thio Timothy , Safran Marc R.
Published: March 2019

Background:

Hip microinstability is an increasingly recognized source of hip pain and disability. Although the clinical entity has been well described, the pathomechanics of this disease remain poorly understood.

Purpose/Hypothesis:

The purpose of this study was to determine the role of capsular laxity in atraumatic hip microinstability. Our hypothesis was that cyclic stretching of the anterior hip capsule would result in increased hip range of motion and femoral head displacement.

Study Design:

Controlled laboratory study.

Methods:

In this study, 7 hip specimens met inclusion criteria (age, 18-46 years). Specimens were stripped of all soft tissue, aligned, cut, and potted by use of a custom jig. A materials testing system was used to cyclically stretch the anterior hip capsule in extension and external rotation while rotating about the mechanical axis of the hip. A motion tracking system was used to record hip rotation and displacement of the femoral head relative to the acetabulum in the anterior-posterior, medial-lateral, and superior-inferior directions. Testing was conducted at baseline, after venting, and after capsular stretching.

Results:

With the hip in anatomic neutral alignment, cyclic stretching of the anterior hip capsule resulted in increased hip rotation ( P < .001). Femoral head displacement significantly increased relative to the vented state in the medial-lateral ( P < .001), anterior-posterior ( P = .013), and superior-inferior ( P = .036) planes after cyclic stretching of the anterior hip capsule.

Conclusion:

The anterior hip capsule plays an important role in controlling hip rotation and femoral head displacement. This study is the first to display significant increases in femoral head displacement through a controlled cyclic stretching protocol of the anterior hip capsule.

Clinical Relevance:

This study is directly applicable to the treatment of atraumatic hip microinstability. The results quantitatively define the relative importance of the hip capsule in controlling femoral head motion. This allows for a better understanding of the pathophysiological process of hip microinstability and serves as a platform to develop effective surgical techniques for treatment of this disease.
Return to Sport as an Outcome Measure for Shoulder Instability: Surprising Findings in Nonoperative Management in a High School Athlete Population
Authors: Shanley Ellen , Thigpen Charles , Brooks John , Hawkins Richard J. , Momaya Amit , Kwapisz Adam , Kissenberth Michael J. , Tokish John M.
Published: March 2019

Background:

Young age and contact sports have been postulated as risk factors for anterior shoulder instability. Management after shoulder instability is controversial, with studies suggesting that nonoperative management increases the risk of recurrence. Several studies examined return to play after an in-season instability episode, and few followed these patients to determine if they were able to successfully compete in a subsequent season. No study has evaluated this question in a high school athlete population.

Purpose:

To compare the likelihood of return to scholastic sport and complete the next full season without an additional time-loss injury among athletes with anterior shoulder instability in terms of treatment, instability type, and sport classification.

Study Design:

Cohort study; Level of evidence, 2

Methods:

Athletes were included in this study as identified by a scholastic athletic trainer as experiencing a traumatic time-loss anterior shoulder instability injury related to school-sponsored participation. The cohort was predominantly male (n = 108, 84%) and consisted mostly of contact athletes (n = 101, 78%). All athletes had dislocation or subluxation diagnosed by a board-certified physician who determined the athlete’s course of care (nonoperative vs operative). Successful treatment was defined as completion of care and return to the athlete’s index sport, with full participation for the following season. Chi-square and relative risk analyses were completed to compare success of treatment (nonoperative vs operative care) and instability type. Separate logistic regressions were used to compare the effect of sex and sport classification on the athletes’ ability to return to sport. Statistical significance was set a priori as α = .05.

Results:

Scholastic athletes (N = 129) received nonoperative (n = 97) or operative (n = 32) care. Nonoperatively treated (85%) and operatively treated (72%) athletes successfully returned to the same sport without injury for at least 1 full season ( P = .11). Players sustaining a dislocation were significantly more likely to fail to return when compared with those sustaining a subluxation (26% vs 89%, P = .013). Sex ( P = .85) and sport classification ( P = .74) did not influence the athlete’s ability to return to sport, regardless of treatment type.

Conclusion:

A high percentage of athletes with shoulder instability achieved successful return to sport without missing any additional time for shoulder injury. Those with subluxations were at almost 3 times the odds of a successful return compared with those sustaining a dislocation.
The effect of manganese exposure on GnRH secretion via Nrf2/mGluR5/COX-2/PGE2/signaling pathway
Authors: Qi Zhipeng , Mi Chao , Wu Fengdi , Yang Xinxin , Sang Yanqi , Liu Yanan , Li Jiashuo , Yang Haibo , Xu Bin , Liu Wei , Xu Zhaofa , Deng Yu
Published: March 2019

There are limited studies focused on the precise mechanism of gonadotropin-releasing hormone (GnRH) secretion dysfunction after overexposure to manganese (Mn). The objective of the present study was to explore the mechanism of Mn disruption of GnRH synthesis via nuclear factor erythroid-2-related factor-2 (Nrf2)/metabotropic glutamate receptor-5 (mGluR5)/cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) signaling pathway in vitro and in vivo. Primary astrocytes were cultured and treated with different doses of Mn, tert-butylhydroquinonet (tBHQ; Nrf2 agonists), 3-[(2-methyl-4-thaizolyl) ethynyl] pyridine (MTEP; mGluR5 inhibitor), and celecoxib (COX-2 inhibitor) to measure the levels of COX-2, mGluR5, Nrf2, and Nrf2 target genes. Mice were randomly divided into 11 groups, of which included the control group, 12.5-, 25-, and 50-mg/kg MnCl2 group, dimethyl sulfoxide (DMSO) group, tBHQ control group, tBHQ pretreatment group, MTEP control group, MTEP pretreatment group, celecoxib control group, and celecoxib pretreatment group. The injection was administered every day for 2 weeks. Then, levels of GnRH, PGE2, COX-2, mGluR5, Nrf2, Nrf2 target genes, and morphological changes in the hypothalamus of mice were measured. Mn reduced protein levels of Nrf2 and mRNA expression of Nrf2 target genes and increased mGluR5, COX-2, PGE2, and GnRH levels. Meanwhile, injury-related histomorphology changes in the hypothalamus of mice were significantly present. In conclusion, excessive exposure to Mn disrupts GnRH secretion through Nrf2/mGluR5/COX-2/PGE2 signaling pathway.
The Performance of Diagnostic Criteria for Hemophagocytic Lymphohistiocytosis in Critically Ill Patients
Authors: Meena Nikhil K. , Sinokrot Odai , Duggal Abhijit , Alpat Daisy , Singh Zeba N. , Coviello Jean M. , Li Manshi , Wang Xiaofeng , Mireles-Cabodevila Eduardo
Published: March 2019

Objective:

The diagnostic criteria for secondary hemophagocytic lymphohistiocytosis (HLH) have not been validated in the critically ill adult population. We set out to evaluate the performance of diagnostic criteria and determine the ferritin cutoff in critically ill adults.

Design:

A retrospective single-center study.

Setting and Patients:

Patients admitted to intensive care unit between 2008 and March 2010. Data were collected on consecutive patients who had ferritin measured. Charts were reviewed for the diagnostic criteria of HLH and components of Hscore.

Measurements and Main Results:

A total of 445 patients had a ferritin level measured during the study period. A diagnosis of HLH was made for 10 patients. Having 5 of 6 criteria had a specificity of 97% and a sensitivity of 70%. Hemophagocytosis was found in 41 (47.1%) of 87 bone marrow biopsies. Two hundred thirty-one patients had a ferritin level above 500 ng/dL. When determining the odds of HLH being clinically diagnosed, the optimal cut point for ferritin was 1197 ng/dL. When determining the odds of HLH based on the Hscore, the best cutoff was 143.5 (sensitivity of 90% and specificity of 90%) and patients who had HLH in our study population had an Hscore of 203.8 ± 64.9.

Conclusion:

In this cohort of critically ill patients, the HLH criteria are specific for HLH but not sensitive. Critically ill patients can have a higher incidence of hemophagocytosis without HLH. A higher ferritin cutoff in combination with 5 other clinical criteria is comparable to the Hscore for the recognition of HLH in the critically ill population.
Feasibility of a Mindfulness-Based Intervention for Caregivers of Veterans: A Pilot Study
Authors: Lara-Cinisomo Sandraluz , Fujimoto Elinor M. , Santens Ryan L.
Published: March 2019

Purpose: This pilot study aimed to assess the feasibility of conducting an 8-week mindfulness-based intervention with caregivers of veterans and to examine the effectiveness of the intervention to improve mindfulness using the Five Facet Mindfulness Questionnaire compared with waitlist controls. Design: In this randomized controlled trial, 23 caregivers of veterans were assigned to either the intervention or waitlist group. Method: Compliance with mindfulness instruction and attendance was assessed among those in the intervention. Wilcoxon signed-rank tests compared within group pre- and post-intervention scores and Mann–Whitney U tests compared difference scores (post–pre) by group type. Effect sizes were also calculated. Compliance variables were correlated with difference scores in the intervention group only. Findings: Of the 23 participants, 11 were assigned to the intervention; 100% of participants were retained. There was significant improvement from pre- to post-intervention in four of the five facets of mindfulness ( p < .05) in the intervention group. Significant between-group differences ( p < .05) were also observed in two of the five facets. Effect sizes ranged from small (.44) to large (.89). No significant improvement was observed in the waitlist control group. Conclusions: A mindfulness-based intervention is feasible and acceptable to improve mindfulness in caregivers of veterans.
Organizing evaluation: Assessing combat leadership quality
Authors: Wagstaff William A.
Published: March 2019

What determines military effectiveness? Previous literature has examined factors such as military doctrine, culture, and capabilities, as well as regime type and civil–military relations, but has largely ignored military leadership quality. Competent military leaders positively influence battle outcomes by ensuring proper implementation of battleplans and quick reaction to an increasingly dynamic battlefield. This paper formally models the relationship between high-ranking military commanders and their immediate subordinates to examine the commander’s ability to evaluate her personnel. I vary the ability of the subordinates to signal their commander to determine how different signaling structures influence what commanders may learn. This analysis reveals that commanders opt for less informative signals from subordinates as the military professionalizes, potentially impeding their ability to identify and remove incompetent subordinates. Leaving incompetent subordinates in command reduces the ability of the military to improve. Evidence from the US Army’s leadership decisions after the Battle of Kasserine Pass and Operation Avalanche illustrates these results.
Universal screening of newborns for biliary atresia: Cost-effectiveness of alternative strategies
Authors: Masucci Lisa , Schreiber Richard A , Kaczorowski Janusz , Collet JP , Bryan Stirling
Published: March 2019

Objective

Biliary atresia, a rare newborn liver disease, is the most common cause of liver-related death in children and the main indication for paediatric liver transplantation. Early detection and surgical intervention with a Kasai portoenterostomy offers the best chance for long-term patient survival. We conducted a cost-effectiveness analysis to compare no universal screening with screening using either a home-based infant stool colour card with passive card distribution strategy, or conjugated bilirubin testing.

Methods

A Markov model was developed, with structure, costs, and probabilities informed by the literature and clinical expert opinion, to simulate a newborn cohort over a 10-year time horizon. Health benefits were expressed as life-years gained. This analysis was conducted from the perspective of the Canadian publicly funded health care system (all costs in Canadian dollars). Both deterministic and probabilistic analyses were conducted.

Results

Screening using a home-based colour card with passive card distribution was a cost-effective option. For a population of 392,902 annual births in Canada, this strategy cost approximately $192,000 more than no universal screening but led to eight life-years gained (incremental cost-effectiveness ratio (ICER) = $24,065 per life-year gained). Screening using conjugated bilirubin testing versus the colour card cost $2,369,199 more and led to five more life-years gained (ICER= $473,840 per life year gained), and so was not cost-effective.

Conclusions

A home-based screening program using infant stool colour cards with a passive distribution strategy could be highly cost-effective when administered at a low unit cost and with a reasonable screening performance.
When the Advantaged Feel Victimised: The Case of Hindus in India
Authors: Tripathi R. C. , Kumar R. , Tripathi V. N.
Published: March 2019

This article seeks to understand the collective victimhood of the Hindus, a majority group in India, relative to the feelings of collective victimhood of the Muslim minority. It studies the role that is played by feelings of collective victimhood (CV) along with ingroup identity, fraternalistic relative deprivation (FRD), intergroup emotions and relative power in responding to intergroup conflict situations. The results showed that Hindus reported collective victimhood in greater amount compared to Muslims. Muslims felt more FRD than Hindus. Hindus also carried more negative emotions as a consequence of experiencing collective victimhood. The preferred reaction of Hindus in conflict situations was of revenge and less of reconciliation. Collective victimhood of Hindus was explained by ingroup identity and negative emotions associated with the experiences of collective victimhood and fraternalistic relative deprivation. The action of revenge of Hindus and Muslims was explained by different sets of factors. Identity and CV-related negative emotions were more important in explaining the revengeful reactions of Hindus, while in the case of Muslims relative power, FRD and FRD-related negative emotions were found more efficacious. Results are explained in the context of current Hindu–Muslim relations in India.
Recruiting and Retaining People With Disabilities for Qualitative Health Research: Challenges and Solutions
Authors: Banas Jennifer R. , Magasi Susan , The Kim , Victorson David E.
Published: March 2019

There are 56.7 million people with disabilities (PWD) living in the United States; yet, PWD are significantly underrepresented in health research. Even when researchers purposively seek to include PWD in studies, challenges emerge related to recruitment and retention, leading to inadequate representation and surface understandings of this population. This in turn contributes to the perpetuation of implicit and explicit health disparities that are already experienced by this population. Grounded within a qualitative, community-based participatory health research framework, we highlight challenges associated with recruiting and retaining PWD in health research, including a critical analysis of the research enterprise structure, how this disables accessible research practices for PWD, and leads to continued skepticism among PWD regarding the value of participating in research. Finally, we propose solutions to create and maintain a culture of access and inclusion as well as long-term collaborative and equity-focused partnerships.
The Salience of “Hegemonic Masculinity”
Authors: Messerschmidt James W.
Published: March 2019

This article argues that the concept of “hegemonic masculinity” remains highly salient to critical masculinities studies. The author outlines Raewyn Connell's initial formulation of the concept, how that initial model of hegemonic masculinity has been historically misinterpreted, the reformulation of the concept by Connell and Messerschmidt, and the recent scholarly amplification of the concept. The author concludes that Connell’s original emphasis on the legitimation of unequal gender relations remains essential to both the concept and to the field of critical masculinities studies.
Sigmund Had a Monkey
Authors: Gutmann Matthew
Published: March 2019

Evaluating the males of different species side by side can be enlightening. And it is often entertaining. But we need to be especially careful when we make these comparisons today, because they can easily lead us into naturalizing human male sexual and aggressive behavior, ignoring variation, and ultimately letting men off the hook for their behavior. Boys will be boys is a half-joke that is no longer funny.
Transcriptomics Signature from Next-Generation Sequencing Data Reveals New Transcriptomic Biomarkers Related to Prostate Cancer
Authors: Alkhateeb Abedalrhman , Rezaeian Iman , Singireddy Siva , Cavallo-Medved Dora , Porter Lisa A , Rueda Luis
Published: March 2019

Prostate cancer is one of the most common types of cancer among Canadian men. Next-generation sequencing using RNA-Seq provides large amounts of data that may reveal novel and informative biomarkers. We introduce a method that uses machine learning techniques to identify transcripts that correlate with prostate cancer development and progression. We have isolated transcripts that have the potential to serve as prognostic indicators and may have tremendous value in guiding treatment decisions. Analysis of normal versus malignant prostate cancer data sets indicates differential expression of the genes HEATR5B, DDC, and GABPB1-AS1 as potential prostate cancer biomarkers. Our study also supports PTGFR, NREP, SCARNA22, DOCK9, FLVCR2, IK2F3, USP13, and CLASP1 as potential biomarkers to predict prostate cancer progression, especially between stage II and subsequent stages of the disease.
‘Anything off the bottom shelf’: Ephemeral fairgrounds and material swag
Authors: Trowell Ian
Published: March 2019

Travelling fairgrounds embody the ephemeral. They arrive from elsewhere to occupy an everyday space, momentarily wrenching it from regular purpose and bringing in a bombardment of shimmering surfaces, magical spaces, affects, illusions, fleeting peaks of sensory excess. Utilizing historical resources, interviews with showpeople and gathered testimony, this article examines the material encounter of the British fairground through the prize, what might be considered as a making material of the ephemeral. The prize provides material reminders of the fairground when it has departed, to counterintuitively persist through time as meaningful keepsakes and souvenirs. The fairground prize is tracked as both object and concept, utilizing detailed ‘back-stage’ and ‘front-stage’ flows, Dant’s work around ‘objects in time’, spatial practices and complex crossovers to other cultural trends. Taking his research to the contemporary period, the author proposes a significant shift in the fairground prize that has a wider impact on the aesthetic engagement with the fair.
The sitter’s impression: Memory and early modern portrait medallions
Authors: Howard Rebecca M
Published: March 2019

While the communicative nature of early modern Italian portraits becomes increasingly overt during the 15th and 16th centuries, the continued, and increasing, prevalence of the portrait medallion might at first seem to stand against the tide of period advances in creating portraits that engage with the viewer by looking out of the image. Although the portrait medallion, in its sculpted, metallic form, certainly creates a more physically-lasting work, the object’s lack of a transitive, communicative sitter (as these sitters are nearly always in strict profile) might lead one to assume that the work is less capable of creating any such connection. Taking account of these things, this study challenges this assumption, examining the way that a portrait medallion, in its three-dimensionality, may actually provide a different, yet equally communicative, connection with the mind of a period viewer. Considering the Aristotelian belief that an image might be capable of ‘impressing’ itself in a viewer’s memory – a belief re-examined in the late medieval and early modern periods – this article suggests that patrons of portrait medallions sought to make an impact on the beholder by way of the artwork’s very form. Drawing from the belief that images impress themselves in the mind, as a seal impresses wax, this article adds to readings considering the appeal of portrait medallions in early modernity. By embodying a medium and genre of representation particularly equipped to produce memories, the portrait medallion could metaphorically ‘stamp’ itself on the beholder’s mind, thereby working towards a primary goal of early modern portraiture – perpetually commemorating period sitters.
Bio-compatible wireless inductive thin-film strain sensor for monitoring the growth and strain response of bone in osseointegrated prostheses
Authors: Burton Andrew R , Sun Peng , Lynch Jerome P
Published: March 2019

Many benefits can be derived from in situ monitoring of the growth, load response, and condition of human bone. In particular, bone monitoring offers opportunity to advance understanding and designing of osseointegrated mechanical components fixated into bones such as artificial joints and more recently osseointegrated prosthetic limbs. In this study, a bio-compatible wireless inductive strain-sensing system is proposed, which is designed to monitor the growth and strain response of bone-hosting implants. Thin-film circuit fabrication methods based on lithography are adopted to develop a conformable wireless strain sensor designed as a passive resistive–inductive–capacitive circuit. Two forms of strain sensing are designed into the thin-film sensor. First, parallel-plate capacitors fabricated from metal electrodes and a polyimide dielectric layer are introduced to modulate bone strain onto a resonant frequency of the thin-film sensor. A second resonant frequency is introduced in the sensor design to measure circumferential bone growth using a highly nonlinear titanium-resistive element, whose resistance exponentially increases well after 1000 µε under monotonic increasing hoop strain. To ensure the possibility for implantation in animal subjects in future study, the thin-film sensing system is fabricated using mainly bio-compatible polymers (e.g. polyimide) and metals (e.g. titanium and gold). Fabricated prototypes inductively coupled using an impedance analyzer are experimentally tested. Results reveal linear response of the first resonant frequency to low levels of strain with a sensitivity of 4.555 Hz per unit microstrain. The second resonant frequency is sensitive to the resistive fuse with nonlinear fuse behavior initiated above 1000 µε and impedance phase increasing exponentially thereafter.
Three-dimensional images generated from diffuse ultrasound wave: detections of multiple cracks in concrete structures
Authors: Zhan Hanyu , Jiang Hanwan , Jiang Ruinian
Published: March 2019

The simultaneous detection of multiple defects in concrete structures is a task of pivotal importance for non-destructive testing and evaluation. Diffuse waves experiencing multiple scattering inside media are demonstrated to be sensitive to weak defects. Here, an analytic model is presented for diffuse wave decorrelation associated with sensitivity kernel that describes the time-of-flight distribution in strongly scattering environments. The model is then used for generating three-dimensional images that involve estimating perturbations at each localized position through an iterative, non-linear algorithm. With the consideration of loads and micro-cracks effects on diffuse waves, an application of the approach to a real-size concrete beam shows features that denote the positions and depths of multiple existing cracks. Extension of the approach to other strongly scattering media such as tissues and volcanos is straightforward. This study offers great potential for practical applications such as structural health monitoring, medical image generation, and seismic monitoring.
Combined Effect of Moringa oleifera and Ionizing Radiation on Survival and Metastatic Activity of Pancreatic Cancer Cells
Authors: Hagoel Lior , Vexler Akiva , Kalich-Philosoph Lital , Earon Gideon , Ron Ilan , Shtabsky Alex , Marmor Silvia , Lev-Ari Shahar
Published: March 2019

Background: Radiotherapy is one of the main treatments for malignancies. Radioresistance is a major obstacle in this treatment, calling for new treatments to improve radiotherapy outcome. Herbal medicine has low toxicity and could be a source for new radio-enhancing agents. Moringa oleifera (moringa) is a well-known medicinal plant with antiproliferative and antimetastatic properties. Possible mechanisms of moringa anticancer activity may be related to the expression of PARP-1, Bcl-2, COX-2, p65, p-IκB-a, and others. Purpose: The aims of the present study were to investigate effect of moringa alone and combined with radiation on survival and metastatic activity of pancreatic cancer cells and on tumor growth. Methods and Results: The combination of moringa and radiation significantly inhibited PANC-1 cell survival in a dose-dependent manner, as tested by clonogenic and XTT assays. Moreover, standard transwell cell migration/invasion assays demonstrated reduced metastatic activity of these cells. Pyruvate mitigated the inhibitory effect of combined treatment on cell survival. Flow cytometry of moringa-treated cells revealed induction of apoptosis. Western blot analysis found that the combined treatment decreased expression of the pro-apoptotic protein Bcl-2, and downregulated the key component of DNA repair pathways PARP-1 and the NF-κB-related proteins IκB-α, p65-subunit, and COX-2. Moringa significantly inhibited growth of subcutaneous tumors generated by PANC-1 cells in nude mice. Immunohistochemical analysis demonstrated moringa’s antiproliferative and antiangiogenic effects. Conclusions: Moringa decreased pancreatic cancer cell survival and metastatic activity and significantly inhibited tumor growth. The combination of moringa plus radiation resulted in an additional inhibitory effect that provided the rationale for further investigation of this combination as a novel strategy to overcome pancreatic cancer cell radioresistance.
Multi-objective optimization design of spur gear based on NSGA-II and decision making
Authors: Yao Qizhi
Published: March 2019

Optimization design of spur gear is a complicated work because the performance characteristics depend on different types of decision variables and objectives. Traditional single-objective optimization design of the spur gear always results in poor outcomes relative to other objectives due to objectives’ competition with each other. Therefore, this study works on the spur gear design based on the multi-objective optimization model of elitist non-dominated sorting genetic algorithm (NSGA-II). In the model, gear module, teeth number, and transmission ratio are decision variables, while center distance, bearing capacity coefficient, and meshing efficiency are objectives. Final optimal solutions are picked out from Pareto frontier calculated from NSGA-II using the decision makers of Shannon Entropy, linear programming technique for multidimensional analysis of preference (LINMAP), and technique of order preference by similarity to an ideal solution (TOPSIS). Meanwhile, a deviation index is used to evaluate the reasonable status of the optimal solutions. From triple-objective and dual-objective optimization results, it is found that the optimal solution selected from LINMAP decision maker shows a relatively small deviation index. It indicates that LINMAP decision maker may yield better optimal solution. This study could provide some beneficial information for spur design.
Rigid-flexible coupled dynamics analysis of 3-revolute-prismatic-spherical parallel robot based on multi-software platform
Authors: Luo Haitao , Fu Jia , Jiao Lichuang , Chen Ning , Wu Tingke
Published: March 2019

Kinematics and dynamics are the most important and basic tool for robot research. With the help of computer technology and the respective advantages of three kinds of software, a new method of co-simulation of parallel robot based on multi-platform is proposed, and the mechanical model of multi-body system of 3-revolute-prismatic-spherical parallel robot is established. According to the mechanical analysis of the parallel robot, the rigid-flexible coupling analysis method is adopted. The displacement error shows a periodic change with a period of 4.2 s and the maximum error is [Formula: see text]. The dangerous part of the structure is the root of the lower link, and its maximum stress is 202.64 MPa less than the yield strength of the material. The multi-software platform co-simulation improves the accuracy of the dynamic response analysis of the part under dynamic load, and provides an important theoretical basis for the design and optimization of the parallel robot.
Integrated variable speed limit and ramp metering control study on flow interaction between mainline and ramps
Authors: Wang Xu , Niu Lei
Published: March 2019

During peak periods, bottlenecks are often triggered by excessive demand from both on-ramp and mainline input flows. To relieve bottleneck severity and improve traffic safety, ramp metering and variable speed limit are implemented to control the on-ramp and mainline input flows, and sometimes they are integrated. This article presents a proactive integrated control, with goals to save network-wide travel time and increase traffic flow. A METANET-based macroscopic traffic model was adopted as a prediction model. Micro-simulation tests were performed to evaluate and compare the control approaches among integrated and isolated control scenarios. By decoupling the traffic prediction and simulation models, the control error sources were analyzed. The evaluation revealed that both isolated and integrated controls benefit the traffic network to different extents under varying demand scenarios. Under proactive integrated control, ramp metering is activated solely during slight congestion; or it is activated during high-congestion periods to assist variable speed limit and thus integration maximizes the infrastructure utility.
Experimental study of drilling white Calacatta–Carrara marble using artificial neural approach
Authors: Abbassi Amira , Akrichi Sofien , Ben Yahia Noureddine
Published: March 2019

Highly accurate marble processing is increasingly needed to comply with tight parametric/geometric tolerances and surface integrity specifications encountered while structuring, sculpture, and decorating. In this study, a new approach based on the artificial neural network technique is evaluated for the prediction of process parameters in the machining of white Calacatta–Carrara marble. The rotation speed, feed speed, drill bit diameter, drill bit height, number of pecking cycles, and drilling depth were considered as input factors. Corresponding surface roughness, hole circularity, hole cylindricity, and hole-location error were sought in output. A series of experiments was carried out using a 5-axes computer numerical control vertical machining center (OMAG) to obtain the data used for the training and testing of the artificial neural network with reasonable accuracy, under varying machining conditions. A MATLAB TM interface was developed to predict surface roughness and geometric defects (circularity, cylindricity, and localization). A 6 × 4 size multilayered neural network was developed. The number of iterations was 1000 and no smoothing factor was used. The drill quality (hole-location error, hole circularity, and hole cylindricity) and the surface roughness were modeled and evaluated individually. One hidden layer used for all models, with the number of neurons for all the responses being executed separately, was 12 while the number of neurons in the hidden layer, with all the responses executed together, was 14. In conclusion, from the obtained verified experimentally optimization results, the errors are all within acceptable ranges, which, again, confirm that the artificial neural network technique is an efficient and accurate method in predicting responses in drilling.
Anti-swing control of the overhead crane system based on the harmony search radial basis function neural network algorithm
Authors: Miao Yubin , Xu Fenglin , Hu Yanwei , An Jianping , Zhang Ming
Published: March 2019

The swing of the grab is a main factor affecting the working efficiency of overhead cranes. Thus, planning the optimal motion path can reduce the adverse effects caused by the grab swing and improve the loading and unloading efficiency. The dynamic model of the trolley–grab system is established by considering factors like the change of rope length, wind load, and air resistance. First, the radial basis function neural network is applied to generate a feasible motion trajectory of the crane trolley. Taking the swing angle and angular velocity of the grab at the discharge point as evaluation, the harmony search algorithm is then applied to optimize the neural network parameters and obtain the optimal anti-swing motion trajectory. The numerical simulation and practical testing results show that the harmony search–radial basis function algorithm generates a smooth motion trajectory with good convergence, achieving anti-swing control of the trolley–grab system.
Baseline hemoglobin <11.0 g/dL has stronger prognostic value than anemia status in nasopharynx cancers treated with chemoradiotherapy
Authors: Topkan Erkan , Ekici Nur Yücel , Ozdemir Yurday , Besen Ali Ayberk , Yildirim Berna Akkus , Mertsoylu Hüseyin , Sezen Duygu , Selek Ugur
Published: March 2019

Background:

To retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT).

Methods:

A total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1–3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin <12 g/dL (women) or <13 g/dL (men)) groups according to their pre-treatment hemoglobin measures. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of a pre-treatment hemoglobin cut-off that impacts outcomes. Potential interactions between baseline anemia status and hemoglobin measures and overall survival, locoregional progression-free survival (LRPFS), and progression-free survival were assessed.

Results:

Anemia was evident in 36 patients (24.1%), which was related to significantly shorter overall survival ( P=0.007), LRPFS ( P<0.021), and progression-free survival ( P=0.003) times; all three endpoints retained significance in multivariate analyses ( P<0.05, for each). A baseline hemoglobin value of 11.0 g/dL exhibited significant association with outcomes in ROC curve analysis: hemoglobin <11.0 g/dL (N=26) was linked with shorter median overall survival ( P<0.001), LRPFS ( P=0.004), and progression-free survival ( P<0.001) times, which also retained significance for all three endpoints in multivariate analyses and suggested a stronger prognostic worth for the hemoglobin <11.0 g/dL cut-off value than the anemia status.

Conclusion:

Pre-C-CRT hemoglobin <11.0 g/dL has a stronger prognostic worth than the anemia status with regard to LRPFS, progression-free survival, and overall survival for nasopharyngeal carcinoma patients.
The effect of career awareness on perceived career and talent development self-efficacy and career barriers among nursing students
Authors: Hashish Ebtsam Aly Abou
Published: March 2019

Background

Providing effective methods of raising career awareness for nursing students could affect their career self-efficacy and enable them to overcome the potential career barriers.

Aims

The aim of this study was two-fold: (a) to investigate the effect of career-awareness sessions on perceived career and talent development self-efficacy and career barriers among nursing students; and (b) to determine the relationship between career and talent development self-efficacy and career barriers.

Methods

A quasi-experimental research study with one-group, pre-test post-test design was conducted using a convenience sample of nursing students ( N = 245) who enrolled in the second year at the Technical Nursing Institute, Alexandria University, Egypt. Career Awareness Sessions (CASs) were introduced to nursing students as the study intervention. The Career and Talent Development Self-Efficacy Scale and the Career Barriers Inventory were used to measure study variables for pre- and post-awareness sessions.

Results

CASs had a significant effect on study variables, where the career and talent development self-efficacy score of nursing students significantly increased after sessions. Also, the career barriers score significantly decreased after sessions ( p < 0.001). A significant negative correlation between perceived career and talent development self-efficacy and career barriers was found ( p < 0.001).

Conclusions

Nursing curricula should prepare nursing students by offering continuous educational opportunities to assist them in enhancing their talent development self-efficacy needed for their professional roles and to overcome their potential career barriers.
Remote Monitoring of Diabetes: A Cloud-Connected Digital System for Individuals With Diabetes and Their Health Care Providers
Authors: Joubert Michael , Benhamou Pierre-Yves , Schaepelynck Pauline , Hanaire Hélène , Catargi Bogdan , Farret Anne , Fontaine Pierre , Guerci Bruno , Reznik Yves , Jeandidier Nathalie , Penfornis Alfred , Borot Sophie , Chaillous Lucy , Franc Sylvia , Serusclat Pierre , Kherbachi Yacine , Bavière Eric , Detournay Bruno , Simon Pierre , Charpentier Guillaume
Published: March 2019

Benefits of telemedicine have been proven in the field of diabetes. Among a number of technical solutions, Diabeo® has been studied in both type 1 and type 2 diabetes with intensive insulin therapy. This digital therapeutic system contains a self-monitoring glucose logbook and offers automated insulin dose recommendations thanks to a fully customizable algorithm. In addition, the cloud-based dedicated software also has features to facilitate remote monitoring, including a platform for diabetes nurses who perform coaching and treatment adjustment. A detailed description of this telemedicine system is provided, as well as results of completed clinical studies. In particular, TeleDiab 1’s positive results on HbA1c in type 1 diabetes are detailed. We conclude with a discussion of the role of this telemedicine system within the landscape of mobile apps for diabetes.
Ethnic and Racial Identity Development From an Interdisciplinary Perspective: Introduction to the Special Issue
Authors: Neblett Enrique W. , Roth Wendy D. , Syed Moin
Published: March 2019

Ethnic and racial identity (ERI) is a topic studied within numerous disciplines in the social sciences, humanities, and the arts, but there are relatively few attempts to bridge across disciplines. The purpose of the current special issue was to provide a forum for understanding ERI from an interdisciplinary perspective by bringing together scholars from different disciplines into the same space. This article introduces the historical and conceptual background for the special issue, reviews some of the major contributions of the seven articles included in the issue, and highlights future directions for continuing to examine ERI from an interdisciplinary perspective.
Three-dimensional-guided navigation percutaneous screw fixation of fragility fractures of the pelvis
Authors: Wong Justin Shing Yan , Lau Janice Chi Kay , Chui King Him , Tiu Kwok Leung , Lee Kin Bong , Li Wilson
Published: March 2019

Background:

Three-dimensional (3D)-guided navigation percutaneous screw fixation of pelvi-acetabular fractures has been reported in patients with high-energy trauma. Its use in fragility fractures of the pelvis is expanding and its results are promising.

Methods:

We report a series of 17 consecutive patients with fragility fractures of the pelvis treated with 3D-guided navigation percutaneous screw fixation from 2016 to 2017. Percutaneous screw trajectories were planned preoperatively for the majority of patients. Closed reduction was performed prior to fixation in grossly displaced fractures.

Results:

The mean time to surgery was 8.6 ± 2.4 days, and the mean intraoperative blood loss was 94.1 ± 26.6 mL. One early surgical complication occurred involving an infected pelvic external fixator iliac pin track site, and there were no cases of neurological deficits after fixation. In total, 7 of the 14 patients had screw backout, and the mean backout distance was 8.3 ± 4.4 mm. Cortical perforation was seen in one patient involving an anterior column screw by 5.7 mm; 14 patients were followed up for a mean of 18.7 ± 2.8 months; 13 patients achieved complete fracture union, and 1 patient had a fracture non-union. Premorbid ambulatory function was restored in 8 of the 14 patients. The mean visual analogue scale for pain severity at follow-up was 0.36 ± 0.50. There were no cases of 30-day and 1-year mortality.

Conclusion:

3D-guided navigation percutaneous screw fixation is a safe, precise, and effective surgical technique for managing fragility fractures of the pelvis.
Trends in pediatric cervical spine injuries in the United States in a 10-year period
Authors: Lykissas Marios , Gkiatas Ioannis , Spiliotis Antonios , Papadopoulos Dimitrios
Published: March 2019

Background:

Cervical spine fractures (CSFs) are potentially devastating injuries in pediatric population. Fortunately, these injuries are uncommon in pediatric patients. The purpose of this study was to determine the epidemiology, the risk factors, mechanisms of injury and to identify possible strategies for prevention. In addition, the aim of the current study was to compare CSF sustained in 2003 to CSF sustained in 2008 and 2013 so as to recognize the trend of pediatric CSFs in the United States.

Methods:

The National Electronic Injury Surveillance System was queried for CSF sustained in pediatric population up to 16 years of age for years 2003, 2008, and 2013. Outcomes of interest were patient characteristics (age and sex), causes of CSF, and mechanism of injury.

Results:

Eighty pediatric patients with CSF were identified. The average age was 10.5 years. Boys sustained significantly more CSF than girls. Statistically significant more CSF were occurred in children of 10–16 years than in children up to 9 years. Sports or recreational activities and home-related accidents were the predominant causes of CSF. Mechanisms of injury were age-related, with younger children sustaining CSF as a result of home-related accidents while adolescents commonly injured during sporting or recreational activities. In contrast to current data in literature, motor vehicle accidents were not a major cause of CSF. Comparing the years 2003, 2008, and 2013, statistically significant differences in the incidence of CSF were not found.

Conclusions:

Our study confirms previous findings that adolescents who sustain CSF have higher incidence of sport or recreation-related accidents than younger patients who sustain commonly home-related accidents as a consequence of insufficient parental supervision. The perception that motor vehicle accidents comprise major cause of CSF appears not to be true.
Carer Appraisal Scale: Second Edition of a Novel Carer-Based Outcome Measure
Authors: Jeyasingam Neil , Ip Vincent , Alcock Hannah , Choi Sophia Yoon-Young , Lye Joshua , Perry Rebecca
Published: March 2019

Carers are known to have valuable information regarding patient functioning. It has been repeatedly cited that failure of communication between mental health services and the carers of patients is related to critical incidents and failures in patient care. Despite this, there are no structured interventions for carers to participate in patient care, let alone assist with measuring patient progress. This study builds upon and expands on a previous pilot study of a similar measure that was developed for a specific old-age population to create one suitable for general adult use. Development of the Carer Appraisal Scale was based on a grounded theory approach, beginning with semi-structured interviews with staff members working in the mental health service of a major tertiary referral center, with intent on refinement by focus groups, carer feedback, and eventual reduction in total number of items via factor analysis in order to create an accessible and brief measure suitable for regular clinical use. It is proposed that this measure provides additional value for services in engaging the carers of patients in a clinically meaningful way that will greatly impact on patient care.