bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation Claims Reserving Based on Archimedean Copula
Authors: Noviyanti Lienda , Hasna Afifah R , Zanbar Soleh A. , Chadidjah Anna
Published: September 2019

The problem of how to estimate appropriate incurred but not reported (IBNR) claims reserving has always been among critical problem in general insurance. Estimating of claims reserving is required to increase the optimal service for policyholders. This value should always be available during the period of payment of claims. Its imprecision estimates could destabilize the insurance company. In general, the process of settlement a claim always appear time-lag among claims occurrence, claims reporting and claims payment. Different time-lags formed into the matrix of the Run-off Triangle. Practitioners still perform the chain-ladder method, one of the oldest actuarial literature. This condition is not realistic because the two investigated variables are claim size and time from the moment when claim occurred to the moment when the payment has been reported are correlated. The aim of this study is therefore to use the Archimedean Copula to estimate outstanding IBNR claims reserving. This method gives the estimated value of which is more suitable for fire insurance than the chain-ladder method classics.
On the strong metric dimension of crossed prism graph and edge corona of cycle with path graph
Authors: Yunitasari Astri , Atmojo Kusmayadi Tri
Published: September 2019

Let G be a connected graph with vertex set V(G) and edge set E(G). The interval I[u, v] between u and v is defined as the collection of all vertices that belong to some shortest u − v path. A vertex s ∈ V(G) strongly resolves two vertices u and v if u belongs to a shortest v −s path, denoted by u ∈ I[v, s], or v belongs to a shortest u−s path, denoted by v ∈ I[u, s]. A set S ∈ V(G) is a strong resolving set if every two distinct vertices of G are strongly resolved by some vertex of S. The strong metric basis of G is a strong resolving set with minimal cardinality. The strong metric dimension of G, denoted by sdim(G), is defined as the cardinality of the strong metric basis. In this research, we determine the strong metric dimension of crossed prism graph and edge corona graph Cm
◊ Pn
. We obtain the strong metric dimension of crossed prism graph with n ≥ 4 is n for n even. The strong metric dimension of edge corona graph Cm
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for m ≥ 4, n ≥ 3, m even; sdim(Cm
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)=mn for m ≥ 3, n = 2, m odd; sdim(Cm
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Student’s Difficulties in Solving Higher Order Thinking Skills (HOTS) Problem for Mathematics Based on Verbalizer Cognitive Style
Authors: Rahmawatiningrum A , Kusmayadi T A , Fitriana L
Published: September 2019

Higher Order Thinking Skills (HOTS) problem for mathematics is mathematics problems related to real life and contain elements of analysis, evaluation and creation. This distinction raises the characteristic of thinking in every student called the cognitive style. The aims of this research is to describe student’s difficulties in solving HOTS problem based on verbalizer cognitive style. This research used the qualitative descriptive method, research subjects are 2 students of VII grade Surakarta with verbalizer cognitive style which selected using purposive sampling. Based on the findings, students with a cognitive style verbalizer begin to have difficulty in solving HOTS mathematics problems at the stage of defining goals by expressing problems in a diagram, where diagrams can help solving the problems.
Enhancing the Student’s Reasoning Ability in Solving Real Number System Problems Using the Concept Map
Authors: Khotimah R P , Masduki  , Sungkono J
Published: September 2019

The reasoning is an important aspect of learning mathematics. In studying real analysis, students must have the reasoning ability to understand the concepts and the relation of each other. The aim of this research is to examine the effect of using a concept map for learning on the student reasoning ability in solving a real number system problem. The reasoning can be seen from the indicators: analysis, synthesis, verification, and generalization. This research is quantitative research with pre-test post-test group design. The subject of this research is eighteen students who enrolled in a real analysis course in the Department of Mathematics Education, Universitas Widya Dharma Klaten academic year 2017/2018. The data was collected by test and documentation. The reasoning test was given twice, first is the pre-test that was given before the implementation of the concept map model in the learning process, and the second is post-test that given after the implementation of the model. The data were analyzed by descriptive statistics. The results showed that there was an enhancement of student reasoning ability in solving real number system problems by using a concept map
Classification of Javanese Language Level on Articles Using Multinomial Naive Bayes and N-Gram Methods
Authors: Ardhana A P , Cahyani D E , Winarno
Published: September 2019

Javanese language articles can now be found in electronic media. But for people who are just learning the Javanese language, they have difficulty in knowing the language level that is contained in the article because there is no explanation regarding the type of language level. For this reason, it is necessary to classify the language level in Javanese language based on the article, where the Javanese language is divided into 4 levels, namely ngoko, ngoko alus, krama madya, and krama alus. Before beginning the classification process, the data must be preprocessed. One of the steps in preprocessing method is stemming, which is used to convert the affixes in words into basic words. The Javanese stemming process in this research refers to the Indonesian stemming rules based on the adjusted Nazief-Adriani algorithm. The extraction feature process was carried out using N-Gram with n = 2, 3, 4 (bigram, trigram, and quadgram). After finishing the preprocessing method, the classification process then was executed using Multinomial Naïve Bayes method. In the classification process, there often exist problems related to imbalance data between categories. To overcome this problem, SMOTE resampling method is utilized to balance the data. The classification with N-Gram variations accompanied by SMOTE and using stemming results to maximum accuracy of 67.01% at n = 2, then for the highest precision was at N-Gram n = 4 with condition not using stemming but using SMOTE at value 72.67%. The highest recall value was obtained in two conditions, namely at N-Gram n = 2 either using or not using SMOTE and use stemming, which is 67.00%. From the results of this study, it can be concluded that stemming rules which are adapted from Nazief-Adriani algorithm with the addition of stemming steps and affix list from Javanese language expert can be implemented properly for Javanese language stemming process. And the classification of the Javanese Language level using Multinomial Naïve Bayes and N-Gram methods can result in good enough accuracy, precision, and recall.
Lost times of harvesting processes of the Thai combine harvesters
Authors: Doungpueng K , Chuan-Udom S , Numsong A , Chansrakoo W
Published: September 2019

The loss of time during harvesting processes can affect the effective field capacity. This study aimed to observe and analyse the time that is lost during harvesting processes utilizing Thai combine harvesters. The random data was collected in November 2017 from 28 Thai combine harvesters harvesting Khao Dowk Mali 105 and in May 2017 from 27 Thai combine harvesters harvesting Phitsanulok-2. The theoretical field time, the headland turning time, the un-harvest moving and unloading time, the adjustment and maintenance time, and the bund crossing time were all recorded. The results indicated that the headland turning time and the un-harvest moving and unloading time had been the major influences that had been responsible for the increases in total time and had resulted in decreases in the effective field capacity. The times for adjustment and maintenance and for bund crossing had shown only minor losses.
Use of vegetation indices in monitoring sugarcane white leaf disease symptoms in sugarcane field using multispectral UAV aerial imagery
Authors: Sanseechan P , Saengprachathanarug K , Posom J , Wongpichet S , Chea C , Wongphati M
Published: September 2019

Currently, controlling or identifying of the sugarcane white leaf disease infection is not possible since its symptom need to be observed by human walking throughout fields. Therefore, this research aims to study the ability of vegetation indices to detect white leaf disease infected sugarcane with images taken by multispectral camera mounted on Unmanned Aerial Vehicle. Three sub-images infected with white leaf symptom and 3 other sub-images of normal green leaf were selected for this study. The reflectance values of 6 chosen sub-images were used to calculate 18 vegetation indices, and then these indices were used to compute the difference percentage of vegetation (green versus white) in order to find vegetation indices that are the most sensitive to white leaf symptoms. The results show that vegetation indices that have NIR and Red edge band in their formula (14 vegetation indices) have difference percentage in the range of 14.66 - 45.10, with NDREI, GNDVI yielding the highest difference percentage (44.05 - 45.10%), and vegetation indices that have only visible bands in their formula (4 vegetation indices) have the difference percentage from 14.96 – 26.04%, with GI and NRI resulting in the highest difference percentage 24.04% and 26.04%, respectively.
The energy input-output analysis of maize production in Sundarharaincha Municipality, Morang district, Nepal
Authors: Poudel Sandesh , Bhattarai Saurabh , Sherpa Tsering , Karki Anish , Hyun Kim Dae , Kafle Sagar
Published: September 2019

Maize is the second largest crop grown in Nepal and is grown in all three geographic zones. The objective of this study is to analyse the energy input-output of maize production systems. The study is conducted in Sundarharaincha municipality of Morang district, Nepal, using direct questionnaires methods for the collection of primary data of varying landholding sizes farmers. The study revealed that total energy input and output for maize production system found about 10, 999.61 MJ/ha and 45, 501.52 MJ/ha, respectively, with the highest share by farmyard manure (FYM) about 50%. The energy use efficiency was found 4.14. Total CO2, N2O and CH4 emissions due to chemical inputs were found 163.24 kg/ha, 0.03 kg/ha and 0.33 kg/ha, respectively. The total Global warming potential was found 178.58 CO2 eq. per ha. The average cost of production were calculated USD 301.35/ha and profit USD 272.26/ha.
Numerical simulation of the flow of agricultural seeds inside a rotary drum dryer by DEM
Authors: Wangchai S
Published: September 2019

Drying agricultural seeds is a commonly used industrial process. The drying process of the material inside the rotary drum is directly related to the seed movement in the dryer. However, the movement of agricultural seeds inside the rotary drum dryer has never seriously been studied before. This paper adopts a mathematical model for simulating particle flow in rotary drum dryers for agricultural seeds using discrete element methods (DEMs). It is aimed to study the efficiency of the rotary drum dryer and how this is linked to the type and number of vans and positions of vans mounted inside the rotary drum dryer. The study parameters were performed by varying the rotational speed, inclination of the rotary drum installation with minimal impact on the flow of seeds, and segregation of the seeds in a rotary drum dryer. The simulation results show that different operating conditions were the most significant influences on the movement of seeds. Maximum height of the particle falling can be realized when the rotary drums are operating at an optimum condition for particle loading from the bottom drum.
Temperature profile of moving belt with direct IR heating using CFD modelling
Authors: Vichaiya P , Jongyingcharoen J S
Published: September 2019

Radiation heat transfer requires no medium, so energy lost is minimal. Infrared wave band is used for heating. However, radiative heating has limitation on the penetration depth. It infiltrated only a few millimetres into an object. IR drying can be used for thin layer drying. Continuous IR drying was an ideal process to use in drying. A pilot continuous IR drying tunnel was constructed. CFD model was used to generate the image of temperature profile of a moving belt which no other mean of temperature measurement can be pursued. The model was compared to measuring points for validation. The result was fair. By varying the IR heating power and speed of the belt, many scenarios can be used to find the optimum condition for drying.
Ultrasound assisted solvent extraction oil from dried rice bran soapstock
Authors: Phan V M , Junyusen T , Liplap P , Junyusen P , Taweechuensakul W
Published: September 2019

In this study, neutral oil was recovered from dried rice bran soapstock using ultrasound assisted solvent extraction (UASE). Response surface methodology (RSM) was employed to optimize the UASE parameters to obtain the maximum yield of neutral oil using face centered composite design (FCCD). The parameters included ultrasound power (0.5-4.5W/g), process temperature (35-55°C), and sonication time (4-26 min). The quadratic response models were generated and statistical analysis was performed to validate the models. The results showed that the optimum extraction conditions were ultrasound power of 3.75 W/g, process temperature of 49.71°C, and sonication time of 22.68 min. Ultrasound power and temperature were the most significant parameters for the extraction process. Under the optimal condition, the predicted neutral oil recovery was 98.10%, while corresponding experimental result was 98.21%, suggesting good agreement between the predicted and experimental data and high predictive ability of the models.
Physical properties and volatile compounds of beef flavors produced by direct extrusion
Authors: Sakunwaropat P , Vatanyoopaisarn S , Thumthanaruk B , Wijuntamook S , Pojanasuvonchai B , Rattananupap V , Wongsa J , Rungsardthong V
Published: September 2019

Beef flavors were formed by mixing amino acid, sugar, and wheat flour via the efficient and continuous direct extrusion process. The effect of the extrusion temperature of zone 1, at 80, 100 and 120°C, on the color, solubility, and sensory properties of the beef flavors obtained was investigated. Acceptability of extruded beef flavors, both in powder and liquid forms, was tested compared to the control, which was a commercial beef flavor prepared by the traditional method (boiling and reflux). Volatile compounds of the extruded product and the control were determined by GC-MS, with the solid-phase microextraction method (SPME). The bulk density of the extruded products was significantly higher than the control, but they all showed the same percentage of solubility. Methanethiol, the key component contributing to stewed beef and ground beef, as well as 2-furancarboxaldehyde, 3-(methylthiol)-propanal, 2-[(methylthio) methyl]-furan, was detected in beef flavors both from extrusion and the control. Extrusion at higher temperatures, 100 and 120°C, indicated a more brownish color and obtained higher sensory scores in terms of odor, taste, and overall acceptance than samples extruded at 80°C and the control. Thus, there is a potential to use extrusion to replace traditional methods of production of beef flavors.
Continuous changes of variables and the Magnus expansion
Authors: Casas Fernando , Chartier Philippe , Murua Ander
Published: September 2019

In this paper, we are concerned with a formulation of Magnus and Floquet-Magnus expansions for general nonlinear differential equations. To this aim, we introduce suitable continuous variable transformations generated by operators. As an application of the simple formulas so-obtained, we explicitly compute the first terms of the Floquet-Magnus expansion for the Van der Pol oscillator and the nonlinear Schrödinger equation on the torus.
Myeloid Sarcoma With CBFB-MYH11 Fusion (inv(16) or t(16;16)) Prevails in the Abdomen
Authors: Dalland Joanna C , Meyer Reid , Ketterling Rhett P , Reichard Kaaren K
Published: September 2019

Objectives

Myeloid sarcoma with CBFB-MYH11 fusion may be enriched in abdominal sites. The clinicopathologic features of 11 cases are reported.

Methods

We collected clinical features, morphology, immunophenotype, and bone marrow (BM) involvement of myeloid sarcoma cases with CBFB-MYH11 fusion.

Results

Eleven of 29 total myeloid sarcoma cases were CBFB-MYH11 positive and all 11 involved abdominal sites. The blastic infiltrate was associated with eosinophils in four of 11 cases and plasmacytoid dendritic cell (pDC) nodules in four of six cases. CD34, CD117, and myeloperoxidase were expressed in eight of nine, 10 of 10, and 10 of 10 cases, respectively. Ten of 10 cases showed no BM involvement.

Conclusions

Our current series, combined with a literature review, identifies a compelling series of 31 (94%) of 33 cases of myeloid sarcoma with CBFB-MYH11 fusion showing a marked predilection for abdominal sites. In addition, the lack of obvious associated eosinophils, presence of pDC nodules, and lack of concurrent BM involvement suggest that “myeloid sarcoma with CBFB-MYH11 fusion” may represent a unique phenomenon.
Pentosidine as a Measure of Chronological Age in Wild Birds
Authors: Chaney Richard C. , Blemings Kenneth P. , Bonner James , Klandorf Hillar
Published: September 2019

Birds have few reliable indicators of aging. Pentosidine is a product of nonenzymatic glycation that accumulates in tissues of an animal over its lifespan. The intent of this study was to determine if accumulation of skin pentosidine in birds of known ages changed as a function of time. Skin samples were obtained from the breast of 45 birds of various species obtained from the national aviary. In addition, foot webbing samples were obtained from 17 California Gulls (Larus callifornicus) of known ages. Collagen was measured by a hydroxypro-line spectrophotometric method and pentosidine was quantified using reverse phase high-performance liquid-chromatography. Pentosidine concentration in the skin and foot webbing increased linearly with age (P < 0.001). Hydroxyproline concentrations from the foot webbing were comparable to that measured in the skin; however, pentosidine concentrations were approximately one-fourth of that in skin. Knowledge regarding longevity of birds could provide information for species survival programs and insight into variations in longevity of an entire population.
Attaining Theoretical Coherence Within Relationship-Based Practice in Child and Family Social Work: The Systemic Perspective
Authors: Coulter Stephen , Houston Stanley , Mooney Suzanne , Devaney John , Davidson Gavin
Published: September 2019

Social work practice has an essential, yet ambiguous, relationship with theory. This state of affairs is currently evident in the range of contemporary relationship-based practice (RBP) models being applied within Child and Family Social Work. This article argues that there is an urgent need for a theoretically coherent conceptualisation of these models to enable social work practitioners to embrace their common precepts and so enable more effective interventions. In contrast to attempts to show the distinctiveness of current models for reasons of fidelity, model identity and marketing, this unifying approach advocates for recognition of the commonality and complementarity of contemporary RBP models. The article argues that systemic theory which applies a social constructionist orientation can provide this coherence, helping social workers develop their practice in an informed way. In making this case, the emergent evidence base is noted and recommendations are made about how greater convergence and complementarity can be promoted. This article contributes to the debate about how practice and policy should be guided by theoretical ideas of coherence, alongside more utilitarian ideas advocating the importance of evidence and effectiveness.
Differential inhibitory potentials of three plant extracts against Dermestes maculatus Degeer and microorganisms in smoked catfish, Clarias gariepinus Burchell
Authors: Ajayi Olufunmilayo Eunice , Oladele Oluwole Olakunle , Fabunmi Goodness Osehotue
Published: September 2019

Objectives

Three medicinal plants: Zingiber officinale rhizome, Allium sativum bulb, and Moringa oleifera seeds, were evaluated for progeny inhibition in fish beetle, Dermestes maculatus, and incidence of bacteria and fungi in smoked-dried Clarias gariepinus.

Materials and Methods

Cleaned C. gariepinus were separately soaked in extracts of these selected plants (50 g/1000 ml) for 60 min before smoke-drying in a mud kiln at 105°C and later divided into lots. Sensory evaluation was conducted on uninfested fishes in lot A while fishes in lot B was artificially infested with five pairs of newly emerged adult D. maculatus for 10 days. Number of emerged larva, adult insects, and incidence of microorganisms before and following 90 days in storage after infestation were used as indices of potency of the extracts.

Results

Results obtained showed that all the treated uninfested smoked-dried C. gariepinus retained high scores for taste, texture, aroma, and appearance within the first 5 weeks of storage after smoking when compared with the control. This implied that the tested extracts had no negative effect in terms of sensory attributes on the treated fish during storage and can therefore be used for fish preservation. Meanwhile, A. sativum among all the selected extracts had the least number of larvae (17.67 ± 1.45), adult (21.00 ± 1.53), fungi (9.00 × 102 ± 0.53 sfu/ml) and bacteria counts (11.33 ×102 ± 0.33 cfu/ml) following 90 days in storage after infestation.

Conclusion

Allium sativum among the tested extracts proved to be most effective and could be recommended for control of D. maculatus and microorganisms in smoked C. gariepinus.
Caregiving Across Diverse Populations: New Evidence From the National Study of Caregiving and Hispanic EPESE
Authors: Rote Sunshine M , Angel Jacqueline L , Moon Heehyul , Markides Kyriakos
Published: September 2019

Background and Objectives

The current study employs population-based data to determine the extent to which stress and coping factors are related to self-rated health and distress for informal caregivers (CGs) from the 3 largest racial/ethnic groups in the United States (non-Latino White, African American, and Mexican American).

Research Design and Methods

Data on primary, informal CGs are obtained from the 2015 National Study of Caregiving (NSOC) (n = 667) and the 2016 Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE) CG supplement (n = 287). Logistic regression models of health are presented for all CGs and specifically for dementia CGs.

Results

Caregiving intensity is related to health for non-Latino White CGs and African American dementia CGs. Support from family and friends is related to better self-rated health, but only for African American dementia CGs. While better relationship quality is related to better health for African American CGs and White dementia CGs, formal support utilization is related to worse CG health for Mexican American dementia CGs.

Discussion and Implications

Findings emphasize the importance of earlier detection and intervention with CGs at the beginning in the caregiving career, the interplay of formal and informal support, and appropriate ways to intervene with dementia CGs. Culturally tailored home- and community-based care options are needed to supplement the low levels of CG support, especially for the Mexican American population.
Jerzy Andrzejewski’s Holy Week: Testing Religious Ethics in Times of Atrocity
Authors: Brenner Rachel Feldhay
Published: September 2019

Jerzy Andrzejewski wrote the novella Holy Week at the time of the Warsaw Ghetto Uprising. This real-time Polish fictional response immediately raised critical controversy. Whereas some critics saw it as an inadequate representation of the Holocaust, others considered the 1945 version a product of socialist realism. Here the author argues that Andrzejewski’s wartime fiction investigates the viability of his Catholic existentialist orientation during a time of terror. While his wartime essays and his correspondence with Czesław Miłosz reflected Andrzejewski’s struggle to maintain his faith in human brotherhood, his fiction traced the disintegration of Grace-given faith in the commonality and dignity of all human beings. The stories progress from a tragic ending of friendship to the failure of spiritual resistance and ultimately to the complete moral collapse of the Polish community. The unflinching depiction of the failure of Catholic Poles before their responsibility to extend neighborly love to their doomed Jewish neighbors communicates Andrzejewski’s insistence on the Catholic obligation to love one’s neighbor.
A comprehensive review on renewable and sustainable heating systems for poultry farming
Authors: Cui Yuanlong , Theo Elmer , Gurler Tugba , Su Yuehong , Saffa Riffat
Published: September 2019

Poultry farming is one of energy intensive industries that consume large amount of energy to provide the suitable indoor environment for chicken health and production like meat and eggs. Currently, there are extensive researches and practices of applying renewable and sustainable energy technologies to poultry farming to achieve energy saving and carbon dioxide emission reduction. Therefore, it is worth to retrospect the state-of-the-art development and summarize the key features in this field. The main technologies include photovoltaic (PV), solar collector, hybrid PV/Thermal, thermal energy storage, ground/water/air sources heat pumps, lighting and radiant heating. It is found that up to 85% energy saving can be achieved by using these advanced technologies in comparison to the traditional poultry houses with a payback time of 3–8 years.
Molecular Correlates of Socioeconomic Status and Clinical Outcomes Following Hematopoietic Cell Transplantation for Leukemia
Authors: Knight Jennifer M , Rizzo J Douglas , Wang Tao , He Naya , Logan Brent R , Spellman Stephen R , Lee Stephanie J , Verneris Michael R , Arevalo Jesusa M G , Cole Steve W
Published: September 2019

Background

Clinical outcomes among allogeneic hematopoietic cell transplant (HCT) recipients are negatively affected by low socioeconomic status (SES), yet the biological mechanisms accounting for this health disparity remain to be elucidated. Among unrelated donor HCT recipients with acute myelogenous leukemia, one recent pilot study linked low SES to increased expression of a stress-related gene expression profile known as the conserved transcriptional response to adversity (CTRA) in peripheral blood mononuclear cells, which involves up-regulation of pro-inflammatory genes and down-regulation of genes involved in type I interferon response and antibody synthesis.

Methods

This study examined these relationships using additional measures in a larger archival sample of 261 adults who received an unrelated donor HCT for acute myelogenous leukemia to 1) identify cellular and molecular mechanisms involved in SES-related differences in pre-transplant leukocyte transcriptome profiles, and 2) evaluate pre-transplant CTRA biology associations with clinical outcomes through multivariable analysis controlling for demographic-, disease-, and transplant-related covariates.

Results

Low SES individuals showed increases in classic monocyte activation and pro-inflammatory transcription control pathways as well as decreases in activation of nonclassic monocytes, all consistent with the CTRA biological pattern. Transplant recipients in the highest or lowest quartiles of the CTRA pro-inflammatory gene component had a more than 2-fold elevated hazard of relapse (hazard ratio [HR] = 2.47, 95% confidence interval [CI] = 1.44 to 4.24), P = .001; HR = 2.52, 95% CI = 1.46 to 4.34, P = .001) and more than 20% reduction in leukemia-free survival (HR = 1.57, 95% CI = 1.08 to 2.28, P = .012; HR = 1.49, 95% CI = 1.04 to 2.15, P = .03) compared with the middle quartiles.

Conclusions

These findings identify SES- and CTRA-associated myeloid- and inflammation-related transcriptome signatures in recipient pre-transplant blood samples as a potential novel predictive biomarker of HCT-related clinical outcomes.
Detailed study of ELAIS N1 field with the uGMRT – II. Source properties and spectral variation of foreground power spectrum from 300–500 MHz observations
Authors: Chakraborty Arnab , Roy Nirupam , Datta Abhirup , Choudhuri Samir , Datta Kanan K , Dutta Prasun , Bharadwaj Somnath , Intema Huib , Choudhury Madhurima , Pal Srijita , Choudhury Tirthankar Roy
Published: September 2019

Understanding the low-frequency radio sky in depth is necessary to subtract foregrounds in order to detect the redshifted 21 cm signal of neutral hydrogen from the cosmic dawn, the epoch of reionization and the post-reionization era. In this second paper of the series, we present the upgraded Giant Metrewave Radio Telescope (uGMRT) observation of the ELAIS N1 field made at 300–500 MHz. The image covers an area of ∼1.8 deg2 and has a central background rms noise of ∼ 15 μJy beam−1. We present a radio source catalogue containing 2528 sources (with flux densities > 100 μJy) and normalized source counts derived from that. A detailed comparison of detected sources with previous radio observations is shown. We discuss flux-scale accuracy, positional offsets, spectral index distribution and correction factors in source counts. The normalized source counts are in agreement with previous observations of the same field, as well as model source counts from the Square Kilometre Array Design Study simulation. It shows a flattening below ∼1 mJy that corresponds to a rise in populations of star-forming galaxies and radio-quiet active galactic nuclei. For the first time, we estimate the spectral characteristics of the angular power spectrum or multi-frequency angular power spectrum of diffuse Galactic synchrotron emission over a wide frequency bandwidth of 300–500 MHz from radio interferometric observations. This work demonstrates the improved capabilities of the uGMRT.
The Importance of Estimating Causal Effects for Evaluating a Nicotine Standard for Cigarettes
Authors: Koopmeiners Joseph S , Vock David M , Boatman Jeffrey A , Carroll Dana , Colby Suzanne M , Donny Eric C , Hatsukami Dorothy K , Luo Xianghua , Tidey Jennifer W
Published: September 2019

Recent evidence from randomized clinical trials (RCTs) of very low nicotine content (VLNC) cigarettes indicates that smokers randomized to VLNC cigarettes had significantly lower cigarette use, dependence, and biomarkers of exposure than smokers randomized to normal nicotine content control cigarettes. In these trials, a substantial number of participants did not adhere to their randomized treatment assignment, i.e., they used commercial cigarettes not provided by the trial in place of or in addition to the VLNC cigarettes provided by the trial. As with most RCTs, the analysis of these trials followed the intention-to-treat principle, where participants are analyzed according to their randomized treatment assignment regardless of adherence. Alternately, the analysis of an RCT could focus on the estimation and testing of the causal effect of the intervention, which is the treatment effect if all subjects were to adhere to their randomized treatment assignment. In this commentary, we compare these two approaches, highlighting the important role of causal estimation and inference for evaluating the regulatory effect of a nicotine standard for cigarettes. Additionally, we review the results of the secondary analyses of randomized trials of VLNC cigarettes using causal inference methodology to account for non-adherence to the assigned treatment and discuss the implications for a nicotine standard for cigarettes.
Negative Affect–Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain
Authors: Gilam Gadi , Sturgeon John A , You Dokyoung S , Wasan Ajay D , Darnall Beth D , Mackey Sean C
Published: September 2019

Objective

Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors.

Methods

A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect–related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders.

Results

Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity–worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04).

Conclusions

Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.
Rare Presentation of Postsurgical Pyoderma Gangrenosum Presenting as Necrotizing Soft Tissue Infection
Authors: Flynn Rod L. , Chowdhury Mashiul H. , Rudolph Joseph , Einstein Stephanie
Published: September 2019

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis believed to be mediated by an autoimmune reaction. Typical treatment includes autolytic debridement, management of exudate, protection from trauma, and steroid therapy. A diagnosis of exclusion, PG is frequently mistaken for a wound infection, but antibiotics do not alleviate the condition. Incision and debridement has been observed to cause further spread of the lesions because of pathergy resulting from the additional trauma. This case report describes a patient who was misdiagnosed with necrotic soft tissue infection that was actually postsurgical PG.
Refining Heel Pressure Injury Risk Factors in the Hospitalized Patient
Authors: Delmore Barbara , Ayello Elizabeth A. , Smith Daniel , Rolnitzky Linda , Chu Andy S.
Published: September 2019

OBJECTIVE

To replicate previous research that found four independent and significant predictors of heel pressure injuries (HPIs) in hospitalized patients using a larger and more diverse patient population.

METHODS

Researchers conducted a retrospective, case-control study with a main and a validation analysis (N = 1,937). The main analysis had 1,697 patients: 323 patients who had HPIs and 1,374 who did not. The validation analysis had 240 patients: 80 patients who developed HPIs and 160 who did not. Researchers used a series of diagnosis codes to define variables associated with an HPI. Data were extracted from the New York Statewide Planning and Research Cooperative System for January 2014 to June 2015. Study authors conducted a series of forward stepwise logistic regression analyses for both samples to select the variables that were significantly and independently associated with the development of an HPI in a multivariable setting. Researchers generated a receiver operating characteristic curve using the final model to assess the regression model's ability to predict HPI development.

RESULTS

Seven variables were significant and independent predictors associated with HPIs: diabetes mellitus, vascular disease, perfusion issues, impaired nutrition, age, mechanical ventilation, and surgery. The receiver operating characteristic curve demonstrated predictive accuracy of the model.

CONCLUSIONS

Beyond a risk assessment scale, providers should consider other factors, such as comorbidities, which can predispose patients to HPI development.
Cervical Spine Computed Tomography Hounsfield Units Accurately Predict Low Bone Mineral Density of the Femoral Neck
Authors: Colantonio Donald F. , Saxena Sameer K. , Vanier Alan , Rodkey Daniel , Tintle Scott , Wagner Scott C.
Published: September 2019

Study Design:

A retrospective cohort.

Objective:

The objective of this study to determine the correlation between Hounsfield unit (HU) measurements from the C4 vertebral body and dual-energy x-ray absorptiometry (DXA) T-score.

Summary of Background Data:

Recent attention has turned to the utilization of HU measurements from computed tomography (CT) as a potential screening method for low bone mineral density (BMD). We hypothesized that cervical spine CT HU measurements will correlate with BMD measurements conducted with DXA scans of the femoral neck.

Material and Methods:

Patients with cervical CT and femoral neck DXA scans at 1 institution were included in the study. HUs were manually measured from the cancellous bone in the C4 vertebrae by 1 author blinded to DXA scans. HU measurements were compared with femoral neck DXA T-scores for the entire population.

Results:

A total of 149 patients with 149 cervical CT and femoral neck DXA scans were included in the study. The low BMD group (osteoporotic and osteopenic combined) showed a significant difference in HU compared with the normal groups within the study (P<0.0001). A low BMD screening value of 447 HU captured over 95% of patients with low BMD within our study and provided a sensitivity of 92% and negative predictive value of 82.1%. The male and female intrasex analysis demonstrated a significant difference between the low BMD and normal BMD groups with P=0.001 and P=0.0001, respectively.

Conclusions:

HU measurements taken from the C4 vertebral body on CT scan correlate with low BMD of the femoral neck as determined by DXA scan T-scores. Screening values of 447 HU captured 95% of patients with low BMD, with a high degree of sensitivity, and negative predictive value of 80%. Utilization of cervical spine HU as a screening method provides a simple, quick, and easily assessable screening tool for assessing low BMD.

Level of Evidence:

Level III—diagnostic.
Comparison of Posterior Lumbar Interbody Fusion and Microendoscopic Muscle-preserving Interlaminar Decompression for Degenerative Lumbar Spondylolisthesis With >5-Year Follow-up
Authors: Kimura Ryota , Yoshimoto Mitsunori , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Kobayashi Takashi , Kikuchi Kazuma , Okuyama Koichiro , Kido Tadato , Hirota Ryosuke , Hamada Shuto , Chiba Mitsuho , Abe Eiji , Yamashita Toshihiko , Shimada Yoichi
Published: September 2019

Study Design:

Retrospective analysis of prospectively collected observational multicenter data.

Objective:

To compare the clinical results and rates of revision surgery after posterior lumbar interbody fusion (PLIF) and microendoscopic muscle-preserving interlaminar decompression (ME-MILD) in patients with single-level, mild degenerative lumbar spondylolisthesis (DLS) and follow-up of at least 5 years.

Summary of Background Data:

Surgery for symptomatic DLS remains controversial. Evaluating long-term results may reveal problems such as adjacent segmental diseases of the PLIF and decreased quality of life because of slippage and restenosis of the ME-MILD.

Methods:

We enrolled 116 patients who underwent PLIF (79 patients) or ME-MILD (37 patients). Operative times, blood losses, surgical complications, Short-Form 36 (SF-36), Japanese Orthopedic Association (JOA) score, the JOA Back Pain Questionnaire (JOABPEQ), visual analog scales (VAS), and Zurich Claudication Questionnaire (ZCQ) were evaluated.

Results:

PLIF was observed to require significantly longer operative times and entailed greater operative blood losses than did ME-MILD (151.1 vs. 119.9 min; 202.2 vs. 6.4 mL, respectively). Surgery-related complications were identified in 3 cases in the PLIF group and 2 cases in the ME-MILD group. Seventy-eight patients (50 and 28 patients in the PLIF and ME-MILD groups, respectively) were successfully followed-up for >5 years. The follow-up rate was 67.2%. No significant differences between the groups were found in terms of preoperative and postoperative JOA scores, postoperative JOABPEQ, VAS, or ZCQ. Significant improvements in JOA scores were observed in both groups. Significant improvements in the SF-36 were observed in all subscales except in role physical, general health, vitality, and mental health in the ME-MILD group. Revision surgical procedures were performed in 2 patients in the ME-MILD group and 4 patients in the PLIF group.

Conclusions:

PLIF and ME-MILD resulted in equivalent improvements in SF-36 and JOA scores. There were no differences in revision surgery rates among patients with single-level, mild DLS.

Level of Evidence:

Level III—a retrospective analysis.
Using the Scope in the Treatment of Flatfoot? Are You Kidding?
Authors: Younger Alastair , Symes Michael , Veljkovic Andrea
Published: September 2019

Flatfoot surgery is evolving. As in other areas, less invasive techniques result in fewer wound complications, less postoperative pain, less bleeding, shorter hospital stays, and potentially shorter recovery times. In this article, we outline how the arthroscope can be used in flatfoot surgery to reduce the invasiveness of surgery. The article outlines how to perform a percutaneous gastrocnemius slide for the associated tight heel cord, and how to perform tibialis posterior tendoscopy. A percutaneous medializing calcaneal osteotomy can be performed as an arthroscopic guided procedure to confirm the placement of the saw, and ensure a safe cut. Arthroscopic ankle fusion, triple arthrodesis, subtalar fusion, and navicular cuneiform fusion can be used in select cases to correct the deformity. The methods and techniques are outlined.
Improving Prediction of Fall Risk Using Electronic Health Record Data With Various Types and Sources at Multiple Times
Authors: Jung Hyesil , Park Hyeoun-Ae , Hwang Hee
Published: September 2019

Inpatient falls are among the most common adverse events threatening patient safety. Although many studies have developed predictive models for fall risk, there are some drawbacks. First, most previous studies have relied on an incident-reporting system alone to identify fall events. Thus, it has been found that falls are more likely to be underreported. Second, there has been a controversy on how to select accurate representative values for patient status data across multiple times and various data sources in electronic health records. Given this background, this study used nurses' progress notes as a complementary data source to detect fall events. In addition, we developed criteria including coverage, currency, and granularity in order to integrate electronic health records data documented at multiple times in various data types and sources. Based on this methodology, we developed three models, logistic regression, Cox proportional hazard regression, and decision tree, to predict risk of patient falls and evaluate the predictive performance of these models by comparing the results to results from the Hendrich II Fall Risk Model. The findings of this study will be used in a clinical decision support system to predict risk of falling and provide evidence-based tailored recommendations in the future.
Immune-related Neutropenia Following Treatment With Immune Checkpoint Inhibitors
Authors: Finkel Inbar , Sternschuss Michal , Wollner Mira , Shamai Sivan , Peled Nir , Turgeman Ilit , Shochat Tzippy , Dudnik Elizabeth
Published: September 2019

The existing data with regard to immune-related neutropenia (irN), a rare (incidence—1%) immune-related adverse event of immune checkpoint inhibitors, are scarce. Eight patients with irN were identified through internal databases of 3 participating Israeli cancer centers. In addition, 11 original articles focusing on the clinical course of 24 patients with irN were selected during the PubMed search. Descriptive analysis of clinical and pathologic factors related to irN was performed (n=32); the effect of these on the irN outcomes was assessed. An algorithm for irN evaluation and treatment was proposed. The median time-to-onset of irN (n=32) was 60 days (range, 10–465 d). Grade 3–5 irN, febrile neutropenia, and irN-related death occurred in 81%, 50%, and 9% of patients, respectively. In all, 56%, 22%, 62%, and 25% of patients received PO corticosteroids, IV corticosteroids, granulocyte colony–stimulating factor (GCSF), and intravenous immunoglobulins (IVIG), respectively, with an improvement/resolution rate of 84%. Odds ratios for irN improvement/resolution were as follows: 1.40 [95% confidence interval (CI), 0.03–68.72], 0.43 (95% CI, 0.04–4.22), 2.60 (95% CI, 0.07–97.24), 0.36 (95% CI, 0.03–4.38), 4.02 (95% CI, 0.16–99.48), 2.01 (95% CI, 0.32–12.70), 1.08 (95% CI, 0.02–49.89), 0.42 (95% CI, 0.06–2.91), and 2.73 (95% CI, 0.42–17.51) for granulocyte hyperplasia, granulocyte/all lineage hypoplasia, granulocyte maturation blockade, lymphocyte infiltration on bone marrow biopsy, IV corticosteroids, PO corticosteroids, cyclosporine, IVIG, and GCSF, respectively (P>0.05 for all factors). IrN recurrence rate following immune checkpoint inhibitors rechallenge was 80%. IrN is a rare, life-threatening, early-onset immune-related adverse event. Differentiating between the central, peripheral, and modified peripheral types allows a better prognosis definition. Corticosteroids and GCSF represent the main treatment approaches; IVIG and cyclosporine should be used as salvage treatment.