bluuebunny/crossref_metadata_2025 huggingface dataset:
An acoustic-homologous transfer learning approach for acoustic emission–based rail condition evaluation
Authors: Chen Si-Xin , Zhou Lu , Ni Yi-Qing , Liu Xiao-Zhou
Published: December 2020

This article presents a novel transfer learning approach for evaluating structural conditions of rail in a progressive manner, by using acoustic emission monitoring data and knowledge transferred from an acoustic-related database. Specifically, the low-level layers of a model pre-trained on large audio data are leveraged in our model for feature extraction. Compared with conventional transfer learning approaches that transfer knowledge from models pre-trained on normal images, the proposed approach can handle acoustic emission spectrograms more naturally in terms of both data inner properties and the way of data intaking. The training and testing data used for rail condition evaluation contains two months of acoustic emission recordings, which were acquired from an in situ operating rail turnout with an integrated acoustic emission –based monitoring system. Results show that the evolving stages of rail from intact to critically cracked are successfully revealed using the proposed approach with excellent prediction accuracy and high computation efficiency. More importantly, the study quantitatively shows that audio source data are more relevant to the acoustic emission monitoring data than Image data, by introducing a maximum mean discrepancy metric, and the transfer learning model with smaller maximum mean discrepancy does lead to better performance. As a by-product of the study, it has also been found that the features extracted by the proposed transfer learning model (“bottleneck” features) already exhibit a clustering trend corresponding to the evolving stages of rail conditions even in the training process before any label is annotated, indicating the potential unsupervised learning capability of the proposed approach. Through the study, it is suggested that selecting source data more correspondingly and flexibly would maximize the benefit of transfer learning in structural health monitoring area when facing heterogenous monitoring data under varying practical scenarios.
Augmented reality for enhanced visual inspection through knowledge-based deep learning
Authors: Wang Shaohan , Zargar Sakib Ashraf , Yuan Fuh-Gwo
Published: December 2020

A two-stage knowledge-based deep learning algorithm is presented for enabling automated damage detection in real-time using the augmented reality smart glasses. The first stage of the algorithm entails the identification of damage prone zones within the region of interest. This requires domain knowledge about the damage as well as the structure being inspected. In the second stage, automated damage detection is performed independently within each of the identified zones starting with the one that is the most damage prone. For real-time visual inspection enhancement using the augmented reality smart glasses, this two-stage approach not only ensures computational feasibility and efficiency but also significantly improves the probability of detection when dealing with structures with complex geometric features. A pilot study is conducted using hands-free Epson BT-300 smart glasses during which two distinct tasks are performed: First, using a single deep learning model deployed on the augmented reality smart glasses, automatic detection and classification of corrosion/fatigue, which is the most common cause of failure in high-strength materials, is performed. Then, in order to highlight the efficacy of the proposed two-stage approach, the more challenging task of defect detection in a multi-joint bolted region is addressed. The pilot study is conducted without any artificial control of external conditions like acquisition angles, lighting, and so on. While automating the visual inspection process is not a new concept for large-scale structures, in most cases, assessment of the collected data is performed offline. The algorithms/techniques used therein cannot be implemented directly on computationally limited devices such as the hands-free augmented reality glasses which could then be used by inspectors in the field for real-time assistance. The proposed approach serves to overcome this bottleneck.
Fault state recognition of wind turbine gearbox based on generalized multi-scale dynamic time warping
Authors: Pang Bin , Tian Tian , Tang Gui-Ji
Published: December 2020

Fault diagnosis of wind turbine gearbox is significant to ensure the operating efficiency and reduce the maintenance cost of wind farms. The key to achieve an accurate fault diagnosis is to extract the evidence of fault state identification effectively. Dynamic time warping has been widely used as a classifier for automatic pattern recognition as the dynamic time warping distance can indicate the similarity between two data sequences. The similarity between the analyzed signal and the template signal can be an evidence for characterizing the fault types of the analyzed signal; a generalized multi-scale dynamic time warping algorithm was accordingly developed in this article to quantitatively evaluate the condition information of wind turbine gearbox by calculating the generalized multi-scale dynamic time warping distances between the template signal (i.e. the vibration signal of wind turbine gearbox in normal state) and the testing signal (i.e. the vibration signals of wind turbine gearbox to be analyzed). Then, the sensitive features of the condition information evaluation results obtained via the generalized multi-scale dynamic time warping algorithm were selected by the Laplace Score approach to construct the eigenvector. Finally, random forest was introduced to realize the intelligent fault recognition of wind turbine gearbox. The analysis results of both experimental and engineering signals indicate that the presented method can accurately identify different fault states of wind turbine gearbox. In addition, the proposed method performs a higher accuracy of fault state classification compared with some existing methods.
Treating Sexual Dysfunctions Among Survivors of Child Sexual Abuse: An Overview of Empirical Research
Authors: Gewirtz-Meydan Ateret
Published: December 2020

Sexual problems are very prevalent among survivors of child sexual abuse (CSA). Yet, various approaches to therapy do not seem to address this issue when treating these individuals. Traditional sex therapy may also not suit the experiences of CSA survivors, as CSA was not considered when the most well-known and frequently used techniques were developed. The present review sought to identify (1) theory-based therapeutic approaches that address sexual problems among CSA survivors and offer treatment protocols (including an outline of specific therapy stages, sessions, or techniques) to treat these sexual problems and (2) identify therapeutic approaches that include a protocol for treating sexual problems among CSA survivors that was empirically tested and validated. In total, six approaches for treating sexual dysfunctions among CSA survivors that provide detailed guidelines for implementing the approach within sex therapy for CSA survivors were identified in the literature. Only two of the studies conducted a randomized controlled trial to test the intervention. This overview concludes with important issues to address when treating sexual problems among CSA survivors and a call for additional evidence-based practices for treating sexual problems among survivors of CSA.
The Use of Isolated and Synthesized Latency Functional Analyses in the Assessment and Treatment of Clothing Removal Exhibited by a Child with Autism
Authors: Brown Kristopher
Published: December 2020

The case of a 9-year-old male with autism spectrum disorder (ASD) who presented with problem behavior in the form of high-frequency clothing removal is reported. Descriptive data indicated the behavior occurred when tasks were presented and commonly delayed task demands and resulted in staff attention. Two latency functional analyses with isolated and synthesized contingencies were completed to clarify the operant function of the behavior. Initial results of the synthesized analysis indicated clothing removal was sensitive to attention and escape. However, a subsequent functional analysis with isolated contingencies indicated that the behavior was maintained only by attention. A function-based intervention package consisting of attention extinction, response blocking, and differential reinforcement of other behavior (DRO) effectively reduced the frequency of clothing removal to near-zero levels. Results of the intervention were partially generalized to a new therapist. The use of latency functional analyses as a means to rapidly examine isolated and synthesized contingencies maintaining problem behavior is discussed as well as the effects of the treatment package on the behavior of clothing removal.
Conceptualization and Management of Chronic Pain in an Over 65 Using an ACT Lens—A Single Case Study
Authors: Campbell Rebecca , Prasadarao Podugu Sai Durga Vara , Morris Mary
Published: December 2020

This single case study illustrates the application and utility of Acceptance and Commitment Therapy (ACT) for a 72-year-old Australian male presenting with chronic pain and complex health conditions. Chronic pain often entails complexity among older adults and can impact the patient’s life across a range of domains. Psychological approaches, as stand-alone or adjunct to medical intervention, are widely acknowledged as potentially beneficial to older persons experiencing pain. ACT has been supported as a viable psychological approach for chronic pain and especially suitable for older persons with chronic pain. This study describes an ACT treatment approach for an older person with chronic pain informed via development of an extension of the existing ACT conceptualization of chronic pain. The development of the ACT based model is in keeping with recommendations to seek out mechanisms of change in psychotherapeutic research. Measures of Quality of Life, Depression, Physical Activity, and Acceptance/Avoidance were taken at pre and post treatment, as well as across treatment phases. Improvement was noted in self-reported measures of QOL, depression, and physical activity.
Duplex Ultrasound Can Successfully Identify Endoleaks and Renovisceral Stent Patency in Patients Undergoing Complex Endovascular Aneurysm Repair
Authors: George Justin , Tadros Rami O. , Rao Ajit , Png C. Y. Maximilian , Han Daniel K. , Ilonzo Nicole , Faries Peter L. , McKinsey James F.
Published: December 2020

Efficacy of duplex ultrasound (DU) surveillance of complex EVAR such as FEVAR and ChEVAR has not been studied. All patients undergoing FEVAR or ChEVAR at a single multihospital institution were retrospectively reviewed. Postoperative surveillance included DU at 1 month and CTA at 3 months. 82 patients met inclusion criteria including 39 (47.6%) ChEVAR and 43 (52.4%) FEVAR cases. DU identified endoleak with aneurysm sac enlargement in 3 cases requiring reintervention. CTA at 3 months detected 2 new endoleaks without growth and 1 renal artery stent occlusion. Replacement of initial postoperative imaging with DU did not result in any missed endoleaks, deaths, ruptures, or branch occlusions.
Intermittent Skill Training Results in Moderate Improvement in Functional Outcome in a Mouse Model of Ischemic Stroke
Authors: Nemchek Victoria , Haan Emma M. , Kerr Abigail L.
Published: December 2020

Background

Stroke is a leading cause of disability worldwide. Focused training of the impaired limb has been shown to improve its functional outcome in animal models. However, most human stroke survivors exhibit persistent motor deficits, likely due to differences in rehabilitation intensity between experimental (animal) and clinical (human) settings.

Objective

The current study investigated the effect of training intensity on behavioral outcome in a mouse model of stroke.

Methods

Mice were trained preoperatively on a skilled reaching task. After training, mice received a unilateral photothrombotic stroke. Postoperatively, animals received either daily rehabilitative training (traditional intensity), intermittent rehabilitative training (every other day), or no rehabilitative training (control). Assessment of the impaired limb occurred after 14 training sessions (14 days for the Traditional group; 28 days for the Intermittent group).

Results

Assessment of the impaired limb illustrated that traditional, daily training resulted in significantly better performance than no training, while intermittent training offered moderate performance gains. Mice receiving intermittent training performed significantly better than control mice but did not exhibit reaching performance as strong as that of animals trained daily.

Conclusions

The intensity of rehabilitation is important for optimal recovery. Although intermediate intensity offers some benefit, it is not intensive enough to mimic the performance gains traditionally observed in animal models. These results suggest that intensive training, which is often unavailable for human stroke survivors, is necessary to achieve an optimal functional outcome. The lower bounds of training intensity for functional benefit still need to be determined.
Development and Implementation of a Phased Framework for Collecting the COVID-19 Virus Material at a Medical University
Authors: Hemsath DiAnna
Published: December 2020

As national leaders in infectious disease outbreaks, the University of Nebraska Medical Center (UNMC) and its hospital partner Nebraska Medicine monitored and treated COVID-19 patients, starting with evacuees from Wuhan, China in February 2020. To document UNMC’s institutional response to the COVID-19 pandemic, and future outbreaks or pandemics, UNMC’s McGoogan Health Sciences Library Special Collections and Archives (SCA) Department faculty quickly established an archival collecting strategy to create a broad documentation package with multiple collecting phases. The initial phase included a contemporaneous response for digital collecting, timeline creation, and community collecting, followed by later collecting of personal papers, artifacts, and oral histories from key players who are also front-line workers. The combined collecting approach ensured early digital content preservation, captured public momentum, and provided the structure for longer-term collecting, after time for healing and relationship-building with prospective donors.
Collecting COVID at the California State University: Shared Approaches, Divergent Implementations
Authors: Visintainer Sean D. , Feldman April W. , Kruger Pamela Nett , Livingston Christopher B.
Published: December 2020

COVID-19 is a paradigm-shattering development which will have far-ranging effects, many still unforeseen and unanticipated. Community collecting initiatives provide insight and local-level perspectives to momentous events. Examined with other institutions’ holdings, these collecting initiatives illustrate larger trends and allow for a comparative look at reflections and reactions toward historic happenings like the ongoing pandemic. When the virus first spread, rapid-response collection was at the foremost thoughts of many California State University (CSU) archivists. Thankfully, the CSU’s 23 campuses have a robust community of archival practice, called the CSU Archives and Archivists Roundtable (CSUAAR). CSU archivists engaged each other promptly by conversing, collaborating, supporting, and sharing. We will discuss the community of practice at the CSU, highlight how the CSUAAR facilitated projects and developed some shared approaches to collecting efforts, and illustrate three different rapid-response collecting projects developed at the university level (CSU Bakersfield, CSU Northridge, and CSU San Marcos).
Design Thinking for Challenges and Change in K–12 and Teacher Education
Authors: Parker Michele , Cruz Laura , Gachago Daniela , Morkel Jolanda
Published: December 2020

Common to all the cases included in this special issue, we observed a degree of collaborative decision-making that is human-centered and shows empathy. Through it, multiple voices are acknowledged and heard. These cases demonstrate the beginning of a process of contextualization of Design Thinking in K–12 and teacher education. We hope that this special issue will prompt conversations to explore and critique the possibilities and imagine the real change that it might bring.
Minimally Invasive Aortic Valve Surgery in Octogenarians: Reliable Option or Fallback Solution?
Authors: Cammertoni Federico , Bruno Piergiorgio , Rosenhek Raphael , Pavone Natalia , Farina Piero , Mazza Andrea , Iafrancesco Mauro , Nesta Marialisa , Chiariello Giovanni A. , Comerci Gianluca , Pasquini Annalisa , Cavaliere Franco , Guarneri Sergio , Marzetti Emanuele , Rabini Alessia , Piarulli Alessandra , Sanesi Valerio , D’Errico Denise , Massetti Massimo
Published: December 2020

Objective

Aortic valve disease is more and more common in western countries. While percutaneous approaches should be preferred in older adults, previous reports have shown good outcomes after surgery. Moreover, advantages of minimally invasive approaches may be valuable for octogenarians. We sought to compare outcomes of conventional aortic valve replacement (CAVR) versus minimally invasive aortic valve replacement (MIAVR) in octogenarians.

Methods

We retrospectively collected data of 75 consecutive octogenarians who underwent primary, elective, isolated aortic valve surgery through conventional approach (41 patients, group CAVR) or partial upper sternotomy (34 patients, group MIAVR).

Results

Mean age was 81.9 ± 0.9 and 82.3 ± 1.1 years in CAVR and MIAVR patients, respectively ( P = 0.09). MIAVR patients had lower 24-hour chest drain output (353.4 ± 207.1 vs 501.7 ± 229.9 mL, P < 0.01), shorter mechanical ventilation (9.6 ± 2.4 vs 11.3 ± 2.3 hours, P < 0.01), lower need for blood transfusions (35.3% vs 63.4%, P = 0.02), and shorter hospital stay (6.8 ± 1.6 vs 8.3 ± 4.3 days, P < 0.01). Thirty-day mortality was zero in both groups. Survival at 1, 3, and 5 years was 89.9%, 80%, and 47%, respectively, in the CAVR group, and 93.2%, 82.4%, and 61.8% in the MIAVR group, with no statistically significant differences (log-rank test, P = 0.35).

Conclusions

Aortic valve surgery in older patients provided excellent results, as long as appropriate candidates were selected. MIAVR was associated with shorter mechanical ventilation, reduced blood transfusions, and reduced hospitalization length, without affecting perioperative complications or mid-term survival.
Barriers to Upper Extremity Reconstruction for Patients With Cerebral Palsy
Authors: Loewenstein Scott N. , Angulo-Parker Francisco , Timsina Lava , Adkinson Joshua
Published: December 2020

Background

Reconstructive surgery for upper extremity manifestations of cerebral palsy (CP) has been demonstrated to be safe and effective, yet many potential candidates are never evaluated for surgery. The purpose of this study was to determine barriers to upper extremity reconstruction for patients with CP in a cohort of upper extremity surgeons and nonsurgeons.

Methods

We sent a questionnaire to 4167 surgeons and nonsurgeon physicians, aggregated responses, and analyzed for differences in perceptions regarding surgical efficacy, patient candidacy for surgery, compliance with rehabilitation, remuneration, complexity of care, and physician comfort providing care.

Results

Surgeons and nonsurgeons did not agree on the literature support of surgical efficacy (73% vs 35% agree or strongly agree, respectively). Both surgeons and nonsurgeons felt that many potential candidates exist, yet there was variability in their confidence in identifying them. Most surgeons (59%) and nonsurgeons (61%) felt comfortable performing surgery and directing the associated rehabilitation, respectively. Neither group reported that patient compliance, access to rehabilitation services, and available financial resources were a major barrier, but surgeons were more likely than nonsurgeons to feel that remuneration for services was inadequate (37% vs 13%). Both groups agreed that surgical treatments are complex and should be performed in the setting of a multidisciplinary team.

Conclusions

Surgeons and nonsurgeons differ in their views regarding upper extremity reconstructive surgery for CP. Barriers to reconstruction may be addressed by performing higher level research, implementing multispecialty educational outreach, developing objective referral criteria, increasing surgical remuneration, improving access to trained upper extremity surgeons, and implementing multidisciplinary CP clinics.
Effectiveness of Convalescent Plasma Therapy for COVID-19 Patients in Hunan, China
Authors: Hu Xingsheng , Hu Chunhong , Jiang Dixuan , Zuo Qian , Li Ya , Wang Yang , Chen Xiangyu
Published: December 2020

Objective:

To investigate clinical efficacy and safety of convalescent plasma (CP) therapy in coronavirus disease 2019 (COVID-19) patients.

Methods:

We included 4 severe patients and 3 critical patients. The date of admission to hospital ranged from January 30 to February 19, 2020. We retrospectively collected clinical and outcome data. Relative parameters were compared.

Results:

After CP therapy, the symptoms and respiratory functions were improved. Median PaO2/FIO2 increased from 254 (142-331) to 326 (163–364), and dependence of oxygen supply decreased. Median time to lesion’s first absorption was 5 (2–7) days, undetectable viral RNA was 11 (3.5–15.7) days. Median lymphocyte count (0.77 × 109/L vs 0.85 × 109/L) and albumin level (31g/L vs 36 g/L) were elevated, C-reactive protein (44 mg/L vs 18 mg/L), D-dimer (5.9 mg/L vs 4 mg/L) and lactate dehydrogenase (263 U/L vs 245 U/L) decreased. No obvious adverse reactions were observed. At the follow-up on June 14, 2020, 6 patients had completely recovered and one died from terminal disease.

Conclusion:

CP therapy for COVID-19 was effective and safe. Three patients who did not combine with antiviral therapy after CP also obtained viral clearance and clinical improvement. However, CP therapy failed to save the life of a terminally ill patient.
A nonlinear Wiener degradation model integrating degradation data under accelerated stresses and real operating environment
Authors: Sun Li , Zhao Fangchao , Balakrishnan Narayanaswamy , Zhou Honggen , Gu Xiaohui
Published: December 2020

Remaining useful life (RUL) prediction in real operating environment (ROE) plays an important role in condition-based maintenance. However, the life information in ROE is limited, especially for some long-life products. In such cases, accelerated degradation test (ADT) is an effective method to collect data and then the accelerated degradation data are converted to normal level of accelerated stresses through acceleration factors. However, the stresses in ROE are different from normal stresses since there are some other stresses except normal stresses, which cannot be accelerated, but still have impact on the degradation. To predict the RUL in ROE, a nonlinear Wiener degradation model is proposed based on failure mechanism invariant principle which is the precondition and requirement of an ADT and a calibration factor is introduced to calibrate the difference between ROE and normal stresses. Moreover, the unit-to-unit variability is considered in the concern model. Based upon the proposed approach, the RUL distribution is derived in closed form. The unknown parameters in the model are obtained by a new two-step method through fuzing converted degradation data in normal stresses and degradation data in ROE. Finally, the validity of the proposed model is demonstrated through several simulation data and a case study.
Are They All the Same? The Distribution of Personal Wealth Between the Left and the Right in Latin America
Authors: Lazreg Nordin , Angel Alejandro , Saint-Martin Denis
Published: December 2020

Conventional wisdom indicates that politicians in Latin America are all wealthy. However, the literature on both political elites and social origins of political parties indicates that we should expect differences in the capital accumulation of politicians depending on their ideological position. This study seeks to explore that question using financial disclosure forms made available in six Latin American countries: Argentina, Bolivia, Brazil, Chile, Peru, and the Dominican Republic. We calculate the median wealth of the main political parties in each country and compared them according to their ideological position on the left–right continuum. We consistently find that the most right-leaning party in each country had a higher median wealth than the most left-leaning one. This relation is non-linear since centrist parties often represent anomalies in the distribution of wealth. When there are no ideological differences, we do not observe significant wealth differences either.
American Society of ExtraCorporeal Technology: Development of Standards and Guidelines for Pediatric and Congenital Perfusion Practice (2019)
Authors: Oldeen Molly Elisabeth , Angona Ronald E. , Hodge Ashley , Klein Tom
Published: December 2020

The development of standards and guidelines by professional societies offers clinicians guidance toward providing evidence-based care. The ultimate goals of standards and guidelines are to standardize care and improve patient safety and outcomes while also minimizing risk. The American Society of ExtraCorporeal Technology (AmSECT) currently offers perfusionists several clinical resources, primarily the Standards and Guidelines for Perfusion Practice; however, no document exists specific to pediatric perfusion. Historically, the development of a pediatric-specific document has been limited by available scientific evidence due to smaller patient populations, sample sizes, and variable techniques among congenital perfusionists. In the current setting of evolving clinical practices and increasingly complex cardiac operations, a subcommittee of pediatric perfusionists developed the Standards and Guidelines for Pediatric and Congenital Perfusion Practice. The development process included a comprehensive literature review for supporting evidence to justify new recommendations or updates to the existing AmSECT Adult Standards and Guidelines document. Multiple revisions incorporating feedback from the community led to a finalized document accepted by the AmSECT membership and made available electronically in May 2019. The Standards and Guidelines for Pediatric and Congenital Perfusion Practice is an essential tool for pediatric perfusionists and serves as the backbone for institutionally based protocols, promotes improved decision-making, and identifies opportunities for future research and collaboration with other disciplines. The purpose of this manuscript is to summarize the process of development, the content, and recommended utilization of AmSECT’s Standards and Guidelines for Pediatric and Congenital Perfusion Practice.
Use of Quality-Adjusted Tooth Years as an Outcome Measure of Periodontal Treatment: A Quasi Experimental Study
Authors: Mohd-Dom Tuti Ningseh , Puteh Sharifa Ezat Wan , Ayob Rasidah , Tennant Marc , Aljunid Syed Mohamed
Published: December 2020

Aim:

To develop a simple approach to estimate quality-adjusted tooth years of teeth (QATY) treated for periodontitis and determine gains in QATY after undergoing cause-related periodontal therapy (CRPT). Quality-adjusted life years (QALY) gained for these patients were also determined.

Materials and Methods:

Patients newly diagnosed with periodontitis ( n = 165, 58.8% females, mean age 43.3 years) were recruited from periodontal specialist clinics. They received CRPT within a period of one year. We used the EuroQoL 5 Dimension (EQ-5D) and the Malaysian Oral Health Impact Profile (OHIP-14) indexes to measure changes in quality-of-life after one year of periodontal treatment. We then used these two scores to calculate their respective utilities and subsequently calculated QALY and QATY.

Results:

Proportions of deep periodontal sites (≥ 4 mm) decreased from 32.7% to 23.2% and patients gained an average of 0.3 mm of clinical attachment level per tooth at post-treatment follow-up. Improvements in means of OHIP-14 scores from 20.30 to 12.7 were consistent with changes in EQ-5D utilities from 0.81 to 0.91. Treated teeth gained 20.4 years for longevity while patients gained 17 QATYs. This is in line with the increase of 3.8 QALYs. Both treatment outcomes and clinical parameters were statistically significant at P < .0001.

Conclusions:

The method of estimating QATY using utilities derived from OHIP-14 combined with tooth life expectancy demonstrated that it may be used to measure effective treatment outcomes and is found to be consistent with improvements in QALY scores as calculated using EQ-5D-3L.
Tribal Land Rights: A Situational Analysis in the Context of West Bengal
Authors: Biswas Sudipta , Pal Sukumar
Published: December 2020

Tribal communities in India are most deprived. Socio-economically, they are poor and marginalised. The root cause of socio-economic marginalisation can be attributed to alienation of tribal people from their land, territory and resources. The overall situation of the tribal population of West Bengal is not better than the national average, even more deprived than the tribal population of other states. Despite progressive land reform laws and political commitment to implement such laws, issues of tribal land rights have not been addressed adequately. There is no such exclusive study to understand the situation of tribal land rights in the state of West Bengal. This article analyses the status of tribal land rights in the state context and makes some suggestions for improving the situation. It is found that despite distribution of land titles, a large section of the tribal population remains landless. A sizable portion has not received received record-of-rights. Claims of many tribal people for forest patta remain pending or stand rejected. Tribal land alienation continues to be a matter of concern. The state has not taken any concrete steps for the restoration of unlawfully alienated tribal lands. A large section of the tribal sharecroppers in the state remain unrecorded.
Return-to-Play Guidelines After Patellar Instability Surgery Requiring Bony Realignment: A Systematic Review
Authors: Chatterji Rishi , White Alex E. , Hadley Christopher J. , Cohen Steven B. , Freedman Kevin B. , Dodson Christopher C.
Published: December 2020

Background:

Recurrent patellar instability can be treated nonoperatively or surgically, and surgical management may vary based on the causative pathology in the structures surrounding the patella. Although isolated soft tissue reconstruction is among the most common operative treatments, certain patient populations require bony realignment for adequate stabilization.

Purpose:

To evaluate postoperative guidelines, including return to play and rehabilitation, after bony procedures involving the tibial tubercle for patellar instability.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review on return-to-play guidelines was conducted with studies published from 1997 to 2019 that detailed procedures involving bony realignment by tibial tubercle osteotomies and tibial tubercle transfers with or without soft tissue reconstruction. Exclusion criteria included animal or cadaveric studies, basic science articles, nonsurgical rehabilitation protocols, and patients with mean age <18 years. Studies were assessed for return-to-play criteria, rehabilitation protocols, and bias.

Results:

Included in the review were 39 studies with a total of 1477 patients and 1598 knees. Mean patient age ranged from 17.5 to 34.0 years, and mean follow-up ranged from 23 to 161 months. All 39 studies described postoperative rehabilitation; however, only 16 studies specifically outlined return-to-play criteria. The most commonly cited return-to-play criterion was quadriceps strength (62.5%). Range of motion (50.0%), physical therapy protocols (18.8%), and radiographic evidence of healing (18.8%) were other cited objective criteria for return-to-play. Four of 16 (25.0%) studies described subjective criteria for return to play, including pain, swelling, and patient comfort and confidence. Of the 11 studies that described a timeline for return to play, the range was between 2 and 6 months.

Conclusion:

The results revealed that 100% of papers evaluated lacked adequate return-to-play guidelines. Moreover, timelines significantly varied among studies. More clearly defined return-to-play guidelines after tibial tubercle transfer for patellar instability are required.
Assessment and Trends in the Methodological Quality of the Top 50 Most Cited Articles in Shoulder Instability
Authors: Agarwalla Avinesh , Yao Kaisen , Gowd Anirudh K. , Amin Nirav H. , Leland J. Martin , Romeo Anthony A. , Liu Joseph N.
Published: December 2020

Background:

Citation counts have often been used as a surrogate for the scholarly impact of a particular study, but they do not necessarily correlate with higher-quality investigations. In recent decades, much of the literature regarding shoulder instability is focused on surgical techniques to correct bone loss and prevent recurrence.

Purpose:

To determine (1) the top 50 most cited articles in shoulder instability and (2) if there is a correlation between the number of citations and level of evidence or methodological quality.

Study Design:

Cross-sectional study.

Methods:

A literature search was performed on both the Scopus and the Web of Science databases to determine the top 50 most cited articles in shoulder instability between 1985 and 2019. The search terms used included “shoulder instability,” “humeral defect,” and “glenoid bone loss.” Methodological scores were calculated using the Modified Coleman Methodology Score (MCMS), Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS) score.

Results:

The mean number of citations and mean citation density were 222.7 ± 123.5 (range, 124-881.5) and 16.0 ± 7.9 (range, 6.9-49.0), respectively. The most common type of study represented was the retrospective case series (evidence level, 4; n = 16; 32%) The overall mean MCMS, Jadad score, and MINORS score were 61.1 ± 10.1, 1.4 ± 0.9, and 16.0 ± 3.0, respectively. There were also no correlations found between mean citations or citation density versus each of the methodological quality scores.

Conclusion:

The list of top 50 most cited articles in shoulder instability comprised studies with low-level evidence and low methodological quality. Higher-quality study methodology does not appear to be a significant factor in whether studies are frequently cited in the literature.
Stride-Phase Kinematic Parameters That Predict Peak Elbow Varus Torque
Authors: Tanaka Hiroshi , Hayashi Toyohiko , Inui Hiroaki , Muto Tomoyuki , Tsuchiyama Kohnan , Ninomiya Hiroki , Nakamura Yasuo , Kobashi Syoji , Nobuhara Katsuya
Published: December 2020

Background:

During baseball pitching, a high amount of elbow varus torque in the arm cocking-to-acceleration phase is thought to be a biomechanical risk factor for medial elbow pain and injury. The biomechanics of the stride phase may provide preparation for the arm cocking-to-acceleration phase that follows it.

Purpose:

To determine the kinematic parameters that predict peak elbow varus torque during the stride phase of pitching.

Study Design:

Descriptive laboratory study.

Methods:

Participants were 107 high school baseball pitchers (age range, 15-18 years) without shoulder or elbow problems. Whole-body kinematics and kinetics during fastball pitching were analyzed using 3-dimensional measurements from 36 retroreflective markers. A total of 26 kinematic parameters of the upper and lower limbs during the stride phase leading up to the stride foot contact were extracted for multiple regression analysis to assess their combined effect on the magnitude of peak elbow varus torque.

Results:

Increased wrist extension, elbow pronation, knee flexion on the leading leg, knee extension on the trailing leg at stride foot contact, and upward displacement of the body’s center of mass in the stride phase were significantly correlated with decreased peak elbow varus torque (all P < .05). Moreover, 38% of the variance in peak elbow varus torque was explained by a combination of these 5 significant kinematic variables ( P < .001).

Conclusion:

We found that 5 kinematic parameters during the stride phase and the combination of these parameters were associated with peak elbow varus torque. The stride phase provides biomechanical preparation for pitching and plays a key role in peak elbow varus torque in subsequent pitching phases.

Clinical Relevance:

The present data can be used to screen pitching mechanics with motion capture assessment to reduce peak elbow varus torque. Decreased peak elbow varus torque is expected to reduce the risk of elbow medial pain and injury.
Co-creating Simulated Cultural Communication Scenarios with Indigenous Animators: An Evaluation of Innovative Clinical Cultural Safety Curriculum
Authors: Maar Marion , Bessette Nicole , McGregor Lorrilee , Lovelace Amy , Reade Maurianne
Published: December 2020

Background:

Building on partnerships with Indigenous communities and with the support of the Northern Ontario School of Medicine, faculty created groundbreaking, authentic cultural immersion curriculum designed to foster culturally safe interpersonal skills and cultural understanding. However, structural barriers to the teaching of clinical communication skills for culturally safe care to Indigenous patients persisted. To address this challenge, faculty collaborated with Indigenous animators on the co-creation of a new teaching modality of Simulated Cultural Communication Scenarios. We evaluated student learning experience, the faculty teaching experience, the attainment of teaching goals, benefits, and areas for improvement for this approach.

Methods:

We piloted 9 Simulated Cultural Communication Scenarios with 64 medical students and 17 tutors. We collected quantitative and qualitative data regarding their experiences and perceptions of the new curriculum. The quantitative data was statistically summarized, and the qualitative data was coded and thematically analyzed.

Results:

The emergent themes indicate that co-created Simulated Cultural Communication Scenarios support the acquisition of culturally safe clinical skills because the modality fosters authentic, safe, context rich, and anti-oppressive patient dialogue with Indigenous animators. Recommendations for optimizing the sessions included ensuring tutors have a deep understanding of the significance of cultural safety in patient care. As the pedagogy is different from the familiar standardized clinical skills sessions, tutors and students benefit from education on the pedagogical approach.

Conclusion:

Simulated Cultural Communication Scenarios, co-created with cultural insiders and academic educators, represent an authentic education approach to teaching culturally safe clinical encounters. The findings contribute to our understanding of translating social accountability into the clinical setting.
The Political Possibilities of an Administrative Boundary: How the Transforming M-Ward Project ‘Constructed’ the Ward
Authors: Bhide Amita
Published: December 2020

This article reflects on the significance of an administrative boundary in producing distinctive forms of political assertion. It shows how acts of highlighting the ward boundaries of a marginal suburban ward in Mumbai illuminated an important scale of discriminatory spatial governance and also helped its residents organise and articulate a new politics of infrastructural need at a significant planning scale.
Brolucizumab-Associated Intraocular Inflammation in Eyes Without Retinal Vasculitis
Authors: Witkin Andre J. , Hahn Paul , Murray Timothy G. , Arevalo J. Fernando , Blinder Kevin J. , Choudhry Netan , Emerson Geoff G. , Goldberg Roger A. , Kim Stephen J. , Pearlman Joel , Schneider Eric W. , Tabandeh Homayoun , Wong Robert W. ,   for the Research and Safety in Therapeutics Committee, American Society of Retina Specialists
Published: December 2020

Purpose:

This work analyzes a series of eyes with brolucizumab-associated intraocular inflammation (IOI) without retinal vasculitis reported to the American Society of Retina Specialists.

Methods:

The American Society of Retina Specialists Research and Safety in Therapeutics Committee analyzed clinical characteristics from submitted reports of IOI after brolucizumab. Eyes with retinal vasculitis or that received intraocular antibiotics were excluded.

Results:

Forty-nine eyes of 45 patients were collected. Mean visual acuity (VA) at baseline was 20/49 (range, 20/20-5/200). Patients presented with IOI a mean of 24 days (range, 3-63 days) after their most recent brolucizumab injection; 61% presented for an unscheduled visit while 39% presented at routine follow-up. Mean VA at IOI presentation was 20/67 (range, 20/20-3/200). The most common symptoms were floaters (78%) and blurry vision (76%). Pain (20%) and redness (16%) were less common; 3 (6%) eyes were asymptomatic. IOI was anterior only in 18%, posterior only in 31%, and both anterior and posterior in 51% of eyes. Treatment included topical steroids alone in 67% of eyes, whereas 10% of eyes received no treatment. Mean VA at last follow-up was 20/56 (range, 20/20-1/200). Three (6%) eyes lost 3 or more lines and 1 (2%) eye lost 6 or more lines.

Conclusions:

Brolucizumab-associated IOI without retinal vasculitis typically presented with a delayed onset of a few weeks. Often, VA decline was relatively mild. Most symptoms resolved and nearly all had a return-to-baseline VA, but a small percentage of patients had a significant decrease in VA at last follow-up.
Agile, Traditional, and Hybrid Approaches to Project Success: Is Hybrid a Poor Second Choice?
Authors: Gemino Andrew , Horner Reich Blaize , Serrador Pedro M.
Published: December 2020

Three project management approaches—traditional, agile, and hybrid—were considered in this study. Results from an international study, including 477 cross-industry projects, indicated that 52% of projects could be categorized as hybrid approaches. A regression analysis using multiple outcome measures indicated substantial explanatory power (0.21 < R 2 <0.41). Analysis suggested that hybrid and agile approaches significantly increase stakeholder success over traditional approaches while achieving the same budget, time, scope, and quality outcomes. Hybrid approaches were found to be similar in effectiveness to fully agile approaches. Results validate decisions by practitioners to combine agile and traditional practices and suggest that hybrid is a leading project management approach.
Unusual onset of thyroid associated orbitopathy during pregnancy: case report and review of literature
Authors: Aranyosi Janos K. , Deli Tamas , Erdei Annamaria , Toth Geza , Jakab Attila , Fodor Mariann , Nagy Endre V. , Ujhelyi Bernadett
Published: December 2020

Background

Thyroid associated orbitopathy (TAO) is the most common extrathyroidal complication of Graves’ disease. The disease course ranges from mild, where symptomatic therapy is sufficient, to severe, where high dose steroid administration or orbital decompression surgery is required. Women of their reproductive age are more likely to be affected. Although pregnancy is a state of enhanced immune tolerance, TAO may develop or worsen in 0.2–0.4% of pregnant women.

Case presentation

We present the case of a 19-year-old woman who has developed hyperthyroidism and progressive TAO during the second trimester of her third pregnancy, which has improved postpartum. The possible mechanisms and the importance of follow up in pregnancy is discussed.

Conclusions

Expectant mothers with Graves’ disease require follow up of eye signs throughout pregnancy, preferably in the setting of a thyroid-eye clinic.
Friend of a Friend with Benefits ontology (FOAF+): extending a social network ontology for public health
Authors: Amith Muhammad , Fujimoto Kayo , Mauldin Rebecca , Tao Cui
Published: December 2020

Background

Dyadic-based social networks analyses have been effective in a variety of behavioral- and health-related research areas. We introduce an ontology-driven approach towards social network analysis through encoding social data and inferring new information from the data.

Methods

The Friend of a Friend (FOAF) ontology is a lightweight social network ontology. We enriched FOAF by deriving social interaction data and relationships from social data to extend its domain scope.

Results

Our effort produced Friend of a Friend with Benefits (FOAF+) ontology that aims to support the spectrum of human interaction. A preliminary semiotic evaluation revealed a semantically rich and comprehensive knowledge base to represent complex social network relationships. With Semantic Web Rules Language, we demonstrated FOAF+ potential to infer social network ties between individual data.

Conclusion

Using logical rules, we defined interpersonal dyadic social connections, which can create inferred linked dyadic social representations of individuals, represent complex behavioral information, help machines interpret some of the concepts and relationships involving human interaction, query network data, and contribute methods for analytical and disease surveillance.
Automated segmentation and diagnosis of pneumothorax on chest X-rays with fully convolutional multi-scale ScSE-DenseNet: a retrospective study
Authors: Wang Qingfeng , Liu Qiyu , Luo Guoting , Liu Zhiqin , Huang Jun , Zhou Yuwei , Zhou Ying , Xu Weiyun , Cheng Jie-Zhi
Published: December 2020

Background

Pneumothorax (PTX) may cause a life-threatening medical emergency with cardio-respiratory collapse that requires immediate intervention and rapid treatment. The screening and diagnosis of pneumothorax usually rely on chest radiographs. However, the pneumothoraces in chest X-rays may be very subtle with highly variable in shape and overlapped with the ribs or clavicles, which are often difficult to identify. Our objective was to create a large chest X-ray dataset for pneumothorax with pixel-level annotation and to train an automatic segmentation and diagnosis framework to assist radiologists to identify pneumothorax accurately and timely.

Methods

In this study, an end-to-end deep learning framework is proposed for the segmentation and diagnosis of pneumothorax on chest X-rays, which incorporates a fully convolutional DenseNet (FC-DenseNet) with multi-scale module and spatial and channel squeezes and excitation (scSE) modules. To further improve the precision of boundary segmentation, we propose a spatial weighted cross-entropy loss function to penalize the target, background and contour pixels with different weights.

Results

This retrospective study are conducted on a total of eligible 11,051 front-view chest X-ray images (5566 cases of PTX and 5485 cases of Non-PTX). The experimental results show that the proposed algorithm outperforms the five state-of-the-art segmentation algorithms in terms of mean pixel-wise accuracy (MPA) with $$0.93\pm 0.13$$

0.93
±
0.13

and dice similarity coefficient (DSC) with $$0.92\pm 0.14$$

0.92
±
0.14

, and achieves competitive performance on diagnostic accuracy with 93.45% and $$F_1$$

F
1

-score with 92.97%.

Conclusion

This framework provides substantial improvements for the automatic segmentation and diagnosis of pneumothorax and is expected to become a clinical application tool to help radiologists to identify pneumothorax on chest X-rays.