bluuebunny/crossref_metadata_2025 huggingface dataset:
Seismic risk prioritization of a large portfolio of dams: Revisited
Authors: Hariri-Ardebili Mohammad Amin , Nuss Larry K
Published: September 2018

The development of potential failure mode analysis and risk analysis has greatly improved the state-of-practice for the safety of dams. Risk analysis are well developed in many industries (such as building design, medicine, and insurance) and has greatly advanced in the dams industry over the last 40 years. Engineers and scientists are now deeply investigating and thinking about failure mechanisms associated with operating dams and the probabilities of dam failures. As such, the condition of dams and the risks associated with their operation are now being portrayed better than ever before to dam safety officials and decision-makers. Accurate and adequate risk analyses for a portfolio of dams is extremely important in today’s environment to manage limited budgets and potentially save (or redirect) expensive rehabilitations to identified and critical needs. The goal is to reduce risks of a portfolio of dams in an efficient and cost-effective manner. This article provides a review on risk-based dam terminology and bridging the semi-quantitative and numerical simulation. Moreover, a review of the current state-of-practice for prioritizing a large portfolio of dams subjected to seismic loadings and potential risks is provided. As a potential application, the seismic risk of the 18 dams (which have been experienced relatively large earthquakes) all over the world is evaluated. The semi-quantitative approach is contrasted with finite element model for one of the selected dams.
Experimental study of tribological and mechanical properties of TiN coating on AISI 52100 bearing steel
Authors: Uddin Ghulam Moeen , Khan Awais Ahmad , Ghufran Muhammad , Tahir Zia-ur-Rehman , Asim Muhammad , Sagheer Muhammad , Jawad Muhammad , Ahmad Jawad , Irfan Muhammad , Waseem Bilal
Published: September 2018

The surface coating is one of the novel approaches to enhance the performance and durability of the mechanical components by decreasing the wear and friction among two interacting bodies. In this study, tribological and mechanical properties of titanium nitride (TiN) coatings were investigated on the AISI 52100 bearing steel deposited by low-temperature physical vapor deposition system. Surface morphology and elemental composition of the TiN coating were analyzed by scanning electron microscope and energy-dispersive X-ray spectrum, respectively. Substrate surface roughness and coating thickness of TiN were varied for correlative analysis among adhesion, mechanical, and tribological properties. Scratch and tribo tests were performed for evaluating the adhesion and tribological properties, respectively. Samples having the substrate surface roughness (0.2 ± 0.05 µm) and the coating thickness of more than 2.83 µm presented relatively better adhesion, wear resistance, and lower coefficient of friction of the TiN coating.
Lane-change prediction method for adaptive cruise control system with hidden Markov model
Authors: Yuan Wei , Li Zhen , Wang Chang
Published: September 2018

A test platform with a millimeter-wave radar sensor, lane-line sensor, gyroscope, and controller area network was established to improve safety in using adaptive cruise control systems in vehicles. The motion-state characterization data of the host vehicle and surrounding vehicles in a real traffic environment were captured. The prediction method for the lane-changing maneuver of the vehicle ahead was developed using a hidden Markov model based on the distance between the host vehicle and the front vehicle, as well as the lateral and longitudinal velocities of the vehicle in front. The adaptive cruise control system control algorithm for assessing the target vehicle was optimized. The model was tested, and its predictions were compared with measured data. Result shows that the lane-changing and lane-keeping behaviors of the vehicle ahead can be predicted efficiently and accurately by the model. The maximum prediction accuracy rate for straight roads was 97% with the time window length of 4.5 s, whereas that for curved roads was 96% with the time window length of 3.5 s.
Is Thermal Imaging a Useful Predictor of the Healing Status of Diabetes-Related Foot Ulcers? A Pilot Study
Authors: Aliahmad Behzad , Tint Aye Nyein , Poosapadi Arjunan Sridhar , Rani Priya , Kumar Dinesh Kant , Miller Julie , Zajac Jeffrey D. , Wang Gayathiri , Ekinci Elif Ilhan
Published: September 2018

Introduction:

In clinical practice, both area and temperature of the ulcer have been shown to be effective in tracking the healing status of diabetes-related foot ulcer (DRFU). However, traditionally, the area of the DRFU is measured regardless of the temperature distribution. The current prospective, observational study used thermal imaging, as a more accurate tool, to measure both the area and the temperature of DRFU. We aimed to predict healing of DRFU using thermal imaging within the first 4 weeks of ulceration.

Method:

A pilot study was conducted where thermal and color images of 26 neuropathic DRFUs (11 healing vs 15 nonhealing) from individuals with type 1 or 2 diabetes were taken at the initial clinic visit (baseline), at week 2, and at week 4. The thermal images were segmented into isothermal patches to identify the wound boundary and area corresponding to temperature distribution. Five parameters were obtained: temperature of the wound bed, area of the isothermal patch of the wound bed, area of isothermal patch of periwound, number of isolated isothermal patches of the wound region, and physical wound bed area from color image. The ulcers were also measured by experienced podiatrists over 4 consecutive weeks and used as the healing reference.

Results:

For healing cases, the ratio of the area of the wound bed to its baseline measured using thermal images was found to be significantly lower at 2 weeks compared to nonhealing cases and this corresponded with a 50% reduction in area of DRFU at 4 weeks (group rank-based nonparametric analysis of variance P = .036). In comparison, neither the planimetric area measured using color images nor the temperature of the wound bed was associated with the healing.

Conclusion:

This study of 26 patients demonstrates that change in the isothermal area of DRFU can predict the healing status at week 4. Thermal imaging of DRFUs has the advantage of incorporating both area and temperature allowing for early prediction of the healing of these ulcers. Further studies with greater sample sizes are required to test the significance of these results.
Considering Blood Dilution improves the Precision of Continuous Whole Blood Glucose Measurements
Authors: Benesch Carsten , Kuhlenkötter Mareike , Heise Tim
Published: September 2018

Background:

One major advantage of automated over manual clamps are continuous measurements of blood glucose concentrations (BG) allowing frequent adaptations in glucose infusion rates (GIR). However, BG measurements might be affected by changes in blood dilution. ClampArt®, a modern automated clamp device, corrects BG measurements for blood dilution, but the impact of this correction is unclear.

Methods:

The authors performed a retrospective analysis of BG during glucose clamps comparing values with a fixed dilution factor with those corrected for the actual blood dilution.

Results:

Clamp quality substantially improved with the consideration of blood dilution: Mean accuracy fell from 8.1% ± 2.9% to 4.1% ± 0.8%, precision improved from 9.6 ± 3.6 mg/dl to 3.7 ± 1.3 mg/dl and control deviation from −2.6 ± 4.2 mg/dl to 0.2 ± 0.2 mg/dl.

Conclusions:

Correcting continuous BG measurements for blood dilution significantly increases BG measurement and clamp quality.
Detection of serrated lesions in proximal colon by simulated sigmoidoscopy vs faecal immunochemical testing in a multicentre, pragmatic, randomised controlled trial
Authors: Carot Laura , Castells Antoni , Hernández Cristina , Alvarez-Urturi Cristina , Balaguer Francesc , Lanas Angel , Cubiella Joaquín , Tasende Jose D , Jover Rodrigo , Hernandez Vicent , Carballo Fernando , Bujanda Luis , Quintero Enrique , Andreu Montserrat , Bessa Xavier ,   ColonPrev study
Published: September 2018

Background

The diagnostic yield of the faecal immunochemical test and sigmoidoscopy in detecting proximal serrated polyps in a colorectal cancer screening programme has not been fully assessed.

Aim

We determined the detection rate of proximal serrated polyps by simulated sigmoidoscopy and faecal immunochemical test compared with total colonoscopy in a population‐based, multicentre, nationwide, randomised controlled trial (ColonPrev study).

Methods

Sigmoidoscopy yield was simulated based on the UK‐Flexible Sigmoidoscopy Trial for total colonoscopy referral. Definitions were: proximal serrated polyp (proximal serrated polyp): sessile serrated polyp or hyperplastic polyp of any size and proximal at‐risk serrated polyp (at‐risk proximal serrated polyp): sessile serrated polyp of any size or hyperplastic polyp ≥ 10 mm, both located proximally to the splenic flexure.

Results

A total of 10,611 individuals underwent faecal immunochemical test and 5059 underwent total colonoscopy and were evaluated by simulated sigmoidoscopy. Sigmoidoscopy and faecal immunochemical test were less accurate in detecting proximal serrated polyps (odds ratio: 0.13; 95% confidence interval: 0.10–0.18 and 0.13; 0.09–0.18, p < 0.0001, respectively). Both tests were inferior to colonoscopy in detecting at‐risk proximal serrated polyps, and sigmoidoscopy was inferior to faecal immunochemical test in detecting these lesions (odds ratio: 0.17; 95% confidence interval: 0.10–0.30 and 0.25; 0.17–0.37, p < 0.0001, respectively).

Conclusion

Sigmoidoscopy and faecal immunochemical test are less accurate in detecting proximal serrated polyps than colonoscopy, particularly in women.
Making comprehensible speeches when your constituents need it
Authors: Lin Nick , Osnabrügge Moritz
Published: September 2018

Parliamentary speech is a prominent avenue that political elites can use in parliament to communicate with the electorate. However, we have little understanding of how exactly Members of Parliament craft their speeches to communicate with the districts they represent. We expect that Members of Parliament adapt the comprehensibility of their speeches to their constituents’ linguistic skills since doing so facilitates effective communication. Using parliamentary speeches from the German Bundestag, we reveal that Members of Parliament tend to make their speeches less complicated when their constituents are relatively poor, less educated, and come from an immigration background. Our findings have important implications for the study of political representation and communication strategies.
Serious Mental Illness, Neighborhood Disadvantage, and Type 2 Diabetes Risk: A Systematic Review of the Literature
Authors: Walsan Ramya , Bonney Andrew , Mayne Darren J , Pai Nagesh , Feng Xiaoqi , Toms Renin
Published: September 2018

Aim of the Study: This review aims to systematically synthesize the body of literature examining the association between neighborhood socioeconomic disadvantage and serious mental illness (SMI)–type 2 diabetes (T2D) co-occurrence. Methods: We conducted an electronic search of four databases: PubMed, Scopus, Medline, and Web of Science. Studies were considered eligible if they were published in English, peer reviewed, quantitative, and focused on the association between neighborhood disadvantage and SMI-T2D comorbidity. Study conduct and reporting complied with PRISMA guidelines, and the protocol is made available at PROSPERO (CRD42017083483). Results: The one eligible study identified reported a higher burden of T2D in persons with SMI but provided only a tentative support for the association between neighborhood disadvantage and SMI-T2D co-occurrence. Conclusion: Research into neighborhood effects on SMI-T2D comorbidity is still in its infancy and the available evidence inconclusive. This points to an urgent need for attention to the knowledge gap in this important area of public health. Further research is needed to understand the health resource implications of the association between neighborhood deprivation and SMI-T2D comorbidity and the casual pathways linking them.
Welcome to the Machine: A Model of Legislator Personality and Communications Technology Adoption
Authors: Hollibaugh Gary E. , Ramey Adam J. , Klingler Jonathan D.
Published: September 2018

Political scientists have long considered ideology, partisanship, and constituency in determining how members of the United States Congress make decisions. Meanwhile, psychologists have held that personality traits play central roles in decision making. Here, we bridge these literatures by offering a framework for modeling how personality influences legislative behavior. Drawing from experimental economics and neuropsychology, we identify core cognitive constraints for the “Big Five” personality model, parameterizing them in ways useful for crafting formal models of legislative behavior. We then show one example of the applicability of this framework by creating a formal decision-theoretic model of constituency communication. We show that when there exists uncertainty over the true state of the world, personality traits have more influence on individual decisions.
Is restricted hip movement a risk factor for anterior cruciate ligament injury?
Authors: Nakano Naoki , Bartlett Jonathan , Khanduja Vikas
Published: September 2018

Restricted hip movement along with femoroacetabular impingement (FAI) has been reported to be an important risk factor in anterior cruciate ligament (ACL) injury. We performed a literature review assessing the evidence that FAI, or restricted hip movement, contributes to the likelihood of sustaining an ACL injury to provide an evidence-based and comprehensive update on the relationship between these pathologies. Studies were divided into three categories: clinical studies, radiological studies and cadaveric studies. Clinical studies primarily assessed the limitations to hip movement in patients with ACL injury, and numerous studies of this kind have demonstrated a relationship between restricted movement and ACL injury. Radiological studies have been able to demonstrate a higher number of bony hip abnormalities in patients with ACL injury. However, due to variable results within these studies, it is unclear which kinds of bony abnormality are specifically associated with an increased risk of ACL injury. Cadaveric studies have demonstrated that peak ACL relative strain was inversely related to the range of internal rotation of the femur, thus providing a potential mechanism for this relationship. In conclusion, clinical and radiological studies have established a correlation between restricted hip and ACL injury, but have been unable to demonstrate an increased risk of future ACL injury in individuals with restricted hip movement. Future prospective cohort studies are necessary to confirm this. Additionally, these findings highlight the need for a thorough clinical assessment of the hip when assessing patients with an ACL injury.
What Does the Public Want? Structural Consideration of Citizen Preferences in Health Care Coverage Decisions
Authors: Cleemput Irina , Devriese Stephan , Kohn Laurence , Devos Carl , van Til Janine , Groothuis-Oudshoorn Catharina G. M. , van de Voorde Carine
Published: September 2018

Background. Multi-criteria decision analysis can improve the legitimacy of health care reimbursement decisions by taking societal preferences into account when weighting decision criteria. This study measures the relative importance of health care coverage criteria according to the Belgian general public and policy makers. Criteria are structured into three domains: therapeutic need, societal need, and new treatments’ added value. Methods. A sample of 4,288 citizens and 161 policy makers performed a discrete choice experiment. Data were analyzed using multinomial logistic regression analysis. Level-independent criteria weights were determined using the log-likelihood method. Results. Both the general public and policy makers gave the highest weight to quality of life in the appraisal of therapeutic need (0.43 and 0.53, respectively). The general public judged life expectancy (0.14) as less important than inconvenience of current treatment (0.43), unlike decision makers (0.32 and 0.15). The general public gave more weight to “impact of a disease on public expenditures” (0.65) than to “prevalence of the disease” (0.56) when appraising societal need, whereas decision makers’ weights were 0.44 and 0.56, respectively. When appraising added value, the general public gave similar weights to “impact on quality of life” and “impact on prevalence” (0.37 and 0.36), whereas decision makers judged “impact on quality of life” (0.39) more important than “impact on prevalence” (0.29). Both gave the lowest weight to impact on life expectancy (0.14 and 0.21). Limitations. Comparisons between the general public and policy makers should be treated with caution because the policy makers’ sample size was small. Conclusion. Societal preferences can be measured and used as decision criteria weights in multi-criteria decision analysis. This cannot replace deliberation but can improve the transparency of health care coverage decision processes.
Using Assistive Technology to Generate Social Skills Use for Students With Emotional Behavior Disorders
Authors: Murry Francie
Published: September 2018

Researchers have demonstrated the positive outcomes of using video self-modeling (VSM) with students with emotional behavior disorders (EBDs). VSM typically refers to teacher-created videos demonstrating desired skills or behaviors where the student is the video model performing the skill at a level higher than his or her typical display. The purpose of this article is to demonstrate the ease and effectiveness of a student-created VSM to generate social skills use in rural general education classrooms. Included are the steps three students with EBD used to produce VSM using an e-book application as an assistive technology to promote their performance of social skills in the general education environment. Suggestions are provided for school personnel who want to implement this assistive technology strategy in the general education setting.
Molecular classification of primary mediastinal large B-cell lymphoma using routinely available tissue specimens
Authors: Mottok Anja , Wright George , Rosenwald Andreas , Ott German , Ramsower Colleen , Campo Elias , Braziel Rita M. , Delabie Jan , Weisenburger Dennis D. , Song Joo Y. , Chan Wing C. , Cook James R. , Fu Kai , Greiner Tim , Smeland Erlend , Holte Harald , Savage Kerry J. , Glinsmann-Gibson Betty J. , Gascoyne Randy D. , Staudt Louis M. , Jaffe Elaine S. , Connors Joseph M. , Scott David W. , Steidl Christian , Rimsza Lisa M.
Published: September 2018

Primary mediastinal large B-cell lymphoma (PMBCL) is recognized as a distinct entity in the World Health Organization classification. Currently, the diagnosis relies on consensus of histopathology, clinical variables, and presentation, giving rise to diagnostic inaccuracy in routine practice. Previous studies have demonstrated that PMBCL can be distinguished from subtypes of diffuse large B-cell lymphoma (DLBCL) based on gene expression signatures. However, requirement of fresh-frozen biopsy material has precluded the transfer of gene expression–based assays to the clinic. Here, we developed a robust and accurate molecular classification assay (Lymph3Cx) for the distinction of PMBCL from DLBCL subtypes based on gene expression measurements in formalin-fixed, paraffin-embedded tissue. A probabilistic model accounting for classification error, comprising 58 gene features, was trained on 68 cases of PMBCL and DLBCL. Performance of the model was subsequently evaluated in an independent validation cohort of 158 cases and showed high agreement of the Lymph3Cx molecular classification with the clinicopathological diagnosis of an expert panel (frank misclassification rate, 3.8%). Furthermore, we demonstrate reproducibility of the assay with 100% concordance of subtype assignments at 2 independent laboratories. Future studies will determine Lymph3Cx’s utility for routine diagnostic purposes and therapeutic decision making.
Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting
Authors: Kilani Rami
Published: September 2018

Background

Competence in laparoscopic skills is important for all gynaecological surgeons. Most residency programmes teach technical skills in the operating room and through lectures, where the evaluation of surgical skills is usually done through subjective evaluation. After graduating residency, most surgeons depend on themselves to decide if they are competent in performing a certain procedure. The objective of this study is to evaluate the accuracy of surgeon self-assessment compared with expert assessment of competence in laparoscopic surgical skills. A double-blind prospective cohort study was undertaken at Prince Hamza Hospital between January 2016 and April 2016 in Amman, Jordan. Eight practicing gynecologists and obstetricians performed and recorded 88 laparoscopic procedures including ovarian cystectomy, salpingectomy for ectopic pregnancy, salpingoophorectomy, resection of endometriosis, adhesiolysis and ovarian drilling. Participating gynecologists recorded the procedures and were asked to complete a Global Rating Index of Technical Skills (GRITS) evaluation after the surgery testing across multiple areas with a lowest score of 8 and a highest score of 40. Two well-versed laparoscopic experts in objective structured assessment of technical skills (OSATS) also independently scored all procedures using the same parameters. The correlation coefficient and internal consistency were calculated.

Results

The GRITS score was calculated for each participant with a mean assessment score of 3.47 for each parameter. Participants self-assessment scores were significantly higher than expert assessment scores (p<0.05). The correlation coefficient was calculated and it can be seen that there was high inter-expert correlation in assessment across all participants evaluations (ICC > 0.90).

Conclusion

Self-assessment of surgical laparoscopic skills is higher than expert evaluation of these technical skills. Quality assurance measures need to be revisited and restructured through more frequent assessments using peer and expert assessment alongside self-assessment. Gynecologists also need to undergo proper assessment prior to starting independently performing procedures that require new skills.
Clinical and Molecular Characteristics May Alter Treatment Strategies of Thyroid Malignancies in DICER1 Syndrome
Authors: van der Tuin Karin , de Kock Leanne , Kamping Eveline J , Hannema Sabine E , Pouwels Marie-Jose M , Niedziela Marek , van Wezel Tom , Hes Frederik J , Jongmans Marjolijn C , Foulkes William D , Morreau Hans
Published: September 2018

Context

DICER1 syndrome is a rare autosomal-dominantly inherited disorder that predisposes to a variety of cancerous and noncancerous tumors of mostly pediatric and adolescent onset, including differentiated thyroid carcinoma (DTC). DTC has been hypothesized to arise secondarily to the increased prevalence of thyroid hyperplastic nodules in syndromic patients.

Objective

To determine somatic alterations in DICER1-associated DTC and to study patient outcomes.

Design

Retrospective series.

Setting

Tertiary referral centers.

Patients

Ten patients with germline pathogenic DICER1 variants and early-onset DTC.

Methods

Somatic DICER1 mutation analysis, extensive somatic DNA variant and gene fusion analyses were performed on all tumors.

Results

Median age at DTC diagnosis was 13.5 years and there was no recurrent or metastatic disease (median follow-up, 8 years). All thyroid specimens showed diffuse nodular hyperplasia with at least one focus suspicious of DTC but without infiltrative growth, extrathyroidal extension, vascular invasion, or lymph node metastasis. Most of the individual nodules (benign and malignant) sampled from the 10 tumors harbored distinct DICER1 RNase IIIb hotspot mutations, indicating a polyclonal composition of each tumor. Furthermore, nine of 10 DICER1-related DTCs lacked well-known oncogenic driver DNA variants and gene rearrangements.

Conclusion

On the basis of our clinical, histological, and molecular data, we consider that most DICER1-related DTCs form a low-risk subgroup. These tumors may arise within one of multiple benign monoclonal nodules; thus, hemi-thyroidectomy or, more likely, total thyroidectomy may often be required. However, radioiodine treatment may be unnecessary given the patients’ ages and the tumors’ low propensity for metastases.
Adipose Tissue Expansion by Overfeeding Healthy Men Alters Iron Gene Expression
Authors: Segrestin Berenice , Moreno-Navarrete José Maria , Seyssel Kevin , Alligier Maud , Meugnier Emmanuelle , Nazare Julie-Anne , Vidal Hubert , Fernandez-Real José Manuel , Laville Martine
Published: September 2018

Context

Iron overload has been associated with greater adipose tissue (AT) depots. We retrospectively studied the potential interactions between iron and AT during an experimental overfeeding in participants without obesity.

Methods

Twenty-six participants (mean body mass index ± SD, 24.7 ± 3.1 kg/m2) underwent a 56-day overfeeding (+760 kcal/d). Serum iron biomarkers (ELISA), subcutaneous AT (SAT) gene expression, and abdominal AT distribution assessed by MRI were analyzed at the beginning and the end of the intervention.

Results

Before intervention: SAT mRNA expression of the iron transporter transferrin (Tf) was positively correlated with the expression of genes related to lipogenesis (lipin 1, ACSL1) and lipid storage (SCD). SAT expression of the ferritin light chain (FTL) gene, encoding ferritin (FT), an intracellular iron storage protein, was negatively correlated to SREBF1, a gene related to lipogenesis. Serum FT (mean, 92 ± 57 ng/mL) was negatively correlated with the expression of SAT genes linked to lipid storage (SCD, DGAT2) and to lipogenesis (SREBF1, ACSL1). After intervention: Overfeeding led to a 2.3 ± 1.3-kg weight gain. In parallel to increased expression of lipid storage–related genes (mitoNEET, SCD, DGAT2, SREBF1), SAT Tf, SLC40A1 (encoding ferroportin 1, a membrane iron export channel) and hephaestin mRNA levels increased, whereas SAT FTL mRNA decreased, suggesting increased AT iron requirement. Serum FT decreased to 67 ± 43 ng/mL. However, no significant associations between serum iron biomarkers and AT distribution or expansion were observed.

Conclusion

In healthy men, iron metabolism gene expression in SAT is associated with lipid storage and lipogenesis genes expression and is modulated during a 56-day overfeeding diet.
Using the SuperNO2VA Device on a Patient With a Known Difficult Airway: A Case Report Facilitating Fiberoptic Intubation and Postoperative Nasal Positive Pressure
Authors: Cataldo Steven H. , Mondal Samhati , Lester Laeben C. , Hensley Nadia B.
Published: September 2018

Upper airway obstruction during anesthesia is the leading cause of complications during sedation, intubation, and emergence. Devices to support oxygenation and ventilation are costly, require capital equipment, and cannot be used during transport. We present a 46-year-old man with sleep apnea and anticipated difficult airway undergoing a cardiac ablation under general endotracheal intubation. The SuperNO2VA nasal mask provided high-flow nasal oxygen and positive pressure during awake fiberoptic intubation and on extubation, maintaining airway patency in the operating room, during transport, and in recovery. The SuperNO2VA is inexpensive and portable and should be considered for high-risk patients with difficult airways.
Never Say Never: The Use of Nitric Oxide in Patients With Obstructed Pulmonary Veins: A Case Report
Authors: Sokoliuk Victoria , DiNardo James A. , Brown Morgan L.
Published: September 2018

Pulmonary vein stenosis (PVS) is a progressive disease with pulmonary hypertension (PH) as a major cause of morbidity and mortality. Traditional management of PH with inhaled nitric oxide (iNO) is typically avoided in PVS patients because, while iNO may reduce pulmonary vascular resistance, PH persists as pulmonary blood flow increases in the presence of a downstream resistive lesion. We report 3 cases with primary PVS and PH in which iNO was used to successfully decrease mean pulmonary artery pressures with clinical improvement. Based on this experience, we suggest that iNO can be used to treat PH in select patients with PVS.
Thoracic Outlet Syndrome Treated With Injecting Botulinum Toxin Into Middle Scalene Muscle and Pectoral Muscle Interfascial Planes: A Case Report
Authors: Rahman Abed , Hamid Albaraa , Inozemtsev Konstantin , Nam Andrew
Published: September 2018

Thoracic outlet compression syndrome is a complex syndrome of neurovascular compression at the superior thoracic aperture, thought to occur at 1 of 3 anatomical compartments: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Injection into the middle interscalene muscle (ISM) and/or pectoralis muscle plane (PECS I and II) is gaining popularity because it provides significant symptomatic relief. A 44-year-old woman was diagnosed with thoracic outlet compression syndrome, with failed conservative therapy, including physical therapy. She refused surgical intervention. ISM and PECS I and II blocks with botulinum toxin type A were successful. In combination, PECS I/II and ISM injections can provide excellent symptomatic relief.
Breathing with floating ribs: XROMM analysis of lung ventilation in savannah monitor lizards
Authors: Cieri Robert L. , Moritz Sabine , Capano John G. , Brainerd Elizabeth L.
Published: September 2018

The structures and functions of the vertebrate lung and trunk are linked through the act of ventilation, but the connections between these structures and functions are poorly understood. We used XROMM to measure rib kinematics during lung ventilation in three savannah monitor lizards, Varanus exanthematicus. All of the dorsal ribs, including the floating ribs, contributed to ventilation; the magnitude and kinematic pattern showed no detectable cranial-to-caudal gradient. The true ribs acted as two rigid bodies connected by flexible cartilage, with the vertebral rib and ventromedial shaft of each sternal rib remaining rigid and the cartilage between them forming a flexible intracostal joint. Rib rotations can be decomposed into bucket handle rotation around a dorsoventral axis, pump handle rotation around a mediolateral axis, and caliper motion around a craniocaudal axis. Dorsal rib motion was dominated by roughly equal contributions of bucket and pump rotation in two individuals and by bucket rotation in the third individual. The recruitment of floating ribs during ventilation in monitors is strikingly different from the situation in iguanas, where only the first few true ribs contribute to breathing. This difference may be related to the design of the pulmonary system and life history traits in these two species. Motion of the floating ribs may maximize ventilation of the caudally and ventrolaterally-positioned compliant saccular chambers in the lungs of varanids, while restriction of ventilation to a few true ribs may maximize crypsis in iguanas.
Recent advances in understanding the auditory cortex
Authors: King Andrew J. , Teki Sundeep , Willmore Ben D.B.
Published: September 2018

Our ability to make sense of the auditory world results from neural processing that begins in the ear, goes through multiple subcortical areas, and continues in the cortex. The specific contribution of the auditory cortex to this chain of processing is far from understood. Although many of the properties of neurons in the auditory cortex resemble those of subcortical neurons, they show somewhat more complex selectivity for sound features, which is likely to be important for the analysis of natural sounds, such as speech, in real-life listening conditions. Furthermore, recent work has shown that auditory cortical processing is highly context-dependent, integrates auditory inputs with other sensory and motor signals, depends on experience, and is shaped by cognitive demands, such as attention. Thus, in addition to being the locus for more complex sound selectivity, the auditory cortex is increasingly understood to be an integral part of the network of brain regions responsible for prediction, auditory perceptual decision-making, and learning. In this review, we focus on three key areas that are contributing to this understanding: the sound features that are preferentially represented by cortical neurons, the spatial organization of those preferences, and the cognitive roles of the auditory cortex.
A systematic approach to mapping longitudinal data usage: Reflections on tracking Millennium Cohort Study activity
Authors: Kneale Dylan , Patalay Praveetha , Thomas James , Khatwa Meena , Stansfield Claire , Fitzsimons Emla
Published: September 2018

Background: The Millennium Cohort Study is the youngest of the UK’s four national birth cohort studies, but the only study (to our knowledge) where a systematic approach to exploring data usage has been undertaken.

Methods: In this paper we: (i) explore previous exercises and provide justification for our approach; (ii) share headline findings of our research, (iii) outline the challenges of intersecting systematic review methods with survey design methods; and (iv) discuss the implications for future survey design as well as for future exercises tracking survey data usage. All of the results were obtained through undertaking systematic searches across 30 databases which generated over 4000 results. We then searched these records, first on title and abstract and then on the full text and extracted data on studies that fell within our specific areas of interest.

Results: A total of 481 studies were identified as using MCS data in novel analyses. Among these studies, measures that have been collected across sweeps—diet, BMI, SDQ and screen time—are all comparatively well used. Data that were collected from the child’s own reports (e.g. friendships and feelings) have seldom been utilised in comparison to data collected through parental reports and using validated tools (e.g. SDQ). Imposing thresholds on data was found to be problematic in some cases, for example for BMI, where a number of different thresholds for overweight and obesity were in use. The use of different thresholds can lead to substantial differences in the results obtained.

Conclusions: Longitudinal consistency in measures is key to identifying change over time, and the review helped map the degree of consistency in measures, and their utility. The findings shaped decisions around inclusion of variables in MCS7 (age 17 years), as well as the way in which existing data were deposited.
Neuraxial anesthesia for postpartum tubal ligation at an academic medical center
Authors: Delgado Carlos , Van Cleve Wil , Kent Christopher , Dinges Emily , Bollag Laurent A.
Published: September 2018

Background: Use of an in situ epidural catheter has been suggested to be efficient to provide anesthesia for postpartum tubal ligation (PPTL). Reported epidural reactivation success rates vary from 74% to 92%. Predictors for reactivation failure include poor patient satisfaction with labor analgesia, increased delivery-to-reactivation time and the need for top-ups during labor. Some have suggested that this high failure rate precludes leaving the catheter in situ after delivery for subsequent reactivation attempts. In this study, we sought to evaluate the success rate of neuraxial techniques for PPTL and to determine if predictors of failure can be identified.

Methods: After obtaining IRB approval, a retrospective chart review of patients undergoing PPTL after vaginal delivery from July 2010 to July 2016 was conducted using CPT codes, yielding 93 records for analysis. Demographic, obstetric and anesthetic data (labor analgesia administration, length of epidural catheter in epidural space, top-up requirements, time of catheter reactivation, final anesthetic technique and corresponding doses for spinal and epidural anesthesia) were obtained.

Results: A total of 70 patients received labor neuraxial analgesia. Reactivation was attempted in 33 with a success rate of 66.7%. Patient height, epidural volume of local anesthetic and administered fentanyl dose were lower in the group that failed reactivation. Overall, spinal anesthesia was performed in 60 patients, with a success rate of 80%.

Conclusions: Our observed rate of successful postpartum epidural reactivation for tubal ligation was lower than the range reported in the literature. Our success rates for both spinal anesthesia and epidural reactivation for PPTL were lower than the generally accepted rates of successful epidural and spinal anesthesia for cesarean delivery. This gap may reflect a lower level of motivation on behalf of both the patients and anesthesia providers to tolerate “imperfect” neuraxial anesthesia once fetal considerations are removed.
Association between intermittent administration of parathyroid hormone 1-34 and ectopic calcification in rats
Authors: Radwan Israa Ahmed , Sedky Korany Nahed , Adel Ezzat Bassant
Published: September 2018

The present study was conducted to determine the association between parathyroid hormone 1-34 administration and ectopic calcification in rats with glucocorticoid induced osteoporosis. A total of 18 rats were used in the current study. Osteoporosis was induced in all rats via dexamethasone administration, then rats were randomly distributed into Control and Forteo groups and were sacrificed 4 weeks after initiation of drug administration. Hemi-mandibles were decalcified followed by routine histological analysis. Among the Forteo group rats, three rats displayed the presence of ectopic calcification. True pulp stone, intra-pulpal calcified structure with entrapped cells and intra periodontal bone-like calcified structure with entrapped cells were observed while no ectopic calcification was noticed in the control group.
Quantum Harmonic Analysis of the Density Matrix
Authors: De Gosson Maurice A.
Published: September 2018

We will study rigorously the notion of mixed states and their density matrices. We will also discuss the quantum-mechanical consequences of possible variations of Planck's constant h. This review has been written having in mind two readerships: mathematical physicists and quantum physicists. The mathematical rigor is maximal, but the language and notation we use throughout should be familiar to physicists.Quanta 2018; 7: 74–110.
Trends in the seasonal variation of paediatric fractures
Authors: Segal D. , Slevin O. , Aliev E. , Borisov O. , Khateeb B. , Faour A. , Palmanovich E. , Brin Y. S. , Weigl D.
Published: September 2018

Purpose

The incidence of paediatric fractures is known to peak during the summer as a consequence of unsupervised physical activity. A more sedentary lifestyle is a potential cause for changes in paediatric seasonal fracture frequency and severity. The aim of this study was to evaluate the current seasonal variations of paediatric fractures in order to determine resource allocation in hospitals, community clinics and prevention programs.

Methods

A single institutional review of historical data of all patients aged 0 to 16 years that were diagnosed with fractures between April 2014 and July 2017 in the emergency department of a level 3 orthopaedic trauma centre was conducted. In all, 3484 fractures were reviewed, of which 2991 were included. We stratified fractures according to patients’ variants and the hour, day and month with respect to holidays, weekends and weather.

Results

While the fracture rate on school days was 6.62 per day, the fracture rate during the summer vacation was 4.45 (p < 0.01). Hot weather was correlated with low fracture rates. The peak hours of admission were 12:00 to 13:00 and 18:00 to 22:00, with more moderate differences during non-school periods.

Conclusion

The local seasonal variation of paediatric fractures has a bimodal distribution, with similar nadirs during both summer and winter. These rates might reflect a shift to a more sedentary lifestyle during the summer vacation. The presented data can assist in improving the value of injury prevention measures and medical resources allocation.

Level of evidence

II
Use of Raman spectroscopy to screen diabetes mellitus with machine learning tools
Authors: Guevara Edgar , Torres-Galván Juan Carlos , Ramírez-Elías Miguel G. , Luevano-Contreras Claudia , González Francisco Javier
Published: September 2018

Type 2 diabetes mellitus (DM2) is one of the most widely prevalent diseases worldwide and is currently screened by invasive techniques based on enzymatic assays that measure plasma glucose concentration in a laboratory setting. A promising plan of action for screening DM2 is to identify molecular signatures in a non-invasive fashion. This work describes the application of portable Raman spectroscopy coupled with several supervised machine-learning techniques, to discern between diabetic patients and healthy controls (Ctrl), with a high degree of accuracy. Using artificial neural networks (ANN), we accurately discriminated between DM2 and Ctrl groups with 88.9–90.9% accuracy, depending on the sampling site. In order to compare the ANN performance to more traditional methods used in spectroscopy, principal component analysis (PCA) was carried out. A subset of features from PCA was used to generate a support vector machine (SVM) model, albeit with decreased accuracy (76.0–82.5%). The 10-fold cross-validation model was performed to validate both classifiers. This technique is relatively low-cost, harmless, simple and comfortable for the patient, yielding rapid diagnosis. Furthermore, the performance of the ANN-based method was better than the typical performance of the invasive measurement of capillary blood glucose. These characteristics make our method a promising screening tool for identifying DM2 in a non-invasive and automated fashion.
Padlock Probe Assay for Detection and Subtyping of Seasonal Influenza
Authors: Neumann Felix , Hernández-Neuta Iván , Grabbe Malin , Madaboosi Narayanan , Albert Jan , Nilsson Mats
Published: September 2018

BACKGROUND

Influenza remains a constant threat worldwide, and WHO estimates that it affects 5% to 15% of the global population each season, with an associated 3 to 5 million severe cases and up to 500000 deaths. To limit the morbidity and the economic burden of influenza, improved diagnostic assays are needed.

METHODS

We developed a multiplexed assay for the detection and subtyping of seasonal influenza based on padlock probes and rolling circle amplification. The assay simultaneously targets all 8 genome segments of the 4 circulating influenza variants—A(H1N1), A(H3N2), B/Yamagata, and B/Victoria—and was combined with a prototype cartridge for inexpensive digital quantification. Characterized virus isolates and patient nasopharyngeal swabs were used for assay design and analytical validation. The diagnostic performance was assessed by blinded testing of 50 clinical samples analyzed in parallel with a commercial influenza assay, Simplexa™ Flu A/B & RSV Direct.

RESULTS

The assay had a detection limit of 18 viral RNA copies and achieved 100% analytical and clinical specificity for differential detection and subtyping of seasonal circulating influenza variants. The diagnostic sensitivity on the 50 clinical samples was 77.5% for detecting influenza and up to 73% for subtyping seasonal variants.

CONCLUSIONS

We have presented a proof-of-concept padlock probe assay combined with an inexpensive digital readout for the detection and subtyping of seasonal influenza strains A and B. The demonstrated high specificity and multiplexing capability, together with the digital quantification, established the assay as a promising diagnostic tool for seasonal influenza.
Graphical Approach to Compare Concentration Constants of Hill and Michaelis-Menten Equations
Authors: V. Emelyanova Elena
Published: September 2018

The aim of present study was to describe the graphical technique how to go from Hill concentration constant to Michaelis constant.

To compare enzymatic processes, the kinetics of which is subjected to different regularities, it is possible to use constants that characterize catalytic activity (Vmax) and concentration constants that are the substrate concentration at which the rate of the enzymatic process is equal to a half of maximum permissible rate. Concentration constants are S0.5 for Hill equation and Km for Michaelis-Menton equation. The graphical approach was proposed in order to go from concentration constant of Hill equation to Michaelis concentration of the process that could be characterized by the same catalytic activity (the same values of minimum and maximum rates) similar to that observed in the process described by Hill equation.
Raw pH fall-out as a sign of a mycorrhizal modifier of Sorghum sudanensis
Authors: Masoero Giorgio , Peiretti Pier Giorgio , Cugnetto Alberto , Giovannetti Giusto
Published: September 2018

The management of symbiotic Microbial Biota (MB) in the soil as agents that promote the yield and health of crops, is aimed at inducing modifications of the phenotype of plants, both over and under the ground. It is here shown, in Sorghumsudanensis plants, that: i) a simple response to MB inoculation is the result of the fall out of the raw pH; ii) the simple NIR scans of leaves can be considered to rapidly classify the outcomes; iii) the raw pH can be considered a key-variable of leaf modifications. An experiment was carried out on Sorghumsudanensis. The plants were seeded in pots and grown for 66 d, and then a control non-inoculated group (C) was compared with thirteen Arbuscular Mycorrhizae (AM) Glomus inoculated groups and with two commercial MB products. A total of 374 raw pH measurements conducted on the leaves showed that the 5.18 pH units in the C group were scaled by -1.9% (P<0.0336) in the MB group and by -3.4% in the AM group (P<0.0001), with a relevant diversity between groups. Direct discrimination of these three groups, by means of smart NIR-SCIO, showed a % reclassification of the C, MB and AM groups of 74%, 59% and 96% in the fresh leaves and of 65%, 51% and 94% in the dried ground leaves, respectively. The composition of the dried leaves, based on a set of 14 variables predicted via NIRS models, plus the total foliar dry weight and percentage, showed a typical increase in protein, ash and hemicellulose, and a typical decrease in the cellulose, dry matter, crude fiber and crop maturity index. These variables were related to the foliar pH, as a key-variable, by means of a PLS standard model (R2 0.81) in which a low pH steadily favored the dry mass weight and, to a lesser extent, the hemicellulose and the digestible NDF contents; on the other hand, a high pH increased the dry matter percentage and the cellulose content of the leaves. As expected, the leaves of the inoculated plants showed a more juvenile ontogenic status. The epigean botanical modifications can be considered harmonic expressions of a luxuriant symbiosis, as testified by the homologous NIR categorization. The outlook for a symbiotic agriculture, with mycorrhizal plants, should consider the raw pH as a multifaceted variable.