bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethical complexities in assessing patients’ insight
Authors: Guidry-Grimes Laura
Published: January 2019

The question of whether a patient has insight is among the first to be considered in psychiatric contexts. There are several competing conceptions of clinical insight, which broadly refers to a patient’s awareness of their mental illness. When a patient is described as lacking insight, there are significant implications for patient care and to what extent the patient is trusted as a knower. Insight is currently viewed as a multidimensional and continuous construct, but competing conceptions of insight still lack consensus on the specifics. Studies also give contradictory evidence regarding the frequency and consequences of poor insight. A number of crucial questions remain unanswered. After outlining some of the key theoretical disagreements about what insight means, I highlight ethical issues that have not received much attention in the literature. Given the conceptual ambiguities and the absence of standardised bedside tools, there are significant ethical concerns about insight assessments. I highlight two main ethical concerns, specifically that these assessments risk: (1) marginalising patients by setting unattainable ideals for self-knowledge and (2) minimising the patient’s own perspective on their mental health. I close with recommendations for documenting and responding to concerns about poor insight, so patients who are vulnerable to losing epistemic trust are better supported in their therapeutic relationships.
Blameworthy bumping? Investigating nudge’s neglected cousin
Authors: Miyata-Sturm Ainar
Published: January 2019

The realm of non-rational influence, which includes nudging, is home to many other morally interesting phenomena. In this paper, I introduce the term bumping, to discuss the category of unintentional non-rational influence. Bumping happens constantly, wherever people make choices in environments where they are affected by other people. For instance, doctors will often bump their patients as patients make choices about what treatments to pursue. In some cases, these bumps will systematically tend to make patients’ decisions worse. Put another way: doctors will sometimes harm their patients by bumping them in systematic (although still unintentional) ways. I use the case of medical overuse, the provision of medical services where the likely harm outweighs the likely benefit to the patient, as a touchstone for arguing that doctors who systematically bump their patients towards harm can be blameworthy for their unwitting influence.
The Chest Australia Trial: a randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer
Authors: Emery Jon D , Murray Sonya R , Walter Fiona M , Martin Andrew , Goodall Stephen , Mazza Danielle , Habgood Emily , Kutzer Yvonne , Barnes David John , Murchie Peter
Published: January 2019

Background

International research has focused on screening and mass media campaigns to promote earlier patient presentation and detect lung cancer earlier. This trial tested the effect of a behavioural intervention in people at increased risk of lung cancer on help-seeking for respiratory symptoms.

Methods

Parallel, individually randomised controlled trial. Eligible participants were long-term smokers with at least 20 pack-years, aged 55 and above. The CHEST intervention entailed a consultation to discuss and implement a self-help manual, followed by self-monitoring reminders to encourage help-seeking for respiratory symptoms. The control group received a brief discussion about lung health. Both groups had baseline spirometry. Telephone randomisation was conducted, 1:1, stratified Medical Research Council (MRC) dyspnoea score and general practice. Participants could not be blinded; data extraction and statistical analyses were performed blinded to group assignment. The primary outcome was respiratory consultation rates.

Results

We randomised 551 participants (274 intervention, 277 control) from whom the primary outcome was determined for 542 (269 intervention, 273 control). There was a 40% relative increase in respiratory consultations in the intervention group: (adjusted rates (95% CI) intervention 0.57 (0.47 to 0.70), control 0.41 (0.32 to 0.52), relative rate 1.40 (1.08 to 1.82); p=0.0123). There were no significant differences in time to first respiratory consultation, total consultation rates or measures of psychological harm. The incremental cost-effectiveness ratio was $A1289 per additional respiratory consultation.

Conclusions

A behavioural intervention can significantly increase consulting for respiratory symptoms in patients at increased risk of lung cancer. This intervention could have an important role in primary care as part of a broader approach to improve respiratory health in patients at higher risk.

Trial registration number

Australian New Zealand Clinical Trial Registry (1261300039 3752). This was registered pre-results.
SPATIAL ASPECT OF HUNTING COOPERATION IN PREDATORS WITH HOLLING TYPE II FUNCTIONAL RESPONSE
Authors: SINGH TEEKAM , BANERJEE SANDIP
Published: January 2019

In this paper, we have investigated a spatial predator–prey model with hunting cooperation in predators. Using linear stability analysis, we obtain the condition for diffusive instability and identify the corresponding domain in the space of controlling parameters. Using extensive numerical simulations, we obtain complex patterns, namely, spotted pattern, stripe pattern and mixed pattern in the Turing domain, by varying the hunting cooperation parameter in predators and carrying capacity of preys. The results focus on the effect of hunting cooperation in pattern dynamics of a diffusive predator–prey model and help us in better understanding of the dynamics of the predator–prey interaction in real environments.
COMPARISON OF NECK MUSCLE ELECTROMYOGRAPHY ACTIVITY IN RESPONSE TO EXTERNAL FORCE BETWEEN STATIC AND DYNAMIC LOADING
Authors: KAK D. W. , ANITA A. R. , NIZLAN N. M. , NORMALA I. , ABDUL JALIL N. A. , WONG S. V.
Published: January 2019

Understanding the behavior of neck muscles is essential to accurately simulate the human head-neck segment movement especially for low-speed motor vehicle crash situation. Some head-neck mathematical models were designed using neck muscle activation behavior in isometric contraction (static loading) as the properties of neck muscle activation. However, neck muscle activation pattern and strength capability may vary between static and dynamic loading. This study aimed to determine the differences between neck muscle activation level under static and dynamic loading. A neck strength test involving 22 human volunteers was conducted with two different tasks in extension and flexion direction with three different loads. The neck muscle activation level is determined through measuring the electromyography (EMG) responses of selected flexor and extensor muscles using surface bilateral electrode and recorded. The findings showed that neck muscle activation level was significantly greater in dynamic loading than static loading ([Formula: see text]). These implied that more efforts from neck muscles were required to resist against dynamic loading than static loading. Nonetheless, the differences in EMG activities between these two loading conditions progressively decreased when more loads were applied. This study has established an empirical model to describe the relationship between neck muscle activation level and force output for both loading condition in flexion and extension.
Taking a Studio Course in Distributed Software Engineering from a Large Local Cohort to a Small Global Cohort
Authors: Billingsley William , Torbay Rosemary , Fletcher Peter R. , Thomas Richard N. , Steel Jim R. H. , Süß Jörn Guy
Published: January 2019

One of the challenges of global software engineering courses is to bring the practices and experience of large geographically distributed teams into the local and time-limited environment of a classroom. Over the last 6 years, an on-campus studio course for software engineering has been developed at the University of Queensland (UQ) that places small teams of students on different features of a common product. This creates two layers of collaboration, as students work within their teams on individual features, and the teams must interoperate with many other teams on the common product. The class uses continuous integration practices and predominantly asynchronous communication channels (Slack and GitHub) to facilitate this collaboration. The original goal of this design was to ensure that students would authentically experience issues associated with realistically sized software projects, and learn to apply appropriate software engineering and collaboration practices to overcome them, in a course without significant extra staffing. Data from the development logs showed that most commits take place outside synchronous class hours, and the project operates as a temporally distributed team even though the students are geographically co-located. Since 2015, a course adapted from this format has also been taught at the University of New England (UNE), an Australian regional university that is also a longstanding provider of distance education. In this course, most students study online, and the class has to be able to work globally, because as well as students taking part from around Australia, there are also typically a small number of students taking part from overseas. Transferring the course to a smaller but predominantly online institution has allowed us to evaluate the distributed nature of the course, by considering what aspects of the course needed to change to support students who are geographically distributed, and comparing how the two cohorts behave. This has produced an overall course design, to teach professional distributed software engineering practices, that is adaptable from large classes to small, and from local to global.
Reducing Writebacks Through In-Cache Displacement
Authors: Bakhshalipour Mohammad , Faraji Aydin , Ghahani Seyed Armin Vakil , Samandi Farid , Lotfi-Kamran Pejman , Sarbazi-Azad Hamid
Published: January 2019

Non-Volatile Memory (NVM) technology is a promising solution to fulfill the ever-growing need for higher capacity in the main memory of modern systems. Despite having many great features, however, NVM’s poor write performance remains a severe obstacle, preventing it from being used as a DRAM alternative in the main memory. Most of the prior work targeted optimizing writes at the main memory side and neglected the decisive role of upper-level cache management policies on reducing the number of writes.

In this article, we propose a novel cache management policy that attempts to maximize write-coalescing in the on-chip SRAM last-level cache (LLC) for the sake of reducing the number of costly writes to the off-chip NVM. We decouple a few physical ways of the LLC to have a dedicated and exclusive storage for the dirty blocks after being evicted from the cache and before being sent to the off-chip memory. By
displacing
dirty blocks in exclusive storage, they are kept in the cache based on their
rewrite distance
and are evicted when they are unlikely to be reused shortly. To maximize the effectiveness of exclusive storage, we manage it as a
Cuckoo Cache
to offer associativity based on the various applications’ demands. Through detailed evaluations targeting various single- and multi-threaded applications, we show that our proposal reduces the number of writebacks by 21%, on average, over the state-of-the-art method and enhances both performance and energy efficiency.
A Hardware-Efficient Block Matching Algorithm and Its Hardware Design for Variable Block Size Motion Estimation in Ultra-High-Definition Video Encoding
Authors: Zheng Jianwei , Lu Chao , Guo Jiefeng , Chen Deming , Guo Donghui
Published: January 2019

Variable block size motion estimation has contributed greatly to achieving an optimal interframe encoding, but involves high computational complexity and huge memory access, which is the most critical bottleneck in ultra-high-definition video encoding. This article presents a hardware-efficient block matching algorithm with an efficient hardware design that is able to reduce the computational complexity of motion estimation while providing a sustained and steady coding performance for high-quality video encoding. A three-level memory organization is proposed to reduce memory bandwidth requirement while supporting a predictive common search window. By applying multiple search strategies and early termination, the proposed design provides 1.8 to 3.7 times higher hardware efficiency than other works. Furthermore, on-chip memory has been reduced by 96.5% and off-chip bandwidth requirement has been reduced by 39.4% thanks to the proposed three-level memory organization. The corresponding power consumption is only 198mW at the highest working frequency of 500MHz. The proposed design is attractive for high-quality video encoding in real-time applications with low power consumption.
Performance-Aware Test Scheduling for Diagnosing Coexistent Channel Faults in Topology-Agnostic Networks-on-Chip
Authors: Bhowmik Biswajit , Deka Jatindra Kumar , Biswas Santosh , Bhattacharya Bhargab B.
Published: January 2019

High--performance multiprocessor SoCs used in practice require a complex network-on-chip (NoC) as communication architecture, and the channels therein often suffer from various manufacturing defects. Such physical defects cause a multitude of system-level failures and subsequent degradation of reliability, yield, and performance of the computing platform. Most of the existing test approaches consider mesh-based NoC channels only and do not perform well for other regular topologies such as octagons or spidergons, with regard to test time and overhead issues. This article proposes a topology-agnostic test mechanism that is capable of diagnosing on-line, coexistent channel-short, and stuck-at faults in these special NoCs as well as in traditional mesh architectures. We introduce a new test model called
Damaru
to decompose the network and present an efficient scheduling scheme to reduce test time without compromising resource utilization during testing. Additionally, the proposed scheduling scheme scales well with network size, channel width, and topological diversity. Simulation results show that the method achieves nearly 92% fault coverage and improves area overhead by almost 60% and test time by 98% compared to earlier approaches. As a sequel, packet latency and energy consumption are also improved by 67.05% and 54.69%, respectively, and they are further improved with increasing network size.
Writeback-Aware LLC Management for PCM-Based Main Memory Systems
Authors: Pourshirazi Bahareh , Beigi Majed Valad , Zhu Zhichun , Memik Gokhan
Published: January 2019

With the increase in the number of data-intensive applications on today's workloads, DRAM-based main memories are struggling to satisfy the growing data demand capacity. Phase Change Memory (PCM) is a type of non-volatile memory technology that has been explored as a promising alternative for DRAM-based main memories due to its better scalability and lower leakage energy. Despite its many advantages, PCM also has shortcomings such as long write latency, high write energy consumption, and limited write endurance, which are all related to the write operations.

In this article, we propose a novel writeback-aware Last Level Cache (LLC) management scheme named WALL to reduce the number of LLC writebacks and consequently improve performance, energy efficiency, and lifetime of a PCM-based main memory system. First, we investigate the writeback behavior of LLC sets and show that writebacks are not uniformly distributed among sets; some sets observe much higher writeback rates than others. We then propose a writeback-aware set-balancing mechanism, which employs the underutilized LLC sets with few writebacks as an auxiliary storage for the evicted dirty lines from sets with frequent writebacks. We also propose a simple and effective writeback-aware replacement policy to avoid the eviction of the dirty blocks that are highly reused after being evicted from the cache.

Our experimental results show that WALL achieves an average of 30.9% reduction in the total number of LLC writebacks, compared to the baseline scheme, which uses the LRU replacement policy. As a result, WALL can reduce the memory energy consumption by 23.1% and enhance PCM lifetime by 1.29×, on average, on an 8-core system with a 4GB PCM main memory, running memory-intensive applications.
Decreased electrogenic anionic secretory response in the porcine colon following in vivo challenge withBrachyspiraspp. supports an altered mucin environment
Authors: Enns Cole B. , Harding John C. S. , Loewen Matthew E.
Published: January 2019

Brachyspira spp. cause diarrheal disease in multiple animal species by colonization of the colon, resulting in colitis, mucus induction, and disrupted ion transport. Unique to spirochete pathogenesis is the immense production of mucus, resulting in a niche mucin environment likely favoring spirochete colonization. Mucin rheological properties are heavily influenced by anionic secretion, and loss of secretory function has been implicated in diseases such as cystic fibrosis. Here, the effects on the agonist-induced electrogenic anionic secretory response by infectious colonic spirochete bacteria Brachyspira hyodysenteriae and Brachyspira hampsonii were assessed in the proximal, apex, and distal sections of colon in Ussing chambers. Activation of secretion via isoproterenol, carbachol, and forskolin/3-isobutyl-1-methylxanthine demonstrated a significantly decreased change in short-circuit current ( Isc) in Brachyspira-infected pigs in all sections. Tissue resistances did not account for this difference, rather, it was attributed to a decrease in anionic secretion as indicated by a decrease in bumetanide inhibitable Isc. Quantitative RT-PCR and Western blot analyses determined that the major anionic channels of the epithelium were downregulated in diarrheic pigs paired with altered mucin gene expression. The investigated cytokines were not responsible for the downregulation of anion channel gene transcripts. Although IL-1α was upregulated in all segments, it did not alter cystic fibrosis transmembrane conductance regulator (CFTR) mRNA expression in Caco-2 monolayers. However, a whole cell Brachyspira hampsonii lysate significantly reduced CFTR mRNA expression in Caco-2 monolayers. Together, these findings indicate that these two Brachyspira spp. may directly cause a decreased anionic secretory response in the porcine colon, supporting an altered mucin environment likely favoring spirochete colonization.

NEW & NOTEWORTHY This research demonstrates for the first time that the niche mucin environment produced by two infectious spirochete spp. is supported by a decrease in the electrogenic anionic secretory response throughout the porcine colon. Our findings suggest that the host’s cytokine response is not likely responsible for the decrease in anionic secretory function. Rather, it appears that Brachyspira spp. directly impede ion channel transcription and translation, potentially altering colonic mucin rheological properties, which may favor spirochete colonization.
Deficiency of cationic amino acid transporter-2 protects mice from hyperoxia-induced lung injury
Authors: Jin Yi , Liu Yusen , Nelin Leif D.
Published: January 2019

The pathology of acute lung injury (ALI) involves inducible nitric oxide (NO) synthase (iNOS)-derived NO-induced apoptosis of pulmonary endothelial cells. In vitro, iNOS-derived NO production has been shown to depend on the uptake of l-arginine by the cationic amino acid transporters (CAT). To test the hypothesis that mice deficient in CAT-2 ( slc7a2−/− on a C57BL/6 background) would be protected from hyperoxia-induced ALI, mice ( slc7a2−/− or wild-type) were placed in >95% oxygen (hyperoxia) or 21% oxygen (control) for 60 h. In wild-type mice exposed to hyperoxia, the exhaled nitric oxide (exNO) was twofold greater than in wild-type mice exposed to normoxia ( P < 0.005), whereas in slc7a2−/− mice there was no significant difference between exNO in animals exposed to hyperoxia or normoxia ( P = 0.95). Hyperoxia-exposed wild-type mice had greater ( P < 0.05) lung resistance and a lower ( P < 0.05) lung compliance than did hyperoxia-exposed slc7a2−/− mice. The lung wet-to-dry weight ratio was greater ( P < 0.005) in the hyperoxia-exposed wild-type mice than in hyperoxia-exposed slc7a2−/− mice. Neutrophil infiltration was lower ( P < 0.05) in the hyperoxia-exposed slc7a2−/− mice than in the hyperoxia-exposed wild-type mice as measured by myeloperoxidase activity. The protein concentration in bronchoalveolar lavage fluid was lower ( P < 0.001) in the hyperoxia-exposed slc7a2−/− mice than in similarly exposed wild-type mice. The percent of TUNEL-positive cells in the lung following hyperoxia exposure was significantly lower ( P < 0.001) in the slc7a2−/− mice than in the wild-type mice. These results are consistent with our hypothesis that lack of CAT-2 protects mice from acute lung injury.
Two weeks of exercise training intensity on appetite regulation in obese adults with prediabetes
Authors: Heiston Emily M. , Eichner Natalie Z. M. , Gilbertson Nicole M. , Gaitán Julian M. , Kranz Sibylle , Weltman Arthur , Malin Steven K.
Published: January 2019

No short-term exercise data exist testing whether training intensity modifies hormonal and perceived appetite in obese adults with prediabetes. Therefore, we compared the effects of short-term moderate-continuous (CONT) vs. high-intensity interval (INT) training on appetite regulation. Twenty-eight obese adults [age: 61.3 ± 1.5 yr; body mass index (BMI): 33.2 ± 1.1 kg/m2] with prediabetes were randomized to work-matched CONT ( n = 14) or INT ( n = 14) training for 2 wk. Plasma acylated ghrelin (AG), des-acylated ghrelin (dAG), active glucagon-like peptide-1 (GLP-1), and insulin were measured at 0, 30, and 60 min of a 75-g oral glucose tolerance test (OGTT) before and after training. Visual analog scales were administered at 0 and 120 min during the OGTT to examine perceived appetite. Three-day food logs were collected before and after testing to assess ad libitum diet. CONT and INT increased peak oxygen consumption ( P < 0.01) and decreased BMI ( P < 0.01). Although neither intervention altered fasting levels of AG ( P = 0.94), dAG ( P = 0.36), or insulin ( P = 0.67), CONT raised GLP-1 compared with INT ( P = 0.05). Exercise training did not affect postprandial suppression of AG ( P = 0.81) and dAG ( P = 0.67) or stimulation of GLP-1 ( P = 0.67) and insulin ( P = 0.32). Both interventions tended to decrease total energy and protein intake ( P = 0.09 and P = 0.05, respectively), despite no change in fasting hunger ( P = 0.88) and reduced perceived fullness at 120 min during the OGTT ( P = 0.05). We conclude that 2 wk of exercise training intensity does not modulate appetite-regulatory hormones in obese adults with prediabetes. Although perceived fullness to the OGTT was reduced after exercise, CONT and INT decreased energy intake, suggesting that exercise does not elicit compensatory appetite behavior to gain weight.

NEW & NOTEWORTHY Adults with prediabetes are at risk for appetite dysregulation. Although exercise promotes weight management, it is unclear whether moderate-continuous or high-intensity interval training is more beneficial for appetite regulation. We show that 2 wk of exercise, independent of intensity, does not alter postprandial appetite hormones or hunger, despite slight reductions in food intake and weight. These data support exercise as an effective method to induce negative energy balance without compensatory weight gain.
Blinded and unblinded hypohydration similarly impair cycling time trial performance in the heat in trained cyclists
Authors: Funnell Mark P. , Mears Stephen A. , Bergin-Taylor Kurt , James Lewis J.
Published: January 2019

Knowledge of hydration status may contribute to hypohydration-induced exercise performance decrements; therefore, this study compared blinded and unblinded hypohydration on cycling performance. Fourteen trained, nonheat-acclimated cyclists (age: 25 ± 5 yr; V̇o2peak: 63.3 ± 4.7 ml·kg−1·min−1; cycling experience: 6 ± 3 yr) were pair matched to blinded (B) or unblinded (UB) groups. After familiarization, subjects completed euhydrated (B-EUH; UB-EUH) and hypohydrated (B-HYP; UB-HYP) trials in the heat (31°C); 120-min cycling preload (50% Wpeak) and a time trial (~15 min). During the preload of all trials, 0.2 ml water·kg body mass−1 was ingested every 10 min, with additional water provided during EUH trials to match sweat losses. To blind the B group, a nasogastric tube was inserted in both trials and used to provide water in B-EUH. The preload induced similar ( P = 0.895) changes in body mass between groups (B-EUH: −0.6 ± 0.5%; B-HYP: −3.0 ± 0.5%; UB-EUH: −0.5 ± 0.3%; UB-HYP −3.0 ± 0.3%). All variables responded similarly between B and UB groups ( P ≥ 0.558), except thirst ( P = 0.004). Changes typical of hypohydration (increased heart rate, rating of perceived exertion, gastrointestinal temperature, serum osmolality and thirst, and decreased plasma volume; P ≤ 0.017) were apparent in HYP by 120 min. Time trial performance was similar between groups ( P = 0.710) and slower ( P ≤ 0.013) with HYP for B (B-EUH: 903 ± 89 s; B-HYP: 1,008 ± 121 s; −11.4%) and UB (UB-EUH: 874 ± 108 s; UB-HYP: 967 ± 170 s; −10.1%). Hypohydration of ~3% body mass impairs time trial performance in the heat, regardless of knowledge of hydration status.

NEW & NOTEWORTHY This study demonstrates, for the first time, that knowledge of hydration status does not exacerbate the negative performance consequences of hypohydration when hypohydration is equivalent to ~3% body mass. This is pivotal for the interpretation of the many previous studies that have not blinded subjects to their hydration status and suggests that these previous studies are not likely to be confounded by the overtness of the methods used to induce hypohydration.
Two-Dimensional Optical Metasurfaces: From Plasmons to Dielectrics
Authors: Liu Bo , Song Kerui , Xiao Jiangnan
Published: January 2019

Metasurfaces, kinds of planar ultrathin metamaterials, are able to modify the polarization, phase, and amplitude of physical fields of optical light by designed periodic subwavelength structures, attracting great interest in recent years. Based on the different type of the material, optical metasurfaces can be separated in two categories by the materials: one is metal and the other is dielectric. Metal metasurfaces rely on the surface plasma oscillations of subwavelength metal particles. Nevertheless, the loss caused by the metal structures has been a trouble, especially for devices working in transmit modes. The dielectric metasurfaces are based on the Faraday-Tyndall scattering of high-index dielectric light scattering particles. By reasonably designing the relevant parameters of the unit structure such as the size, direction, and shape, different functions of metasurfaces can realize and bring a wide range of applications. This article focuses on the metasurface concepts such as anomalous reflections and refractions and the working principle of different types of metasurfaces. Here, we briefly review the progress in developing optical over past few years and look into the near future.
Microstructure and Damping Capacity of ZK60 Alloy Sheets Fabricated by Twin Roll Casting and Hot Rolling Process
Authors: Chen Hongmei , Li Xiaowen
Published: January 2019

ZK60 magnesium alloy sheets with 0.65 mm thickness were successfully fabricated by twin roll casting (TRC) and subsequent hot rolling process. Fine equiaxed grains were obtained after T6 treatment by the short-term TRC and hot rolling process, and the grain size for different reduction ratio per pass was similar. The studied sheets exhibited high strength and elongation, and the tensile strength, yield strengths, and elongation for the 10% and 30% reduction per pass were above 400 MPa, 300 MPa, and 17.0 %, respectively. The damping capacity values at low strain decreased with increasing the reduction ration per pass and the values at high strain were similar for the different reduction ration per pass. The lower reduction ratio per pass and the heat treatment between rolling passes can improve the mobility of dislocations, which indicated that this process was beneficial for improving damping capacity. Compared with higher reduction ratio per pass, the high tensile properties and damping capacity were obtained by 10% reduction per pass hot rolling process.
A Propensity-Score Matching Comparison between 27-Gauge and 25-Gauge Vitrectomy Systems for the Repair of Primary Rhegmatogenous Retinal Detachment
Authors: Veritti Daniele , Sarao Valentina , Lanzetta Paolo
Published: January 2019

Purpose. To compare the anatomical and visual results and complications of 27-gauge versus 25-gauge transconjunctival sutureless vitrectomy for the management of primary rhegmatogenous retinal detachment. Methods. A prospective, propensity score-matched 6-month study was performed. All patients underwent either 27-gauge or 25-gauge vitrectomy as the first surgical intervention and were followed up over a 6-month period, in order to evaluate anatomical success, change in best-corrected visual acuity (BCVA), and intraoperative and postoperative complications including intraocular pressure dysregulation. Results. Propensity score matching resulted in two groups of 37 eyes each. All eyes completed a six-month follow-up. Baseline demographic and preoperative ocular characteristics showed no statistically significant difference between the two cohorts. The single operation success rate was 33/37 (89%) for 27-gauge cases and 34/37 (92%) for 25-gauge cases (p=0.7). The final anatomical success rate was 100% for each of the two cohorts. Mean BCVA change at the 6-month postoperative follow-up visit was −0.67 logMAR in the 27-gauge group and −0.71 logMAR in the 25-gauge group (p=0.9). Two patients in the 25-gauge group experienced transient hypotony after surgery. Conclusion. No significant difference between 27-gauge and 25-gauge transconjunctival sutureless vitrectomy for the repair of primary rhegmatogenous retinal detachment was recorded in terms of reattachment rate, BCVA, intraoperative and postoperative complications.
Design of Rhombus-Shaped Slot Patch Antenna for Wireless Communications
Authors: Saravanan Manavalan , Rangachar Madihally Janardhana Srinivasa
Published: January 2019

A single feed circularly polarized patch antenna is presented. The antenna consists of a rhombus-shaped slot incorporated in the radiating patch at its center. The antenna is designed to operate at 2.3 GHz band. The antenna achieves left-hand polarization or right-hand polarization based on the orientation of the slot in the radiating patch. The antenna parameters are synthesized using a high-frequency structure simulator and its characteristics are validated by the Agilent network analyzer (N9925A) and antenna test systems. The measured results obtained agree with simulated results and show that the antenna achieves −10 dB impedance bandwidth of 85 MHz (2.27 GHz–2.355 GHz) for left-hand polarization and 85 MHz (2.26 GHz–2.345 GHz) for right-hand polarization. The antenna gives a 3 dB axial ratio beamwidth of 95°(−35° ≤ AR ≤ 60°) for both left-hand polarization and right-hand polarization along with better 3 dB axial ratio bandwidth of 140° in the operating band. The antenna also achieves a good cross-polarization isolation of −17 dBic for both left-hand and right-hand polarization at its operating frequency. Hence, the antenna is best suited for modern wireless communication systems.
A Hybrid Simulated Annealing Heuristic for Multistage Heterogeneous Fleet Scheduling with Fleet Sizing Decisions
Authors: Li Bing , Yang Xinyu , Xuan Hua
Published: January 2019

This paper deals with multistage heterogeneous fleet scheduling with fleet sizing decisions (MHFS-FSD). This MHFS-FSD attempts to integrate vehicles allocation and fleet sizing decisions considering the vehicle routing of multiple vehicle types. The problem is formulated as mixed integer programming model. The matrix formulation denoting vehicle allocation scheme is explored according to the characteristic of this problem. Generating vehicle allocation scheme with greedy heuristic procedure (VA-GHP) as initial solution of problem is presented. The USP-IVA method to update the initial solution generated by VA-GHP approach is developed. And then, incorporating VA-GHP and USP-IVA into simulated annealing algorithm, a novel heuristic called HSAH-GHP&IVA is proposed. Finally, some experiments are designed to test the proposed heuristic and the results show that the heuristic can generate reasonably good solutions in short CPU times.
Safety and Efficacy of Nonanesthesiologist-Administrated Propofol during Endoscopic Submucosal Dissection of Gastric Epithelial Tumors
Authors: Abe Keiichiro , Tominaga Keiichi , Kanamori Akira , Suzuki Tsunehiro , Kino Hitoshi , Nakano Masakazu , Sugaya Takeshi , Tsuchida Kouhei , Majima Yuichi , Murohisa Toshimitsu , Iijima Makoto , Goda Kenichi , Irisawa Atsushi
Published: January 2019

Objective. There is no consensus regarding administration of propofol for performing endoscopic submucosal dissection (ESD) in patients with comorbidities. The aim of this study was to evaluate the safety and efficacy of propofol-induced sedation administered by nonanesthesiologists during ESD of gastric cancer in patients with comorbidities classified according to the American Society of Anesthesiologists (ASA) physical status. Methods. Five hundred and twenty-two patients who underwent ESD for gastric epithelial tumors under sedation by nonanesthesiologist-administrated propofol between April 2011 and October 2017 at Dokkyo Medical University Hospital were enrolled in this study. The patients were divided into 3 groups according to the ASA physical status classification. Hypotension, desaturation, and bradycardia were evaluated as the adverse events associated with propofol. The safety of sedation by nonanesthesiologist-administrated propofol was measured as the primary outcome. Results. The patients were classified according to the ASA physical status classification: 182 with no comorbidity (ASA 1), 273 with mild comorbidity (ASA 2), and 67 with severe comorbidity (ASA 3). The median age of the patients with ASA physical status of 2/3 was higher than the median age of those with ASA physical status of 1. There was no significant difference in tumor characteristics, total amount of propofol used, or ESD procedure time, among the 3 groups. Adverse events related to propofol in the 522 patients were as follows: hypotension (systolic blood pressure<90 mmHg) in 113 patients (21.6%), respiratory depression (SpO2<90%) in 265 patients (50.8%), and bradycardia (pulse rate<50 bpm) in 39 patients (7.47%). There was no significant difference in the incidences of adverse events among the 3 groups during induction, maintenance, or recovery. No severe adverse event was reported. ASA 3 patients had a significantly longer mean length of hospital stay (8 days for ASA 1, 9 days for ASA 2, and 9 days for ASA 3, P=0.003). However, the difference did not appear to be clinically significant. Conclusions. Sedation by nonanesthesiologist-administrated propofol during ESD is safe and effective, even for at-risk patients according to the ASA physical status classification.
Research on UUV Obstacle Avoiding Method Based on Recurrent Neural Networks
Authors: Lin Changjian , Wang Hongjian , Yuan Jianya , Yu Dan , Li Chengfeng
Published: January 2019

In this paper, we present an online obstacle avoidance planning method for unmanned underwater vehicle (UUV) based on clockwork recurrent neural network (CW‐RNN) and long short‐term memory (LSTM), respectively. In essence, UUV online obstacle avoidance planning is a spatiotemporal sequence planning problem with the spatiotemporal data sequence of sensors as input and control instruction to motion controller of UUV as output. And recurrent neural networks (RNNs) have proven to give state‐of‐the‐art performance on many sequence labeling and sequence prediction tasks. In order to train the networks, a UUV obstacle avoidance dataset is generated and an offline training and testing is adopted in this paper. Finally, the proposed two types of RNN based online obstacle avoidance planners are compared in path cost, obstacle avoidance planning success rate, training time, time‐consumption, learning, and generalization, respectively. And the good performance of the proposed methods is demonstrated with a series of simulation experiments in different environments.
FAPRP: A Machine Learning Approach to Flooding Attacks Prevention Routing Protocol in Mobile Ad Hoc Networks
Authors: Luong Ngoc T. , Vo Tu T. , Hoang Doan
Published: January 2019

Request route flooding attack is one of the main challenges in the security of Mobile Ad Hoc Networks (MANETs) as it is easy to initiate and difficult to prevent. A malicious node can launch an attack simply by sending an excessively high number of route request (RREQ) packets or useless data packets to nonexistent destinations. As a result, the network is rendered useless as all its resources are used up to serve this storm of RREQ packets and hence unable to perform its normal routing duty. Most existing research efforts on detecting such a flooding attack use the number of RREQs originated by a node per unit time as the threshold to classify an attacker. These algorithms work to some extent; however, they suffer high misdetection rate and reduce network performance. This paper proposes a new flooding attacks detection algorithm (FADA) for MANETs based on a machine learning approach. The algorithm relies on the route discovery history information of each node to capture similar characteristics and behaviors of nodes belonging to the same class to decide if a node is malicious. The paper also proposes a new flooding attacks prevention routing protocol (FAPRP) by extending the original AODV protocol and integrating FADA algorithm. The performance of the proposed solution is evaluated in terms of successful attack detection ratio, packet delivery ratio, and routing load both in normal and under RREQ attack scenarios using NS2 simulation. The simulation results show that the proposed FAPRP can detect over 99% of RREQ flooding attacks for all scenarios using route discovery frequency vector of sizes larger than 35 and performs better in terms of packet delivery ratio and routing load compared to existing solutions for RREQ flooding attacks.
Stochastic Modeling and Dynamic Analysis of the Cardiovascular System with Rotary Left Ventricular Assist Devices
Authors: Son Jeongeun , Du Dongping , Du Yuncheng
Published: January 2019

Left ventricular assist devices (LVADs) have been used for end‐stage heart failure patients as a therapeutic option. The aortic valve plays a critical role in heart failure and its treatment with a LVAD. The cardiovascular‐LVAD model is often used to investigate the physiological demands required by patients and predict the hemodynamic of the native heart supported with a LVAD. As it is a “bridge-to-recovery” treatment, it is important to maintain appropriate and active dynamics of the aortic valve and the cardiac output of the native heart, which requires that the LVAD pump be adjusted so that a proper balance between the blood contributed through the aortic valve and the pump is maintained. In this paper, we investigate how the pump power of the LVAD pump can affect the dynamic behaviors of the aortic valve for different levels of activity and different severities of heart failure. Our objective is to identify a critical value of the pump power (i.e., breakpoint) to ensure that the LVAD pump does not take over the pumping function in the cardiovascular‐pump system and share the ejected blood with the left ventricle to help the heart to recover. In addition, the hemodynamic often involves variability due to patients’ heterogeneity and the stochastic nature of the cardiovascular system. The variability poses significant challenges to understanding dynamic behaviors of the aortic valve and cardiac output. A generalized polynomial chaos (gPC) expansion is used in this work to develop a stochastic cardiovascular‐pump model for efficient uncertainty propagation, from which it is possible to rapidly calculate the variance in the aortic valve opening duration and the cardiac output in the presence of variability. The simulation results show that the gPC‐based cardiovascular‐pump model is a reliable platform that can provide useful information to understand the effect of the LVAD pump on the hemodynamic of the heart.
Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
Authors: Guo Ying , Ren Manyi , Ge Lili , Sun Chao , Li Rui , Ma Cheng’en , Sui Shujian
Published: January 2019

We performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and October 2017 were consecutively included in our prospective observational study. TWEAK concentrations were detected in septic patients and healthy controls. Dynamic changes of TWEAK concentrations between 1st day and 3rd day of admission to ICU (ΔTWEAK concentrations) were also measured. A total of 79 septic patients were included and 19 of them (24.1%) died after a follow-up period of 28 days. We identified arterial lactate, NT-proBNP, and male gender as independent factors for 28-day mortality of patients with sepsis. The serum levels of TWEAK were significantly lower in septic patients compared to controls (417.4 ± 196.7 pg/ml versus 1243.8 ± 174.3 pg/ml, p<0.001). We found a positive correlation between TWEAK concentrations and SOFA score (Spearman correlation coefficient 0.235, p=0.037). Area under the receiver operating characteristic curve (AUROC) of ΔTWEAK concentrations for 28-day mortality was 0.754 (95% CI 0.645–0.844). We also evaluated the diagnostic performance of combinative index (ΔTWEAK concentrations and lactate) and obtained an AUROC of 0.860 (95% CI 0.763-0.928). In conclusion, our study found lower TWEAK concentrations in septic patients than those in healthy controls. Furthermore, the increased TWEAK concentrations during disease process predict higher 28-day mortality in septic patients. Dynamic changes of TWEAK should be an important supplement for current prognostic markers.
On the Heat Capacity of a Quasi-Two-Dimensional Electron Gas
Authors: Baymatov P. J. , Gulyamov A. G. , Abdulazizov B. T.
Published: January 2019

Numerical and analytical results of the investigation of the thermodynamic properties of a quasi-2D electron gas are presented. The density of states, the temperature derivative of the chemical potential, and the heat capacity of the gas at the resonance points and away from it are analyzed. It is shown that, in the dependence of the heat capacity on the chemical potential, there are additional steps at the resonance points. The width of the additional steps increases with temperature. With the increase in temperature, when the main steps are practically blurred, there are still visible marks from the additional steps.
Time‐Inconsistent Preferences, Retirement, and Increasing Life Expectancy
Authors: Chen Shou , Li Guangbing
Published: January 2019

We study consumption behavior, retirement decisions, and endogenous growth within a dynamic equilibrium when individuals have present‐biased preferences. Compared to individual with exponential preferences, individual with hyperbolic preferences will choose to retire early for present‐biased preferences but to delay retirement for the initial time preference rate. We extend the benchmark equilibrium model to age‐dependent survival law and solve numerically the equilibrium effects. It shows that, at the same age, the consumption‐capital ratio may have slightly positive effect on increasing life expectancy before retirement but has a significantly positive effect on it after retirement.
Tocotrienol-Rich Fraction (TRF) Treatment Promotes Proliferation Capacity of Stress-Induced Premature Senescence Myoblasts and Modulates the Renewal of Satellite Cells: Microarray Analysis
Authors: Lim Jing Jye , Wan Zurinah Wan Ngah , Mouly Vincent , Norwahidah Abdul Karim
Published: January 2019

Human skeletal muscle is a vital organ involved in movement and force generation. It suffers from deterioration in mass, strength, and regenerative capacity in sarcopenia. Skeletal muscle satellite cells are involved in the regeneration process in response to muscle loss. Tocotrienol, an isomer of vitamin E, was reported to have a protective effect on cellular aging. This research is aimed at determining the modulation of tocotrienol-rich fraction (TRF) on the gene expressions of stress-induced premature senescence (SIPS) human skeletal muscle myoblasts (CHQ5B). CHQ5B cells were divided into three groups, i.e., untreated young control, SIPS control (treated with 1 mM hydrogen peroxide), and TRF-posttreated groups (24 hours of 50 μg/mL TRF treatment after SIPS induction). The differential gene expressions were assessed using microarray, GSEA, and KEGG pathway analysis. Results showed that TRF treatment significantly regulated the gene expressions, i.e., p53 (RRM2B, SESN1), ErbB (EREG, SHC1, and SHC3), and FoxO (MSTN, SMAD3) signalling pathways in the SIPS myoblasts compared to the SIPS control group (p<0.05). TRF treatment modulated the proliferation capacity of SIPS myoblasts through regulation of ErbB (upregulation of expression of EREG, SHC1, and SHC3) and FoxO (downregulation of expression of MSTN and SMAD3) and maintaining the renewal of satellite cells through p53 signalling (upregulation of RRM2B and SESN1), MRF, cell cycle, and Wnt signalling pathways.
Duodenal Ulceration following Holmium Laser Lithotripsy
Authors: Pabla Baldeep , Morgan Douglas R.
Published: January 2019

The epidemiology of peptic ulcer disease (PUD) has changed considerably in the last several decades. Previously a chronic disease characterized by frequent recurrences with a high rate of surgical interventions, it is now largely a self-limited disease that is medically managed. The role of acid suppression was widely recognized as being important in the pathogenesis of PUD in the 19th century, while it was not until the 1980s and 1990s that the importance of Helicobacter pylori infection was identified. Today, PUD is largely caused by either H. pylori infection or nonsteroidal anti-inflammatory drug use. However, other less common etiologies of this disease are becoming more relevant as the prevalence of H. pylori decreases and proton pump inhibitor therapy is increasingly common. Here, we report a case of duodenal ulceration following bilateral rigid ureteroscopy with holmium laser lithotripsy.
Simultaneous Stimulation of the Globus Pallidus Interna and the Nucleus Basalis of Meynert in the Parkinson-Dementia Syndrome
Authors: Nombela Cristina , Lozano Andrés , Villanueva Clara , Barcia Juan A.
Published: January 2019

Background/Aim: The prevalence of cognitive symptoms in recently diagnosed Parkinson’s disease (PD) patients may be as high as 60%. We report a novel deep brain stimulation (DBS) strategy targeting both motor and cognitive symptoms. Methods: A PD patient diagnosed with mild cognitive impairment underwent DBS surgery targeting the globus pallidus interna (GPi; to treat motor symptoms) and the nucleus basalis of Meynert (NBM; to treat cognitive symptoms) using a single electrode per hemisphere. Results: Compared to baseline, 2-month follow-up after GPi stimulation was associated with motor improvements, whereas partial improvements in cognitive functions were observed 3 months after the addition of NBM stimulation to GPi stimulation. Conclusion: This case explores an available alternative for complete DBS treatment in PD, stimulating 2 targets at different frequencies with a single electrode lead.