bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Ambulatory Transitional Care Management on 30-Day Readmission Rates
Authors: Ballard Jonathan , Rankin Wade , Roper Karen L. , Weatherford Sarah , Cardarelli Roberto
Published: May 2018

A process improvement initiative for transitional care management (TCM) was evaluated for effectiveness in reducing 30-day readmission rates in a retrospective cohort study. Regression models analyzed the association between level of TCM component implementation and readmission rates among patients discharged from a university medical center hospital. Of the 1884 patients meeting inclusion criteria, only 3.7% (70) experienced a 30-day readmission. Patients receiving the full complement of TCM had 86.6% decreased odds of readmission compared with patients who did not receive TCM ( P < .001). However, the complete package of TCM services under Medicare guidelines may not be essential. A postdischarge telephone call did not reduce readmission odds, provided a TCM office visit occurred. Important for risk assessment models targeting patients for TCM, the number of previous hospital admissions, not age, predicted 30-day readmission risk. This study provides evidence that primary care–based TCM can reduce 30-day readmissions even when overall rates are low.
Drillers’ Cognitive Skills Monitoring Task
Authors: Roberts Ruby Clyde , Flin Rhona , Cleland Jennifer , Urquhart Jim
Published: May 2018

Drilling incidents have emphasized that offshore drillers require a high level of cognitive skills, including situation awareness and decision making, to maintain safe and efficient well control. Although a number of tools for supporting operators’ cognition are available in other high-risk industries, there is no specific tool for drilling. We developed a prototype monitoring task simulating drilling scenarios, Drillers’ Situation Awareness Task, with drilling experts and piloted with 14 drilling personnel. Preliminary results suggest that it is viable as a tool for examining drillers’ cognition and has the potential for training and formatively assessing cognitive skills in drilling.
Heterotopic Gastric Mucosa in the Common Bile Duct With Cholangiocarcinoma
Authors: Kim Yeseul , Jung Min Jung , Shin Su-Jin
Published: May 2018

Gastric heterotopia within the biliary system is extremely rare. Moreover, the combination of gastric heterotopia in the bile duct with cholangiocarcinoma has not been reported. We describe a case of heterotopic gastric mucosa in the common bile duct with cholangiocarcinoma. An 80-year-old male was admitted with abdominal pain. Abdominal computed tomography revealed wall thickening from the hilar duct to the distal common bile duct. Biopsy from the distal bile duct showed only benign gastric foveolar-type epithelium and fundic glands. Although the diagnosis of the biopsy was benign, malignancy was strongly suspected from the radiologic findings, and excision of the bile ducts was performed. Microscopically, the resected specimen showed poorly formed malignant glands and gastric heterotopia also identified in the common bile duct. Three months later, the patient’s state worsened due to recurrence, and he died. To our knowledge, this is the first report of gastric heterotopia in the bile duct accompanying cholangiocarcinoma.
Inhibition of Aortic Calcification by Policosanol in Dyslipidemic Rabbits Is Enhanced by Pentoxifylline
Authors: Elseweidy Mohamed M. , Mohamed Hoda E. , Elrashidy Rania A. , Atteia Hebatallah H. , Elnagar Gehad M.
Published: May 2018

Policosanol (POL) is a hypocholesterolemic drug of natural origin and has been shown to reduce circulating levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) in healthy participants. Recently, we have reported that POL can attenuate aortic calcification in diabetic dyslipidemic rats; however, the underlying mechanism is not fully elucidated. We aimed to investigate the effect of POL on aortic calcification and whether PCSK9 has a contributory role and also to examine whether the combination of POL with pentoxifylline (PTX) as anti–tumor necrosis factor α would offer additional benefits. Thirty adult male New Zealand rabbits weighing 1.5 to 2 kg were randomly assigned to 5 groups. One group received standard chow diet and served as normal control group (NC). The other 4 groups received 0.5% wt/wt cholesterol-rich diet for 12 weeks and concurrently treated with placebo, POL, PTX, or a combination of POL and PTX. Sera samples and aortic tissue were collected for biochemical measurements and histological assessment. Rabbits fed a cholesterol-rich diet demonstrated dyslipidemia, increased inflammatory state, and elevated serum levels of PCSK9, compared to the NC group. Aortic calcification was evident in dyslipidemic rabbits, represented by increased calcium deposition and osteopontin expression in aortic tissue, along with elevated serum levels of alkaline phosphatase and osteocalcin. Dyslipidemic rabbits showed a significant upregulation of wingless-type MMTV integration site family 3A and bone morphogenetic protein 2 genes in their aortic tissue. Policosanol significantly reduced circulating PCSK9 levels, suppressed calcification markers, and attenuated aortic calcification. Combination of POL with PTX alleviated aortic calcification to a greater extent than either monotherapy, which may be attributed to further suppression of PCSK9 and calcification markers. These findings suggested that POL exerted anticalcifying effect partly via inhibition of PCSK9. Combination of POL and PTX offered additional benefits and might represent a promising therapeutic option for aortic calcification.
Active control of stick-slip torsional vibrations in drill-strings
Authors: Ritto Thiago G , Ghandchi-Tehrani Maryam
Published: May 2018

This paper presents active vibration control to reduce the stick-slip oscillations in drill-strings. A simplified two degrees-of-freedom drill-string torsional model is considered. The nonlinear interaction between the rock and the bit is included in the model, where its parameters are fitted with field data from a 5 km drill-string system. Different proportional-derivative (PD)-control strategies are employed and compared, including the one that takes into account the weight-on-bit (axial force) and the bit speed. Optimization problems are proposed to obtain the values of the gain coefficients, and a torsional stability map is constructed for different weight-on-bit values and top-drive speeds. It is noted that the information of the dynamics at the bottom increases the performance of the PD-controller significantly in terms of the torsional vibration suppression, for the system analyzed.
Why Do So Few Consumers Use Health Care Quality Report Cards? A Framework for Understanding the Limited Consumer Impact of Comparative Quality Information
Authors: Bhandari Neeraj , Scanlon Dennis P. , Shi Yunfeng , Smith Rachel A.
Published: May 2018

Despite growing investment in producing and releasing comparative provider quality information (CQI), consumer use of CQI has remained poor. We offer a framework to interpret and synthesize the existing literature’s diverse approaches to explaining the CQI’s low appeal for consumers. Our framework cautions CQI stakeholders against forming unrealistic expectations of pervasive consumer use and suggests that they focus their efforts more narrowly on consumers who may find CQI more salient for choosing providers. We review the consumer impact of stakeholder efforts to apply the burgeoning knowledge of consumers’ cognitive limitations to the design and dissemination of the new generation of report cards; we conclude that while it is too limited to draw firm conclusions, early evidence suggests consumers are responding to the novel design and dissemination strategies. We find that consumers continue to have difficulty accessing reliable report cards, while the media remains underused in the dissemination of report cards.
Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs: 15 years follow-up of the thrust plate prosthesis and the Bi-Metric stem
Authors: Christiansen Janus D , Laursen Mogens B , Ejaz Ashir , Nielsen Poul T
Published: May 2018

Introduction:

The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric).

Methods:

In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline was the 1st postoperative day, and subsequent follow-up was performed at 6 months, 1, 2, 8, 12 and 15 years after surgery. A four regions of interest (ROI) protocol was developed to assess BMD.

Results:

In ROI1, bone resorption was significantly higher for group A at 6 months with a mean difference of 10% (95% confidence interval [CI], 4–16; p = 0.003) and 8% (95% CI, 1–15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23–69) to 93 (55–100) in group A and from 51 (24–72) to 94 (78–100) in group B.

Conclusion:

The TPP was not found to be inferior to the Bi-Metric stem regarding bone preservation. The decrease in BMD in ROI4 was greater in group B. Clinical and radiological results also revealed that the TPP was not inferior to the Bi-Metric stem.
Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
Authors: Frederix Ines , Vanderlinden Lien , Verboven Anne-Sophie , Welten Maria , Wouters Donna , De Keulenaer Gilles , Ector Bavo , Elegeert Ivan , Troisfontaines Pierre , Weytjens Caroline , Mullens Wilfried , Dendale Paul
Published: May 2018

Aims

The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up.

Methods

Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t0); 142 CHF patients (65% male; age: 76 ± 10 years; EF: 36 ± 15%) were alive and entered the follow-up study (time point: t1) with a final evaluation at 79 months (time point: t2). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t1 – t2). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs.

Results

Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group ( p = 0.04). Healthcare costs did not differ significantly between the TM (€ 9140 ± 10580) and UC group (€ 12495 ± 22433) ( p = 0.87).

Discussion

An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: https://clinicaltrials.gov/ct2/show/NCT03171038 ).
The use of a diamond ranking and peer interviews to capture pupils’ perspectives
Authors: Niemi Reetta , Kumpulainen Kristiina , Lipponen Lasse
Published: May 2018

In the new national core curriculum for Finnish preschool and basic education, rationales for supporting pupil participation are framed by the goal of developing school communities by listening to pupils’ perspectives, the social nature of teaching and learning and pupils’ participatory role in planning, implementing and evaluating their own learning. Also in educational literature, listening to pupils’ perspectives is seen as the first step of participation. Framed by these rationales, this article is based on a 6-week-long participatory learning project in one second-grade classroom in Finland. The research group of 8-year-olds included 11 girls and 10 boys. In this study, we used diamond ranking and peer interviews as mediating tools in listening to the pupils’ perspectives. In the article, we describe how a diamond ranking and a peer interview worked as a tool in capturing pupils’ perspectives. Two questions guided the research work: (1) How did diamond ranking and the peer interview work together as a method to improve teacher’s understanding from the pupils’ perspectives? and (2) How did diamond ranking and the peer interview work together as a method to promote pupils’ participation? In this study, the second graders were able to implement diamond ranking. This activity was used as a tool to stimulate pupils’ perspectives that were then captured in peer interviews. The methods provided important information about the pupils and helped the teacher to understand their perspectives. Diamond ranking and peer interviews also revealed information that was not related to pedagogical practices but indicated the sense of relatedness among pupils. In this study, the process of peer interviews was a child-led practice, while the process of diamond ranking activity was teacher-oriented. The method would have served pupils’ participation better if pupils had been more involved in the data collection.
They can’t safeguard you when they are under stress
Authors: Nisar Sehran Khan , Rasheed Muhammad Imran , Qiang Wang
Published: May 2018

The purpose of this research is to explore work-related stress in the police of Azad Jammu and Kashmir (AJ&K), Pakistan. The research aims to identify factors that contribute most towards job stress in AJ&K police and study the nature of and reasons underlying these factors. Political and media pressure has not been widely studied within the context of job stress in the police, and researchers have attempted to bridge this gap and make a theoretical contribution by highlighting the importance of political and media pressure as a job stressor for the police profession. This is exploratory research in which a survey was conducted in three large cities of AJ&K, Pakistan. Primary data was collected through a questionnaire comprising closed and open-ended interview questions. Descriptive statistics, correlation and regression analysis were conducted using SPSS. Content analysis of the interview statements was also undertaken to enhance the validity of the study. The research findings showed that although lack of resources is the biggest issue, other factors like political and media pressure, and long working hours are also significantly and positively associated with job stress in the police in AJ&K. The article draws attention towards political and media pressure as a job stressor for police. The research has an important role in compelling top management in AJ&K police to ponder the issue of job stress within their department. The findings are also important for police in other countries who are facing similar issues.
An assessment of performance trade-offs in diesel engines equipped with regenerative electrically assisted turbochargers
Authors: Song Kang , Upadhyay Devesh , Xie Hui
Published: May 2018

The regenerative electrically assisted turbocharger offers performance benefits, such as reduced turbo-lag, over the conventional turbocharger. However, regenerative electrically assisted turbocharger introduces additional control degrees of freedom as well as new causalities in the air-path dynamics of boosted engines. This is because the electrical power applied to (or removed from) the turbocharger shaft disrupts the natural coupling between the engine exhaust, and the turbocharger operation found in conventionally boosted systems. The ideal performance objective of regenerative electrically assisted turbocharger is to achieve fast boost response with improved fuel economy and minimal impact on engine-out emissions. These performance criteria, as we show in this article, drive performance trade-offs that must be considered for optimal system performance. In this article, we investigate these trade-off relationships based on a high fidelity GT-SUITE engine model for a heavy-duty diesel engine. An optimal control law is used in conjunction with a control-oriented plant model. Results from load step tests and from the federal test cycle (FTP-75) indicate that using a properly designed optimal controller, it is possible to manage these trade-offs, and to simultaneously achieve benefits in boost response, FE as well as engine-out emissions.
Responsibility, polity, value: The (un)changing norms of planning practices
Authors: Savini Federico
Published: May 2018

To address the social, spatial and environmental problems of cities, planners often promote and engage with spatial practices that are intended to be experimental, innovative or transformative of existent processes. Yet, the actual nature of the novelty of these practices is often not explicit nor problematised by their proponents. This article develops an institutionalist framework to better appreciate the variegated nature of change in planning practices. It understands planning as embedded in, and simultaneously impacting on, three types of institutionalised norms: operational norms that define and allocate responsibilities among actors, collective norms that (re)produce planning polities and constitute the spatial-temporal context of their actions and constitutional norms that substantiate the idea of value defining the eligible stakeholders of a particular process. The article mobilises this framework and argues that contemporary planning practices convey a (a) shifting of responsibility towards individuals and households, (b) disaggregation of city regions through polycentric localism and (c) the reproduction of the process of accumulative valorisation of land. The article concludes reflecting on the complexity institutional change.
Acoustic emission characterization of local bending behavior for adhesively bonded hybrid external patch repaired glass/epoxy composite laminates
Authors: Andrew J Jefferson , Arumugam V , Ramesh C
Published: May 2018

This article investigates the influence of homogeneous and hybrid external patches based on glass and Kevlar plain weave woven fabrics on local bending response of adhesively bonded external patch repairs in damaged glass/epoxy composite laminates. The intent of using hybrid external patches was to combine the excellent high displacement to failure property of Kevlar fiber as a ductile reinforcement with the superior mechanical property of glass fiber as a brittle reinforcement. The undamaged normal specimens were taken as the standard specimen for evaluation of residual mechanical properties. In all hybrid patches, the proportion of Kevlar and glass fibers was equal (i.e. 50% of Kevlar and 50% of glass by volume fraction), while lay-up configurations were different. This further allowed studying the associated effects of hybridization and lay-up configuration on local bending response of the repaired laminates. All the specimens were subjected to cyclic quasi-static indentation tests with a step loading method. The indentation tests have also been monitored in real time by acoustic emission system. The acoustic emission results illustrated various damage profiles and correlates with the mechanical test results to point out the load to a transformation in damage mechanisms during indentation loading with respect to the effect of each patch material on the performance of the repaired glass/epoxy specimens. Results showed that hybridization and lay-up configurations of the external patches played a significant role on local bending response (i.e. ultimate load, stiffness, residual deformation, displacement to failure, and damage pattern) of the repaired glass/epoxy specimens. Specimens repaired using intra-ply hybrid patches showed the best local bending response.
Relationship of spirometric, body plethysmographic, and diffusing capacity parameters to emphysema scores derived from CT scans
Authors: Kahnert Kathrin , Jobst Bertram , Biertz Frank , Biederer Jürgen , Watz Henrik , Huber Rudolf M , Behr Jürgen , Grenier Philippe A , Alter Peter , Vogelmeier Claus F , Kauczor Hans-Ulrich , Jörres Rudolf A
Published: May 2018

Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evaluated using a qualitative binary emphysema score. The binary score was positive for emphysema in 52.5% of patients, and there were significant differences between the positive/negative groups regarding forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), intrathoracic gas volume (ITGV), residual volume (RV), specific airway resistance (sRaw), transfer coefficient (KCO), transfer factor for carbon monoxide (TLCO), age, pack-years, and body mass index (BMI). Stepwise discriminant analyses revealed the combination of FEV1/FVC, RV, sRaw, and KCO to be significantly related to the binary emphysema score. The additional positive predictive value of body plethysmography, however, was only slightly higher than that of the conventional combination of spirometry and diffusing capacity, which if taken alone also achieved high predictive values, in contrast to body plethysmography. The additional information on the presence of CT-diagnosed emphysema as conferred by body plethysmography appeared to be minor compared to the well-known combination of spirometry and CO diffusing capacity.
Anti-Human Trafficking Campaigns
Authors: Szablewska Natalia , Kubacki Krzysztof
Published: May 2018

This study aims to systematically identify and review studies on anti-human trafficking campaigns published in peer-reviewed journals to determine the extent to which such campaigns have been critically and rigorously evaluated so as to guide future policies and practice in this area and to identify the main characteristics, problems, and challenges associated with the campaigns in the identified studies. This systematic literature review identified 16 studies that have assessed anti-human trafficking campaigns but found that none of these included outcome, process, or impact evaluations. As identified in our study, anti-human trafficking campaigns tend to rely on advertising techniques to target vulnerable groups and the wider public, with the primary aim of informing and educating. Further, a thematic analysis of the studies identified problems in eight areas that require attention in the future development of anti-human trafficking campaigns: stereotyping, compounding human trafficking with migration, conflating prostitution with human trafficking, sexualization/erotization of women, victimization, role of anti-human trafficking organizations, data shortcomings, and oversimplification of human trafficking. Studies presenting the results of evaluations of social marketing anti-human trafficking campaigns are urgently needed to show which social marketing tools work and to provide an evidence base for future campaigns.
Providing Health Education to Mixtec Farmworkers in California via Workshops and Radio: A Feasibility Study
Authors: Young Sandra , Gomez Norma , Maxwell Annette E.
Published: May 2018

Originating from one of the poorest areas in Mexico, Mixtecs are one of the largest indigenous groups of workers in California. Providing health education to this group is challenging because many do not speak English or Spanish, and indigenous languages are mainly oral, not written. We explored the feasibility of conveying health information through the radio and in promotora-led workshops. The study included an evaluation of the workshops through surveys before the workshop and 4 to 6 months later in a subsample of 96 indigenous women. The number of radio listeners averaged more than 2,000 per month, and 500 community members attended a workshop. Among women who completed pre- and postworkshop assessments ( N = 75), there was a statistically significant increase in knowledge of how to get a wellness visit, where to get a free mammogram, and mammography screening guidelines. Women who ever had a mammogram or wellness visit at baseline were significantly more likely to report receipt of this service during the follow-up period than women who never had this service. Educational workshops and radio are promising and culturally appropriate strategies to provide health information in this community. However, many women need additional assistance to navigate access to health care.
A real-time locating system for localization of high-speed mobile objects
Authors: Kim Minhyuk , Chang Sekchin
Published: May 2018

This article addresses a novel real-time locating system for localization of high-speed mobile objects in fading environments. The proposed locating system exploits time difference of arrival measurements based on ultra-wideband signals. However, the ultra-wideband signals cause a frequency-selective fading due to their short time duration, which induces severe inter-symbol interference. Moreover, high-speed objects cause fast fading due to large Doppler spread. Therefore, the fading cases considerably reduce the localization performance. The presented locating system relies on a new localization approach in order to overcome the fading issues, which utilizes a modification of extended Kalman filtering. Especially, the suggested locating method works well even in the zero time difference of arrival case, which occurs due to a very deep fading. Experiment results verify that the proposed real-time locating system gives excellent localization performance in severe fading environments. The results also exhibit that the presented locating system is superior to the conventional locating systems in the localization of high-speed mobile objects under fading environments.
Electrical Stimulation of the Lower Esophageal Sphincter to Treat Gastroesophageal Reflux After POEM
Authors: Rieder Erwin , Paireder Matthias , Kristo Ivan , Schwameis Katrin , Schoppmann Sebastian F.
Published: May 2018

As per-oral endoscopic myotomy (POEM) is not followed by any anti-reflux procedure, a common concern is the risk of postoperative gastro-esophageal reflux disease (GERD). Electrical stimulation of the lower esophageal sphincter (LES-EST) could be an option for post-POEM GERD. A 68-year old male obese patient underwent successful POEM but developed GERD not responsive to proton pump inhibitors. Consecutively, the patient had implanted an electrical LES stimulation device, consisting of bipolar LES-electrodes connected to a subcutaneous pulse generator. POEM reduced the Eckardt score (9 vs. 0), the LES resting pressure (52.0 vs. 16.4 mmHg), and the Integrated Relaxation Pressure (62.0 vs. 10.0 mmHg). LES-EST substantially reduced post-POEM GERD symptoms. GERD-HRQL scores indicated the elimination of heartburn (26 vs. 7) and regurgitation (24 vs. 3) at three months. A reduced total number refluxes (82 vs. 14) was observed. The %-time of pH below 4 was only slightly reduced (8.6% to 6.2%).LES-EST appears to be a feasible option to symptomatically treat post-POEM GERD for patients not ideal for conventional anti-reflux surgery.
Murburn Concept: A Molecular Explanation for Hormetic and Idiosyncratic Dose Responses
Authors: Parashar Abhinav , Gideon Daniel Andrew , Manoj Kelath Murali
Published: May 2018

Recently, electron transfers and catalyses in a bevy of redox reactions mediated by hemeproteins were explained by murburn concept. The term “murburn” is abstracted from “ mur ed burn ing” or “ m ild u n r estricted burn ing” and connotes a novel “ m olecule- u nbound ion– r adical” interaction paradigm. Quite unlike the genetic regulations and protein-level affinity-based controls that govern order and specificity/selectivity in conventional treatments, murburn concept is based on stochastic/thermodynamic regulatory principles. The novel insight necessitates a “reactivity outside the active-site” perspective, because select redox enzymatic activity is obligatorily mediated via diffusible radical/species. Herein, reactions employing key hemeproteins (as exemplified by CYP2E1) establish direct experimental connection between “additive-influenced redox catalysis” and “unusual dose responses” in reductionist and physiological milieu. Thus, direct and conclusive molecular-level experimental evidence is presented, supporting the mechanistic relevance of murburn concept in “maverick” concentration-based effects brought about by additives. Therefore, murburn concept could potentially explain several physiological hormetic and idiosyncratic dose responses.
A review on topological architecture and design methods of cable-driven mechanism
Authors: Hong Huajie , Ali Jabran , Ren Lei
Published: May 2018

Research on the cable-driven mechanism has greatly developed with the booming of the robots in the past 30 years, and a range of corresponding theoretical studies have been published on them. The large-scale robot or manipulator with the complex cable-driven mechanism can be reconfigured. However, more theoretical studies are required on their topological architecture design and optimization to achieve this. Therefore, the applied cable-driven architectures and the corresponding theoretical studies are reviewed and summarized here. The parallel, serial, and differential architecture are illustrated, as well as their theories and methods, such as the workspace analysis based on the Jacobian matrix, particle swarm optimization and genetic algorithm, and kinematic design based on the graph theory are described. The features of the architecture and the theory studies are concluded. It is hoped that this study will help with design of future studies.
An intermediate point obstacle avoidance algorithm for serial robot
Authors: Chen Zhuo , Su Weihua , Li Bin , Deng Baosong , Wu Hang , Liu Baozhen
Published: May 2018

The trajectory planning and obstacle avoidance of serial robot is an important area of research and efficient optimization algorithms are needed. This article proposes an intermediate point obstacle avoidance algorithm to ensure smooth trajectory and efficient movement during the obstacle avoidance process. Using the intermediate point obstacle avoidance algorithm, the robotic arm can steer obstacle around with the minimum joint space variations and the shortest end motion trajectory. We also design a novel collision detection strategy and fitness evaluation function based on genetic algorithm to optimize the intermediate point parameters. In order to evaluate the performance of the intermediate point obstacle avoidance algorithm, we have conducted three typical experiments: single obstacle, multiple obstacles, and no obstacle. The experimental results demonstrate that the proposed method can not only effectively realize the obstacle avoidance, but also efficiently improve the movement performance of the robotic arm.
Computer vision–based automatic rod-insulator defect detection in high-speed railway catenary system
Authors: Han Ye , Liu Zhigang , Lee DJ , Liu Wenqiang , Chen Junwen , Han Zhiwei
Published: May 2018

Maintenance of catenary system is a crucial task for the safe operation of high-speed railway systems. Catenary system malfunction could interrupt railway service and threaten public safety. This article presents a computer vision algorithm that is developed to automatically detect the defective rod-insulators in a catenary system to ensure reliable power transmission. Two key challenges in building such a robust inspection system are addressed in this work, the detection of the insulators in the catenary image and the detection of possible defects. A two-step insulator detection method is implemented to detect insulators with different inclination angles in the image. The sub-images containing cantilevers and rods are first extracted from the catenary image. Then, the insulators are detected in the sub-image using deformable part models. A local intensity period estimation algorithm is designed specifically for insulator defect detection. Experimental results show that the proposed method is able to automatically and reliably detect insulator defects including the breakage of the ceramic discs and the foreign objects clamped between two ceramic discs. The performance of this visual inspection method meets the strict requirements for catenary system maintenance.
Ultra-protective mechanical ventilation without extra-corporeal carbon dioxide removal for acute respiratory distress syndrome
Authors: Regunath Hariharan , Moulton Nathanial , Woolery Daniel , Alnijoumi Mohammed , Whitacre Troy , Collins Jonathan
Published: May 2018

Background

Tidal hyperinflation can still occur with mechanical ventilation using low tidal volume (LVT) (6 mL/kg predicted body weight (PBW)) in acute respiratory distress syndrome (ARDS), despite a well-demonstrated reduction in mortality.

Methods

Retrospective chart review from August 2012 to October 2014. Inclusion: Age >18years, PaO2/FiO2<200 with bilateral pulmonary infiltrates, absent heart failure, and ultra-protective mechanical ventilation (UPMV) defined as tidal volume (VT) <6 mL/kg PBW. Exclusion: UPMV use for <24 h. Demographics, admission Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, arterial blood gas, serum bicarbonate, ventilator parameters for pre-, during, and post-UPMV periods including modes, VT, peak inspiratory pressure (PIP), plateau pressure (Pplat), driving pressure, etc. were gathered. We compared lab and ventilator data for pre-, during, and post-UPMV periods.

Results

Fifteen patients (male:female = 7:8, age 42.13 ± 11.29 years) satisfied criteria, APACHEII 20.6 ± 7.1, mean days in intensive care unit and hospitalization were 18.5 ± 8.85 and 20.81 ± 9.78 days, 9 (60%) received paralysis and 7 (46.67%) required inotropes. Eleven patients had echocardiogram, 7 (63.64%) demonstrated right ventricular volume or pressure overload. Eleven patients (73.33%) survived. During-UPMV, VT ranged 2–5 mL/kg PBW(3.99 ± 0.73), the arterial partial pressure of carbon dioxide (PaCO2) was higher than pre-UPMV values (84.81 ± 18.95 cmH2O vs. 69.16 ± 33.09 cmH2O), but pH was comparable and none received extracorporeal carbon dioxide removal (ECCO2-R). The positive end-expiratory pressure (14.18 ± 7.56 vs. 12.31 ± 6.84 cmH2O), PIP (38.21 ± 12.89 vs. 32.59 ± 9.88), and mean airway pressures (19.98 ± 7.61 vs. 17.48 ± 6.7 cm H2O) were higher during UPMV, but Pplat and PaO2/FiO2 were comparable during- and pre-UPMV. Driving pressure was observed to be higher in those who died than who survived (24.18 ± 12.36 vs. 13.42 ± 3.25).

Conclusion

UPMV alone may be a safe alternative option for ARDS patients in centers without ECCO2-R.
Ocrelizumab: a new milestone in multiple sclerosis therapy
Authors: Mulero Patricia , Midaglia Luciana , Montalban Xavier
Published: May 2018

B cells play a central role in the pathogenesis of multiple sclerosis (MS): they are involved in the activation of pro-inflammatory T cells, secretion of pro-inflammatory cytokines and production of autoantibodies directed against myelin. Hence, the use of B cell-depleting monoclonal antibodies as therapy for autoimmune diseases, including MS, has increased in recent years. Previous results with rituximab, the first therapeutic B cell-depleting chimeric monoclonal antibody that showed efficacy in MS clinical trials, encouraged researchers to evaluate the efficacy of a humanized anti-CD20 antibody, ocrelizumab, in MS. A large phase II clinical trial in patients with relapsing-remitting MS (RRMS) designed to explore the effects of two doses of ocrelizumab (600 mg and 2000 mg) compared with placebo showed a pronounced effect on radiological and relapse-related outcomes. These results were confirmed in two phase III trials (OPERA I and II) that compared the efficacies of ocrelizumab with interferon beta-1a in patients with relapsing MS, and showed decreased annualized relapse rates (46% in OPERA I and 47% in OPERA II), as well as fewer numbers of gadolinium-enhanced lesions on magnetic resonance imaging (MRI) scans (94% in OPERA I and 95% in OPERA II). Notably, ocrelizumab is the first drug to lower rates of clinical and MRI-evidenced progression in patients with primary progressive MS (PPMS). The phase III trial (ORATORIO) in patients with PPMS met its primary efficacy endpoint: the percentage of patients with 12-week confirmed disability progression was significantly lower in the active treatment group (32.9%) than in patients receiving placebo (39.3%). In March 2017, this evidence led the US Food and Drug Administration to approve the licence for ocrelizumab (Ocrevus®) as a treatment for MS, as the first treatment approved for PPMS and as the first monoclonal antibody for secondary progressive MS.
Shiga toxin–producing Escherichia coli (STEC) O157 outbreak associated with likely transmission in an inflatable home paddling pool in England, June 2017
Authors: Pereboom MTR , Todkill D , Knapper E , Jenkins C , Hawker J , Coetzee N
Published: May 2018

In June 2017, an outbreak of Shiga toxin–producing Escherichia coli (STEC) O157 infection with phage type 21/28 and identical genotypic profiles involving three children from Staffordshire was reported. Two cases developed haemolytic uraemic syndrome (HUS). Person-to-person transmission via a shared inflatable home paddling pool was the most likely route of infection, following contamination by the first case. The source of infection in the first case was not identified. We recommend that individuals experiencing gastroenteritis should not bathe in paddling pools and that water should be changed at frequent intervals throughout the day to minimise the spread of infection.
Motion Masking by Stationary Objects: A Study of Simulated Saccades
Authors: Duyck Marianne , Wexler Mark , Castet Eric , Collins Thérèse
Published: May 2018

Saccades are crucial to visual information intake by re-orienting the fovea to regions of interest in the visual scene. However, they cause drastic disruptions of the retinal input by shifting the retinal image at very high speeds. The resulting motion and smear are barely noticed, a phenomenon known as saccadic omission. Here, we studied the perception of motion during simulated saccades while observers fixated, moving naturalistic visual scenes across the retina with saccadic speed profiles using a very high temporal frequency display. We found that the mere presence of static pre- and post-saccadic images significantly reduces the perceived amplitude of motion but does not eliminate it entirely. This masking of motion perception could make the intra-saccadic stimulus much less salient and thus easier to ignore.
Engineering a microcirculation for perfusion control of ex vivo–assembled organ systems: Challenges and opportunities
Authors: Kottamasu Pavan , Herman Ira
Published: May 2018

Donor organ shortage remains a clear problem for many end-stage organ patients around the world. The number of available donor organs pales in comparison with the number of patients in need of these organs. The field of tissue engineering proposes a plausible solution. Using stem cells, a patient’s autologous cells, or allografted cells to seed-engineered scaffolds, tissue-engineered constructs can effectively supplement the donor pool and bypass other problems that arise when using donor organs, such as who receives the organ first and whether donor organ rejection may occur. However, current research methods and technologies have been unable to successfully engineer and vascularize large volume tissue constructs. This review examines the current perfusion methods for ex vivo organ systems, defines the different types of vascularization in organs, explores various strategies to vascularize ex vivo organ systems, and discusses challenges and opportunities for the field of tissue engineering.
Counter-framing: Implications for public relations
Authors: Anderson William B.
Published: May 2018

This article seeks to introduce the concept of counter-framing (i.e. a frame that contradicts the original frame and is introduced at a later date than the original) to the public relations literature so that scholars might more accurately examine the democratic environment where competitive debate is expected and meaning is negotiated. The article begins with a summary of how public relations scholars have studied framing before highlighting research from political science researchers on counter-framing. A case study of the battle for gun control legislation in the United States is then used to examine and contextualize the framing/counter-framing dynamic. This study adds the duration of time between messages as a possible factor that might influence framing effects.
Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis
Authors: Glisic Marija , Shahzad Sara , Tsoli Stergiani , Chadni Mahmuda , Asllanaj Eralda , Rojas Lyda Z , Brown Elizabeth , Chowdhury Rajiv , Muka Taulant , Franco Oscar H
Published: May 2018

Aims

The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes.

Methods and results

Nineteen observational studies (seven cohort and 12 case–control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70–1.62), 0.98 (95% CI 0.66–1.47) and 1.02 (95% CI 0.72–1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74–3.94), but not oral POCs (RR 1.06, 95% CI 0.7–1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32–0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant.

Conclusions

This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.
Medical management of esophageal food impaction refractory to endoscopic interventions
Authors: Stemboroski Lauren , Brown Ronald , Rizg Keyrillos , Scolapio James S , Malespin Miguel , de Melo Silvio W
Published: May 2018

Most esophageal food impactions either pass spontaneously or are treated endoscopically. Severe food impactions can require extensive endoscopic therapy that potentially could lead to procedure-related complications. There are few alternate therapies available when endoscopy fails. Traditionally, pharmacologic therapy with glucagon has been performed with varying success. This case report and discussion will outline the management of a complete food impaction and medical therapies available when first-line endoscopic treatment fails. We present a case in which the endoscopic intervention for esophageal food bolus impaction was unsuccessful.
Chest pain from pill-induced esophagitis: A rare side effect of ascorbic acid
Authors: Zhang Yu , Tong Yarong , Wang Weihong , Xu Lei
Published: May 2018

Pill-induced esophagitis is a rare cause of acute chest pain. Patients likely to be affected are those with underlying esophageal disorders, those who ingest medications without a sufficient amount of water, or adopt a supine position during or shortly after swallowing medication. Esophagitis secondary to ingestion of ascorbic acid pills is extremely rare. Here, we report a case of ascorbic acid-induced esophagitis in a middle-aged adult, with no known underlying pathological abnormalities of the esophagus. Diagnosis was made based on the history and endoscopic findings. The patient fully recovered and an esophageal ulcer healed after discontinuation of ascorbic acid.
An evaluation of osteopathic treatment on psychological outcomes with patients suffering from chronic pain: A prospective observational cohort study collected through a health and well-being academy
Authors: Edwards Darren J , Toutt Craig
Published: May 2018

Co-morbid mental health conditions such as anxiety, depression and fear avoidance are often associated with chronic pain. This novel study aimed to explore the impact of osteopathic treatment on several psychological outcome measures relating to anxiety, depression, mental health and fear avoidance for a chronic pain population receiving osteopathic treatment over a 2-week period. The findings show that there were significant reductions in anxiety, pain, mental health dysfunction and improvements in self-care. These results are promising, and it is suggested that now a full-scale randomised controlled trial should be conducted.
Potential role of soluble TNF-α receptors in diagnosis of idiopathic membranous nephropathy
Authors: Xun Chunhua , Zhao Yong , Wang Wenjuan , Cheng Tiantian
Published: May 2018

Soluble tumor necrosis factor alpha (TNF-α) receptors contain two receptors: soluble tumor necrosis factor receptor (sTNFR) 1 and 2, and the aim of our study was to discover their concentration and diagnostic value for idiopathic membranous nephropathy (IMN). In total, 58 patients with IMN, 51 patients with chronic kidney disease (CKD), and 30 healthy volunteers were enrolled in this study. Levels of serum sTNFR1 and sTNFR2 were determined by enzyme-linked immunosorbent assay (ELISA). Serum cystatin C (CysC), urea, creatinine (CREA), uric acid (UA), total protein (TP), albumin (ALB), and 24-h urinary protein (proteinuria, PRO) were examined by automatic biochemical analyzer. Levels of sTNFR1 and sTNFR2 were significantly higher in IMN group than CKD and control group ( P < 0.05). In IMN group, there were significant correlation between sTNFR1 and sTNFR2 ( P < 0.01). Both sTNFR1 and sTNFR2 were positively related to serum urea, CREA, CysC, UA, 24-h PRO ( P < 0.05) and negatively related to ALB ( P < 0.01). Receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of sTNFR1 and sTNFR2 were 0.997 and 0.993, respectively, when control was healthy volunteers. When sTNFR1 cut-off was 959.15 pg/mL, the sensitivity and specificity were 96.6% and 100%, respectively. When sTNFR2 cut-off was 2449.43 pg/mL, the sensitivity and specificity were 93.1% and 100%, respectively. While the control was CKD group, AUC of sTNFR1 and sTNFR2 were 0.647 and 0.626, respectively. When sTNFR1 cut-off was 3356.57 pg/mL, the sensitivity and specificity were 72.4% and 60.8%, respectively. When sTNFR2 cut-off was 6497.34 pg/mL, the sensitivity and specificity were 72.4% and 58.8%, respectively. This is the first study to show that both levels of sTNFR1 and sTNFR2 increased and correlated with serum urea, CREA, CysC, UA, ALB, 24-h PRO and could be usable for IMN diagnosis and differential diagnosis between IMN and CKD.