bluuebunny/crossref_metadata_2025 huggingface dataset:
Bridge-surface panoramic-image generation for automated bridge-inspection using deepmatching
Authors: Won Jongbin , Park Jong-Woong , Shim Changsu , Park Man-Woo
Published: June 2020

Visual inspection is important for the efficient maintenance of bridge structures and has recently been supplemented with the use of image-processing techniques that can localize and quantify damages using images captured from bridges. A series of overlapping bridge images can be combined for constructing a panoramic bridge-surface image in which the locations and sizes of the damages can be noted. Despite the excellent performance of image-processing techniques, generating panoramic images from a series of bridge-surface images is challenging as bridge-surface images may not possess distinct patterns or patterns that can act as reference feature points for stitching adjacent images. To address this issue, this paper presents a general method for stitching bridge-surface images using Deepmatching, which determines a pixel-wise correspondence between an image pair in comparison with conventional feature-wise matching methods. To employ Deepmatching for panoramic-image generation, (1) image matching pair search using 2D Delaunay triangulation, (2) parametric model for optimal image stitching were developed, and (3) field validation was conducted in this study. First, possible image matching pairs are organized using the two-dimensional Delaunay triangulation, and then Deepmatching is used to determine the matching points between possible image pairs. The developed parametric model refines the valid image matching pair, which is used for obtaining optimal global homographies for panoramic-image generation. For the validation of the proposed method, a lab-scale experiment on a flat concrete wall and a field experiment on a concrete bridge were conducted. The experimental validation demonstrates that the proposed method successfully identifies dense matching points between image pairs and generates a panoramic image while minimizing the occurrence of ghosting and drift.
Acquisition target selection and technological relatedness: The moderating role of Top Management Team demographic faultlines
Authors: Kavuşan Korcan , Ateş Nüfer Yasin , Nadolska Anna
Published: June 2020

We investigate why some acquirers value targets’ technological relatedness (i.e. similarity and complementarity) more than others. We propose that the importance of technological relatedness as a target selection criterion is influenced by the extent to which an acquirer Top Management Team is divided into subgroups based on managers’ demographic characteristics (i.e. faultlines). That is because an acquirer Top Management Team’s understanding of technological relatedness depends on the team’s information processing capabilities, driven primarily by Top Management Team faultlines. Our analysis of 94 realized acquisitions among 2082 potential acquisition matches in high-technology industries shows that while both technological similarity and complementarity increase the likelihood of an acquisition match, only the impact of technological complementarity is affected by Top Management Team faultlines. Specifically, we find that Top Management Teams with moderately strong divisions between subgroups pay more attention to technological complementarities between their firm and potential acquisition targets than Top Management Teams with very strong or weak divisions.
Testing the residential daylight score: Comparing climate-based daylighting metrics for 2444 individual dwelling units in temperate climates
Authors: Dogan T , Park YC
Published: June 2020

Evaluation metrics using climate-based daylight modelling paradigms have become the de-facto standard in work environments but have only limited applicability in residential architecture. Qualities of daylight cited in the architectural design literature, such as daily and seasonal availability of daylight as well as access to direct sunlight, are simulated in detail but are usually overlooked in the commonly used evaluation metrics. In a recent paper, a new climate-based, annual daylight evaluation framework called the residential daylight score has been proposed for cold and temperate climates. It assesses daylight autonomy and access to direct light in 12 daily and seasonal bins and proposes targets for seasonal and diurnal daylight autonomy and duration of direct sunlight exposure. While the metric aims to capture essential characteristics of residential daylight, only a few reference cases exist in the literature to adequately judge its achievability and applicability. This paper aims to thoroughly test the residential daylight score and provide reference cases for 2444 apartments from a set of 18 multifamily buildings that compare the new metric with currently used climate-based metrics.
Quantitative analysis of the stacked autoencoder method in MIMO-ACO-OFDM VLC systems
Authors: Hao LL , Li CD , Wang DY
Published: June 2020

In this paper, a stacked autoencoder network is utilised to realise the signal constellation and transceivers adapted to the dimmable indoor visible light communication system in order to acquire lower symbol error probability. Its decoder parts function as denoising and the equaliser for the proposed multiple-input multiple-output (MIMO) orthogonal frequency division multiplexing (OFDM) visible light communication system which can compensate the non-linear transfer function and the crosstalk between multiple LED data streams. The bit error rate performance as well as the influence of LED spatial intervals on root mean square delay spread, impulse response and bit rate have been analysed considering multipath reflections of the indoor MIMO-VLC system. The numerical results show that the a stacked autoencoder technique performs better in bit error rate reduction compared with state-of-art the zero forcing and minimum mean squared error algorithm. The experiment also shows, when the semi-angle at half power of LEDs and the field of view of Photodetectors become small, better performance can be achieved at the centre of the room, which can be explained by strong beam converge and the decreased multipath interference. Moreover, enlarging the separation between LEDs leads to improved bit error rate performance and reduced channel correlation of channel matrix, which need to be optimally chosen in practice.
Good Health and Wellness: Reflections on Implementing Health Promotion in Indian Country
Authors: Gerber Colin , Locklear Sofia , Stewart Kai , Marshall LaTisha , Colleen Gunnar , James Rosalina
Published: June 2020

In 2014, the Centers for Disease Control and Prevention (CDC) launched “A Comprehensive Approach to Good Health and Wellness in Indian County” (GHWIC) to promote health and chronic disease prevention in tribal communities while facilitating cross-cultural learning and relationship-building. Through GHWIC, CDC aimed to work with American Indian and Alaska Native communities to identify effective health promotion strategies to address chronic disease disparities. Tribal sovereignty, community context, and consideration of tribal histories (e.g., oppression, genocide, and cultural erasure) are key to health improvement efforts and work with tribes. These elements center experience, knowledge, and self-determination to reclaim good health and wellness as Indigenous peoples see it. The Implementation Reflection Project was a qualitative inquiry composed of one-on-one discussions and small group sessions conducted to explore experiences of CDC staff, national partners, and tribal recipients as they implemented GHWIC program activities. The Project documented observations and recommendations for future tribal health funding efforts and identified best practices for effective partnerships with tribes and tribal organizations. Findings centered around tribal experiences with GHWIC, improved program processes, the importance of relationships, and the effects of internal capacity on implementation. Key suggestions for future work with tribal entities included simplifying and clarifying roles, expectations, and administration requirements, and establishing clear and consistent communication between program partners. The approach CDC used with GHWIC recipients was effective and respectful, but room for growth remains. Potential future collaborators in Indian Country should consider these findings when planning health promotion initiatives.
Prism adaptation treatment for spatial neglect post brain tumour removal: A case report
Authors: Chen Peii , Lander Viktoriya , Noce Natalia , Hreha Kimberly
Published: June 2020

Purpose/aim:

Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survivors with spatial neglect to improve function. This case report explored the feasibility and potential effects of prism adaptation treatment in an individual with spatial neglect after glioblastoma removal.

Methods

Feasibility was designed and tested to include acceptability and implementation. Exploratory aim on the effectiveness of the intervention was determined using the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process, star cancellation, line bisection and scene copying.

Results

The patient reported favouring the treatment. Eight sessions, one session a day, were completed over two weeks. The patient’s spatial neglect symptoms reduced on all assessments.

Conclusion

Prism adaptation treatment was feasible and effective; however, further research is needed to understand the complete benefits of prism adaptation treatment in this population.
Wellbore trajectory control tool seal system leakage analysis based on steady gap flow
Authors: Shi Lei , Wang Keqiang , Feng Ding , Zhang Hong , Wang Peng
Published: June 2020

Lubricant leakage will inevitably occur during the working process of wellbore trajectory control tools. Even including the lubricant compensation system, serious leakage will still cause lacks lubrication of the internal mechanical structure as well as electronic system damaged by external infiltration fluid, especially when it comes to battery sub and other electronic equipment. Seal system leakage prediction method was presented based on the assumption of steady gap flow. It is assumed that there is a constant gap between the lip seal and the rotating shaft, the gap height is determined by oil film thickness, and the length of the gap was determined by the contact analysis using the Mooney–Rivlin constitutive model. The analysis results show that the contact length between the primary seal lip and the rotary shaft is about 0.1 mm under the condition of ensuring the contact between the deputy seal lip and the rotary shaft. The overall lubricant leakage finite element analysis model was established, and the relationship between the internal lubricant pressure of the tool and the total leakage was obtained. The results of analysis indicate that under the internal pressure of 0.03 MPa, the lubricant leakage is approximately 6 mL/h, which was verified by experiments.
Three-dimensional mechanical modeling of the barbell bench press exercise: Unveiling the biomechanical function of the triceps brachii
Authors: Biscarini Andrea , Calandra Andrea , Contemori Samuele
Published: June 2020

A three-dimensional biomechanical model has been developed to understand and quantify the effect of the triceps brachii force during bench press exercises executed with different external loads, grip widths, and positions of the barbell relative to the shoulders at the beginning of the lift. The upper limbs, chest, and barbell were modeled as a closed three-dimensional articulated system. The elbow extension torque [Formula: see text] developed by the triceps brachii is transferred through the links of the closed chain, yielding a shoulder transverse-flexion torque [Formula: see text], shoulder adduction torque [Formula: see text], and shoulder internal-rotation torque [Formula: see text] proportional to [Formula: see text]. The proportionality factors [Formula: see text], [Formula: see text], and [Formula: see text] are independent of the load and displayed a considerable change during the lift: [Formula: see text] increased from 0.5 to 2, while [Formula: see text] and [Formula: see text] decreased progressively to zero, with a value at the beginning of the lift between 0.5 and 1 depending on the starting barbell position and grip width. Overall, [Formula: see text] considerably decreased the demand for shoulder transverse-flexion and adduction muscle-torque, slightly increased the demand for shoulder abduction muscle-torque in the final phase of the lift, and induced a shoulder internal-rotation torque that should be equilibrated by an opposite torque developed by the shoulder external rotators. With the results of this study, sport practitioners can manage the variants and kinematics of the bench press exercise to modulate the effect of the triceps brachii force on the mechanical output during different phases of the lift and planes of movement.
Alterations in Violinists’ Practice Behaviors in Response to Differing Technical Demands in the Material
Authors: Strietelmeier Andrew
Published: June 2020

The pedagogical literature strongly suggests that when a musician works on a specific piece of repertoire, one should choose practice strategies tailored to the challenges presented by that material. Such a behavioral choice could represent an instantiation of focused and deliberate practice, a critical aspect of the relationship between experience and the acquisition of expertise. However, most of the literature investigating individual practice has used a single stimulus for all participants, or else has employed surveys or other proxy measures of practicing behavior. In this study, participants of three different experience levels (high school, collegiate, or professional violinists) practiced three excerpts, each featuring a different signature challenge. Results suggest that practice is highly idiosyncratic, that participants do adjust their approaches to the challenges of the material, but that individuals of differing experience levels identify remarkably similar problems within the material.
The dashboard pandemic
Authors: Everts Jonathan
Published: June 2020

The dashboard is the most striking cultural artefact of the current coronavirus (SARS-CoV-2) pandemic. It reveals the fraught pandemic politics which are centred around territorial approaches on the scale of the state rather than international cooperation, democratic liberation, and local care. The dashboard is a biopolitical technology of anxiety, prompting national states of emergency. This narrow approach to framing the COVID-19 crisis is rooted in military-style pandemic preparedness planning that became fashionable in the 21st century. However, there is mounting evidence that this approach does not adequately address the uneven and unjust geographies of the present.
Studying Instagram Beyond Selfies
Authors: Caliandro Alessandro , Graham James
Published: June 2020

Of approximately 40 billion photos posted on Instagram, only 282 million are selfies—just 0.7%. Thus, for all its zeitgeisty appeal, the selfie is in fact a niche phenomenon in the larger context of Instagram genres. Noting this fact, we identified an opportunity to engage with scholars from all over the world with the challenge of proposing new theories and approaches capable of unlocking the full socio-anthropological potential of Instagram. As the articles collected in this special issue testify, Instagram has an enormous impact on people’s everyday lives on many levels—socially, culturally, economically, and politically—and so, indubitably, it deserves rigorous academic attention. Given the scale and complexity of these impacts, studying Instagram poses different kinds of challenges and many gaps are still to be filled. With this special issue we don’t claim to resolve all the issues noted above. More modestly, our goal is to kick-start a fruitful conversation among social media scholars interested in furthering Instagram studies.
Moderated Mediation Between Transformational Leadership and Organizational Commitment: The Role of Procedural Justice and Career Growth Opportunities
Authors: Bashir Muhammad Sajjad , Haider Sajid , Asadullah Muhammad Ali , Ahmed Munir , Sajjad Muhammad
Published: June 2020

This study examined a moderated mediation model to explain how the indirect effect of transformational leadership (TL) on employees’ organizational commitment (OC) via procedural justice (PJ) is moderated by career growth opportunities (CGOs) in organizations. Data were gathered from 265 college faculty members. The results indicate that PJ serves as mediator between TL and OC, and this mediation process is affected by career growth. This research contributes to the leadership, human resource management, and organizational psychology literature by explaining how CGOs may affect the mediating process of PJ through which the relationship between TL and OC is determined. Organizational leaders can take insights from the findings of this study to increase their employees’ OC. Theoretical implications and future research directions have been discussed.
Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies
Authors: Belk John W. , Kraeutler Matthew J. , Thon Stephen G. , Littlefield Connor P. , Smith John H. , McCarty Eric C.
Published: June 2020

Background:

The effect of platelet-rich plasma (PRP) augmentation for meniscal repair (MR) is unclear, as current evidence is limited to small, mostly nonrandomized studies.

Purpose:

To systematically review the literature to evaluate the efficacy and safety of MR with PRP augmentation.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies (level of evidence 1-3) that compared the clinical efficacy of MR performed with versus without PRP. The search phrase used was platelet-rich plasma meniscus. Patients were assessed based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS) for pain, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the subjective International Knee Documentation Committee (IKDC) score, and treatment failure.

Results:

We identified 6 studies (2 studies with level 1 evidence; 4 studies with level 3 evidence) that met inclusion criteria, for a total of 309 patients undergoing MR with PRP (mean age, 31.9 years) and 445 patients without PRP augmentation (mean age, 29.6 years). The mean follow-up was 32.8 months (range, 12-72 months). Overall, 17.0% of PRP patients experienced MR failure compared with 22.1% of non-PRP patients. No differences in VAS, Lysholm, or subjective IKDC scores were found between groups except in 1 study, in which postoperative subjective IKDC scores were significantly better in the PRP group ( P < .01). Another study found significantly better postoperative WOMAC scores among PRP patients, and 2 studies found significantly better KOOS subscores among PRP patients.

Conclusion:

There are a limited number of high-quality studies comparing outcomes and healing rates between patients undergoing MR with versus without PRP augmentation. Based on the available evidence, patients undergoing MR with PRP augmentation experience similar clinical outcomes at midterm follow-up when compared with conventional MR, and additional studies are needed to determine the efficacy of MR augmented with PRP.
We Are Projects: Narrative Capital and Meaning Making in Projects
Authors: Carlsen Arne , Pitsis Tyrone S.
Published: June 2020

Research on projects has to a limited degree taken issue with how projects are chief producers of meaning at work. We develop the concept of narrative capital as a basic mechanism for how people can engender meaning in and through projects in organizations. Narrative capital is derived from experiences that people appropriate into their individual and collective life stories, retrospectively, as adding to a repertoire of accumulated learning and mastering, and prospectively, in terms of living with purpose and hope. We chart implications for meaning making in projects as expanding ownership, expanding connections of impact, and extending narrative possibility.
Macrophage hypophagia as a mechanism of innate immune exhaustion in mAb-induced cell clearance
Authors: Pinney Jonathan J. , Rivera-Escalera Fátima , Chu Charles C. , Whitehead Hannah E. , VanDerMeid Karl R. , Nelson Ashley M. , Barbeau Michelle C. , Zent Clive S. , Elliott Michael R.
Published: June 2020

Macrophage antibody (Ab)-dependent cellular phagocytosis (ADCP) is a major cytotoxic mechanism for both therapeutic unconjugated monoclonal Abs (mAbs) such as rituximab and Ab-induced hemolytic anemia and immune thrombocytopenia. Here, we studied the mechanisms controlling the rate and capacity of macrophages to carry out ADCP in settings of high target/effector cell ratios, such as those seen in patients with circulating tumor burden in leukemic phase disease. Using quantitative live-cell imaging of primary human and mouse macrophages, we found that, upon initial challenge with mAb-opsonized lymphocytes, macrophages underwent a brief burst (<1 hour) of rapid phagocytosis, which was then invariably followed by a sharp reduction in phagocytic activity that could persist for days. This previously unknown refractory period of ADCP, or hypophagia, was observed in all macrophage, mAb, and target cell conditions tested in vitro and was also seen in vivo in Kupffer cells from mice induced to undergo successive rounds of αCD20 mAb-dependent clearance of circulating B cells. Importantly, hypophagia had no effect on Ab-independent phagocytosis and did not alter macrophage viability. In mechanistic studies, we found that the rapid loss of activating Fc receptors from the surface and their subsequent proteolytic degradation were the primary mechanisms responsible for the loss of ADCP activity in hypophagia. These data suggest hypophagia is a critical limiting step in macrophage-mediated clearance of cells via ADCP, and understanding such limitations to innate immune system cytotoxic capacity will aid in the development of mAb regimens that could optimize ADCP and improve patient outcome.
Loss of GPVI and GPIbα contributes to trauma-induced platelet dysfunction in severely injured patients
Authors: Vulliamy Paul , Montague Samantha J. , Gillespie Scarlett , Chan Melissa V. , Coupland Lucy A. , Andrews Robert K. , Warner Timothy D. , Gardiner Elizabeth E. , Brohi Karim , Armstrong Paul C.
Published: June 2020

Trauma-induced coagulopathy (TIC) is a complex, multifactorial failure of hemostasis that occurs in 25% of severely injured patients and results in a fourfold higher mortality. However, the role of platelets in this state remains poorly understood. We set out to identify molecular changes that may underpin platelet dysfunction after major injury and to determine how they relate to coagulopathy and outcome. We performed a range of hemostatic and platelet-specific studies in blood samples obtained from critically injured patients within 2 hours of injury and collected prospective data on patient characteristics and clinical outcomes. We observed that, although platelet counts were preserved above critical levels, circulating platelets sampled from trauma patients exhibited a profoundly reduced response to both collagen and the selective glycoprotein VI (GPVI) agonist collagen-related peptide, compared with those from healthy volunteers. These responses correlated closely with overall clot strength and mortality. Surface expression of the collagen receptors GPIbα and GPVI was reduced on circulating platelets in trauma patients, with increased levels of the shed ectodomain fragment of GPVI detectable in plasma. Levels of shed GPVI were highest in patients with more severe injuries and TIC. Collectively, these observations demonstrate that platelets experience a loss of GPVI and GPIbα after severe injury and translate into a reduction in the responsiveness of platelets during active hemorrhage. In turn, they are associated with reduced hemostatic competence and increased mortality. Targeting proteolytic shedding of platelet receptors is a potential therapeutic strategy for maintaining hemostatic competence in bleeding and improving the efficacy of platelet transfusions.
CFTR targeted therapies: recent advances in cystic fibrosis and possibilities in other diseases of the airways
Authors: Patel Sheylan D. , Bono Taylor R. , Rowe Steven M. , Solomon George M.
Published: June 2020

Cystic fibrosis transmembrane conductance regulator (CFTR) is an ion transporter that regulates mucus hydration, viscosity and acidity of the airway epithelial surface. Genetic defects inCFTRimpair regulation of mucus homeostasis, causing severe defects of mucociliary clearance as seen in cystic fibrosis. Recent work has established that CFTR dysfunction can be acquired in chronic obstructive pulmonary disease (COPD) and may also contribute to other diseases that share clinical features of cystic fibrosis, such as asthma, allergic bronchopulmonary aspergillosis and bronchiectasis. Protean causes of CFTR dysfunction have been identified including cigarette smoke exposure, toxic metals and downstream effects of neutrophil activation pathways. Recently, CFTR modulators, small molecule agents that potentiate CFTR or restore diminished protein levels at the cell surface, have been successfully developed for variousCFTRgene defects, prompting interest in their use to treat diseases of acquired dysfunction. The spectrum of CFTR dysfunction, strategies for CFTR modulation, and candidate diseases for CFTR modulation beyond cystic fibrosis will be reviewed in this manuscript.
Microbial and metabolomic profiles in correlation with depression and anxiety co-morbidities in diarrhoea-predominant IBS patients
Authors: Liu Tong , Gu Xiang , Li Li-Xiang , Li Ming , Li Bing , Cui Xiao , Zuo Xiu-li
Published: June 2020

Background

Psychological co-morbidities in irritable bowel syndrome (IBS) have been widely recognized, whereas less is known regarding the role of gut microbial and host metabolic changes in clinical and psychological symptoms in IBS.

Results

A total of 70 diarrhoea-predominant IBS (IBS-D) patients and 46 healthy controls were enrolled in this study. Stool and urine samples were collected from both groups for 16S rRNA gene sequencing and metabolomic analysis.

The results showed that fecal microbiota in IBS-D featured depleted Faecalibacterium (adjusted P = 0.034), Eubacterium rectale group (adjusted P = 0.048), Subdoligranulum (adjusted P = 0.041) and increased Prevotella (adjusted P = 0.041). O-ureido-L-serine, 3,4-dihydroxybenzenesulfonic acid and (R)-2-Hydroxyglutarate demonstrated lower urinary concentrations in IBS-D patients. We further built correlation matrices between gut microbe abundance, differentiated metabolite quantities and clinical parameters. Dialister manifested negative association with IBS severity (r = − 0.285, P = 0.017), anxiety (r = − 0.347, P = 0.003) and depression level (r = − 0.308, P = 0.010). Roseburia was negatively associated with IBS severity (r = − 0.298, P = 0.012). Twenty metabolites correlated with anxiety or depression levels, including 3,4-dihydroxymandelaldehyde with SAS (r = − 0.383, P = 0.001), 1-methylxanthine with SDS (r = − 0.347, P = 0.004) and 1D-chiro-inositol with SAS (r = − 0.336, P = 0.005). In analysis of microbe-metabolite relationship, 3,4-dihydroxymandelaldehyde and 1-methylxanthine were negatively correlated with relative abundance of Clostridiumsensu stricto.

Conclusions

Our findings demonstrated altered microbial and metabolomic profiles associated with clinically and psychological symptoms in IBS-D patients, which may provide insights for further investigations.
Comparative transcriptome analysis of mulberry reveals anthocyanin biosynthesis mechanisms in black (Morus atropurpurea Roxb.) and white (Morus alba L.) fruit genotypes
Authors: Huang Gaiqun , Zeng Yichun , Wei Ling , Yao Yongquan , Dai Jie , Liu Gang , Gui Zhongzheng
Published: June 2020

Background

To gain a better understanding of anthocyanin biosynthesis in mulberry fruit, we analyzed the transcriptome of the mulberry varieties Da 10 (Morus atropurpurea Roxb., black fruit) and Baisang (Morus alba L., white fruit).

Results

We found that whereas Da 10 had high levels of cyanidin 3-O-glucoside (Cy), and pelargonidin 3-O-glucoside (Pg), Baisang contained only Cy, at low levels. Based on a comparative transcriptome analysis, we annotated more than 27,085 genes (including 1735 new genes). Genes that were differentially expressed between Da 10 and Baisang were detected at three stages of fruit development: S1 [4256 genes, 10 days post-anthesis (DPA)], S2 (5612 genes, 19 DPA), and S3 (5226 genes, 28 DPA). Anthocyanin biosynthesis was found to be associated with the expression of 15 core genes and 5 transcription factors. Relative to Baisang, Da 10 showed a significant upregulation of genes involved in the early stages (production of the intermediate compounds chalcone and dihydroflavonol) and late stages (production of Cy and Pg) of anthocyanin biosynthesis. Baisang showed a significant downregulation of the genes involved in the early stages of anthocyanin biosynthesis and overexpression of flavanone 3-hydroxylase (FLS), resulting in the generation of quercetin and/or myricetin but not anthocyanins.

Conclusions

The biosynthesis of anthocyanin in mulberry fruit is initiated from the precursor, phenylalanine, and mediated by the upregulation of dihydroflavonol 4-reductase, anthocyanidin synthase, anthocyanidin 3-O-glucosyltransferase, and cyanidin-3-O-glucoside 2-O-glucuronosyltransferase, and downregulation of FLS to produce Cy and Pg.
Modified-ramped position: a new position for intubation of obese females: a randomized controlled pilot study
Authors: Hasanin Ahmed , Tarek Hager , Mostafa Maha M. A. , Arafa Amany , Safina Ahmed G. , Elsherbiny Mona H. , Hosny Osama , Gado Ahmed A. , Almenesey Tarek , Hamden Ghada Adel , Mahmoud Mohamed , Amin Sarah
Published: June 2020

Background

Endotracheal intubation requires optimum position of the head and neck. In obese females, the usual ramped position might not provide adequate intubating conditions. We hypothesized that a new position, termed modified-ramped position, during induction of anesthesia would facilitate endotracheal intubation through bringing the breasts away from the laryngoscope and would also improve the laryngeal visualization.

Methods

Sixty obese female patients scheduled for general anesthesia were randomly assigned into either ramped or modified-ramped position during induction of anesthesia. In the ramped position (n = 30), the patient head and shoulders were elevated to achieve alignment of the sternal notch and the external auditory meatus; while in the modified-ramped position (n = 30), the patient shoulders were elevated using a special pillow, and the head was extended to the most possible range. Our primary outcome was the incidence of failed laryngoscopic insertion in the oral cavity (the need for patient repositioning). Other outcomes included time till vocal cord visualization, time till successful endotracheal intubation, difficulty of the mask ventilation, and Cormack-Lehane grade for laryngeal view.

Results

Fourteen patients (47%) in ramped group required repositioning to facilitate introduction of the laryngoscope in the oral cavity in comparison to one patient (3%) in the modified-ramped position (p < 0.001). Modified-ramped position showed lower incidence of difficult mask ventilation, shorter time for glottic visualization, and shorter time for endotracheal tube insertion compared to the ramped position. The Cormack-Lehane grade was better in the modified-ramped position.

Conclusion

Modified-ramped position provided better intubating conditions, improved the laryngeal view, and eliminated the need for repositioning of obese female patients during insertion of the laryngoscope compared to ramped position.

Clinical trial registration

Identifier: NCT03640442. Date: August 2018.
Regional and patient-related factors influencing the willingness to use general practitioners as coordinators of the treatment in northern Germany - results of a cross-sectional observational study
Authors: Hansen Heike , Schäfer Ingmar , Porzelt Sarah , Kazek Agata , Lühmann Dagmar , Scherer Martin
Published: June 2020

Background

In most countries, the general practitioner (GP) is the first point of contact in the healthcare system and coordinator of healthcare. However, in Germany it is possible to consult an outpatient specialist even without referral. Coordination by a GP might thus reduce health expenditures and inequalities in the healthcare system. The study describes the patients’ willingness/commitment to use the GP as coordinator of healthcare and identifies regional and patient-related factors associated with the aforementioned commitment to the GP.

Methods

Cross-sectional observational study using a standardised telephone patient survey in northern Germany. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban areas, environs, rural areas) and stratified proportionally to the population size. Patients who had consulted the GP within the previous three months, and had been patients of the practice for at least three years were randomly selected from medical records of primary care practices in these districts and recruited for the study. Multivariate linear regression models adjusted for random effects at the level of federal states, administrative districts and practices were used as statistical analysis methods.

Results

Eight hundred eleven patients (25.1%) from 186 practices and 34 administrative districts were interviewed. The patient commitment to a GP attained an average of 20 out of 24 possible points. Significant differences were found by sex (male vs. female: + 1.14 points, p < 0.001), morbidity (+ 0.10 per disease, p = 0.043), education (high vs. low: − 1.74, p < 0.001), logarithmised household net adjusted disposable income (− 0.93 per step on the logarithmic scale, p = 0.004), regional category (urban areas: − 0.85, p = 0.022; environs: − 0.80, p = 0.045) and healthcare utilisation (each GP contact: + 0.30, p < 0.001; each contact to a medical specialist: − 0.75, p = 0.018). Professional situation and age were not significantly associated with the GP commitment.

Conclusion

On average, the patients’ commitment to their GP was relatively strong, but there were large differences between patient groups. An increase in the patient commitment to the GP could be achieved through better patient information and targeted interventions, e.g. to women or patients from regions of higher urban density.

Trial registration

The study was registered in ClinicalTrials.gov (NCT02558322).
Spatio-temporal variation of malaria hotspots in Central Senegal, 2008–2012
Authors: Dieng Sokhna , Ba El Hadj , Cissé Badara , Sallah Kankoe , Guindo Abdoulaye , Ouedraogo Boukary , Piarroux Martine , Rebaudet Stanislas , Piarroux Renaud , Landier Jordi , Sokhna Cheikh , Gaudart Jean
Published: June 2020

Background

In malaria endemic areas, identifying spatio-temporal hotspots is becoming an important element of innovative control strategies targeting transmission bottlenecks. The aim of this work was to describe the spatio-temporal variation of malaria hotspots in central Senegal and to identify the meteorological, environmental, and preventive factors that influence this variation.

Methods

This study analysed the weekly incidence of malaria cases recorded from 2008 to 2012 in 575 villages of central Senegal (total population approximately 500,000) as part of a trial of seasonal malaria chemoprevention (SMC). Data on weekly rainfall and annual vegetation types were obtained for each village through remote sensing. The time series of weekly malaria incidence for the entire study area was divided into periods of high and low transmission using change-point analysis. Malaria hotspots were detected during each transmission period with the SaTScan method. The effects of rainfall, vegetation type, and SMC intervention on the spatio-temporal variation of malaria hotspots were assessed using a General Additive Mixed Model.

Results

The malaria incidence for the entire area varied between 0 and 115.34 cases/100,000 person weeks during the study period. During high transmission periods, the cumulative malaria incidence rate varied between 7.53 and 38.1 cases/100,000 person-weeks, and the number of hotspot villages varied between 62 and 147. During low transmission periods, the cumulative malaria incidence rate varied between 0.83 and 2.73 cases/100,000 person-weeks, and the number of hotspot villages varied between 10 and 43. Villages with SMC were less likely to be hotspots (OR = 0.48, IC95%: 0.33–0.68). The association between rainfall and hotspot status was non-linear and depended on both vegetation type and amount of rainfall. The association between village location in the study area and hotspot status was also shown.

Conclusion

In our study, malaria hotspots varied over space and time according to a combination of meteorological, environmental, and preventive factors. By taking into consideration the environmental and meteorological characteristics common to all hotspots, monitoring of these factors could lead targeted public health interventions at the local level. Moreover, spatial hotspots and foci of malaria persisting during LTPs need to be further addressed.

Trial registration

The data used in this work were obtained from a clinical trial registered on July 10, 2008 at www.clinicaltrials.gov under NCT00712374.
Late-onset MELAS syndrome with mtDNA 14453G→A mutation masquerading as an acute encephalitis: a case report
Authors: Yokota Yuki , Hara Makoto , Akimoto Takayoshi , Mizoguchi Tomotaka , Goto Yu-ichi , Nishino Ichizo , Kamei Satoshi , Nakajima Hideto
Published: June 2020

Background

A unique patient with MELAS syndrome, who initially masqueraded as having acute encephalitis and was eventually diagnosed with MELAS syndrome harboring a mtDNA 14453G → A mutation, is described.

Case presentation

A 74-year-old Japanese man was admitted to another hospital due to acute onset of cognitive impairment and psychosis. After 7 days he was transferred to our hospital with seizures and deteriorating psychosis. The results of primary ancillary tests that included EEG, CSF findings, and brain MRI supported the diagnosis of an acute encephalitis. HSV-DNA and antibodies against neuronal surface antigens in the CSF were all negative. With the assistance of the lactate peak on the brain lesions in the magnetic resonance spectroscopy image and genetic analysis of the biopsied muscle, he was eventually diagnosed with MELAS syndrome harboring mtDNA 14453G → A mutation in the ND6 gene.

Conclusions

This case provides a caveat that MELAS syndrome can manifest in the symptoms and ancillary tests masquerading as an acute encephalitis caused by infection or autoimmunity. This is the first adult patient seen to harbor the mtDNA14453G → A with a unique onset, which broadens the phenotypic spectrum of MELAS syndrome associated with ND6 gene mutation.
Differentiation of suprasellar meningiomas from non-functioning pituitary macroadenomas by 18F-FDG and 13N-Ammonia PET/CT
Authors: Ding Lei , Zhang Fangling , He Qiao , Li Zhoulei , Shi Xinchong , Li Ruocheng , Zhang Xiangsong
Published: June 2020

Background

Differentiation of suprasellar meningiomas (SSMs) from non-functioning pituitary macroadenomas (NFPMAs) is useful for clinical management. We investigated the utility of 13N-ammonia combined with 18F-FDG positron emission tomography (PET)/computed tomography (CT) in distinguishing SSMs from NFPMAs retrospectively.

Methods

Fourteen NFPMA patients and eleven SSM patients with histopathologic diagnosis were included in this study. Every patient underwent both 18F-FDG and 13N-ammonia PET/CT scans. The tumor to gray matter (T/G) ratios were calculated for the evaluation of tumor uptake.

Results

The uptake of 18F-FDG was higher in NFPMAs than SSMs, whereas the uptake of 13N-ammonia was obviously lower in NFPMAs than SSMs. The differences of 18F-FDG and 13N-ammonia uptake between the two groups were significant respectively (0.92[0.46] vs 0.59[0.29], P < 0.05, 18F-FDG; 1.58 ± 0.56 vs 2.80 ± 1.45, P < 0.05, 13N-ammonia). Tumor classification demonstrated a high overall accuracy of 96.0% for differential diagnosis. When the two traces were combined, only 1 SSM was misclassified into the NFPMA group.

Conclusion

SSMs and NFPMAs have different metabolic characteristics on 18F-FDG and 13N-ammonia PET images. The combination of these two tracers can effectively distinguish SSMs from NFPMAs.
Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters
Authors: Wallerstein Avi , Kam Joseph Wai Keung , Gauvin Mathieu , Adiguzel Eser , Bashour Mounir , Kalevar Ananda , Cohen Mark
Published: June 2020

Background

To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D).

Methods

Consecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between − 10.00 to − 13.50 D underwent LASIK with the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs).

Results

114 eyes had a preoperative SEQ of − 11.02 ± 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within ± 0.50, ± 0.75 and ± 1.00 D of intended SEQ (R2 = 0.71). The efficacy index was 0.93 ± 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 ± 0.33. The safety index was 1.05 ± 0.12. The average myopic regression was − 0.51 ± 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 ± 0.8 vs. 9.1 ± 0.7; P <  0.001), with less NVDs (P <  0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 ± 0.34, 0.67 ± 0.25, and 0.70 ± 0.40 μm.

Conclusions

Very high myopia LASIK between − 10.00 to − 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.
Short-time evaluation on intraocular scattering after implantable collamer lens implantation for correcting high myopia
Authors: Yu Zhe , Li Jun , Song Hui
Published: June 2020

Background

To compare the intraocular scattering before and after implantation of implantable collamer lens (ICL) V4c for correction of high myopia in a short term.

Methods

In this study, 38 eyes of 19 patients who underwent the implantation of ICL V4c were followed up for 3 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective scattering index (OSI), modulation transfer function cutoff frequency (MTF cutoff), strehl ratio (S/R), OV100%, OV20% and OV9% were measured pre- and postoperatively. Meantime, the Pseudophakic Dysphotopsia Questionnaire (PDQ) was scored to evaluate the subjective satisfaction of intraocular scattering pre- and postoperatively.

Results

The UCVA were − 0.02 ± 0.06, − 0.03 ± 0.07 and − 0.04 ± 0.07 logMAR at 1 week, 1 month and 3 months postoperatively which were significantly better than those preoperatively (P < 0.05). The BCVA were − 0.09 ± 0.09, − 0.09 ± 0.1 and − 0.1 ± 0.11 logMAR at 1 week, 1 month and 3 months after surgery, which were better than those before surgery significantly (t = 15.64, P < 0.05). The mean OSI were 2.37 ± 1.6, 1.63 ± 0.94, 1.5 ± 0.86 and 1.43 ± 1.05 preoperatively, 1 week, 1 month and 3 months postoperatively which was found significant difference (F = 12.92 P < 0.05). No significant differences were found in MTF cut off (F = 0.61, P = 0.62), S/R (F = 0.58, P = 0.36), OV100% (F = 0.966, P = 0.65), OV20% (F = 0.121, P = 0.96) and OV9% (F = 1.01, P = 0.30) between pre- and postoperatively. The PDQ results indicated that intraocular scattering reduced at 3 months after surgery significantly (P < 0.05).

Conclusions

The ICL V4c implantation for correcting high myopia induced less intraocular scattering and visual disorder than spectacle correction.
Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees
Authors: Kaltenbach Elisa , Hermenau Katharin , Schauer Maggie , Dohrmann Katalin , Elbert Thomas , Schalinski Inga
Published: June 2020

Background

Trauma-focused therapy approaches are recommended as treatment for posttraumatic stress disorder (PTSD). This includes the treatment of trauma-related suffering in refugee populations. However, there is a lack of knowledge about symptom trajectories in refugees living in volatile conditions. This has led to fear of “retraumatisation” and general skepticism in clinicians concerning the use of exposure therapy.

Methods

To test the relevance of this concern, we investigated PTSD symptom trajectories and potentially influencing factors during the course of Narrative Exposure Therapy (NET) in a refugee sample living in Germany. Refugees filled out the PTSD Checklist prior to each treatment session and also during follow-up interviews. Therapists continuously documented positive and negative life events as well as the content of the treatment sessions. Additionally, structured clinical interviews were conducted pre-treatment and at follow-up time points.

Results

On average, clients presented with substantial decreases in PTSD symptoms already during and after NET. However, symptom trajectories differed and ranged from fast responders to slow responders to no immediate response during treatment. Importantly, a persistent worsening of symptoms was not observed, also not after exposure to the most distressing events. In contrast, stressful life experiences seemed to aggravate PTSD symptoms.

Conclusions

Consistent with earlier studies, NET leads to clinically and behaviorally relevant reductions in PTSD symptoms both throughout and following treatment in refugees living in volatile conditions. Concerns about imaginal exposure in refugees were not substantiated. While stressful life events contributed to transient symptom increases, they weren’t found to prevent the overall effectiveness of NET.

Trial registration

NCT02852616.