bluuebunny/crossref_metadata_2025 huggingface dataset:
The friction effects for contact force analysis of three-axes CNC machine tool
Authors: Hwang Yunn-Lin , Ta Thi-Na
Published: August 2018

Purpose

The purpose of this paper is to study the influence of friction on static and dynamic characteristics, as well as the strength and lifetime of a flexible three-axes computer numerical control (CNC) machine tool.

Design/methodology/approach

The machine tool is first modeled by using finite element method to analyze static structure with frictionless surface-to-surface contact type. Because the machine tool structure is becoming more and more sophisticated over time, the significant influence of contact conditions between structural elements on the dynamic characteristics of the whole structure must be considered. To examine the dynamic effects caused by inertia forces and displacement of moving bodies on contact stress, the coefficient of friction between two contact bodies is added to perform dynamic simulation and compare the results with the static analysis results.

Findings

Distribution of stress and contact forces in solid-flexible contact is also studied by using the fundamental dynamic characteristics of a bushing joint.

Originality/value

Finally, the influence of dynamic structure, cutting conditions and material properties on the strength and lifetime of the CNC machine tool is discussed by using fatigue analysis. Consequently, this research can be used for efficient simulation of structural dynamics, lifetime assessment and interactions of the real CNC machine with the machine tool structure in a virtual environment.
Acceptance and use predictors of fitness wearable technology and intention to recommend
Authors: Talukder Md Shamim , Chiong Raymond , Bao Yukun , Hayat Malik Babur
Published: August 2018

Purpose

The purpose of this paper is to identify the key facilitators and inhibitors of fitness wearable technology (FWT) adoption and the intention to recommend this technology.

Design/methodology/approach

An innovative and integrated research model was developed by combining constructs from two well-established theoretical models, the extended unified theory of acceptance and use of technology (UTAUT2) and diffusion of innovation (DOI). The proposed research model was empirically validated using data collected from 392 respondents in China. The data was analyzed using the partial least squares method, a statistical analysis technique based on structural equation modeling.

Findings

The results indicate that performance expectancy, effort expectancy, social influence, habit, compatibility and innovativeness have significant direct and indirect effects on FWT adoption and the intention to recommend it. The significance of people’s intention to recommend FWT to others in social networking sites (e.g. Facebook, Weibo, and WeChat) is also confirmed.

Practical implications

The findings may facilitate the design and implementation of FWT products, applications and functionalities that can achieve high consumer acceptance and positive recommendations in social networks.

Originality/value

This study is among the first to investigate FWT adoption from behavioral, social and environmental perspectives. It also highlights the importance of social marketing campaigns and suggests directions of future wearable technology adoption research.
Phase-wise analysis of dynamic relationship among gold, crude oil, US dollar and stock market
Authors: Singh Narinder Pal , Sharma Sugandha
Published: August 2018

Purpose

The purpose of this paper is to investigate the dynamic relationship among Gold, Crude oil, Indian Rupee-US Dollar and Stock market-Sensex (gold, oil, dollar and stock market (GODS)) in the pre-crisis, the crisis and the post-crisis periods in the Indian context.

Design/methodology/approach

The authors use Johansen’s cointegration technique, Vector Error Correction Model (VECM), Vector Auto Regression, VEC Granger Causality/Block Exogeneity Wald Test, and Granger Causality and Toda Yamamoto modified Granger causality to study long-run relationship and causality.

Findings

Johansen’s cointegration test results indicate that there is a long-run equilibrium relationship among the variables in the pre-crisis and the crisis periods but not in post-crisis period. VECM results report that none of four models of the variables show long-run causality in the pre-crisis period. During the crisis period, both crude oil and Sensex models show long-run causality. However, in some cases, results indicate short-run causality. The authors find one-way causality from USD and Sensex to crude oil, and from gold and Sensex to USD. Thus, the authors conclude that the relationship among GODS is dynamic across global financial crisis.

Practical implications

The research findings of this study are vital to the large group of stakeholders and participants of gold, crude oil, US dollar and stock market in emerging economies like India. The results are useful to importers, exporters, government, policy makers, corporate houses, retail investors, portfolio managers, commodity traders, treasury and fund managers, other commercial traders, etc.

Originality/value

This study is one of its kinds as it investigates the relationship among GODS in India in different sub-periods like before, during and after the global financial crisis of 2008. None of the studies compare phase-wise relationship among GODS in the Indian context. The study contributes to the economic theory and the body of knowledge. It highlights the need to revisit the economic theory to explain the interplay mechanism among GODS.
Integrated care: mobilising professional identity
Authors: Best Stephanie , Williams Sharon
Published: August 2018

Purpose

Integrated care has been identified as essential to delivering the reforms required in health and social care across the UK and other healthcare systems. Given this suggests new ways of working for health and social care professionals, little research has considered how different professions manage and mobilise their professional identity (PI) whilst working in an integrated team. The paper aims to discuss these issues.

Design/methodology/approach

A qualitative cross-sectional study was designed using eight focus groups with community-based health and social care practitioners from across Wales in the UK during 2017.

Findings

Participants reported key factors influencing practice were communication, goal congruence and training. The key characteristics of PI for that enabled integrated working were open mindedness, professional trust, scope of practice and uniqueness. Blurring of boundaries was found to enable and hinder integrated working.

Research limitations/implications

This research was conducted in the UK which limits the geographic coverage of the study. Nevertheless, the insight provided on PI and integrated teams is relevant to other healthcare systems.

Practical implications

This study codifies for health and social care practitioners the enabling and inhibiting factors that influence PI when working in integrated teams.

Originality/value

Recommendations in terms of how healthcare professionals manage and mobilise their PI when working in integrated teams are somewhat scarce. This paper identifies the key factors that influence PI which could impact the performance of integrated teams and ultimately, patient care.
Recordkeeping and disaster management in public sector institutions in Ghana
Authors: Asamoah Catherine , Akussah Harry , Musah Adams
Published: August 2018

Purpose

The purpose of this study is to examine the disaster management procedures and measures adopted by public institutions in managing their information resources with a view to identifying possible problems and making recommendations for their resolution.

Design/methodology/approach

Questionnaires, interviews and observation were used to collect data from 65 respondents from 19 ministries and five respondents from the Public Records and Archives Administration Department (PRAAD) and the National Disaster Management Organization (NADMO). Descriptive statistics and content analysis were used to analyze the data collected for the study.

Findings

In the 19 ministries surveyed, the findings revealed high levels of unpreparedness to manage disasters concerning public records. The study also revealed the exposure of the ministries to various kinds of risks in their operations, and the lack of coordination between the heads of public sector institutions, NADMO and PRAAD. Also, inadequate budgetary allocation for the records department of the ministries and PRAAD was identified.

Research limitations/implications

The study concentrated on the headquarters (HQ) of the ministries because they are the administrative headquarters of public sector institutions and they make policies that are complied with by all the Regional and District branches as well as the Departments and Agencies in executing their tasks. The major limitation of the study was the inability of the researcher to cover all the ministries.

Practical implications

The recommendations made included cooperation among heads of the ministries, PRAAD and NADMO to develop a national information disaster management plan for the effective management of public records and information and a comprehensive program in public institutions to orientate staff on information disaster management.

Social implications

The study set the tone for public sector institutions and other institutions in the same area of operation to review the processes and procedures with regard to recordkeeping. Also, the study is anticipated to draw the attention of policy-makers (management of the ministries) and regulatory bodies in the field of records and disaster management (PRAAD and NADMO) to review their plans and policies to make provision for information disaster management.

Originality/value

The study is a research paper and critically looks at the disaster preparedness of public sector institutions in managing their records/information. It also examines whether there are any collaboration and coordination among public sector institutions in Ghana in having disaster preparedness and management plan to safeguard public records/information.
Reciprocal relationship between herpes zoster and cardiovascular diseases: A nationwide population‐based case–control study in Korea
Authors: Seo Hyun‐Min , Cha Myung‐Jin , Han Ju Hee , Han Kyungdo , Park Sang Hyun , Bang Chul Hwan , Lee Ji Hyun , Lee Jun Young , Choi Eue‐Keun , Park Young Min
Published: August 2018

Recently, herpes zoster (HZ) has been identified as a risk factor for stroke, but there have been few studies on the relationship between HZ and other cardiovascular diseases (CVD), including myocardial infarction (MI) and heart failure (HF). The purpose of this study was to investigate the risk of HZ occurrence after CVD and the occurrence of CVD after HZ. This was a retrospective case–control study based on the National Health Insurance System claims database for 20 311 patients with HZ and 13 980 patients with CVD and 1:5 age‐ and sex‐matched control subjects for each from January 2006 to December 2013. We evaluated the reciprocal relationship between HZ and CVD including MI, ischemic stroke and HF. Severe HZ requiring hospitalization independently increased the risk of subsequent MI (hazard ratio [HR], 1.831; 95% confidence interval [CI], 1.354–2.476)], ischemic stroke (HR, 1.523; 95% CI, 1.212–1.915) and HF (HR, 2.034; 95% CI, 1.615–2.562) during the study period. Likewise, patients with an episode of MI, ischemic stroke or HF were also at increased risk of HZ hospitalization (after MI: HR, 1.625; 95% CI, 1.144–2.308; after stroke: HR, 1.518; 95% CI, 1.177–1.957; and after HF: HR, 1.485, 95% CI 1.041–2.117). Our results suggest that there is a significant reciprocal relationship between severe HZ requiring hospitalization and CVD including MI, ischemic stroke and HF.
Development of Kasabach–Merritt phenomenon following vaccination: More than a coincidence?
Authors: Ji Yi , Chen Siyuan , Yang Kaiying , Xia Chunchao , Peng Suhua
Published: August 2018

Kasabach–Merritt phenomenon (KMP) occurred uniquely in patients with kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). We report the clinical characteristics of two patients with KHE involving the right upper arm. The patients demonstrated rapid enlargement of the lesion with severe KMP shortly after vaccination. Sirolimus was used to treat the KHE with KMP. The patients showed a quick normalization of the platelet level. The follow‐up examination revealed that the size of the mass was significantly decreased. This report raises the intriguing possibility that extrinsic factors may contribute to the development of KMP in the context of an already existing KHE.
Lipoxin A4 ameliorates renal ischaemia–reperfusion‐induced acute lung injury in rats
Authors: Liu Zhaohui , Qu Min , Yang Qiang , Chang Yulin
Published: August 2018

Lipoxin A4 (LA4), a bioactive product of arachidonic acid, has been shown to exert strong anti‐inflammatory activity. By contrast, the anti‐inflammatory action of LA4 in a renal ischaemia–reperfusion (RIR)‐mediated acute lung inflammation (ALI) model and the potential pathogenesis of the condition is still unclear. The aim of the current research was to investigate the effect of LA4 on RIR‐induced ALI. The rat ALI model was induced by RIR. LA4 was injected via the tail vein immediately after RIR. The results indicate that LA4 markedly inhibits inflammatory cells infiltration, attenuates myeloperoxidase activity, and reduces the concentration of inflammatory mediators and Toll‐like receptor 4 (TLR4) in RIR‐induced ALI. Furthermore, LA4 suppressed nuclear factor kappa B (NF‐κB) p65 and mitogen‐activated protein kinase (MAPK) activation. The protective effect of LA4 in RIR‐stimulated ALI was reversed by BOC‐2 (an antagonist of the LA4 receptor). These results indicate that LA4 exerts powerful anti‐inflammatory functions in RIR‐induced ALI by attenuating TLR4 expression via MAPK and NF‐κB signalling. Accordingly, LA4 might be an underlying treatment drug for RIR‐induced ALI.
Peanut (Arachis hypogaea L.): A Prospective Legume Crop to Offer Multiple Health Benefits Under Changing Climate
Authors: Akram Nudrat Aisha , Shafiq Fahad , Ashraf Muhammad
Published: August 2018

Peanut is a multipurpose oil‐seed legume, which offer benefits in many ways. Apart from the peanut plant's beneficial effects on soil quality, peanut seeds are nutritious and medicinally and economically important. In this review, insights into peanut origin and its domestication are provided. Peanut is rich in bioactive components, including phenolics, flavonoids, polyphenols, and resveratrol. In addition, the involvement of peanut in biological nitrogen fixation is highly significant. Recent reports regarding peanut responses and N2 fixation ability in response to abiotic stresses, including drought, salinity, heat stress, and iron deficiency on calcareous soils, have been incorporated. As a biotechnological note, recent advances in the development of transgenic peanut plants are also highlighted. In this context, regulation of transcriptional factors and gene transfer for the development of stress‐tolerant peanut genotypes are of prime importance. Above all, this review signifies the importance of peanut cultivation and human consumption in view of the scenario of changing world climate in order to maintain food security.
Continuous intravenous infusion of insulin and heparin vs plasma exchange in hypertriglyceridemia‐induced acute pancreatitis
Authors: Jin Meng , Peng Jin Min , Zhu Hua Dong , Zhang Hui Min , Lu Bo , Li Yi , Qian Jia Ming , Yu Xue Zhong , Yang Hong
Published: August 2018

Objective

Acute triglyceride‐lowering therapy is crucial in the early treatment of hypertriglyceridemia‐induced pancreatitis. This study aimed to compare the efficacy of continuous i.v. infusion of insulin and heparin therapy (IHT) and plasma exchange to lower triglyceride levels in the acute phase of hypertriglyceridemia‐induced pancreatitis.

Methods

A retrospective observational study was conducted in a tertiary teaching hospital. Patients with hypertriglyceridemia‐induced pancreatitis were consecutively enrolled from 2012 to 2017. Serum triglyceride levels and clinical data during hospitalization were collected. The primary outcome was the rapid reduction of triglyceride levels.

Results

Of the 62 patients enrolled, 34 (54.8%) were treated with IHT and the others with plasma exchange. A reduced triglyceride level of (66.9 ± 21.5)% after the first plasma exchange session and that of (75.0 ± 14.6)% after the first day of IHT were observed. There were no significant differences in the reduction of triglyceride (F = 0.334), high sensitivity C‐reactive protein (F = 0.127) and the acute physiology and chronic health evaluation II score (F = 2.589) between the two groups (all P > 0.05). The medical cost during hospitalization was significantly lower in the IHT group than in the plasma exchange group (RMB [59 512.4 ± 23 645.1] vs RMB [89 461.9 ± 48 324.0], P < 0.05). Adverse effects were observed in six patients in the plasma exchange group but none in the IHT group.

Conclusion

As a minimally invasive and economical strategy, IHT is effective and non‐inferior to plasma exchange in achieving a rapid reduction of triglyceride levels.
Feeling for Forgers: Character, Sympathy and Financial Crime in London during the Late Eighteenth Century
Authors: Milka Amy
Published: August 2018

Sympathy for forgers was not uncommon in the eighteenth century. This article reveals the emotional underside of the culture of credit, demonstrating the importance of emotions to understanding multivalent forms of capital such as ‘honour’ and ‘credit’. It explores the relationship between the courtroom and public opinion, and suggests that trials for forgery evoked a set of emotional responses that was specific to a particular emotional community. Using a history of emotions approach, the article explains how and why emotion was evoked, performed and interpreted within the courtroom space, and how this influenced eighteenth‐century attitudes to forgery.
Randomized Clinical Trial of Intravenous Acetaminophen as an Analgesic Adjunct for Older Adults With Acute Severe Pain
Authors: Chang Andrew K. , Bijur Polly E. , Ata Ashar , Campbell Caron , Pearlman Scott , White Deborah , Chertoff Andrew , Restivo Andrew , Gallagher E. John
Published: August 2018

Objectives

Older adults are at risk for undertreatment of pain. We examined intravenous (IV) acetaminophen as an analgesic adjunct to IV opioids in the care of older emergency department (ED) patients with acute severe pain.

Methods

This was a randomized clinical trial conducted in two EDs in the Bronx, New York. Eligible adults aged 65 years and older with acute severe pain were randomized to 0.5 mg of IV hydromorphone and 1 g of IV acetaminophen or 0.5 mg of IV hydromorphone and 100 mL of normal saline placebo. The primary outcome was the between group difference in improvement of numerical rating scale (NRS) pain scores at 60 minutes. Secondary outcomes were the between‐group differences in the proportion of patients who chose to forgo additional pain medications at 60 minutes; the proportion who developed side effects; the proportion who required rescue analgesia; and between‐group differences in NRS pain scores at 5, 15, 30, and 45 minutes.

Results

Eighty‐one patients were allocated to each arm. Eighty patients in the IV acetaminophen arm and 79 patients in the placebo arm had sufficient data for analysis. At 60 minutes, patients in the hydromorphone + IV acetaminophen group improved by 5.7 NRS units while those in the hydromorphone + placebo group improved by 5.2 NRS units, for a difference of 0.6 NRS units (95% confidence interval [CI] = –0.4 to 1.5). A total of 28.7% of patients in the hydromorphone + IV acetaminophen group wanted more analgesia at 60 minutes versus 29.1% in the hydromorphone + placebo group, for a difference of –0.4% (95% CI = –14.3% to 13.5%). These differences were neither clinically nor statistically significant. Safety profiles were similar in both groups.

Conclusion

In this randomized clinical trial, the addition of IV acetaminophen to IV hydromorphone as an adjunctive analgesic for acute, severe, pain in older adults provided neither clinically nor statistically superior pain relief when compared to hydromorphone alone within the first hour of treatment.
Fragmented QRS as a predictor of in‐hospital life‐threatening arrhythmic complications in ST‐elevation myocardial infarction patients
Authors: Attachaipanich Tanawat , Krittayaphong Rungroj
Published: August 2018

Background

Fragmented QRS (fQRS) complex is an electrocardiographic pattern that reflects the inhomogeneity of ventricular depolarization. The aims of this study were to determine the prognostic significance of fQRS for predicting in‐hospital life‐threatening arrhythmic complications in ST‐elevation myocardial infarction (STEMI) patients, and to identify the most appropriate duration of cardiac rhythm monitoring in STEMI patients with fQRS.

Methods

Patients diagnosed with and treated for STEMI at Siriraj Hospital (Bangkok, Thailand) during 2009–2012 were enrolled. Patients were divided according to fQRS status (having or not having fQRS) at hospital admission. The primary outcome was in‐hospital life‐threatening arrhythmic events, including sustained ventricular tachycardia and ventricular fibrillation. Time to last life‐threatening arrhythmic event from hospital admission was recorded.

Results

Of the 452 patients that were included, 96 patients (21.2%) had fQRS. There were significantly more life‐threatening arrhythmic events in the fQRS group than in the non‐fQRS group (22.9% vs. 4.5%, respectively; p < 0.001). Median (IQR) time to last life‐threatening arrhythmic event from hospital admission was significantly longer in fQRS than in non‐fQRS (6.58 hr [3.08–39.34] vs. 2.59 hr [1.75–5.75], respectively; p = 0.047). Multivariate analysis identified fQRS as an independent predictor of in‐hospital life‐threatening arrhythmic events (OR: 4.162, 95% CI: 1.669–10.384; p = 0.002).

Conclusions

The presence of fQRS complex on admission ECG was found to be an independent predictor of in‐hospital life‐threatening arrhythmic events in STEMI patients. Since the time to last life‐threatening arrhythmic event from admission was longer in fQRS than in non‐fQRS, cardiac rhythm monitoring longer than 24–48 hr may be needed in patients with fQRS.
Nomogram predicting survival of hepatocellular carcinoma with portal vein tumour thrombus after curative resection
Authors: Hu Yiren , You Sunwu , Yang Zhangwei , Cheng Shuqun
Published: August 2018

Background

The aim of this study was to combine clinicopathologic variables associated with overall survival and disease‐free survival after curative resection for hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) into a prediction nomogram.

Methods

We retrospectively analysed 358 patients who underwent curative resection for HCC with PVTT at the Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, China. Two‐thirds of the patients were randomly assigned to the training set (n = 252) and one‐third were assigned to the validation set (n = 106). Multivariate analysis by Cox proportional hazards regression was performed using the training set, and the nomogram was constructed. Discrimination and calibration were performed using the validation set.

Results

The multivariate Cox model identified alpha fetoprotein, hepatitis B surface antigen (HBsAg), tumour diameter, tumour capsule, PVTT type and TNM stage as covariates associated with 1‐year survival, and alpha fetoprotein, HBsAg, tumour diameter, tumour capsule and PVTT type with half‐year disease‐free survival. In the validation set, the nomogram exhibited superior discrimination power (Harrell’s C‐index 0.78) compared with the American Joint Committe on Cancer TNM classification, the Cancer of the Liver Italian Program grade and the Japan Integrated Staging grade. Calibration of the nomogram‐predicted survival corresponding closely with the actual survival, the predicted survival was within a 10% margin of ideal nomogram.

Conclusion

We developed a nomogram predicting 1‐year overall survival and half‐year disease‐free survival after curative resection for HCC with PVTT. Validation data sets revealed good discrimination and calibration, suggesting good clinical utility. The nomogram improved individualized predictions of survival.
Influence of liver fibrosis on prognosis after surgical resection for resectable single hepatocellular carcinoma
Authors: Suh Suk‐Won , Choi Yoo Shin
Published: August 2018

Background

Surgical resection (SR) is recommended for single hepatocellular carcinoma (HCC) in patients with well‐preserved liver function. However, unexpected liver fibrosis sometimes found at the SR which leads to a poor outcome. This study investigated the influence of liver fibrosis on prognosis after SR for HCC.

Methods

A total of 189 patients with Child‐Turcotte‐Pugh grade A who underwent curative SR for a single HCC <5 cm were evaluated. Patients were assigned to two groups based on the degree of fibrosis (mild or severe), as determined by histological evaluation.

Results

Severe fibrosis was present in 49 patients (25.9%); these patients had greater posthepatectomy liver failure (P = 0.000) and HCC recurrence (P = 0.016). Severe liver fibrosis (hazard ratio (HR) = 1.849, 95% confidence interval (CI) 1.191–2.869; P = 0.006), microvascular invasion (HR = 1.854, 95% CI 1.183–2.906; P = 0.007), and poor histologic grade (HR = 2.097, 95% CI 1.230–3.574; P = 0.007) were related to HCC recurrence.

Conclusion

Severe fibrosis can be found even in patients with well‐preserved liver function and it leads to poorer early post‐operative and late oncologic outcomes, therefore it should be considered before therapeutic decision making of HCC.
Preferred weight‐related terminology by parents of children with obesity
Authors: Hirschfeld‐Dicker Lior , Samuel Roy David , Tiram Vakrat Elinor , Dubnov‐Raz Gal
Published: August 2018

Aim

In order to improve weight‐related discussion with patients and minimise their discomfort, the terminology used by medical staff should be carefully chosen. The aim of the study was to identify the most motivating weight‐related terminology to use with children with obesity.

Methods

Focus groups were used to generate a list of 12 weight‐related terms in Hebrew, sent by a questionnaire to parents of children and adolescents with obesity. Terms were graded according to how desirable, stigmatising, blaming or motivating they were perceived. We identified the most positive and negative weight‐based terms and conducted linear regressions to predict child motivation to lose weight when positive terms are used.

Results

The least stigmatising and most motivating and desirable terms were ‘unhealthy body weight’ and ‘unhealthy lifestyle’. Medical staff mostly used ‘overweight’, which was relatively inoffensive yet not very motivating. ‘Fat/obese’ (‘Shamen’) was the most stigmatising and blaming term and the least desired. Only 20% of parents endorsed a nonverbal graphical tool to describe body size.

Conclusion

Our findings encourage using health‐based terminology over weight‐based terminology to promote treatment and lifestyle changes in children with obesity. Healthcare professionals should adopt patient‐centred care and improve the weight‐related terms they use with children with obesity.
Bendamustine and rituximab in elderly patients with low‐tumour burden follicular lymphoma. Results of the LYSA phase II BRIEF study
Authors: Gyan Emmanuel , Sonet Anne , Brice Pauline , Anglaret Bruno , Laribi Kamel , Fruchart Christophe , Tilly Hervé , Araujo Carla , Soubeyran Pierre , Gonzalez Hugo , Morineau Nadine , Nicolas‐Virelizier Emmanuelle , Ghesquières Hervé , Salles Bruno , Bouabdallah Réda , Orfeuvre Hubert , Fahri Jonathan , Couturier Olivier , Xerri Luc , Feugier Pierre ,   the Lymphoma Study Association (LYSA)
Published: August 2018

The treatment of low‐tumour burden follicular lymphoma (LTBFL) remains a challenge. Rituximab‐based strategies may be improved by adding chemotherapy. This Lymphoma Study Association multicentre phase II study assessed rituximab and bendamustine in 63 patients with untreated LTBFL who were aged over 60 years old and had a follicular lymphoma International Prognostic Index (FLIPI) score ≥2. Induction comprised 4 weekly cycles of rituximab 375 mg/m2 intravenously combined with 2 cycles of bendamustine 90 mg/m2 days 1–2 with a 28‐day interval, followed by twelve cycles of 375 mg/m2 rituximab maintenance therapy every 8 weeks. The primary endpoint was complete response (CR)/unconfirmed CR (CRu), at 12 weeks. Median age was 67·4 years and median FLIPI was 3. Ultimately, 18 patients (29%) had high tumour burden according to Groupe d'Etude des Lymphomes Folliculaires criteria. The 12‐week CR/CRu rate was 54·0% and the overall response rate was 93·7%. Surprisingly, 3 patients died during maintenance (2 sepsis, 1 neoplasm). Progression‐free survival was 85·4% at 24 months. In LTBFL patients with FLIPI ≥2, two cycles of rituximab and bendamustine result in a CR rate of 54·0%. However, the treatment‐related deaths observed do not allow this regimen to be recommended for LTBFL patients aged over 60 years.

EudraCT: 2010‐020757‐14; ClinicalTrials.gov: NCT01313611.
The hospital provision of reasonable adjustments for people with learning disabilities: Findings from Freedom of Information requests
Authors: Heslop Pauline , Read Stuart , Dunwoodie Stirton Fred
Published: August 2018

Accessible Summary

The Equality Act is a law to make sure that people are treated fairly. The law says that anyone providing a service to the general public, including hospitals, must make “reasonable adjustments” for disabled people. A reasonable adjustment is changing the way the hospital usually does things so that disabled people are able to use their services. The aim of this study was to find out whether the funders of health care (called Clinical Commissioning Groups or CCGs) and hospitals were keeping to the Equality Act .

Some funders and hospitals did not reply to our questions. All of the other funders said that they wrote into their agreements that disabled people must be able to use the hospital. Eight of 186 told us that they checked up on whether this happened or not.

Most of the hospitals could tell us the number of people with learning disabilities that had been inpatients, but fewer could tell us the number of people with learning disabilities who used outpatients or accident and emergency. About half of the hospitals said they did not check up on services for people with learning disabilities or they did not share these reports with the public.

This research is important because it suggests that some hospitals may not be following the Equality Act , and that more could be done to make sure that people with learning disabilities are able to access health care.

Background

The Equality Act places a duty on service providers to make “reasonable adjustments” for disabled people. The aim of this study was to explore key aspects relating to the provision of reasonable adjustments for people with learning disabilities in hospitals.

Methods

The research questions were explored using Freedom of Information (FOI) requests submitted to 206 CCGs and 141 hospital trusts in England.

Results

One hundred and eighty‐six CCGs reported that they included the requirement to provide equal access to services in their contracts with providers. Eight CCGs provided evidence about how they ensured reasonable adjustments were provided. One hundred and twelve of 132 responding hospital trusts provided information about the number of inpatients with learning disabilities; eighty‐three of 132 provided data about outpatients and 88 of 132 provided data about A&E. Sixty‐four of 125 responding trusts explicitly stated that they did not undertake audits of learning disability services or did not make any such reports publicly accessible.

Conclusions

The findings contribute to concern about the gap between legislation and guidance, and its practical application “on the ground.” If CCGs are not assessing contractual compliance to provide equitable access to services for people with learning disabilities, and trusts are not aware of the number of people with learning disabilities using their services, or their access requirements, this raises concerns about their compliance with the Equality Act .
BMAL1 deficiency promotes skeletal mandibular hypoplasia via OPG downregulation
Authors: Zhou Xin , Yu Ran , Long Yanlin , Zhao Jiajia , Yu Shaoling , Tang Qingming , Chen Lili
Published: August 2018

Objectives

Skeletal mandibular hypoplasia (SMH), a common type of developmental deformities, results in impaired aesthetics of facial profile, occlusal dysfunction and poor life quality. In this study, BMAL1 deficiency leads to SMH formation, and we aim to investigate the mechanism by which BMAL1 deficiency induces SMH.

Materials and methods

Circadian rhythm‐disordered mouse models were constructed by placing animals in a jet lag schedule of 6‐h light advance every 7 days for 4 or 8 weeks. The OPG expression was evaluated by histomorphometry, immunohistochemistry and western blot analysis. The mechanism by which BMAL1 affects OPG expression was investigated by chromatin immunoprecipitation and luciferase reporter assays. The phenotypes caused by BMAL1 knockout can be rescued by exogenous supplementation with OPG.

Results

We demonstrate that the expressions of BMAL1 and OPG decreased in SMH patients. Circadian rhythm‐disordered mice and Bmal1−/− mice exhibited decreased expression of OPG, reduced bone mass and bone size of mandibles. Our results revealed that BMAL1 bound directly to the Opg promoter and upregulated its expression, thus inhibiting osteoclast differentiation. BMAL1 deficiency increased osteoclast differentiation by downregulating OPG expression. In vitro, the enhancement effect of osteoclast differentiation caused by BMAL1 knockdown was significantly reversed by exogenous supplementation with OPG. Importantly, bone loss caused by BMAL1 knockout can be partially reversed by injecting OPG Intraperitoneally.

Conclusions

These results indicate that the circadian clock plays a critical role in the growth and development of mandible by regulating OPG expression, and present a potential therapeutic strategy to prevent SMH.
Frequency of crown and root dilaceration of permanent incisors after dental trauma to their predecessor teeth
Authors: de Amorim Camila Silva , Americano Gabriela Caldeira Andrade , Moliterno Luiz Flávio Martins , de Marsillac Mirian de Waele Souchois , Andrade Márcia Rejane Thomas Canabarro , Campos Vera
Published: August 2018

Background/Aims

Dental trauma to the predecessor teeth can cause crown and root dilacerations to the successor teeth, which can interfere with the normal development of permanent teeth. The aims of this study were to verify the types of trauma more frequent to the predecessor teeth that cause dilaceration to their successor teeth, to determine the frequency of crown and root dilacerations in permanent incisors, taking into account the child's age at the time of trauma, and to describe the types of treatment performed.

Materials and Methods

Details of 815 anterior primary teeth with dental injury were obtained from 483 dental records of children aged 0‐9 years at the time of trauma.

Results

Of 815 traumatized primary teeth, 161 successor teeth were clinically and radiographically reviewed until complete eruption and had some type of sequel. Avulsion and intrusive luxation were the most frequent types of trauma to the predecessor teeth that caused dilaceration to their successor teeth. Enamel discoloration (30.4%), hypoplasia (23.6%), root (14.3%) and crown (9.9%) dilacerations were the most common sequelae observed in the successor teeth. Root and crown dilacerations were more frequent in children aged more than and up to 3 years, respectively. Tooth extraction and orthodontic treatment were the most common treatments.

Conclusions

Dentists must be aware of the relationship between the child's age at the time of trauma to the predecessor tooth and the type of sequel to the successor tooth in order to diagnose, monitor, and treat the sequel properly.
Traits of criticality in membrane potential fluctuations of pyramidal neurons in the CA1 region of rat hippocampus
Authors: Kosmidis Efstratios K. , Contoyiannis Yiannis F. , Papatheodoropoulos Costas , Diakonos Fotios K.
Published: August 2018

Evidence that neural circuits are operating near criticality has been provided at various levels of brain organisation with a presumed role in maximising information processing and multiscale activity association. Criticality has been linked to excitation at both the single‐cell and network levels, as action potential generation marks an obvious phase transition from a resting to an excitable state. Using in vitro intracellular recordings, we examine irregular, small amplitude membrane potential fluctuations from CA1 pyramidal neurons of Wistar male rats. We show that these fluctuations, confounded with noise, carry information relevant to the neuronal state. The underlying dynamics exhibit intermittent characteristics shown to describe the temporal fluctuations of the order parameter of a macroscopic system at its critical point even in the absence of firing. An externally applied stimulus serves as the control parameter, driving the system in and out of its critical state. Based on our experimental observations we calculate the equivalent of the isothermal critical exponent δh finding a value which depends on the applied stimulus. For each neuron there is a stimulus amplitude for which the critical behaviour becomes most pronounced. The corresponding mean value of δh in the considered ensemble of neurons is δh ≈ 1.89, close to theoretical predictions for critical networks. Finally, we show that the firing rate of a neuron decreases exponentially with δh.
Intraspecific trait variation and trade‐offs within and across populations of a toxic dinoflagellate
Authors: Brandenburg Karen M. , Wohlrab Sylke , John Uwe , Kremp Anke , Jerney Jacqueline , Krock Bernd , Van de Waal Dedmer B.
Published: August 2018

Intraspecific trait diversity can promote the success of a species, as complementarity of functional traits within populations may enhance its competitive success and facilitates resilience to changing environmental conditions. Here, we experimentally determined the variation and relationships between traits in 15 strains of the toxic dinoflagellate Alexandrium ostenfeldii derived from two populations. Measured traits included growth rate, cell size, elemental composition, nitrogen uptake kinetics, toxin production and allelochemical potency. Our results demonstrate substantial variation in all analysed traits both within and across populations, particularly in nitrogen affinity, which was even comparable to interspecific variation across phytoplankton species. We found distinct trade‐offs between maximum nitrogen uptake rate and affinity, and between defensive and competitive traits. Furthermore, we identified differences in trait variation between the genetically similar populations. The observed high trait variation may facilitate development and resilience of harmful algal blooms under dynamic environmental conditions.
Can the performance effect be ignored in the attendance policy discussion?
Authors: Sund Kristian J. , Bignoux Stephane
Published: August 2018

Should universities require students to attend? Academics disagree. One side in the discussion of university attendance policies has tried to dismiss any association between attendance and student performance, insisting that students have a fundamental right to choose what and when to attend. By merging student record data and course attendance data for three cohorts of final year undergraduate students at a London‐based university, we are able to isolate attendance effects for 674 students, giving us a large sample, without the inherent weaknesses of more traditional survey methods. We provide fresh empirical evidence for the positive association between attendance and exam performance, and argue for a more balanced view in the attendance policy discussion. Politicians and Higher Education policies are increasingly focused on employability, student retention and completion indicators. Carefully crafted attendance policies can have positive effects on pass and completion rates, primary policy targets of Higher Education funders and policymakers. Attendance effects therefore cannot simply be ignored.
Modelling student migration to Karnataka for Higher Education using a partial least square structural equation model
Authors: Rao Sandeep , Andini Veena
Published: August 2018

With increasing student migration for Higher Education to Karnataka, it is important to understand the reasons which influence the migrants. Studies have indicated various push and pull factors for migration. This paper identifies career opportunities, value for education, brand equity, living conditions and others as pull factors of student migration using exploratory factor analysis. Further, the paper develops a structural equation model using a partial least square technique based on the factors explored. The research is based on primary data collected from students who migrated to Karnataka for Higher Education. The partial least square structural equations model shows that job opportunities and academic progression are the main factors influencing the decision to migrate to Karnataka.
Shaping efficiency as a function of time of a new heat‐treated instrument
Authors: De‐Deus G. , Belladonna F. G. , Simões‐Carvalho M. , Cavalcante D. M. , Ramalho C. N. M. J. , Souza E. M. , Lopes R. T. , Silva E. J. N. L.
Published: August 2018

Aim

To assess the shaping ability of the new XP‐endo Shaper instrument after different working times.

Methodology

Ten mesial roots of mandibular molars were scanned in a micro‐computed tomographic device and prepared using the XP‐endo Shaper instrument up to the working length (WL) according to the manufacturer's recommendation. Then, each specimen was subjected to an extra 15, 30 and 45 s of active instrumentation at the WL. Postoperative scans were performed after canal preparation at each time‐point. Then, the registered pre‐ and postoperative datasets were examined to evaluate the percentages of volume and surface area of the instrumented canal, surface area of noninstrumented canal areas and the volume of removed dentine. Repeated measures general linear model was used to compare the differences in either the increase or the reduction of the parameters amongst the time‐points. Alpha‐error was set at 5%.

Results

Extending the period of XP‐endo Shaper active instrumentation at WL significantly influenced several parameters such as volume (P < 0.001) and surface area (P < 0.001) of the instrumented canal, surface area of noninstrumented canal areas (P < 0.001), and volume of removed dentine (P < 0.001).

Conclusions

Extending the activation time of XP‐endo Shaper instruments at WL resulted in a more comprehensive root canal preparation, increasing the volume and surface area of root canal preparation and the volume of removed dentine.
The ocean as frontier
Authors: Steinberg Philip E.
Published: August 2018

This editorial explores how the concept of the frontier calls attention to the ocean as a space of both opening and closure. Whilst the new opportunities suggested by a frontier imply an opening, the realisation of these opportunities typically requires a degree of (en)closure. At the same time, however, because spaces like the ocean cannot easily be enclosed by existing political institutions, the frontier opens new spaces for regulatory and, ultimately, ethical innovations. In short, while there is much to be concerned about in the opening of the ocean as a “frontier”, this opening also presents political opportunities.
A robust quasi‐superhydrophobic ceria coating prepared using air‐plasma spraying
Authors: Hu Lingyue , Song Xuefeng , Jin Dongliang , Xing Chen , Shan Xiao , Zhao Xiaofeng , Guo Fangwei , Xiao Ping
Published: August 2018

Hydrophobic coatings that could survive in harsh environment have a wide range of applications from industry to houseware. However, the state‐of‐the‐art polymer‐based coatings cannot meet such requirements due to their low melting point and poor wear resistance. In this study, we reported a plasma sprayed ceramic coating made of ceria with exceptional hydrophobicity, high‐temperature stability, and good wear resistance. The coating exhibited a water contact angle (WCA) up to 139°, due to the intrinsic hydrophobicity of ceria and unique surface morphology produced by plasma spraying. The WCA only slightly decreased to 131° after annealing at 773 K. In addition, the polished coating (WCA ~ 116°) was still more hydrophobic than the sintered bulk specimen (WCA ~ 95°) with the same composition and roughness, which can be attributed to the surface chemistry change induced by Ar+ ion bombing by plasma. It is believed that such robust hydrophobic coating should have great potential in engineering application.
Broadband emission and flat optical gain glass containing Ag aggregates for tunable laser
Authors: Zhong Hua , Chen Baojiu , Fu Shaobo , Li Xiangping , Zhang Jinsu , Xu Sai , Zhang Yanqiu , Tong Lili , Sui Guozhu , Xia Haiping
Published: August 2018

Spectroscopic properties of Sm3+‐doped borate glass with silver aggregates were investigated, and it was found that the glass presented broad excitation and emission band covering violet‐infrared region. Furthermore, the optical gain coefficients at various wavelengths were measured via an amplified spontaneous emission technique, it was confirmed that the glass displayed flat net optical gain coefficient in almost full visible region. In addition, the fluorescent temperature quenching of the glass was examined, and it was seen that about 50% of room temperature emission intensity was kept when the sample was heated up to 325°C.
Validating GO4KIDDS as a brief measure of adaptive skills in special education settings for children with severe intellectual disability
Authors: Pan Xinyu , Totsika Vasiliki , Nicholls Gemma , Paris Andreas
Published: August 2018

Background

Adaptive skills measures tend to be lengthy. The GO4KIDDS (Great Outcomes for Kids Impacted by Severe Developmental Disabilities; (Journal of Applied Research in Intellectual Disabilities, 58, 2015 and 594)) Brief Adaptive Behaviour Scale was developed to provide a brief assessment of adaptive skills. Our study aimed to examine the psychometric properties of G04KIDDS Brief Adaptive Scale in a large sample of children in special education.

Methods

Teachers reported on 361 students with severe to profound intellectual disability. The scale's factor structure was examined through principal components analysis (PCA), while its convergent validity was examined in relation to the Vineland (VABS‐II; Vineland‐II adaptive behavior scales, Circle Pines, MN, AGS and 2005).

Results

The PCA indicated a single component measuring overall adaptive skills, which had excellent internal consistency (alpha = 0.93), and convergent validity (Pearson's r = 0.81).

Conclusions

Teacher‐reported scores on GO4KIDDS Brief Behaviour Scale can provide a reliable and valid composite of adaptive skills in children with severe to profound intellectual disability. The scale will be useful to researchers and teachers who need a brief descriptive assessment of adaptive functioning.