bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying and Categorizing ADRs in Psychiatric Residential Long-Stay Patients Utilizing UKU-SERS Scale
Authors: Mathew Joelin , Varghese Amruta , Sajith Manjusha
Published: August 2020

Background:

Psychotropic drugs are essential but not devoid of adverse drug reactions (ADRs), which lead to non-compliance and further failure of therapy, hampering the patient’s quality of life.

Methods:

A cross-sectional, observational study was carried out in a residential nursing home in Pune, India, from October 2018 to March 2019. Psychiatric inpatients of both genders and all ages receiving psychotropic drugs for at least one month were enrolled. Patients who were not alert or oriented enough to give a detailed history and response to a questionnaire, including dementia patients, and those who were not willing to give informed consent were excluded. The ADRs were categorized, and their management was documented using the Udvalg for Kliniske Unders gelser (UKU) side effect rating scale. ADRs were assessed for causality and severity using the WHO-Uppsala Monitoring Centre (WHO-UMC) causality assessment scale and the Modified Hartwig and Siegel scale.

Results:

In our study, 115 patients (76.6%) experienced 273 adverse drug events. Atypical antipsychotics accounted for the maximum number of ADRs (54.94%; n = 150). The most common ADRs were weight gain, constipation, and tremors. The majority of ADRs were “mild” and had a “possible” causality relationship.

Conclusion:

The study demonstrated a high incidence of ADRs, which was primarily managed either by reduction of dose or continued drug use with the treatment of side effects.
A Randomized Controlled Trial to Assess Feasibility and Acceptability of Telephone-Based Psychosocial Interventions in Individuals who Attempted Suicide
Authors: Sreedaran Priya , Beniwal Ram Pratap , Chari Uttara , Smitha T S  , Vidhya Shree S V  , Gupta Varsha , Bhatia Triptish , Deshpande Smita N
Published: August 2020

Background:

Brief contact interventions such as telephone-based contacts appear to be useful in individuals who attempted suicide. Most studies of telephone-based contacts in such individuals typically consisted of frequent phone reminders for adherence to treatment and seeking help for mental health issues. Telephone-based psychosocial interventions that incorporate elements of supportive and problem-solving strategies are of interest in Indian settings due to their potential application in mitigating the wide mental health gap. Feasibility studies of telephone-based psychosocial interventions could help ascertain the difficulties that arise in the implementation of such treatments.

Methods:

A multicentric randomized controlled trial (RCT) is currently underway in general hospital settings in two Indian cities to study the efficacy of telephone-based psychosocial interventions in individuals with a recent suicide attempt, with routine telephone contacts (TCs) serving as the comparator. Prior to that RCT, this feasibility study was conducted to assess the acceptability of the telephone-based intervention and telephone contacts. Feasibility was assessed using dropout rates. Acceptability was assessed using participant-rated Likert-based visual analog scores from 0 to 10, with higher scores indicating greater acceptability.

Results:

Dropout rates and mean acceptability scores for telephone-based psychosocial interventions were 38.5% and 8.63, while those for TCs were 41.7% and 7.57, respectively.

Conclusions:

Telephone-based psychosocial interventions are feasible and acceptable in individuals with a recent suicide attempt.
Structured Teaching and the Play of Preschoolers With Developmental Disabilities: An Evaluation
Authors: Pullum Megan R. , King Seth A. , Kennedy Krystal
Published: August 2020

Play represents an important component of early childhood education and is linked to the development of communication and social skills, particularly for children with developmental disabilities who often lack play skills. Structured teaching is a systematic method that entails visually arranging and organizing the learning environment. Although effective for older individuals with disabilities, research examining the efficacy of structured teaching in increasing the play skills of young children is limited. This study examined the effects of structured teaching on the appropriate play of five preschool-age children with developmental disabilities. Results suggest structured teaching produced a higher level of play for two of the participants; however, gains were generally not maintained following discontinuation of the instruction. Findings, though mixed, have implications for practice and future research.
The efficacy of the figure-of-eight suture technique in the treatment of tunnel bleeding of the femoral artery route after percutaneous coronary intervention or angiography
Authors: Huang Ya , Nong Jing-Guo , Xue Qiao , Feng Quan-Zhou , Lu Cai-Yi
Published: August 2020

Objective

To evaluate the efficacy of the figure-of-eight (FOE) suture technique in the treatment of tunnel bleeding after femoral artery puncture compared with manual compression (MC).

Methods

This prospective, randomized, controlled study enrolled patients that had received transfemoral coronary artery angiography or percutaneous coronary intervention and then developed tunnel bleeding. They were randomly assigned into two groups: FOE suture group (ES group) and manual compression group (MC group). Total treatment time, performance frequency, performance time, rate of deep vein thrombosis (DVT) and in-hospital time after the procedure were compared.

Results

A total of 152 patients were enrolled in the study (ES group, n = 63; MC group, n = 89). Compared with the MC group, the total treatment time (mean ± SD: ES 22.3 ± 5.4 h versus MC 26.8 ± 6.8 h), performance frequency (mean ± SD: ES 2.1 ± 0.7 versus MC 2.6 ± 1.1), performance time (mean ± SD: ES 8.9 ± 2.5 min versus MC 12.3 ± 4.1 min), in-hospital time after the procedure (mean ± SD: ES 3.5 ± 1.2 days versus MC 4.8 ± 2.1 days) and DVT rate (ES 0.0% versus MC 6.7%) were significantly lower in the ES group.

Conclusion

The FOE suture technique effectively treated tunnel bleeding after femoral artery puncture.
Association between a DJ-1 polymorphism and the risk of Parkinson's disease: a PRISMA-compliant systematic review and meta-analysis
Authors: Liu Jie , Li Chunrong , Zhou Xiaoyang , Sun Jian , Zhu Meng , Zhang Hongliang , Cheng Lei , Li Guobin , He Tao , Deng Wenshuai
Published: August 2020

Objective

In recent years, a number of case–control studies have focused on the association between the DJ-1 g.168_185del polymorphism and the risk of Parkinson's disease (PD). However, the results have been conflicting. To estimate the relationship between the DJ-1 g.168_185del polymorphism and PD susceptibility, a comprehensive meta-analysis was performed.

Methods

Eligible studies concerning the DJ-1 g.168_185del polymorphism and PD susceptibility were searched for in the PubMed, Web of Science, Embase, Wanfang, CNKI, and VIP databases. Odds ratios and 95% confidence intervals were calculated to estimate the strength of the associations. In total, 11 studies were included in this meta-analysis, including 13 case–control studies with 2890 cases and 3043 controls.

Results

This meta-analysis revealed that DJ-1 g.168_185del variants are associated with PD susceptibility in the non-Asian population, but not in the Asian population.

Conclusions

Our meta-analysis suggests that DJ-1 gene variants are not associated with the risk of PD in the overall population.
Adverse effects of erenumab on cerebral proliferative angiopathy: A case report
Authors: Lehman Laura L , Bruccoleri Rebecca , Danehy Amy , Swanson Julie , Mrakotsky Christine , Smith Edward , Orbach Darren B , Burstein Rami
Published: August 2020

Background

Cerebral proliferative angiopathy is a vascular malformation associated with compromised blood-brain barrier and with migraine-like headache. Treating blood-brain barrier-compromised patients with erenumab, an anti-calcitonin gene-related peptide receptor monoclonal antibody, may be risky.

Case

We describe a case of a 22-year-old chronic migraine patient with cerebral proliferative angiopathy who presented to our hospital in status epilepticus 2 d after his first dose of erenumab. Serial magnetic resonance imaging (MRI) studies demonstrated progressive areas of diffusion restriction including the brain tissue adjacent to the cerebral proliferative angiopathy, bilateral white matter and hippocampi. His 6-month post-presentation magnetic resonance imaging was notable for white matter injury, encephalomalacia surrounding cerebral proliferative angiopathy and bilateral hippocampal sclerosis. He remains clinically affected with residual symptoms, including refractory epilepsy and cognitive deficits.

Conclusion

The evidence presented in this case supports further investigation into potential deleterious side effects of erenumab in patients with compromised blood-brain barrier, such as individuals with intracranial vascular malformations.
A Word of Caution for Future Studies in Patellofemoral Pain: A Systematic Review With Meta-analysis
Authors: Grant Camila , Fick Cameron N. , Welsh Judith , McConnell Jenny , Sheehan Frances T.
Published: August 2020

Background:

Patellar maltracking is widely accepted as an underlying mechanism of patellofemoral pain. However, methodological differences in the literature hinder our ability to generate a universal quantitative definition of pathological patellofemoral kinematics (patellar maltracking) in patellofemoral pain, leaving us unable to determine the cause of patellofemoral pain.

Purpose:

To systematically review the literature to provide evidence regarding the influence of confounding variables on patellofemoral kinematics.

Study Design:

Systematic review and random effects meta-analysis of control-case studies.

Methods:

A literature search of case-control studies that evaluated patellofemoral kinematics at or near full extension and were written in English was conducted using Embase, PubMed, Scopus, and Web of Science up to September 2019. Cases were defined as patients with patellofemoral pain. Studies were eliminated if they lacked quantitative findings; had a primary aim to assess therapy efficacy; or included participants with osteoarthritis and/or previous trauma, pathology, or surgery. A quality assessment checklist was employed to evaluate each study. Meta-analyses were conducted to determine the influence of confounding variables on measures of patellofemoral kinematics.

Results:

Forty studies met the selection criteria, with quality scores ranging from 13% to 81%. Patient characteristics, data acquisition, and measurement methods were the primary sources of methodological variability. Active quadriceps significantly increased lateral shift (standardized mean difference [SMD]shift = 0.33; P = .0102) and lateral tilt (SMDtilt = 0.43; P = .006) maltracking. Individuals with pain secondary to dislocation had greater effect sizes for lateral maltracking than had those with isolated patellofemoral pain (ΔSMDshift = 0.71, P = .0071; ΔSMDtilt = 1.38, P = .0055).

Conclusion:

This review exposed large methodological variability across the literature, which not only hinders the generalization of results, but ultimately mitigates our understanding of the underlying mechanism of patellofemoral pain. Although our meta-analyses support the diagnostic value of maltracking in patellofemoral pain, the numerous distinct methods for measuring maltracking and the limited control for cofounding variables across the literature prohibit defining a single quantitative profile. Compliance with specific standards for anatomic and outcome measures must be addressed by the scientific and clinical community to establish methodological uniformity in this field.
A Randomized Controlled Trial Comparing Traditional Plaster Cast Rehabilitation With Functional Walking Boot Rehabilitation for Acute Achilles Tendon Ruptures
Authors: Maempel Julian F. , Clement Nick D. , Duckworth Andrew D. , Keenan Oisin J.F. , White Tim O. , Biant Leela C.
Published: August 2020

Background:

There has been a shift toward functional nonoperative rehabilitation in the treatment of Achilles tendon rupture (ATR) despite a shortage of studies directly comparing nonoperative functional rehabilitation with traditional nonoperative immobilization.

Purpose:

To compare patient-reported outcome measures and functional outcomes for nonoperatively treated ATR with traditional cast immobilization or functional rehabilitation in a walking boot.

Study Design:

Randomized controlled clinical trial; Level of evidence, 2.

Methods:

In a single-center nonblinded study, 140 patients were randomized to compare treatment for acute ATR in (1) an immobilizing cast in reducing degrees of equinus over a 10-week period with 8 weeks of nonweightbearing mobilization or (2) a walking boot for 8 weeks with reducing equinus and immediate full weightbearing. Exclusion criteria were delayed presentation >2 weeks after injury, tendon reruptures, and latex allergy. Analysis was undertaken on an intention-to-treat basis.

Results:

A total of 69 patients (median age, 41 years [interquartile range, 33-50.5 years]) were randomized to walking boot treatment and 71 patients (41 [32-49]) to cast treatment. At 6 months, patients treated in a walking boot reported better Short Musculoskeletal Function Assessment (SMFA) dysfunction index (6.62 [2.21-12.50] vs 10.66 [4.96-13.42]; P = .050), SMFA bother index (7.29 [2.08-14.58] vs 10.42 [5.73-19.27]; P = .04), Achilles Tendon Total Rupture Score (71.5 [53.50-84.25] vs 54.0 [37-76]; P = .01), and Foot and Ankle Questionnaire core score (91 [81.89-97.55] vs 85 [78.25-92.09]; P = .04). At 1 year, there was no difference in SMFA dysfunction index (2.21 [0.74-5.88] vs 2.94 [1.47-6.62]; P = .25), SMFA bother index (2.08 [0-9.38] vs 5.21 [0.52-11.98]; P = .25), Achilles Tendon Total Rupture Score (92 [72.50-96] vs 87.5 [66.0-94.75]; P = .21), or Foot and Ankle Questionnaire core score (97.75 [89.46-99.00] vs 95.50 [90.88-97.50]; P = .18). Rerupture occurred in 5 and 11 patients ( P = .075) and venous thromboembolism in 2 and 3 patients ( P = .67) in the boot and cast groups, respectively. Fifteen patients in the boot group but none in the cast group had skin problems ( P < .001). Patients treated in a boot returned to driving at a median 12 weeks (vs 13 weeks for cast; P = .045), but there was no difference in time to return to work ( P = .48).

Conclusion:

Functional rehabilitation with early weightbearing is a safe alternative to traditional immobilizing treatment for ATR, giving better early functional outcomes, albeit with a higher incidence of transient minor skin complications.

Registration:

NCT02598843 (ClinicalTrials.gov identifier).
Signals in the Waves of Surf: Category Development and Signals in Surf Music
Authors: Punt Matthijs B. , van Venrooij Alex
Published: August 2020

The aim of this paper is to investigate to what extent the understanding of market categories changes over time and how this is reflected in the importance of different category signals in periods of category maturation and revival. We test the changing influence of different types of category signals on inclusion rates of surf music compilation albums, which represent the understanding of “surf music” from a market-based perspective. We find that “elaborate” signals to the category label of surf music showed to be important during both the stage of maturity and revival. However, restricted category signals using surf slang actually lost their importance over time. Finally, signaling surf-related locations had no effect in early times, but increased chances of inclusion during a revival. By addressing these changes over time in the importance of category signals, we add to recent studies on mechanisms of categorization during different stages of category development.
Effects of Formative Assessment Strategies on the Fractions Computation Skills of Students With Disabilities
Authors: Bottge Brian A. , Ma Xin , Gassaway Linda J. , Jones Megan , Gravil Meg
Published: August 2020

Learning to compute with fractions is a major challenge for many students and especially for students with disabilities (SWD). Phase 1 of this study employed a randomized pretest–posttest comparison design to test the effects of two versions of formative assessment combined with an instructional program called Fractions at Work. In one condition, teachers used technology-assisted prompts to assess student performance and remediate errors. In the comparison condition, teachers gave students the same items for assessing progress but used their own methods of reteaching. Results indicated no difference between the two methods. However, pretest-to-posttest gain scores were significantly higher on all three measures regardless of type of formative assessment, and students maintained much of what they had learned. Phase 2 examined issues related to instructional dosage. Students who received additional weeks of instruction scored significantly higher than students who went back to their business-as-usual curriculum.
Effect of metallothionein 1A rs8052394 polymorphism on lead, cadmium, zinc, and aluminum levels in factory workers
Authors: Singh Preeti , Mitra Prasenjit , Goyal Taru , Kumar Pilla VSN Kiran , Sharma Shailja , Sharma Praveen
Published: August 2020

Metallothioneins (MTs) are low molecular weight cysteine-rich, metal-binding proteins. They are involved in transportation and detoxification of heavy metals, homeostasis of essential metals, and as antioxidation against reactive oxygen species. Polymorphisms in a gene may increase or decrease the expression efficiency of a gene. This study aimed to determine the genetic effect of MT1A rs8052394 on lead (Pb), cadmium (Cd), zinc (Zn), and aluminum (Al) levels in factory workers. The study included 100 occupationally heavy metal exposed workers from different factories around Jodhpur. Pb, Cd, Zn, and Al levels were measured by atomic absorption spectrophotometry. Individuals with the GG genotype had lower Pb, Zn, and Al levels and higher Cd levels than AA and AG genotypes. The genotyping of MT1A rs8052394 was done by the polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP). The mean ± standard deviation of Pb, Cd, Zn, and Al was 5.88 ± 13.28 µg/dL, 3.52 ± 1.25 µg/L, 16.45 ± 16.69 µg/dL, and 58.92 ± 58.91 µg/L, respectively. A significant association was found between single-nucleotide polymorphisms (SNPs) of MT1A gene and Cd ( p = 0.006) and with Zn levels ( p = 0.031) but no association found with Pb and Al levels. Among the study population, 78 participants were homozygote major (AA), 19 were heterozygote (AG), and 3 were homozygote minor (GG). The χ 2 test presented the genotypic distribution of all three genotypes under the Hardy–Weinberg equilibrium ( p > 0.05). The frequency of the A allele was 87.5% (175) and the G allele was 12.5% (25). To conclude, polymorphism in rs8052394 of the MT1A gene is associated with increased metal accumulation which in turn may lead to increased toxic effects in the exposed individuals. Factory workers thus, should be more cautious about protecting their health against the toxic effects of heavy metals.
COVID-19: Nurses have responded, now it is time to support them as we move forward
Authors: Collins Rhonda
Published: August 2020

The inspiration for The American Nurse Project, Dr. Rhonda Collins, DNP, RN, FAAN, is Chief Nursing Officer for Vocera Communications. Every year around Nurses Week, Dr. Collins publishes a report examining important issues that impact the nursing profession worldwide. Her 2020 CNO report looks at many of the challenges impacting nurses before, during, and after COVID-19—highlighting the mental anguish and physical burdens that COVID-19 has placed on nurses and other frontline healthcare workers as they put themselves in harm’s way to protect others. Dr. Collins examines the foundation of cognitive science and outlines a three-point strategy to guide hospital and nurse leaders moving forward as they strive to support staff members: lightening clinicians’ cognitive load by addressing the difference between documentation and communication, relieving the burden of adapting to multiple systems by giving clinicians control over how they communicate, and providing clinicians with clear, contextual, just-in-time information—using software to enhance workflow, not distract from it. During these unprecedented times, health leaders can honour nurses by providing them with the tools to help strengthen resiliency and healing from this crisis.
Gendered Views in a Feminist State: Swedish Opinions on Crime, Terrorism, and National Security
Authors: Wagnsson Charlotte , Olsson Eva-Karin , Nilsen Isabella
Published: August 2020

Gender differences have been observed regarding many political and social issues, yet we lack comprehensive evidence on differences in perceptions on a wide range of security issues increasingly important to voters: military threats, criminality, and terrorism. Previous research suggests that when women are highly politically mobilized, as they are in Sweden, gender differences in political opinion are large. On the other hand, Swedish politicians have worked hard to reduce gender stereotypical thinking. This prompts the question: Are there gender differences in attitudes on security issues in Sweden, and if so, in what ways do the attitudes differ? This study is based on comprehensive data from focus groups and a large-scale survey. The results show that women were more prone to respond with an “ethic of care,” across security issues. Women were more inclined to understand security problems as structural, explained by macho culture, segregation, and injustice. Women tend to support preventive measures that provide individuals with opportunities to choose “the right path,” such as education and economic investment in deprived areas. When asked about national security, women believe more in diplomacy and dialogue. In general, women are less inclined to support various repressive solutions.
Caregivers, Gender, and the Law: An Analysis of Family Responsibility Discrimination Case Outcomes
Authors: Hirsh C. Elizabeth , Treleaven Christina , Fuller Sylvia
Published: August 2020

As workers struggle to combine work and family responsibilities, discrimination against workers based on their status as caregivers is on the rise. Although both women and men feel the pinch, caregiver discrimination is particularly damaging for women, because care is intricately tied to gendered norms and expectations. In this article, we analyze caregiver discrimination cases resolved by Canadian Human Rights Tribunals from 1985 through 2016, to explore how work and caregiving clash. We identify issues involved in disputes and the ways gendered expectations about work–life facilitation inform disputes and outcomes. We find that although women are more likely to bring claims and obtain favorable outcomes, the legal interpretation of claims is highly gendered. Women bring claims involving both their presumed status as caregivers and the practical challenges of seeking accommodations for care, whereas men’s claims are largely accommodation based. In adjudicating cases, Tribunals are more likely to see women than men as lacking credibility when making their claims, questioning their competence and legitimacy. In contrast, men struggle to demonstrate the legal basis of work–family interference, failing to convey how seriously work interferes with family responsibilities.
Examining the Experiences of Remaining Employees after a Coworker Dismissal: Initial Message Characteristics, Information Seeking, Uncertainty, and Perceived Social Costs
Authors: Benedict Bailey C.
Published: August 2020

Organizational exit can be turbulent. This study examines the communication surrounding coworker dismissal, including how remaining employees learn about a coworker’s dismissal and what predicts remaining employees’ information seeking, uncertainty, and perceptions of social costs related to information seeking. Statistical and content analyses were conducted on survey data gathered from 220 participants. Remaining employees most often learned about their coworker’s dismissal from another coworker or the remaining employees’ immediate supervisor; via individual, face-to-face meetings; with moderate formality; at some point within a day of the dismissal; with varying content. Age predicted uncertainty and perceived social costs of information seeking. Message characteristics predicted uncertainty, while interaction frequency predicted the perceived social costs of information seeking. Uncertainty did not predict information-seeking strategy use. Greater perceived social costs predicted less overt questioning and greater observing and testing. This study extends uncertainty reduction and management theories and offers managers advice about communicating coworker terminations.
Utility of serum beta-trace protein as a tool for estimating residual kidney function in peritoneal dialysis patients
Authors: See Yong Pey , Htay Htay , Teixeira-Pinto Armando , Pascoe Elaine M , Hawley Carmel , Cho Yeoungjee , Zhao Eileen , Johnson David W
Published: August 2020

Background:

Beta-trace protein (BTP) is a novel marker for residual kidney function (RKF) without need for urinary collection. We aimed to examine its utility as a tool for estimating RKF in incident peritoneal dialysis (PD) patients.

Methods:

This was a post hoc analysis of incident PD patients from the balANZ trial cohort. The outcomes evaluated were trends of serum BTP concentration with time, factors associated with change in BTP using mixed-effect multilevel linear regression and correlation of BTP with mean urinary urea and creatinine clearances (measured glomerular filtration rate (GFR)). Performances of two BTP-derived equations (Shafi-Eqn and Steubl-Eqn) to estimate GFR were evaluated by reporting bias (median difference between estimated and measured GFR), precision (interquartile range of median bias), accuracy (±2 mL/min of measured GFR) and P30 (percentage estimates within 30% of measured GFR) with confidence intervals (CIs) generated by bootstrapping 2000 replicates. The agreement between BTP-estimated GFR and measured GFR was also plotted graphically on Bland–Altman analysis.

Results:

The study included 161 PD patients. BTP concentration increased with dialysis vintage and was inversely correlated with measured GFR ( r = −0.64). Larger increases in BTP were associated with longer PD vintage and higher dialysate glucose exposure. Biases of BTP-estimated GFRs (Shafi-Eqn and Steubl-Eqn) were 1.2 mL/min/1.73 m2 (95% CI 1.0–1.3 mL/min/1.73 m2) and 0.4 mL/min/1.73 m2 (95% CI 0.2–0.6 mL/min/1.73 m2), respectively. Both BTP-estimated GFRs had poor precision (3.2 mL/min/1.73 m2 (95% CI 2.9–3.5 mL/min/1.73 m2) and 2.8 mL/min/1.73 m2 (95% CI 2.5–3.2 mL/min/1.73 m2), respectively) and accuracy of estimates (55% (95% CI 52–60%) and 59% (95% CI 55–63%), respectively). The mean difference of BTP-estimated GFR (Shafi-Eqn and Steubl-Eqn) and measured GFR were −1.14 mL/min/1.73 m2 and −0.42 mL/min/1.73 m2, respectively, with large limit of agreement on Bland–Altman plot.

Conclusions:

Serum BTP level was inversely related to RKF but neither BTP-estimated GFR equations were sufficiently accurate for routine use in PD patients.
Preparation of hybrid cyanate ester resin in the presence of polysilazane and its properties
Authors: Huo Xiaomeng , Guo Kangkang , Wang Fan , Zhu Yaping , Qi Huimin
Published: August 2020

A hybrid cyanate ester resin containing polysilazane was prepared via the prepolymerization of bisphenol-A dicyanate ester monomer (BADCy) in the presence of polysilazane (PSZ) under low temperature conditions in a short period of time. Fourier transform-infrared (FT-IR) spectroscopy and nuclear magnetic resonance (NMR) spectroscopy reveal that the polymerization reaction of BADCy can be carried out in the presence of PSZ to obtain a hybrid resin below 100°C and polymethylsilazane (PHS) exhibits an improved prepolymerization effect when compared to polydimethylsilazane (PMS). FT-IR spectroscopy and gel permeation chromatography (GPC) showed that the prepolymerization degree of the PHS/BADCy resin increased upon increasing PHS mass fraction from 0 to 12 wt%, polymerization temperature from 60 to 100°C and polymerization time from 0 to 4 h. The PHS/BADCy hybrid resins samples were prepared and their process properties were investigated by rheometry and Differential scanning calorimetry (DSC). The results indicated that their viscosity was <10 Pa.s in the temperature range of 60–130°C, and the initial curing temperature and curing exothermic enthalpy were 121.9°C and 358.9 J/g, respectively. Furthermore, the cured PHS/BADCy resin possesses excellent thermal and mechanical properties, the 5% weight loss temperature (Td5) and glass transition temperature (Tg) were 424–441°C and 273–282°C, respectively. The cured PHS/BADCy resin with 4 wt% PHS showed the highest flexural strength of 146 MPa and flexural modulus of 4.1 GPa.
Wear state evaluation of inner-diameter saw blade based on vibration and noise signals during processing
Authors: Pei Yong-Chen , Liu Qin-Jian , Zhao Ru-Shi , Zhang Hang
Published: August 2020

Slicing and cutting processing by inner-diameter saw blade has advantages of low cost and convenient adjustment of machine tool. In small size and batch processing, inner-diameter saw blade slicing and cutting is a common-used processing method. However, the wear of inner-diameter saw blade will seriously affect surface quality of workpiece cross section. It is necessary to monitor and evaluate the wear in real time. Based on the short-time Fourier transform, this article introduces a new method for assessing the wear of inner-diameter saw blade. By measuring and analyzing time–frequency characteristics of vibration and machining noise signals, wear is monitored in real time. The results show that it is a good method to monitor the wear of inner-diameter saw blade based on vibration of machine and machining noise signals. In addition, this method has no interference and influence on cutting work of inner-diameter saw blade, which provides a new idea for other forms of tool wear detection in engineering.
Development of the innovative differential tool wear modeling for high-feed milling and its experimental verification
Authors: Zhao PeiYi , Cheng Kai , Jiang Bin , Zuo LinHan
Published: August 2020

During the high-feed milling process, the vibrations generated by interrupted cutting cause changes in the instantaneous tool posture, as well as in the working angle and the distribution of the thermal stress coupling fields of each tool blade. These changes result in significant differences in the wear distribution of each tool blade. In this research, well-designed experiments for the high-feed milling of titanium alloys were carried out to identify the key factors affecting the differential wear on the milling tool insert blades. A differential tool wear model for the tool blades was developed in order to comprehensively describe the effects of the location error of the blades, the vibrations in the tool posture, and the working angle of each tool blade. The wear status of the milling tool was simulated based on the dynamic tool trajectories and postures derived by the model, and the entire simulated wear distribution was investigated with an innovative wear boundary recognition method. The differential tool wear model was evaluated and validated by the milling experiments and further supported by simulations.
An α-moving total least squares fitting method for measurement data
Authors: Gu Tianqi , Hu Chenjie , Tang Dawei , Lin Shuwen , Luo Tianzhi
Published: August 2020

The Moving Least Squares (MLS) and Moving Total Least Squares (MTLS) method are widely used for approximating discrete data in many areas such as surface reconstruction. One of the disadvantages of MLS is that it only considers the random errors in the dependent variables. The MTLS method achieves a better fitting accuracy by taking into account the errors of both dependent and independent variables. However, both MLS and MTLS suffer from a low fitting accuracy when applied to the measurement data with outliers. In this work, an improved method named as α-MTLS method is proposed, which uses the Total Least Square (TLS) method based on singular value decomposition (SVD) to fit the nodes in the influence domain and introduces a geometric characteristic parameter α to associated with the abnormal degree of nodes. The generated fitting points are used to construct the parameter and quantify the abnormal degree of the nodes. The node with the largest parameter value is eliminated and the remaining nodes are used to determine the local coefficients. By trimming only one node per influence domain, multiple outliers of measurement data can be effectively handled. There is no need to set threshold values subjectively or assign weights which avoids the negative influence of manual operation. The performance of the improved method is demonstrated by numerical simulations and measurement experiment. It is shown that the α-MTLS method can effectively reduce the influence of the outliers and thus has higher fitting accuracy and greater robustness than that of the MLS and MTLS method.
Effect of selective laser heat treatment on geometrical variation in boron steel components: An experimental investigation
Authors: Ramesh Sagar Vaishak , Wärmefjord Kristina , Söderberg Rikard
Published: August 2020

Selective laser heat treatment is a well-known process for its ability to produce tailor heat treated blanks (THTB). Specifically, ultra high strength boron steels with tailored material properties can be produced. However, this process generates unwanted distortion and influences geometrical variation. This in turn can affect functionality, aesthetics, and performance of the final product. Understanding the effects on geometrical variation in the final product or the assembly will enable in designing and producing geometry assured products. In this paper, boron steel blanks were selectively laser heat treated with a specific heat treatment pattern and laser heating direction sequence. These heat treated blanks were then cold formed. Further on, spot welding simulation of the cold formed parts was performed to assess the effect on geometrical variation at the assembly level. The results show that the effect of selective laser heat treatment on geometrical variation at part level propagates further to the assembly level. It implies that the effect on geometrical variation should be minimized at part level, when the blanks are laser heat treated. Hence, the sources that influence geometrical variation at part level when employing selective laser heat treatment are presented and discussed. The motivation and possibilities to minimize the effects in the early design concept stages is provided.
Case study for sampling effect in nanometric surface roughness of ultra-precision grinding
Authors: Zhang Shaojian , Peng Wei , Xiong Zhiwen , To Suet
Published: August 2020

Nanometric surface roughness (NSR) is commonly produced in ultra-precision grinding (UPG). However, the NSR would be significantly affected by the sampling frequency (SF), i.e. sampling effect, since it is governed by rich low, middle, and high spatial frequency features. Hereby, the case study focused on discussing sampling effect in the NSR of UPG. The theoretical and experimental results have been found that along with the SF increase the NSR rises and rapidly converges and the SF is over 10 times of the spatial frequency for the NSR within the 5% distortion. Moreover, the NSR is acceptable within its 5% variation ratio under two SFs. Further, the SFs should be provided as the measurement traceability, together. Significantly, the case study draws up a better insight into sampling effect in the NSR of UPG along with a feasible suggestion on its measurement.
Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature
Authors: Franco Adriana M de M , Medina Flavio Mac Cord , Balbi Gustavo Guimarães Moreira , Levy Roger Abramino , Signorelli Flavio
Published: August 2020

Objective

There is a broad spectrum of eye involvement in antiphospholipid syndrome (APS). The majority of descriptions are presented as case reports that include mostly APS patients secondary to systemic lupus erythematosus (SLE), with no compelling evidence in primary APS (PAPS). This study aimed to describe ocular manifestations in our well-defined PAPS cohort (APS-Rio) and then perform a systematic literature review (SLR) of ocular manifestations in patients with APS or positivity to aPL without SLE.

Methods

We retrospectively analyzed PAPS patients followed at our outpatient clinics. All patients fulfilled Sydney APS classification criteria (2006). We evaluated them for ocular symptoms and previous ocular diagnoses. Antiphospholipid antibodies and clinical APS manifestations were compared between patients with and without ocular manifestations. For the SLR, electronic databases were searched up to November 2019.

Results

We studied 105 PAPS patients; 90.5% were female and 56.2% were Caucasian. We found ocular manifestations in 37.1% of our cohort. Thrombosis was the main criteria manifestation (95.2%) and lupus anticoagulant was the most prevalent antibody. Ophthalmologic diagnoses were present in 7 patients, with 5 having retinal vessels thromboses. Amaurosis fugax was the leading complaint, present in 30 patients. In the univariate analysis, amaurosis fugax was related to livedo (p = 0.005), Raynaud’s phenomenon (p = 0.048) and the presence of anticardiolipin antibody (≥40 GPL/MPL) (p = 0.041). Hemianopia was associated with arterial hypertension (p = 0.049). In the multivariate analysis, the only association found was between livedo and amaurosis fugax (OR 4.09, 95%CI 1.5–11.11, p = 0.006). Our SLR incorporated 96 articles of ocular manifestations in patients with PAPS or positivity to aPL without SLE. Ocular findings varied from 5 to 88%, including anterior and posterior segments, orbital and neuro-ophthalmologic changes.

Conclusion

There is little evidence on ocular manifestations in PAPS. We described an association between livedo and amaurosis fugax. Prospective studies are needed to promote the best treatment and avoid blindness in PAPS patients.
Edwin Chadwick: A biographical update
Authors: Small Hugh
Published: August 2020

The civil servant Edwin Chadwick (1800–1890) dominated public health policy from 1848 until he was obliged to take early retirement in 1854. Historians have concluded that his activities after 1854 produced no lasting impact. That analysis did not evaluate his contribution to the 1875 Public Health Act. This paper describes how the coordinated activity of Chadwick, Florence Nightingale, and William Farr between 1858 and 1871 produced one of the most successful social reforms in modern history. Unaware of the intellectual capital that this group provided to political decision-makers, historical accounts have tended to attribute the reduction in mortality post-1875 to a natural organic process responding to evident social evils. The rise, fall, and rise again of Chadwick’s influence on public health policy shows how, on the contrary, difficult choices are necessary to resolve social problems.
CD4 and CD8 double-negative immunophenotype of thymoma-associated lymphocytes in a dog
Authors: Wikander Yvonne M. , Knights Kaori , Coffee Calli , Vernau William , Biller David S. , Higginbotham Mary Lynn , Springer Nora L.
Published: August 2020

Persistent small-cell lymphocytosis in dogs with a concurrent mediastinal mass has been associated with both thymoma and small-cell lymphoma. In thymomas, neoplastic thymic epithelial cells induce overproduction and release of polyclonal lymphocytes, whereas thymic lymphoma results in thymic effacement by a clonal expansion of neoplastic lymphocytes and subsequent leukemic phase of lymphoma. Flow cytometry has been used to differentiate these 2 entities by immunophenotyping mediastinal mass aspirates. It has been reported that cases with mediastinal masses in which ≥ 10% of the associated small-cell lymphocytes were double positive for CD4 and CD8 were thymomas, whereas masses associated with < 10% were suggestive of lymphoma. We report a unique case of thymoma-associated lymphocytosis lacking the classic CD4+CD8+ immunophenotype. Our findings suggest that there may be more diversity in the thymoma-associated lymphocyte immunophenotype than has been identified previously; immunophenotyping alone might not be sufficient to differentiate thymic small-cell lymphoma from thymoma-associated lymphocytosis. In dogs with mediastinal masses and peripheral lymphocytosis, employing a variety of testing modalities to avoid misdiagnosis is prudent. These modalities include cytologic and/or histologic evaluation, immunophenotyping, and clonality assessment.
A bioinspired piezocomposite propulsor: An electromechanical model
Authors: Shan Xin , Bilgen Onur
Published: August 2020

This article presents an experimentally validated electromechanical beam model for a representative cymbal-like piezocomposite active segment of a bioinspired piezocomposite aquatic propulsor/pump. The proposed concept is a self-contained propulsion/pumping system involving a series of piezoactive soft cymbal-like segments that are connected by passive soft connective segments. A series of phased excitations in expansion and contraction applied to active segments create a traveling wave along the axis of the pump, which in return propels the fluid. A parametric analysis is conducted using the proposed model to understand the effectiveness of the cymbal-like piezocomposite active segment as a function of critical structural parameters. Area change of the cymbal-like actuators, which is correlated to the propulsion power, is studied based on the analysis of the induced moment, curvature, and area change due to piezoelectric excitation. Objective functions and criteria are proposed and evaluated to understand the effectiveness, and to identify the optimal structural parameters of the piezocomposite pump. The influence of a sealant layer for waterproofing is also examined. Both bimorph and unimorph configurations are analyzed, and the results are compared.
Impact of Caring for Terminally Ill Children on Physicians: A Systematic Scoping Review
Authors: Ngiam Lisa Xin Ling , Ong Yun Ting , Ng Jun Xuan , Kuek Joshua Tze Yin , Chia Jeng Long , Chan Natalie Pei Xin , Ho Chong Yao , Abdurrahman Ahmad Bin Hanifah Marican , Kamal Nur Haidah Ahmad , Cheong Clarissa Wei Shuen , Ng Cheng Han , Tan Xiu Hui , Tan Lorraine Hui En , Chin Annelissa Mien Chew , Mason Stephen , Jumat Muhammad Raihan , Chiam Min , Krishna Lalit Kumar Radha
Published: August 2020

Introduction:

Caring for terminally ill children influences nurses’ and allied health provider’s quality of life, ability to provide personalized, dignified and empathetic care and even their concepts of personhood. In the absence of data this review utilizes the Ring Theory of Personhood (RToP) to evaluate how a physician’s concept of personhood is affected caring for terminally ill children in order to better support them holistically.

Methods:

Using PRISMA Guidelines, 14 researchers carried out independent searches of PubMed, CINAHL, PsycINFO, Cochrane Library and gray literature databases for articles published between 2000 to 2019. Concurrent and independent employment of content and thematic analysis (Split Approach) was used to enhance the trustworthiness of the analysis.

Results:

13,424 titles and abstracts were retrieved, 188 full texts were evaluated, and 39 articles were included and analyzed. Identical categories and themes identified using the Split Approach suggest that caring for dying children in PPC impacts the physician’s professional identity, clinical decision making, personal well-being and relationships. The data also suggests that the magnitude of these effects depends on the presence of protective and risk factors.

Conclusion:

Aside from providing a novel insight into the upon the physician, this review proffers a unique approach to accounting for the presence, magnitude and influence of incoming catalysts, resultant conflicts, and protective and risk factors upon the physician’s personhood. Further studies into the changes in personhood are required. Design of a personalized assessment tool based on the RToP will help direct timely, appropriate and personalized support to these physicians.
Evaluation of Nasal Patency Among Patients With Unilateral Cleft Lip and Palate: Cleft Versus Non-Cleft Side
Authors: Banari Ashwina S. , Datana Sanjeev , Agarwal S. S. , Bhandari S. K.
Published: August 2020

Objective:

To evaluate the nasal patency using acoustic rhinometry (AR) in patients with unilateral cleft lip and palate (UCLP) and to ascertain the rhinological importance of the same.

Methods:

Eccovision Acoustic Rhinometer system was used for assessment of nasal cross-sectional area (CSA) and volume in 15 patients with UCLP. The CSA1, CSA2, and CSA3, which represent the CSA at the nasal valve area and anterior end of the inferior turbinate, the anterior half of the inferior turbinate and the anterior end of the middle turbinate, and the region of middle portion of middle turbinate, respectively, were compared on the cleft and non-cleft side.

Results:

The mean ± SD of CSA1, CSA2, and CSA3 as well as the overall nasal CSA were significantly higher on non-cleft side compared to cleft side ( P value < .001). The mean ± SD of nasal volume was also significantly higher in non-cleft side compared to cleft side ( P value < .001).

Conclusions:

The nasal patency among patients with UCLP demonstrates a range of impairments that can be objectively measured using acoustic rhinometry. The orthodontic, orthopedic, or orthosurgical management of maxillary deficiency in these patients can affect the nasal area and volume and can have an impact on breathing, speech, and sleep. The pretreatment assessment may be useful to identify patients who are at potential risk of deterioration of nasal patency and airway post-intervention. Taking into consideration the multiple diagnostic procedures in the course of long-term multidisciplinary treatment of patients with cleft lip and palate, a noninvasive investigation technique such as AR may be the preferred mode of investigation to ascertain nasal patency.
Three-Dimensional Computer-Assisted Single-Splint 2-Jaw Cleft Orthognathic Surgery: Toward Patient-Centered Surgical Rationale
Authors: Denadai Rafael , Chen Yu-Ray , Lo Lun-Jou
Published: August 2020

Skeletally mature patients with cleft lip and palate commonly present with skeletofacial deformities characterized by varying degrees of intrinsic and acquired dentoskeletal and soft tissue abnormalities. These abnormalities are associated with scarring from previous surgeries and the asymmetric midline and facial contour that impose challenges for adequate reconstruction. These patients frequently require 2-jaw orthognathic surgery to improve occlusal function and for correction of facial deformities. In this article, we have detailed a 3-dimensional computer-assisted single-splint 2-jaw orthognathic surgery technique as a surgical approach for cleft skeletofacial reconstruction, allowing for the surgery to be tailored according to the specific needs and requests of the patients. Further, we have addressed the multidimensionality and specificities of cleft treatment, the wide versatility, adaptability, and applicability of this technique, and the patient-centered rationale for the adoption of this method.