bluuebunny/crossref_metadata_2025 huggingface dataset:
Detecting glaucomatous progression with infrequent visual field testing
Authors: Anderson Andrew J. , Asokan Rashima , Murata Hiroshi , Asaoka Ryo
Published: January 2018

Purpose

Previous work has investigated whether a significant regression slope in the first 2 years for the summary index Mean Deviation (MD) is predictive of rapid (≤−2 dB year−1) glaucomatous visual field progression. This work assumed six visual fields were obtained as per management guidelines, but in clinical practice commonly only two or three fields are measured. We used simulation methods to investigate how reducing test frequency influences the prediction of rapid visual field progression, along with the influence of including criteria based on regression slope.

Methods

We simulated visual field series (N = 100 000) spaced annually in the first 2 years and then biennially. We calculated positive and negative predictive values (PPV & NPV) for detecting rapid progression, based on a criterion of a significant negative regression slope of any magnitude, or of a magnitude less than a particular limit. We performed a second simulation using test frequency and disease prevalence parameters from a dataset of 255 glaucoma patients from The University of Tokyo Hospital, to check the validity of our method.

Results

Prediction values at 2 years were slightly less than those obtained using six visual fields. An addition of an appropriate slope based criterion materially improved PPV, with little detrimental effect on NPV. Simulated prediction values for the Tokyo dataset were similar to those determined empirically.

Conclusion

Infrequent visual field testing does not dramatically alter predictive values at 2 years, but does substantially delay when significant progression may first be detected.
High‐density contact and noninvasive mapping of focal atrial tachycardia: Evidence of dual endocardial exits from an epicardial focus
Authors: Yamashita Seigo , Hooks Darren A. , Cheniti Ghassen , Jais Pierre
Published: January 2018

We report a case of recurrent focal atrial tachycardia (AT) which mechanisms could be resolved by using noninvasive electrocardiographic imaging (ECGI) reconstructing epicardial potentials and rapid high‐density endocardial contact mapping (Rhythmia™, Boston Scientific, Natick, MA, USA). ECGI demonstrated focal activity from the anterior of the left superior pulmonary vein antrum, although Rhythmia™ showed focal activity from the high anterior left atrium with the 2nd focus originating from the site where identical to the focus on the ECGI map with slightly delay (by 8 ms). Elimination of the AT by radiofrequency applications for both of the endocardial focuses indicated the dual endocardial exits from an epicardial focus.
Extubation in the operating room after pediatric liver transplant: A retrospective cohort study
Authors: Gurnaney Harshad G. , Cook‐Sather Scott D. , Shaked Abraham , Olthoff Kim M. , Rand Elizabeth B. , Lingappan Arul M. , Rehman Mohamed A.
Published: January 2018

Background

Early extubation immediately following liver transplantation is increasingly common in adult practice. Some pediatric institutions have begun to adopt this strategy. Careful patient selection is essential in minimizing risk.

Methods

This retrospective cohort study evaluated infants and children who underwent liver transplantation between July 2011 and December 2014. Our primary objective was to determine early extubation rate. Secondary objectives were to identify clinical factors associated with successful early extubation compared with delayed extubation and to examine significant postoperative complications, intensive care unit length of stay, and hospital length of stay.

Results

The early extubation rate was 57.8% (37/64, confidence interval [CI] 44.8%‐70.1%) over this 3.5‐year period, increasing from 42% in 2012 to 58% by the end of 2014. The patients in the early extubation group were more likely to be older than the delayed extubation group (mean [SD], 7 [5.3] years vs 3.5 [5.5] years, difference between the mean [95% CI], 3.5 [0.8, 6.2] years); were to have come from home on the day of surgery (78.4% vs 25.9%); and were less likely to be listed as United Network for Organ Sharing status 1A (2.7% vs 25.9%). The early extubation group received less packed red blood cell volume (mean [SD], 9 [13.2] mL/kg vs 40.6 [48.5] mL/kg, difference between the mean [95% CI], 31.6 [95% CI 14.9, 48.3] mL/kg) and fresh‐frozen plasma (mean 2.7 [SD 9.5] vs 13.3 [SD15.1], difference between the mean [95% CI], 10.5 [4.4,16.7] mL/kg). None of the patients in the early extubation group required reintubation in the first 24 hours following transplant and none experienced hepatic artery thrombosis. The early extubation group had a shorter average postoperative PICU stay (mean 3.8 [SD 2.1] days vs 17.6 [SD 31.3] days, difference between the mean [95% CI], 9.5 [4.3, 14.7] days) and a shorter postoperative hospital stay overall (mean 10.7 [SD 4.3] days vs 29.7 [SD 43.1] days, difference between the mean [95% CI], 19.1 [8.6, 29.6] days).

Conclusion

More than half of our pediatric liver transplant patients were successfully extubated in the operating room immediately following surgery. We believe early extubation to be safe when employed in selected subpopulations of pediatric patients undergoing liver transplantation.
Giant congenital melanocytic nevus with vascular malformation and epidermal cysts associated with a somatic activating mutation in BRAF
Authors: Etchevers Heather C. , Rose Christian , Kahle Birgit , Vorbringer Helmuth , Fina Frédéric , Heux Pauline , Berger Irina , Schwarz Benjamin , Zaffran Stéphane , Macagno Nicolas , Krengel Sven
Published: January 2018

Giant congenital melanocytic nevi may be symptomatically isolated or syndromic. Associations with capillary malformations are exceptional, and development of epidermal cysts has not been described. A 71‐year‐old patient with a giant congenital melanocytic nevus (CMN) of the lower back, buttocks, and thighs was asymptomatic except for unexpected hemorrhage during partial surgical excision years before. Blunt trauma at age 64 initiated recurrent, severe pain under the nevus; multiple large epidermal cysts then developed within it. Imaging and biopsy showed a large, non‐pulsatile venous malformation intermingled with the deep nevus. A low‐abundance, heterozygous BRAF c.1799T>A (p.V600E) mutation was present in both gluteal and occipital congenital nevi; additional mutations in NRAS, GNAQ, GNA11, HRAS, or PIK3CA were undetectable. This is the first demonstration of a recurrent BRAF mutation in multiple large congenital nevi from the same individual, confirming that this malformation can have multiple genetic origins. Early constitutive activation of BRAF can therefore cause unusual associations of giant nevi with vascular malformations, indicating that both pigment and endothelial cell physiology may be affected by mosaic RASopathies.
Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis
Authors: Antoon James W. , Goldman Jennifer L. , Lee Brian , Schwartz Alan
Published: January 2018

Background/Objectives

Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life‐threatening cutaneous reactions, typically to drugs or infection. The incidence and outcomes of these conditions in children are unknown. The objective of this study was to report the overall burden of Stevens‐Johnson syndrome and toxic epidermal necrolysis in children in the United States.

Methods

We performed a retrospective cohort analysis of children and adolescents younger than 18 years of age using the 2009 and 2012 Kids' Inpatient Database.

Results

We identified 1486 children and adolescents hospitalized with a diagnosis of Stevens‐Johnson syndrome or toxic epidermal necrolysis. The national incidence per 100 000 was 6.3 for Stevens‐Johnson syndrome, 0.7 for Stevens‐Johnson syndrome/toxic epidermal necrolysis overlap syndrome, and 0.5 for toxic epidermal necrolysis. The highest incidence in children was in those aged 11‐15 years (38.4 per 100 000). Toxic epidermal necrolysis and Stevens‐Johnson syndrome/toxic epidermal necrolysis overlap syndrome were associated with longer stay, greater mortality, and higher hospital charges than those with Stevens‐Johnson syndrome. Hospital mortality was highest in children with toxic epidermal necrolysis and in children aged 0‐5 years.

Conclusions

The incidence of Stevens‐Johnson syndrome and toxic epidermal necrolysis in children is higher than reported in adults, and there are significant age‐based variations in incidence and outcomes across the pediatric population. Further study is needed to determine the most effective treatment strategies to reduce costs and improve outcomes in children hospitalized with severe cutaneous reactions.
Pediatric kidney transplantation and mortality: Distance to transplant center matters
Authors: Cao Bonnie , Adler Joel T. , Bababekov Yanik J. , Markmann James F. , Chang David C. , Yeh Heidi
Published: January 2018

Distance from pediatric kidney transplant centers may be a significant barrier in accessing care for patients and families, particularly due to the lower number of pediatric kidney transplant centers compared with the number of adult centers. We performed a retrospective cohort study using data from the Scientific Registry of Transplant Recipients to determine the effect of distance on pediatric kidney transplant waitlist outcomes. We found that distance did not play a role in the likelihood of transplantations for patients who were placed on the waitlist. However, living a greater distance from the transplant center was associated with a greater risk of death while on the waitlist. Larger volume centers attracted patients from greater distances, many of whom had other centers closer to their home. Further investigation on the role of distance to transplant center and the likelihood of being evaluated and listed for a kidney transplant would elucidate whether there are additional barriers these patients face.
Identification of a Pyranocoumarin Photosensitizer that is a Potent Inhibitor of Keratinocyte Growth
Authors: Laskin Jeffrey D. , Jan Yi‐Hua , Jetter Michele M. , Guillon Christophe D. , Mariano Thomas M. , Heck Diane E. , Heindel Ned D.
Published: January 2018

Photosensitizers are used in the treatment of epidermal proliferation and differentiation disorders such as psoriasis and vitiligo. In these studies, a ring‐expanded carbon homolog of the linear psoralen (furo[3,2‐g]benzopyran‐7‐one) class of photosensitizers, 4,10‐dimethyl‐2H,8H‐benzo[1,2‐b:5,4‐b′]dipyran‐2‐one (NDH2476), was synthesized and analyzed for biological activity. Following activation by ultraviolet light (UVA, 320‐400 nm), NDH2476 was found to be a potent inhibitor of keratinocyte growth (IC50 = 9 nm). Similar derivatives methylated in the pyran ring, or containing a saturated pyran ring structure, were markedly less active or inactive as photosensitizers. NDH2476 was found to intercalate and damage DNA following UVA light treatment as determined by plasmid DNA unwinding and nicking experiments. Taken together, these data demonstrate that an intact furan ring in psoralen photosensitizers is not required for keratinocyte growth inhibition or DNA damage. Our findings that low nanomolar concentrations of a benzopyranone derivative were active as a photosensitizer indicates that this or a structurally related compound may be useful in the treatment of skin diseases involving aberrant epidermal cell growth and differentiation.
SMARCB1/INI1/BAF47‐ deficient pleural malignant mesothelioma with rhabdoid features
Authors: Kimura Noriko , Hasegawa Masaru , Hiroshima Kenzo
Published: January 2018

Malignant mesothelioma (MM) with rhabdoid features is an MM variant. Fifteen cases have been reported previously, all of which were combined with other types of MM. Herein, we report an autopsy case of pleural MM with monomorphic rhabdoid features. The patient was a 62‐year‐old male without a history of asbestos exposure. An autopsy revealed a soft, granular tumor that replaced the entire left pleura and had invaded to the diaphragm and lower lobe of the lung. The tumor cells, which had eosinophilic plump cytoplasm and eccentric nuclei, were loosely cohesive. Immunohistochemistry showed that the cells were diffusely positive for calretinin, D2‐40, vimentin, CAM5.2, and AE1/AE3; and negative for WT‐1, TTF‐1, CK7, CEA, desmin, CD34, BCL‐2, S100 protein, and p40. Neither homozygous deletion of p16 nor BAP‐1 protein loss was observed. Loss of INI1/BAF47 protein, an indicator of malignant rhabdoid tumor, was observed. Therefore, MM with rhabdoid features was confirmed.
Should You Kill or Embrace Your Competitor: Cloud Service and Competition Strategy
Authors: Li Bo , Kumar Subodha
Published: January 2018

Cloud services have grown rapidly in recent years as a new form of service, but there exists scant research on the competition and service offering strategies of cloud service providers. We study these strategic choices by considering a setting where an incumbent cloud service provider may offer two service classes (premium and standard) and an entrant provider may offer the standard service. We analyze two competitive strategies the incumbent provider: (a) deterring competitor entry, and (b) not deterring competitor entry. We also evaluate two service offering strategies of the incumbent provider: (a) offering both the premium and the standard service, and (b) offering the premium service only. Based on the results of our model, we present several useful managerial insights. First of all, we find that, under monopoly setting, it may sometimes be beneficial for the service provider to encourage higher usage despite the extra cost. Further, in the duopoly setting, higher customer usage impacts the Deter/Allow strategy choice and is neither always beneficial nor always detrimental to the incumbent provider, and such impact depends on profit margin and customer usage distribution. We also find that a larger market encourages the incumbent provider to add the standard service and switch between Allow and Deter strategies, since a larger market size may reduce the profit of an incumbent provider sticking to the Deter strategy. On the capacity side, we discover that the incumbent provider should strive to deter entry threats when it is at a cost advantage in a small market.
My mistake? Enhanced error processing for commanded compared to passively observed actions
Authors: Weller Lisa , Schwarz Katharina A. , Kunde Wilfried , Pfister Roland
Published: January 2018

We often ask other people to carry out actions for us in order to reach our goals. However, these commanded actions may sometimes go awry, and goal attainment is hindered by errors of the following person. Here, we investigated how the commanding person processes these errors of their follower. Because such errors indicate that the original goal of the command is not met, error processing for these actions should be enhanced compared to passively observing another person's actions. Participants thus either commanded another agent to perform one of four key press responses or they passively observed the agent responding. The agent could respond correctly or commit an error in either case. We compared error processing of commanded and passively observed actions using observation‐related post‐error slowing (oPES) as a behavioral marker and observed‐error‐related negativity (oNE/oERN) and observed‐error positivity (oPE) as electrophysiological markers. Whereas error processing, as measured via the oERN, was similarly pronounced for commanded and observed actions, commanded actions gave rise to stronger oPES and a stronger oPE. These results suggest that enhanced monitoring is an automatic by‐product of commanding another person's actions.
Manipulating the focus of attention in working memory: Evidence for a protection of multiple items against perceptual interference
Authors: Barth Anna , Schneider Daniel
Published: January 2018

Visual working memory representations can be shielded from interference by selective attentional focusing using retroactive cues (retro‐cues). However, it is not clear how many representations can be effectively cued and which neural mechanisms provide the protection from distractors. To address these questions, we manipulated the number of attended items by means of a retro‐cue (one, two, or three items) and presented a distractor display during the retention of information in working memory. Analyses of the raw error and a mixture model revealed that a general performance benefit was only present when one item was retro‐cued. Nevertheless, a protection of the item representations against subsequent interference occurred also after a two‐item cue. ERPs revealed a modulation of the posterior negative slow wave following the retro‐cues, reflecting the applied working memory resources dependent on the number of attended representations. Further, the distractor information was encoded into working memory only when the number of attended items was not changed by the retro‐cues (neutral and three‐item conditions), reflected by a P3b following the distractor display. These results suggest that more than one item can be effectively protected from perceptual interference. We propose that the protective effect of selective attention within working memory is based on both a reduction of the number of focused representations and the attentional refreshing of item context and features.
Pathophysiology of severe asthma: We’ve only just started
Authors: King Gregory G. , James Alan , Harkness Louise , Wark Peter A.B.
Published: January 2018

Severe asthma is defined by the high treatment requirements to partly or fully control the clinical manifestations of disease. It remains a problem worldwide with a large burden for individuals and health services. The key to improving targeted treatments, reducing disease burden and improving patient outcomes is a better understanding of the pathophysiology and mechanisms of severe disease. The heterogeneity, complexity and difficulties in undertaking clinical studies in severe asthma remain challenges to achieving better understanding and better outcomes. In this review, we focus on the structural, mechanical and inflammatory abnormalities that are relevant in severe asthma.
E‐cigarettes unlikely to raise significant health concerns in airways disease
Authors: Polosa Riccardo
Published: January 2018

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Continuous Inference for Aggregated Point Process Data
Authors: Taylor Benjamin M. , Andrade-Pacheco Ricardo , Sturrock Hugh J. W.
Published: January 2018

The paper introduces new methods for inference with count data registered on a set of aggregation units. Such data are omnipresent in epidemiology because of confidentiality issues: it is much more common to know the county in which an individual resides, say, than to know their exact location in space. Inference for aggregated data has traditionally made use of models for discrete spatial variation, e.g. conditional auto-regressive models. We argue that such discrete models can be improved from both a scientific and an inferential perspective by using spatiotemporally continuous models to model the aggregated counts directly. We introduce methods for delivering (limiting) continuous inference with spatiotemporal aggregated count data in which the aggregation units might change over time and are subject to uncertainty. We illustrate our methods by using two examples: from epidemiology, spatial prediction of malaria incidence in Namibia, and, from politics, forecasting voting under the proposed changes to parliamentary boundaries in the UK.
Panning for Gold: ‘Model-X’ Knockoffs for High Dimensional Controlled Variable Selection
Authors: Candès Emmanuel , Fan Yingying , Janson Lucas , Lv Jinchi
Published: January 2018

Many contemporary large-scale applications involve building interpretable models linking a large set of potential covariates to a response in a non-linear fashion, such as when the response is binary. Although this modelling problem has been extensively studied, it remains unclear how to control the fraction of false discoveries effectively even in high dimensional logistic regression, not to mention general high dimensional non-linear models. To address such a practical problem, we propose a new framework of ‘model-X’ knockoffs, which reads from a different perspective the knockoff procedure that was originally designed for controlling the false discovery rate in linear models. Whereas the knockoffs procedure is constrained to homoscedastic linear models with n⩾p, the key innovation here is that model-X knockoffs provide valid inference from finite samples in settings in which the conditional distribution of the response is arbitrary and completely unknown. Furthermore, this holds no matter the number of covariates. Correct inference in such a broad setting is achieved by constructing knockoff variables probabilistically instead of geometrically. To do this, our approach requires that the covariates are random (independent and identically distributed rows) with a distribution that is known, although we provide preliminary experimental evidence that our procedure is robust to unknown or estimated distributions. To our knowledge, no other procedure solves the controlled variable selection problem in such generality but, in the restricted settings where competitors exist, we demonstrate the superior power of knockoffs through simulations. Finally, we apply our procedure to data from a case–control study of Crohn's disease in the UK, making twice as many discoveries as the original analysis of the same data.
Correlated Multistate Models for Multiple Processes: An Application to Renal Disease Progression in SystemicLupus Erythematosus
Authors: O’Keeffe Aidan G. , Su Li , Farewell Vernon T.
Published: January 2018

Bidirectional changes over time in the estimated glomerular filtration rate and in urine protein content are of interest for the treatment and management of patients with lupus nephritis. Although these processes may be modelled by separate multistate models, the processes are likely to be correlated within patients. Motivated by the lupus nephritis application, we develop a new multistate modelling framework where subject-specific random effects are introduced to account for the correlations both between the processes and within patients over time. Models are fitted by using bespoke code in standard statistical software. A variety of forms for the random effects are introduced and evaluated by using the data from the Systemic Lupus International Collaborating Clinics.
Medical safety in the care of the person with end‐stage kidney disease
Authors: Duronville John V. , Diamantidis Clarissa J.
Published: January 2018

Much is written about medical safety as it pertains to patients with chronic kidney disease, yet the transition to end‐stage kidney disease and processes inherent to the receipt of dialysis present unique safety challenges in this population. Educational efforts in medical safety need to focus on the areas of greatest threat and where intervention can provide the greatest benefit. This study addresses such safety topics in the dialysis population and identifies potential strategies that may aid in harm reduction.
A valid and reliable method to measure jump‐specific training and competition load in elite volleyball players
Authors: Skazalski C. , Whiteley R. , Hansen C. , Bahr R.
Published: January 2018

Use of a commercially available wearable device to monitor jump load with elite volleyball players has become common practice. The purpose of this study was to evaluate the validity and reliability of this device, the Vert, to count jumps and measure jump height with professional volleyball players. Jump count accuracy was determined by comparing jumps recorded by the device to jumps observed through systematic video analysis of three practice sessions and two league matches performed by a men's professional volleyball team. Jumps performed by 14 players were each coded for time and jump type and individually matched to device recorded jumps. Jump height validity of the device was examined against reference standards as participants performed countermovement jumps on a force plate and volleyball‐specific jumps with a Vertec. The Vert device accurately counted 99.3% of the 3637 jumps performed during practice and match play. The device showed excellent jump height interdevice reliability for two devices placed in the same pouch during volleyball jumps (r = .99, 95% CI 0.98‐0.99). The device had a minimum detectable change (MDC) of 9.7 cm and overestimated jump height by an average of 5.5 cm (95% CI 4.5‐6.5) across all volleyball jumps. The Vert device demonstrates excellent accuracy counting volleyball‐specific jumps during training and competition. While the device is not recommended to measure maximal jumping ability when precision is needed, it provides an acceptable measure of on‐court jump height that can be used to monitor athlete jump load.
Effects of acute isometric resistance exercise on cervicomedullary motor evoked potentials
Authors: Nuzzo J. L. , Barry B. K. , Gandevia S. C. , Taylor J. L.
Published: January 2018

Cervicomedullary motor evoked potentials (CMEPs) in relaxed biceps brachii have been reported to facilitate after acute isometric exercise of the elbow flexors. This facilitation, which reflects either enhanced corticospinal transmission or increased motoneurone excitability, has only been documented in the limb posture used during exercise. In Experiment 1, we tested if these spinal changes “transfer” to a second posture. Fourteen individuals completed 12 sets of high‐force isometric contractions of the elbow flexors with the forearm pronated. Before and after exercise, biceps CMEPs were acquired with the forearm either pronated or supinated. CMEPs in pronation and supination were facilitated after exercise, indicating transfer (57.5 ± 55.5% and 53.9 ± 54.9%, respectively; mean ± SD). In Experiment 2, we examined if exercise posture influences the effect that exercise has on CMEPs. A different sample of 14 individuals performed isometric exercise in 2 sessions. In one, exercise was performed in supination. In the other, exercise was performed in pronation. Exercise intensity and volume were the same as in Experiment 1, as were participant characteristics. CMEPs were unchanged after exercise in supination (13.6 ± 31.2%) and pronation (7.7 ± 41.5%). The absence of an effect differs from the finding of Experiment 1. Thus, effects of acute isometric resistance exercise on corticospinal transmission and/or motoneurone excitability are not as consistent as previously thought. When exercise induces this spinal change, the effect is not specific to the posture used for exercise. However, the change does not always occur, and the reasons for this remain unknown.
The relation between parents' mental state talk and children's social understanding: A meta‐analysis
Authors: Tompkins Virginia , Benigno Joann P. , Kiger Lee Bridget , Wright Bridget M.
Published: January 2018

Though there is empirical support for the relation between parents' mental state talk to children and children's social understanding, including false belief understanding (FBU) and emotion understanding (EU), effect sizes range widely. The current meta‐analysis focused on the relation between parents' mental state talk and children's social understanding and moderators of this relation: parents' mental state talk content (e.g., cognitive vs. emotion talk), quality (e.g., appropriate vs. inappropriate), and context (e.g., book vs. reminiscing). Data from 22 studies examining FBU and 18 examining EU were examined. Participants included 2,298 children (<7 years). Analyses yielded a significant effect size for parents' mental state talk and children's FBU and EU. These relations were stronger under certain circumstances, particularly for children's FBU. For example, in terms of content, cognitive state talk was a stronger predictor of FBU and EU compared to talk about desires and emotions. For FBU, the strongest relations were present when parents' mental state talk was: (a) appropriate and explanatory compared to inappropriate and (b) in a book or self‐report context compared to reminiscing. The results of this study further refine the social constructivist view of social understanding and point to future avenues for research aimed at improving children's social understanding.
Dosimetric benefit of adaptive radiotherapy in the neoadjuvant management of canine and feline thymoma—An exploratory case series
Authors: Rohrer Bley C. , Meier V. , Schneider U.
Published: January 2018

While surgery is the treatment of choice for thymomas, complete excision is not possible in a significant proportion of cases. For these patients, radiotherapy can be used as neoadjunctive, post‐operative adjunctive or sole therapy. During radiotherapy, rapid biological clearance of tumour cells is often observed, requiring adaptation of the treatment plan. Adaptive radiation therapy (RT) is a dynamic process, whereby the treatment plan is altered throughout the treatment course due to changes in morphologic, functional or positioning changes. With the hypothesis, that individually adapted replanning will massively reduce the dose to organs at risk (OAR) in a fast‐changing environment such as a rapidly responding thymoma, the dosimetric impact of adaptive treatment planning in 5 patients with large thymoma was measured. In all patients rapid tumour‐shrinkage of the gross tumour volume was observed after 1 week of therapy, with a mean shrinkage of 31.0% ± 15.2%, or a tumour regression of 5.2% per day. In consequence, there was a considerable change in position of organs such as heart and lung, both of them moving cranially into the high dose area upon tumour regression. After mid‐therapy replanning, the dose to OAR was significantly reduced, with −18.2% in the mean heart dose and −27.9% in the V20 lung dose. Adaptive planning led to a significantly reduced radiation dose and hence protection of OAR for these patients. It can be concluded that adaptive replanning should be considered for canine and feline thymoma patients receiving fractionated RT.
The role of the transfusion practitioner in the multidisciplinary team
Authors: Bielby L. , Haberfield A. , Kelsey G. , Kay S.
Published: January 2018

Background

Transfusion and patient blood management (PBM) processes are complex; while transfusions can be life‐saving, equally there may be associated morbidity and mortality. In Australia, obligations to comply with mandatory governance frameworks have propelled the safety andPBMculture. These frameworks support appropriate product use and levels of safety at all points of the process.

Methods

A key to blood management governance success is the multidisciplinary Blood Management team/Governance Committee. This team includes healthcare executive, clinical governance, consumer/s and medical/laboratory/nursing representatives, with the transfusion practitioner (TP) as a key resource. TheTPis often seen as the driving force for change, working in a multidisciplinary capacity across the clinical spectrum. In Australia, this influence can be within an individual organization, across multiple sites/networks, in metropolitan or rural/regional areas. TheTPconducts a critical role pulling together resources, promoting exchange of information, encouraging engagement and empowering colleagues to facilitate change. Highly developed communication skills assist theTPto engage these many different stakeholders and clinical environments. Collaboration is essential for the multidisciplinary team to function effectively. Highly functional teams recognize knowledge and experience and utilize each member's skills to work together to deliver the best possible outcome for patients. There is a growing body of literature supporting multidisciplinary teams and theTProle improving patient outcomes.

Conclusion

Effective transfusion andPBMpractice require a systematic cross‐specialty approach to ensure success.TPs are an essential link in the multidisciplinary chain and require strong support and leadership to potently effect change and enhance practice.
The metaboreflex does not contribute to the increase in muscle sympathetic nerve activity to contracting muscle during static exercise in humans
Authors: Boulton Daniel , Taylor Chloe E. , Green Simon , Macefield Vaughan G.
Published: January 2018

Key points

It is not clear how sympathetic activity to contracting muscle is controlled.

We recorded muscle sympathetic nerve activity (MSNA) to the ipsilateral tibialis anterior muscle during 4 min of isometric dorsiflexion of the ankle and 6 min of post‐exercise ischaemia, which was repeated contralaterally.

MSNA to the contracting muscle increased within 1 min of static exercise and returned to pre‐contraction levels at the end.

Unlike the increase in MSNA seen in the non‐contracting muscle, post‐exercise ischaemia had no effect on MSNA to the contracted muscle.

We conclude that central command is the primary mechanism responsible for increasing MSNA to contracting muscle and also that the metaboreflex is not expressed in contracting muscle.

Both central command and metaboreflex inputs from contracting muscles increase muscle sympathetic nerve activity (MSNA) to non‐contracting muscle during sustained isometric exercise. We recently showed that MSNA to contracting muscle also increases in an intensity‐dependent manner, although whether this can be sustained by the metaboreflex is unknown. MSNA was recorded from the left common peroneal nerve and individual spikes of MSNA extracted from the nerve signal. Eleven subjects performed a series of 4 min dorsiflexions of the left ankle at 10% of maximum voluntary contraction under three conditions: without ischaemia, with 6 min of post‐exercise ischaemia, and with ischaemia during and after exercise; these were repeated in the right leg. Compared with pre‐contraction values, MSNA to the contracting muscles increased and plateaued in the first minute of contraction (50 ± 18 vs. 34 ± 10 spikes min−1, P = 0.01), returned to pre‐contraction levels within 1 min of the contraction ending and was not influenced by ischaemia during or after contraction. Conversely, MSNA to the non‐contracting muscles was not different from pre‐contraction levels in the first minute of contraction (34 ± 9 vs. 32 ± 5 spikes min−1, P = 0.48), whereas it increased each minute and was significantly greater by the second minute (44 ± 8 spikes min−1, P = 0.01). Ischaemia augmented the MSNA response to contraction (63 ± 25 spikes min−1 after 4 min, P < 0.05) and post‐exercise ischaemia (63 ± 27 spikes min−1 after 6 min, P < 0.01) for the non‐contracting muscles only. These findings support our conclusion that the metaboreflex is not expressed in the contracting muscle during sustained static exercise.
Analysis of the Carrying Capacity for Tubes Under Oblique Loading
Authors: Wang Wei , Qiu Xinming
Published: January 2018

In this study, the plastic deformation mechanism of a fully clamped beam under oblique loading at its free end is analyzed. Supposing the cross sections are variable along the beam length, a characteristic length L∗≡MP/NP, defined as the ratio between fully plastic bending moment MP and fully compression force NP, is employed to estimate the load carrying capacity of each cross section. By finite element (FE) simulations of the conical tubes, it is validated that if the initial failure positon locates in the middle of the beam, it will not change with the total beam length. Then, based on the analytical analysis and FE simulation, a progressive deformation mechanism triggered by bending, notated as progressive bending, is proposed for the first time. From the optimization result of maximizing loading force that the unit mass can withstand, the tubes with constant thickness are found to be better than tubes with graded thickness, when they are used as supporting structures. The multi-objective optimization for tubes with varying cross sections under oblique loading with different angles is also given. Then, two methods to improve the load carrying capacity of tubes are given: (1) to design the cross section of the tube, which is corresponding to let the critical loading force of all the cross sections be equal; (2) to optimize the initial failure point, so as to produce repeated failure modes.
Analysis of the Effect of Open and Close Angle of Workpiece Surface on Contour Error
Authors: Li Qingzhao , Wang Wei , Li Hai , Jiang Yunfeng , Song Zhiyong
Published: January 2018

The machining of complicated surface is a hot spot in manufacturing industry in nowadays. The complicated surfaces should be machined with five-axis machine tools because of its geometric characteristics. In this paper, the characteristic of workpiece surface called open and close angle of surface is defined. The transition area from open angle to close angle will cause the twist and singularity of the surface. The twist mainly affects the principle errors of surface. And the singularity will cause the mutation of rotation axis movement and make an influence on the contour errors. To test the influence of the open and close angle on the contour error, a workpiece with special surface characteristics is designed. With the theoretical, simulational and experimental analyses, the influence law from the open and close angle is found out. The conclusion can be helpful for the tool trajectory planning.
A Dynamic Model for Motion of an ROV due to On-Board Robotics
Authors: Evjenth Andreas , Moe Otto Andreas , Schøn Iselin Violet Kjelland , Impelluso Thomas J.
Published: January 2018

A new method in dynamics — the Moving Frame Method (MFM) — is used to conduct the analysis of how a robotic appendage (manipulator) on a Remotely Operated Vehicle (ROV) affects the motion of the ROV. An ROV performs multiple tasks on the seabed in the oil service industry. In most cases, an ROV pilot monitors and adjusts the movement of the vehicle due to induced motion by currents, buoyancy and the manipulators. Simulation data would assist the pilot and improve the stability of the ROV. This paper exploits a new method to analyze the induced movements of the ROV. The method uses the Special Euclidean Group (SE(3)) and the MFM. The method is supplemented with a restricted variation on the angular velocity to extract the equations of motion for the ROV. Then the equations of motion are solved numerically using Runge-Kutta Method and a reconstruction formula (founded upon the Cayley-Hamilton theorem) to secure the 3D rotations of the vehicle. The resulting motion is visualized with selected 2D plots. The 3D animation is displayed on a 3D web page. This paper closes with a summary of the simplifications used in the model and suggestions for advanced work.
Effect of Substrate Slope on the Aviation Kerosene Spill Fires
Authors: Liu Quanyi , He Yuanhua , Yang Rui , Zhang Hui
Published: January 2018

During the storage and transportation of aviation kerosene, spill fire and explosion caused by the corrosion of pipeline or faulty operation when released and ignited, will pose a huge threat to tanks or facilities nearby. It is critical to investigate the interaction mechanism between spreading and burning of aviation kerosene spill fires to effectively plan for civil aviation safety.

In order to gain a better understanding of aviation kerosene spill fire on sloping surface, a large-scale experimental platform with varying slope of oil groove or substrate surface for aviation kerosene spill fire has been designed and built. Aviation kerosene was selected as the fuel in the continuous spill fire for different leaking rates based on the rotation of the peristaltic pump. Spill fires with the substrate slope of 0° (as the baseline case), 0.5°, 1° and 3° were conducted. The typical burning characteristic parameters of spill fire measured are included burning area, burning rate, flame front et al. It is obtained that 1) the characteristic parameters except the averaged steady burning rate for continuous aviation kerosene spill fire increases apparently with the increasing leaking rate. 2) The effect of substrate slope on the burning of continuous spill fire is significant even though there is only 0.5° variation of the slope. 3) There is a diametrically opposite findings for the averaged steady burning rates and the initial spreading rates of continuous aviation kerosene spill fire decrease with the increasing substrate slope.
Highly Sensitive Strain Sensor Using Dumbbell-Shape Graphene Nanoribbon
Authors: Zhang Qinqiang , Yang Meng , Suzuki Ken , Miura Hideo
Published: January 2018

A nano-scale strip of graphene is known as graphene nano-ribbon (GNR). Previous studies have shown that the armchair-type GNR (aGNR) can open the electronic band gap at room temperature, and the band gap increases monotonically with the decrease in the width of aGNR. The critical width at which aGNR shows semi-conductive characteristics at room temperature is about 70 nm, when it is passivated by hydrogen on both sides. However, the electronic band structure varies frequently as a function of the number of carbon atoms along its width direction. In order to decrease the large variation of the band gap of aGNR to control the electronic properties of GNR for highly sensitive sensors and high performance devices, the electronic band structure of various dumbbell-shape structure of aGNR was analyzed by first-principles calculations based on the density functional theory using implemented in SIESTA package. It was shown that the width of aGNR had a large effect on the electronic band structure and the amplitude of the fluctuation of the band gap as a function of the number of carbon atoms decreased drastically. The electronic band structure of various GNRs under the application of uniaxial strain was also analyzed by using the first-principles calculations, in this study. It was confirmed that the effective band gap of aGNR thinner than 70 nm varies drastically under the application of uniaxial strain, and this result clearly indicates the possibility of a highly sensitive strain sensor using dumbbell-shape GNR structures.
Full Frontal Crashworthiness of Carbon Fiber Composite Front Bumper Crush Can (FBCC) Structures
Authors: Dixit Y. , Begeman P. , Dhaliwal G. S. , Newaz G. , Board D. , Chen Y. , Faruque O.
Published: January 2018

This research study highlights the testing method and relevant results for assessing impact performance of a carbon fiber composite front bumper crush can (FBCC) assembly subjected to full frontal crash loading. It becomes extremely important to study the behavior of lightweight composite components under a crash scenario in order to apply them to automotive structures to reduce the overall weight of the vehicle. Computer-aided engineering (CAE) models are extremely important tools to virtually validate the physical testing by assessing the performances of these structures. Due to lack of available studies on carbon fiber composite FBCCs assemblies under the frontal crash scenario, a new component-level test approach would provide assistance to CAE models and better correlation between results can be made. In this study, all the tests were performed by utilizing a sled-on-sled testing method. An extreme care was taken to ensure that there is no bottoming-out force for this type of test while adjusting the impact speed of sled. Full frontal tests on FBCC structures were conducted by utilizing five high-speed cameras (HSCs), several accelerometers and a load wall.

Excellent correlation was achieved between video tracking and accelerometers results for time histories of displacement and velocity. The standard deviation and coefficient of variance for the energy absorbed were very low suggesting the repeatability of the full frontal tests. The impact histories of FBCC specimens were consistent and in excellent agreement with respect to each other. Post-impact photographs showed the consistent crushing of composite crush cans and breakage of the bumper beam from middle due to the production of tensile stresses stretched caused by straightening of the bumper curvature after hitting the load wall.
Semi Local Friction Factor of Gas Flow Through a Micro-Tube
Authors: Maeda Kenshi , Hong Chungpyo , Asako Yutaka
Published: January 2018

Flow characteristics of laminar gas flow through a micro-tube were experimentally studied on friction factors in this paper. The experiments were performed for nitrogen flow through a stainless steel micro-tube with 123.87 μm in diameter and 50mm in length. Two static pressure tap holes were fabricated on the micro-tube wall at intervals of 5mm with electrical discharge machining. The local pressure was measured to determine the local values of Mach number, temperature and friction factor. Both the Fanning and the Darcy friction factors were obtained under the assumption of a Fanno flow (adiabatic wall) since the external micro-tube wall was covered with the foamed polystyrene. The effects of temperature decrease on friction factors were investigated because the gas temperature steeply decreases near the outlet due to energy conversion from thermal energy into kinetic energy in a high speed gas flow. The obtained friction factors were compared with those in the available literature and also with numerical results.
Largely Deformable and Highly Sensitive Strain Sensor Using Carbon Nanomaterials
Authors: Yumoto Kanji , Suzuki Ken , Miura Hideo
Published: January 2018

A new type tactile sensor with spatial resolution less than 1 mm and the minimum pressure sensitivity less than 10 kPa was proposed by applying MWCNTs (Multi-Walled Carbon Nanotubes). The sensor was embedded into a highly deformable flexible substrate (PDMS: Polydimethylsiloxane) and the obtained gauge factor of the developed sensor was about 5.

Since the electronic properties of MWCNTs vary drastically depending on their deformation under mechanical stress, it is important to make appropriate aspect ratio of MWCNTs for improving their stress-sensitivity. The aspect ratio of MWCNTs are mainly dominated by their growth condition such as the average thickness of catalyst layer, growth temperature, pressure of resource gases and so on. Thus, the optimum growth condition was investigated for forming the MWCNTs with high aspect ratio, in other words, high pressure sensitivity. In addition, in this study, the authors fabricated high quality carbon nano-materials to develop highly sensitive strain sensor. A thermal CVD synthesis process of MWCNTs was developed by using acetylene gas. After the synthesis of MWCNTs, flexible isolation material (PDMS) was coated around the grown MWCNT. Then, the interconnection film was deposited by sputtering. After that, PDMS was coated again to fabricate an upper protection layer. Finally, the bottom interconnection layer was sputtered and patterned. The change of the electrical resistance of the grown MWCNTs was measured by applying a compression test in the load range from 0 to 10 mN. It was found that the electrical resistance of the MWCNTs bundle increased almost linearly with the applied compressive load and this sensor showed the high load sensitivity of 10 mN that is higher than human fingers.
Inspection Data to Support a Digital Twin for Geometry Assurance
Authors: Wärmefjord Kristina , Söderberg Rikard , Lindkvist Lars , Lindau Björn , Carlson Johan S.
Published: January 2018

Geometrical variation is a problem in all complex, assembled products. Recently, the Digital Twin concept was launched as a tool for improving geometrical quality and reduce costs by using real time control and optimization of products and production systems. The Digital Twin for geometry assurance is created together with the product and the production systems in early design phases. When full production starts, the purpose of the Digital Twin turns towards optimization of the geometrical quality by small changes in the assembly process.

To reach its full potential, the Digital Twin concept is depending on high quality input data. In line with Internet of Things and Big Data, the problem is rather to extract appropriate data than to find data. In this paper, an inspection strategy serving the Digital Twin is given. Necessary input data describing form and shape of individual parts, and how this data should be collected, stored and utilized is described.