bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning review and discussion of its future development
Authors: Hao Zhiying
Published: April 2019

This paper is a summary of the algorithms for deep learning and a brief discussion of its future development. In the first part, the concept of deep learning and the advantages and disadvantages of deep learning are introduced. The second part demonstrates several algorithms for deep learning. The third part introduces the application areas of deep learning. Then combines the above algorithms and applications to explore the subsequent development of deep learning. The last part makes a summary of the full paper.
Simulation and experimental study on the air jet pulverization of TiC-containing slag
Authors: Wang Dongsheng , Zhang Jianbo , Zhao Qinge , Huang Jiaxu
Published: April 2019

Process of “high temperature carbonization and low temperature chlorination”, which was considered to be one of the most promising technologies, could extracte more than 70% titanium from the furnace slag containing TiO2 10% - 30%. TiC-containing slag was the product of high temperature carbonization, and to meet the requirement of the following chlorination process, it needs to be crushed and grounded to a suitable size distribution. The air jet pulverization of TiC-containing slag was studied in this paper. On the one hand, By CFD numerical simulation, the distribution regularity of nozzle flow field about the main crushing equipment was obtained with different throat diameters and crushing gas pressures. On the other hand, the influences of nozzle throat diameter, crushing pressure, and collision angles on the particle size of the powder were studied by experiment. With the better parameters, the particle size distribution of the product powder was uniform.
C3I cooperative decision system simulation and optimization based on genetic algorithm for surface warship formation
Authors: Liu Mai-di , Yang Ke-wei , Yang Qing-qing , Yang Zhi-wei
Published: April 2019

The C3I cooperative decision system is the guarantee for combat capabilities of surface warship formations. At present, research on the C3I system simulation lays more emphasis on finding structural logic defects by executing the simulation model, lacking the application of intelligent optimization algorithms to optimize parameters in the system. In this paper, the cooperative decision-making process of surface warship formation defense system is studied. Meanwhile, modelling and optimization methods for cooperative decision system are proposed. Based on simulation models built on the ExtendSim platform, this paper optimizes the staffing strategy of decision makers based on the genetic algorithm, to improve the per capita decision efficiency. The optimized staffing strategy meets objectives and requirements. The research in this paper can provide a scientific and objective reference for relevant decision-makers and researchers.
Replacement of several single function generator protection relay at Badak LNG
Authors: Perdana Iqbal Nusya
Published: April 2019

Badak LNG is a company that operates the largest LNG Plant in Indonesia with maximum production capacity of 22.5 MTPA. The company operates twelve (12) steam turbine generators and one gas turbine generator and one diesel engine generator to supply electricity for process, utility, storage, loading and plant support facility areas, which constitutes the criticality of power generator equipment to keep the reliability of production process. Generator protection relay is one of the equipment that monitors and protects the generator from fault resulting from either internal or external disturbance, preventing the generator from serious damages. Before 2015, Badak LNG used single function relays to protect the generators. The generators are protected by stator differential protection (87), current unbalance (46), loss of excitation (40), reverse power (32), time overcurrent with voltage restraint (51V), and time overcurrent ground (51G). These single function relays wield more disadvantages compared to the newer technology held by the digital relays. Since 2015, Badak LNG have started to replace the single function generator protection relays with the digital type ones.
Optimum threshold of group formation in multiagents
Authors: Shinkawa Kodai , Shioya Isamu
Published: April 2019

This paper presents a simple multi-agent model of group formation, while the behaviour is complicated. The statistical characteristics of the formation are suddenly changed at some states. Their agents are carrying characteristic vectors, meet each other in nondimensional free spaces without any restrictions randomly, and the agents make groups in the spaces if their characteristics are similar, that is, they have high similarities. Actually, for a given threshold on similarities, when the characteristic vectors between two agents are similar in the threshold, the agents join into one. They are not only for agents but also for groups, i.e. two groups can become into one if they are similar, and we repeat it. On the other hand, making groups decrease a satisfaction on groups. In this paper, we show, for a given threshold, there is not only an optimal threshold to maximize the satisfactions among groups which satisfy the threshold, but also the other one to minimize the satisfactions. The thresholds to maximize satisfactions are experimentally approximated by some function on the size of characteristic vectors rather than the number of agents.
Impact of heavy metals on human toxicity using LCA: The case study of Walloon corn
Authors: Gerbinet Saïcha , Van Stappen Florence , Belboom Sandra , Pezennec Eric , Léonard Angélique
Published: April 2019

This paper focuses on potential errors when assessing the human toxicity of corn farming in Wallonia, Belgium. The USEtox method is applied to the farming of 1 hectare of corn. Local data are used for farming data and GaBi datasets for background data. Field emissions due to farming are calculated by the most prevailing models. The results in human toxicity, cancer effect, underline the large contribution of chromium (Cr) emissions. But when characterizing fertilizer composition, only the total chromium is measured and therefore unspecified chromium is used as emissions. However, it is known that chromium in the natural environment is mostly the non-toxic form Cr (III), which would greatly decrease the impact as the characterization factor for unspecified chromium is, in USEtox, the average of Cr (III) and the toxic form Cr (VI). The impact for human toxicity, non-cancer effect is mostly related to zinc emissions even if zinc is relatively harmless. The impact of pesticides is negligible in both cases. These results show that caution must be taken when examining/interpreting toxicity categories.
Regression Monte Carlo for microgrid management
Authors: Alasseur Clemence , Balata Alessandro , Ben Aziza Sahar , Maheshwari Aditya , Tankov Peter , Warin Xavier
Published: April 2019

We study an islanded microgrid system designed to supply a small village with the power produced by photovoltaic panels, wind turbines and a diesel generator. A battery storage system device is used to shift power from times of high renewable production to times of high demand. We build on the mathematical model introduced in [14] and optimize the diesel consumption under a “no-blackout” constraint. We introduce a methodology to solve microgrid management problem using different variants of Regression Monte Carlo algorithms and use numerical simulations to infer results about the optimal design of the grid.
A sparse grid approach to balance sheet risk measurement
Authors: Bénézet Cyril , Bonnefoy Jérémie , Chassagneux Jean-François , Deng Shuoqing , Garcia Trillos Camilo , Lenôtre Lionel
Published: April 2019

In this work, we present a numerical method based on a sparse grid approximation to compute the loss distribution of the balance sheet of a financial or an insurance company. We first describe, in a stylised way, the assets and liabilities dynamics that are used for the numerical estimation of the balance sheet distribution. For the pricing and hedging model, we chose a classical Black & choles model with a stochastic interest rate following a Hull & White model. The risk management model describing the evolution of the parameters of the pricing and hedging model is a Gaussian model. The new numerical method is compared with the traditional nested simulation approach. We review the convergence of both methods to estimate the risk indicators under consideration. Finally, we provide numerical results showing that the sparse grid approach is extremely competitive for models with moderate dimension.
Shapley effects for sensitivity analysis with dependent inputs: bootstrap and kriging-based algorithms
Authors: Benoumechiara Nazih , Elie-Dit-Cosaque Kevin
Published: April 2019

In global sensitivity analysis, the well-known Sobol’ sensitivity indices aim to quantify how the variance in the output of a mathematical model can be apportioned to the different variances of its input random variables. These indices are based on the functional variance decomposition and their interpretation becomes difficult in the presence of statistical dependence between the inputs. However, as there are dependencies in many application studies, this drawback enhances the development of interpretable sensitivity indices. Recently, the Shapley values that were developed in the field of cooperative games theory have been connected to global sensitivity analysis and present good properties in the presence of dependencies. Nevertheless, the available estimation methods do not always provide confidence intervals and require a large number of model evaluations. In this paper, a bootstrap resampling is implemented in existing algorithms to assess confidence intervals. We also propose to consider a metamodel in substitution of a costly numerical model. The estimation error from the Monte-Carlo sampling is combined with the metamodel error in order to have confidence intervals on the Shapley effects. Furthermore, we compare the Shapley effects with existing extensions of the Sobol’ indices in different examples of dependent random variables.
Free boundary value problems and hjb equations for the stochastic optimal control of elasto-plastic oscillators
Authors: Lauriere M. , Li Z. , Mertz L. , Wylie J. , Zuo S.
Published: April 2019

We consider the optimal stopping and optimal control problems related to stochastic variational inequalities modeling elasto-plastic oscillators subject to random forcing. We formally derive the corresponding free boundary value problems and Hamilton-Jacobi-Bellman equations which belong to a class of nonlinear partial of differential equations with nonlocal Dirichlet boundary conditions. Then, we focus on solving numerically these equations by employing a combination of Howard’s algorithm and the numerical approach [A backward Kolmogorov equation approach to compute means, moments and correlations of non-smooth stochastic dynamical systems; Mertz, Stadler, Wylie; 2017] for this type of boundary conditions. Numerical experiments are given.
Network of interacting neurons with random synaptic weights
Authors: Grazieschi Paolo , Leocata Marta , Mascart Cyrille , Chevallier Julien , Delarue François , Tanré Etienne
Published: April 2019

Since the pioneering works of Lapicque [17] and of Hodgkin and Huxley [16], several types of models have been addressed to describe the evolution in time of the potential of the membrane of a neuron. In this note, we investigate a connected version of N neurons obeying the leaky integrate and fire model, previously introduced in [1–3,6,7,15,18,19,22]. As a main feature, neurons interact with one another in a mean field instantaneous way. Due to the instantaneity of the interactions, singularities may emerge in a finite time. For instance, the solution of the corresponding Fokker-Planck equation describing the collective behavior of the potentials of the neurons in the limit N ⟶ ∞ may degenerate and cease to exist in any standard sense after a finite time. Here we focus out on a variant of this model when the interactions between the neurons are also subjected to random synaptic weights. As a typical instance, we address the case when the connection graph is the realization of an Erdös-Renyi graph. After a brief introduction of the model, we collect several theoretical results on the behavior of the solution. In a last step, we provide an algorithm for simulating a network of this type with a possibly large value of N.
Ophthalmologische Abbildungstechnik vor 200 Jahren – der Atlas von Antoine Pierre Demours als Grundlage der Rostocker Kunstaugensammlung
Authors: Schubert Daniel , Niemeyer Günter , Guthoff Rudolf F.
Published: April 2019

Neue Nachforschungen haben ergeben, dass die vor ca. 150 Jahren angefertigte „Rostocker Kunstaugensammlung“ mit 132 in Glas modellierten Vorderabschnittspathologien zum großen Teil auf die
Abbildungen des von Antoine Pierre Demours 1818 veröffentlichten Atlas der Augenheilkunde zurückgeht. Schwerpunkt dieses Beitrages bildet die Analyse der Abbildungstechniken des o. g.
Bildwerkes. Nach gegenwärtigem Kenntnisstand verwendete der Autor unterschiedliche Farbradierungskonzepte, die z. T. individuell nachkoloriert wurden. Die Abbildungen des Demoursʼschen
Atlasʼ stellen nach dem Urteil der Zeitgenossen den Gipfel der wissenschaftlichen Abbildungskunst dar und auch 100 Jahre später wird es in der Fachliteratur als ein bedeutendes illustratives
Werk für die Augenheilkunde beschrieben.
First Total Synthesis of Artekeiskeanol A, C and Altissimacoumarin D
Authors: Talakokkula Anil , Baikadi Karunakar , Narsaiah A.
Published: April 2019

The total syntheses of artekeiskeanol A and C, and altissimacoumarin D have been achieved. The syntheses commenced from commercially available starting materials, 2,4-dihydroxybenzaldehyde and geraniol. The key steps involve Wittig and Riley oxidation reactions.
Chemoselective Demethylation of Methoxypyridine
Authors: Makino Kosho , Hasegawa Yumi , Inoue Takahide , Araki Koji , Tabata Hidetsugu , Oshitari Tetsuta , Ito Kiyomi , Natsugari Hideaki , Takahashi Hideyo
Published: April 2019

A chemoselective demethylation method for various methoxypyridine derivatives has been developed. Treatment of 4-methoxypyridine with L-selectride in THF for 2 h at reflux temperature afforded 4-hydroxypyridine in good yield; no reaction to anisole occurred. The utility of our method was demonstrated by the efficient synthesis of the metabolic substances of the antiulcer agent omeprazole. Chemoselective demethylation at the site of 3,5-dimethyl-4-methoxypyridine in the presence of 4-methoxybenzimidazole was achieved.
Neurodevelopmental Disorders and Array-Based Comparative Genomic Hybridization: Sensitivity and Specificity using a Criteria Checklist for Genetic Test Performance
Authors: Amado-Puentes Alfonso , Reparaz-Andrade Alfredo , Del Campo-García Aida , Blanco-Barca Manuel , Salgado-Barreira Ángel , Del Campo-Pérez Víctor , Fernández-Lorenzo José
Published: April 2019

Background Array-based comparative genomic hybridization (aCGH) is a molecular analysis method for identifying chromosomal anomalies or copy number variants (CNVs) correlating with clinical phenotypes. The aim of our study was to identify the most significant clinical variables associated with a positive outcome of aCGH analyses to develop a simple predictive clinical score.

Methods We conducted a cross-sectional study in a tertiary center comparing the genotype and phenotype of the cases. A score was developed using multivariate logistic regression. The best score cutoff point, sensitivity, specificity, positive and negative predictive values, and area under the curve were calculated with the receiver operating characteristic curve.

Results aCGH identified structural chromosomal alterations responsible for the disorder in 13.7% (95% confidence interval [CI]: 10.9–16.5) of our sample (570 patients analyzed by aCGH). Based on the most frequent phenotypic characteristics among patients with a pathogenic CNV, we have created a checklist with the following items: alteration of the cranial perimeter, stature < percentile (p) 3, weight < p3, presence of brain malformations, ophthalmological malformations, two or more dysmorphic features in the same patient, and autism spectrum disorder diagnosis. Using a score ≥1.5 as the cutoff point for the test, we obtained a sensitivity of 82.4% (95% CI: 73.1–91.8) and a specificity of 54.2% (95% CI: 49.7–58.7).

Conclusion All individuals with a score of 1.5 or higher should be genetically screened by aCGH. This approach can improve clinical indications for aCGH in patients with neurodevelopmental disorders, but the scoring system should be validated in an external group.
Needs assessment of youths in residential child care in Portugal / Evaluación de necesidades de jóvenes en acogimiento residencial en Portugal / Evaluación de necesidades de jóvenes en acogimiento residencial en Portugal
Authors: Tavares-Rodrigues André , González-García Carla , Bravo Amaia , F. Del Valle Jorge
Published: April 2019

Residential child care in Portugal is the most common protection measure in cases of family separation, since family foster care is still very rare. However, little is known about the needs of these children and young people. The purpose of this study is to describe the profile of adolescents close to legal adulthood who are in residential care, comparing it with a Spanish sample. The sample is composed of 345 young people aged 16 to 17 on whom information has been collected regarding their history of protection, family background, schooling, mental health and offending behaviour. A Spanish sample was selected as a comparison group ( N = 384). The results reveal the complexity and special seriousness of the profile of young people in residential care in Portugal compared to a Spanish sample, highlighting a high presence of mental health problems and especially suicidal behaviours. Given these results, efforts should be focused on developing specialized residential care programmes adapted to the specific needs of these young people.
The Steinberg-Lusztig tensor product theorem, Casselman-Shalika, and LLT polynomials
Authors: Lanini Martina , Ram Arun
Published: April 2019

In this paper we establish a Steinberg-Lusztig tensor product theorem for abstract Fock space. This is a generalization of the type A result of Leclerc-Thibon and a Grothendieck group version of the Steinberg-Lusztig tensor product theorem for representations of quantum groups at roots of unity. Although the statement can be phrased in terms of parabolic affine Kazhdan-Lusztig polynomials and thus has geometric content, our proof is combinatorial, using the theory of crystals (Littelmann paths). We derive the Casselman-Shalika formula as a consequence of the Steinberg-Lusztig tensor product theorem for abstract Fock space.
HLA*LA—HLA typing from linearly projected graph alignments
Authors: Dilthey Alexander T , Mentzer Alexander J , Carapito Raphael , Cutland Clare , Cereb Nezih , Madhi Shabir A , Rhie Arang , Koren Sergey , Bahram Seiamak , McVean Gil , Phillippy Adam M
Published: April 2019

HLA*LA implements a new graph alignment model for human leukocyte antigen (HLA) type inference, based on the projection of linear alignments onto a variation graph. It enables accurate HLA type inference from whole-genome (99% accuracy) and whole-exome (93% accuracy) Illumina data; from long-read Oxford Nanopore and Pacific Biosciences data (98% accuracy for whole-genome and targeted data) and from genome assemblies. Computational requirements for a typical sample vary between 0.7 and 14 CPU hours per sample.

Availability and implementation

HLA*LA is implemented in C++ and Perl and freely available as a bioconda package or from https://github.com/DiltheyLab/HLA-LA (GPL v3).

Supplementary information

Supplementary data are available at Bioinformatics online.
scRNAss: a single-cell RNA-seq assembler via imputing dropouts and combing junctions
Authors: Liu Juntao , Liu Xiangyu , Ren Xianwen , Li Guojun
Published: April 2019

Motivation

Full-length transcript reconstruction is essential for single-cell RNA-seq data analysis, but dropout events, which can cause transcripts discarded completely or broken into pieces, pose great challenges for transcript assembly. Currently available RNA-seq assemblers are generally designed for bulk RNA sequencing. To fill the gap, we introduce single-cell RNA-seq assembler, a method that applies explicit strategies to impute lost information caused by dropout events and a combing strategy to infer transcripts using scRNA-seq.

Results

Extensive evaluations on both simulated and biological datasets demonstrated its superiority over the state-of-the-art RNA-seq assemblers including StringTie, Cufflinks and CLASS2. In particular, it showed a remarkable capability of recovering unknown ‘novel’ isoforms and highly computational efficiency compared to other tools.

Availability and implementation

scRNAss is free, open-source software available from https://sourceforge.net/projects/single-cell-rna-seq-assembly/files/.

Supplementary information

Supplementary data are available at Bioinformatics online.
The financial burden of non-communicable diseases in the European Union: a systematic review
Authors: Vandenberghe Désirée , Albrecht Johan
Published: April 2019

Background

Non-communicable diseases (NCDs) impose a significant and growing burden on the health care system and overall economy of developed (and developing) countries. Nevertheless, an up-to-date assessment of this cost for the European Union (EU) is missing from the literature. Such an analysis could however have an important impact by motivating policymakers and by informing effective public health policies.

Methods

Following the PRISMA protocol, we conduct a systematic review of electronic databases (PubMed/Medline, Embase, Web of Science Core Collection) and collect scientific articles that assess the direct (health care-related) and indirect (economic) costs of four major NCDs (cardiovascular disease, cancer, type-2 diabetes mellitus and chronic respiratory disease) in the EU, between 2008 and 2018. Data quality was assessed through the Newcastle–Ottawa Scale.

Results

We find 28 studies that match our criteria for further analysis. From our review, we conclude that the four major NCDs in the EU claim a significant share of the total health care budget (at least 25% of health spending) and they impose an important economic loss (almost 2% of gross domestic product).

Conclusion

The NCD burden forms a public health risk with a high financial impact; it puts significant pressure on current health care and economic systems, as shown by our analysis. We identify a further need for cost analyses of NCDs, in particular on the impact of comorbidities and other complications. Aside from cost estimations, future research should focus on assessing the mix of public health policies that will be most effective in tackling the NCD burden.
The role of democratic legitimacy in the recognition of governments in Africa since the end of the Cold War
Authors: de Wet Erika
Published: April 2019

This article explores whether recent institutional reforms within Africa have modified the traditional criterion of effective control as the decisive requirement for recognition of de jure governments in the region. It examines in particular whether measures adopted by the African Union (AU) for outlawing unconstitutional changes of government have elevated democratic legitimacy to an (additional) criterion for governmental recognition. The article illustrates that on the whole, the practice of the AU has been neither consistent in the condemnation of coup regimes nor keen to support popular movements that oppose authoritarian rule, or scrutinize the democratic pedigree of governments for the purposes of (continued) recognition. In essence, the AU’s institutional commitments to oppose unconstitutional changes of government amount to guiding principles, rather than binding obligations. While at times decisive, democratic legitimacy has not yet replaced effective control as the point of departure for governmental recognition.
Use of Intraoperative Indocyanine Green Angiography for Feeder Vessel Ligation and En Bloc Resection of Intramedullary Hemangioblastoma
Authors: Molina Camilo A , Pennington Zach , Ahmed A Karim , Westbroek Erick , Goodwin Matthew L , Tamargo Rafael , Sciubba Daniel M
Published: April 2019

BACKGROUND

As vascular tumors, intramedullary hemangioblastomas are associated with significant intraoperative blood loss, making them particularly challenging clinical entities. The use of intraoperative indocyanine green or other fluorescent dyes has previously been described to avoid breaching the tumor capsule, but improved surgical outcomes may result from identifying and ligating the feeder arteries and arterialized draining veins.

OBJECTIVE

To describe the use of combined preoperative angiography and intraoperative indocyanine green use for the identification of feeder arteries and arterialized draining veins to decrease blood loss in the resection of intramedullary hemangioblastomas.

METHODS

A patient with cervical myelopathy secondary to a large C3 hemangioblastoma and cervicothoracic syrinx underwent a C2-3 laminoplasty with resection of the lesion. To reduce intraoperative blood loss and facilitate safe lesion resection, the vascular architecture of the lesion was defined via preoperative digital subtraction angiography and intraoperative use of indocyanine green. The latter permitted ligation of the major and minor feeding arteries and arterialized veins prior to tumor breach, allowing for facile en bloc resection of the lesion.

RESULTS

The lesion was resected en bloc with minimal blood loss (approximately 100 mL) and without intraoperative neuromonitoring signal changes. The patient remained at neurological baseline throughout their stay.

CONCLUSION

We present a written and media illustration of a technique for intraoperative indocyanine green use in the en bloc resection of intramedullary hemangioblastoma.
REVIEW OF RADON AND THORON RESEARCH IN KENYA: 1997–2017
Authors: Chege M , Nyambura C
Published: April 2019

Six research studies involving radon and thoron in Kenya were carried out between 1997 and 2007. The studies were mainly small scale and involved a few areas scattered across Nairobi, Rift Valley, Coast and Western regions. The results were captured in seven online journal articles. This paper relooks at the journal articles with the view of underscoring the high radon and thoron areas in Kenya, raising awareness on the sources and risks of radon isotopes in indoor environments and highlighting the need for more research on the isotopes in the country.
PERFORMANCE EVALUATION OF THE EQUIPMENT FOR MEASURING RADIOACTIVITY IN WHOLE FOODSTUFFS WITHOUT DESTRUCTIVE SAMPLE PREPARATION DEVELOPED AFTER THE FUKUSHIMA NPP ACCIDENT
Authors: Yamada Takahiro , Soga Keisuke , Hachinohe Mayumi , Hachisuka Akiko
Published: April 2019

Recently, several types of instruments for measuring radioactivity in whole foodstuff were developed by manufacturers, in which any sample preparation technique such as machining was avoided, and such types of instruments are employed by agricultural producers or municipality radioactivity testing stations in Fukushima. In this study, radioactivity in various kinds of 91 samples collected by residents were measured by use of instruments for radioactivity measurement in whole samples, and the activity in each sample was also measured by use of the conventional gamma-ray spectrometry technique using calibrated Ge detectors after the sample machining procedure. The results obtained by instruments for measurement in whole samples were roughly proportional to the result obtained by a conventional technique, although large differences or unexpected variations were found in some specimens.
Opportunity, Social Mobility, and Women’s Views on Gender Roles in Central Asia
Authors: Urbaeva Jildyz
Published: April 2019

Central Asian countries represent an important context for understanding intersections between Islam, patriarchy, and women’s well-being. In recent decades, challenges and opportunities resulting from transitions to a market economy exacerbated gender imbalances in labor markets and opportunity structures of the region. Women of the region are highly educated and make significant economic contributions to support their families through employment. However, their views about gender roles remain unclear, and it is also uncertain whether opportunity structures and social mobility have influenced these views. The current study addresses these gaps using probability-based survey data (N = 3,405) from four Central Asian countries: Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan. Latent class analysis reveals three latent profiles of women’s views on gender roles: traditional views, egalitarian views, and dual views. Religious identity, education, opportunity structure, and social mobility intersect with women’s ideas about gender roles.
Cross-cultural Applicability of the 12-Step Model: A Comparison of Narcotics Anonymous in the USA and Iran
Authors: Galanter Marc , White William L. , Hunter Brooke D.
Published: April 2019

Objective:

Narcotics Anonymous (NA), a nonprofessional 12-step fellowship for people seeking recovery from addiction, reports 27,677 meetings in the USA, where it was founded, but there is limited literature on its adaptability cross-culturally. We studied NA within the Islamic Republic of Iran to ascertain its relative adaptation in a different cultural setting.

Method:

We surveyed 262 NA members in Iran, supplemented by member interviews, and compared demographic and substance use-related characteristics of members, and also the nature of their respective involvement in NA, to the survey results of a previous US survey (n = 527).

Results:

NA in Iran reports 21,974 meetings. The Iranian respondents surveyed differed relatively little (d < 0.50) from US members on demographics and prior ambulatory substance use disorder treatment, but did have fewer female members (means for Iran and US: 42.4 vs 39.0 years; 77% vs 87%; 6% vs 28%, respectively). They were, however, more involved in the fellowship (d > 0.50) in terms of reporting service as sponsors, experience of spiritual awakening, and achievement of diminished craving (scores of 1–10) (85% vs 48%; 95% vs 84%; 1.03 vs 1.89, respectively). Surveyed NA members in Iran publicized the fellowship with public (36%) and religious (20%) figures, and systematically worked the 12 steps in large sponsor-led groups (

JOURNAL/jamed/04.03/01271255-201912000-00013/inline-graphic1/v/2023-07-18T035637Z/r/image-tiff

= 19 members).

Conclusion:

NA, a 12-step program developed in a Western, predominantly Christian-oriented country, was adapted widely in the Islamic Republic of Iran, a setting different in culture, language, ethnicity, and religious orientation. The growth in its membership derives, in part, from specific innovations that may have broader applicability in other settings.
Suppressive Effect of Everolimus on IL-2, IL-10, IL-21, and IFNγ Levels: Implications for the Successful Minimization of Calcineurin Inhibitor Use in Transplantation
Authors: Iwasaki Kenta , Kitahata Nana , Miwa Yuko , Uchida Kazuharu , Matsuoka Yutaka , Horimi Kosei , Kobayashi Takaaki
Published: April 2019

Background:

Success with calcineurin inhibitors (CNIs) such as cyclosporine A (CSA) and tacrolimus (TAC) in organ transplantation has demonstrated that cytokine suppression is a key factor in patient management. However, the exact effects of recently introduced immunosuppressive agents other than CNI on cytokine expression remain unknown. In this study, the action of the mTOR-inhibitor everolimus (EVR) and that of the antimetabolite mycophenolic acid (MPA) on the transcription of several cytokines was investigated.

Methods:

Peripheral blood mononuclear cells obtained from healthy volunteers were stimulated with anti-CD3/28 microbeads in the presence of CSA, TAC, EVR, and/or MPA for 8 hours. The mRNA levels of each cytokine were measured using quantitative real-time polymerase chain reaction.

Results:

MPA had no inhibitory effect on any of the cytokines tested. EVR showed moderate inhibition of IL-2, IL-10, IL-21, and IFNγ levels. These cytokines were further analyzed to investigate the additive effect of EVR in combination with CNI. The beneficial effect of EVR addition was seen at low concentrations of CSA or TAC, while no additive effect was observed at high concentrations.

Conclusions:

EVR might effectively inhibit the activation of recipient immune cells in combination with a low dose of CNI, maximizing clinical benefit by preventing graft rejection and alleviating CNI-induced adverse effects.
CORRELATION BETWEEN MACULAR MICROSTRUCTURES AND ANISEIKONIA AFTER IDIOPATHIC EPIRETINAL MEMBRANE REMOVAL
Authors: Moon Byung GIL , Yang Young Seong , Chung Heeyoung , Sohn Joonhong
Published: April 2019

Purpose:

To analyze the correlation between preoperative measurements of macular microstructures and aniseikonia after epiretinal membrane removal.

Methods:

This retrospective study included 32 eyes of 32 patients who underwent epiretinal membrane surgery and were followed up for 12 months. Spectral-domain optical coherence tomography was used to measure the thicknesses of the ganglion cell layer–inner plexiform layer, inner nuclear layer (INL), and outer retinal layer in macular microstructures. The new aniseikonia test was used to measure vertical and horizontal aniseikonia scores.

Results:

There was a significant decrease in central macular thickness and ganglion cell layer–inner plexiform layer thickness at 6 and 12 months postoperatively (all P < 0.001). Vertical aniseikonia scores, horizontal aniseikonia scores, and INL and outer retinal layer thicknesses did not show significant changes. Vertical aniseikonia scores and horizontal aniseikonia scores were significantly associated with INL thicknesses of each meridian at each follow-up time point (all P < 0.05). Preoperative vertical and horizontal INL thicknesses were correlated with vertical aniseikonia scores and horizontal aniseikonia scores at 12 months postoperatively (P = 0.014 and P = 0.002, respectively).

Conclusion:

Aniseikonia values did not change after epiretinal membrane removal and were associated with INL thickness before and after surgery. Thus, preoperative INL thickness could be used as a predictor of surgical prognosis in epiretinal membrane patients.
Adolescent vaccinations: updates for the general practitioner
Authors: Mealey Kathleen , Koenigs Laura M.P.
Published: April 2019

Purpose of review

Adolescent providers have a unique opportunity to interface with adolescents during a transformative time period. Optimizing vaccinations may protect teens against preventable but potentially deadly diseases. Healthcare providers must be aware of the evolving vaccination data and up-to-date recommendations for vaccinations.

Recent findings

In spite of the Center for Disease Control recommendations, there is a gap between the actual and desired vaccination rates of adolescents. Tetanus, diphtheria, and acellular pertussis, meningococcal against ACWY serotypes, and human papillomavirus (HPV) are vaccinations unique to the adolescent period. There has been a marked increase in pertussis cases over the last 2 decades. Either of the meningitis B vaccines may be given to 16–18 year olds and are effective in controlling college outbreaks. Increasing evidence continues to demonstrate the safety and efficacy of the HPV vaccination, although a substantial number of adolescents remain unvaccinated. Fortunately, there are proven strategies to remedy this.

Adolescent providers should be aware of the increase in pertussis cases over the past 2 decades and the Category B recommendation for meningococcal B vaccine at 16–18 years, and they should work towards closing the gap between the actual and desired HPV vaccination rates.
Mindfulness-based interventions for adolescent health
Authors: Lin Jessica , Chadi Nicholas , Shrier Lydia
Published: April 2019

Purpose of review

Mindfulness, the practice of paying attention to the present moment, purposefully and nonjudgmentally, has been gaining popularity as adjunct treatment for adolescents with a range of physical and mental health problems. Research conducted in adults and emerging research conducted in adolescents has shown that mindfulness-based interventions can improve outcomes in several areas. The purpose of this review is to discuss recent research on the effects of mindfulness and suggest exercises that primary care clinicians can offer to their adolescent patients.

Recent findings

Research has shown positive effects of mindfulness across several health conditions commonly encountered during adolescence. Mindfulness-based Interventions can reduce symptoms of anxiety and depression. The application of mindfulness can help with the prevention and treatment of binge eating, over-eating, and restrictive eating disorders. In the treatment of substance use disorders, mindfulness can improve emotion regulation and reduce symptoms of withdrawal and craving. Mindfulness can also lead to improvement in overall quality of life for patients suffering from chronic pain. Lastly, mindfulness can be useful for adolescents with ADHD, sleep problems, chronic illness, and stress related to performance sports.

Although research in adolescents remains limited, mindfulness holds promise in the treatment of a range of health conditions in adolescents.
Serial Z-plasty for Correction of Cicatricial Conjunctival Constriction Rings
Authors: Bi Xiaoping , Sun Ying , Fan Xianqun
Published: April 2019

Background:

Cicatricial conjunctival constriction rings caused by trauma seriously influences visual function and causes blepharon deformities. The treatment of cicatricial conjunctival constriction rings is intractable.

Methods:

A 45-year-old male presented severe cicatricial conjunctival constriction ring due to traffic accident injury. This 5-mm diameter constriction ring resulted in the patient's eyelid deformities, including eyelid ptosis, ectropion, and visual obstruction. The patient underwent primary surgery of serial conjunctival Z-plasty for correction of the constriction ring. Conjunctival constriction ring was corrected immediately after Z-plasy. Fornix deepening suturing was adopted to promote formation of fornix and correct eyelid ectropion. A secondary surgery of frontalis flap suspension was adopted to correct ptosis 6 months after Z-plasty.

Results:

The patient achieved a satisfactory and symmetrical appearance with no recurrence of cicatricial conjunctival constriction and no other complications during the 6-month follow-up period.

Conclusion:

In this patient, the authors claimed that serial Z-plasty surgery can effectively be used for correction of cicatricial conjunctival constriction rings. No further material implantation was applied during the operation.
In Vitro Evaluation of the Effects of Different Fixation Methods on Stabilization of Mandibular Body Fractures
Authors: Polat Mehmet Emrah , Dayi Ertunc
Published: April 2019

Purpose:

Mandibular body fractures are considered to be one of the most affected fracture sites in the maxillofacial region. Although the rates of fracture in this region are high, biomechanical evaluations related to this region are rare. The purpose of this investigation was to reveal the effects of different treatment methods onmandibular body fractures.

Method:

Twenty-five synthetic polyurethane hemi-mandibles were used in this study. The hemi-mandibles, which simulated simple unfavorable mandibular body fractures, were divided into 5 groups (n = 5/group) according to the treatment method. The bone segments were fixed using different osteosynthesis methods and 2.0 mm miniplate/screw systems. The groups consisted of locking or conventional systems, 5 or 11 mm long screws and 4 or 6 holes. The hemi-mandibles were loaded vertically with compressive strength until they reached 120 N.

Results:

The results were analyzed using Tamhane's T2 post hoc test, and the significance level was 0.05. Group 1 had the lowest mechanical resistance of all groups and group 5 had the highest. No significant differences were observed in group 2 or 3.

Conclusion:

The locking system miniplate group showed better fixation stability than the conventional systems for the same screw length, and the number of holes and screw length seemed to be effective for stabilization.
Piezoelectric Drilling Hole Technique in Septal Fixation
Authors: Demirbilek Nevzat , Evren Cenk , Çelik Mustafa
Published: April 2019

Objectives:

The act of securing the septum to the midline is very important for the success of the operation during septoplasty and septorhinoplasty operations. The authors’ aim in this study is to open a hole in the anterior nasal spine with the Piezoelectric drilling hole technique so as to fix the septum to the midline with a suture passing through that hole.

Methods:

Patients with anterior segmental deviation on whom we performed septoplasty or closed technique septorhinoplasty were included in the study. The patients were divided into 2 groups, as the Classic and Piezo Groups. A total of 63 patients were included in the study; in the Classic Group, we performed septum fixation with suture of the nasal spine to the mucoperiosteum in 27 patients; whereas in the Piezo Group, fixation was performed on 36 patients using the piezo-surgical suture through a nasal spinal opening. Patients were assessed preoperatively and postoperatively by VAS and NOSE scores, and also by postoperative examinations.

Results:

Preoperative and postoperative VAS-NOSE scores were found to be statistically significantly different in both groups (P < 0.0001, P < 0.0001). Redeviation with no need for revision surgery was reported to develop in 1 patient of the classical group (3.7%).

Conclusion:

Piezoelectric drilling hole technique provides stronger fixation in the midline and prevents postoperative redeviation. Its most important superiority over the other methods used in fixing the septum to the nasal spine is its ability to provide adequate stabilization without damaging soft tissue.
Nasal Alar Pressure Ulcer After Orthognathic Surgery: Clinical Presentation and Preventive Recommendations
Authors: Brasileiro Bernardo Ferreira , Van Sickels Joseph E.
Published: April 2019

Nasotracheal intubation is routinely used in patients undergoing oral and maxillofacial surgery when intermaxillary fixation is needed either intraoperatively or postoperative. Various complications can occur such as epistaxis, turbinectomy, retropharyngeal dissection, tympanites, and nasal alar pressure sores or necrosis, especially when there is a prolonged nasotracheal intubation. The first report of a nasal alar necrosis after prolonged nasotracheal intubation was published by Hatcher et al in 1968. Since then several reports of skin necrosis of the nasal alar region have been published and attributed to a prolonged operation or the technique used in tube placement. Pressure ulcers are a localized damage to the skin and underlying soft tissue and usually appear immediately after the procedure. They start with nonblanchable erythematous intact skin and can evolve to partial thickness loss of skin with exposed dermis and scab formation during the healing process. They may be painful and can cause a cosmetic problem for patients. The literature has several studies of nasal alar necrosis after nasotracheal intubation for head and neck reconstructive surgery, but there is no description of this complication after orthognathic surgery. This paper describes the occurrence of skin nasal alar necrosis following a bimaxillary jaw correction and highlights recommendations for its management and prevention.
Low Uric Acid Indicates Risk of Incidence of Trigeminal Neuralgia
Authors: Chang Bowen , Guan Haochen , Zhu Wanchun , Li Shiting
Published: April 2019

Background and Objective:

Trigeminal neuralgia (TN) is a common cranial nerve disease. Uric acid (URIC), a water-soluble antioxidant discovered in human body, has been recognized in numerous recent studies to exert a crucial part in neuroprotection; however, the influence of URIC on TN remains unclear so far. This study aimed to examine the association of URIC with TN.

Methods:

From January 2017 to September 2018, medical records from the newly diagnosed patients with TN at the Xinhua Hospital were retrospectively recruited and analyzed. The serum URIC, creatinine, blood urea nitrogen, and albumin levels between TN patients and normal subjects were compared through the nonparametric tests. Moreover, the relationship of URIC levels with TN was assessed using the multiple linear regression models.

Results:

Compared with normal subjects (325.7 ± 74.3 μmol/L), URIC contents were remarkably decreased in TN patients (270.2 ± 75.9 μmol/L) (P < 0.05). Besides, URIC was regarded as a protective factor of TN, as verified by multivariate logistic regression models (odds ratio = 0.2, 95% confidence interval = 0.0–0.6; P < 0.05).

Conclusion:

Low URIC content is associated with the risk of incidence of TN, and appropriately increasing the URIC level may prevent TN.
Spontaneous Mediastinal Abscess and Sternal Cleft in the Medically Complex Neonate
Authors: Wiggins Claire J. , Dempsey Robert F. , Monson Laura A.
Published: April 2019

Sternal cleft (SC) is a rare congenital anomaly, occurring with associated developmental anomalies or in isolation. Surgery to reconstruct the sternum is indicated to protect the visceral organs from trauma, to ensure healthy cardiopulmonary function and growth, and to reconstruct the anterior chest wall. Although infection recognized as a postoperative complication following chest wall reconstruction, spontaneous mediastinal infection is rare. To the authors’ knowledge, there is only 1 reported case of spontaneous mediastinal infection with concomitant SC in the literature. Here, the authors present a unique case of a medically complicated infant with a SC who presented with a spontaneous mediastinal abscess.
Determining the incidence of distraction among trauma patients in all modes of transportation
Authors: Le Brittany , Figueroa Cesar , Anderson Craig , Lotfipour Shahram , Barrios Cristobal
Published: April 2019

BACKGROUND

The use of distracting technology is an increasing source of risk for injury among trauma patients. Both drivers and pedestrians show increased unsafe behavior. The data for prevalence and risk for distraction in trauma has varied widely. Our hypothesis is that distraction is more highly prevalent and widely distributed among all mechanisms of injury and variety of trauma patients.

METHODS

A 10-question survey of adult trauma victims at a Level I trauma center regarding distraction at time of event was performed, examining age, sex, ethnicity, education level, mode of injury and role in the accident (driver, passenger, pedestrian, bicyclist, motorcyclist). Multiple-variable logistic regression was performed to identify risk factors for distraction.

RESULTS

From June 2016 to October 2018, 1,316 patients were surveyed, and 1,011 (76.8%) patients reported their role in the traffic accident. The prevalence of distraction was 21.73% among drivers, 9.01% among passengers, 16.50% among pedestrians, 20.00% among bicyclists, and 8.09% among motorcyclists. Males (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.26–2.67) as well as all Others (OR, 2.09; 95% CI, 1.10–3.98) showed statistically significant increased risk for distraction. Motorcyclist (OR, 0.25; 95% CI, 0.13–0.50) and passenger (OR, 0.37; 95% CI, 0.18–0.77) roles during collision were a lowered risk of distraction. Furthermore, Asian/Pacific Islanders (OR, 1.62; 95% CI, 0.94–2.79) trended toward being at greater risk for distraction.

CONCLUSION

Distraction is prevalent among a wide range of traffic accident victims, not just drivers. Males as well as all Others are more likely to be distracted. In contrast, motorcyclists and passengers are less likely to be distracted. Further studies to assist in determining effective interventions and public safety efforts aimed at specific at-risk groups beyond motor vehicle drivers are warranted.

LEVEL OF EVIDENCE

Epidemiological, level V.