bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing objective and self‐reported measures of adherence in haemophilia
Authors: Guedes Vanessa Giroto , Corrente José Eduardo , Farrugia Albert , Thomas Sylvia , Wachholz Patrick Alexander , de Oliveira Vidal Edison Iglesias
Published: July 2019

Aim

To compare subjective and objective measures of adherence to prophylaxis in haemophilia.

Methods

In this cross‐sectional study, we compared participants’ self‐perceived adherence and their estimate of the number of clotting factor concentrates (CFCs) that had been missed over the last period of CFC dispensation with an objective measure of adherence based on counts of CFC vials returned by participants.

Results

We included 29 out of 31 eligible patients in the study. There was no significant correlation between self‐perceived degree of adherence and the objective classification of adherence (Rho: 0.10, 95% CI: −028 to 0.46, P: 0.61) and between the classification of adherence based on the proportion of missed CFC doses assessed by participants’ self‐report and objectively (Rho: 0.32, 95% CI: −0.01 to 0.59, P: 0.11). Conversely, we found evidence of moderate correlation between the proportion of missed CFC doses as assessed by participants’ self‐report and objectively (Rho: 0.56, 95% CI: 0.24 to 0.77, P: 0.003). Participants’ self‐perceived adherence was 3 times more likely to be rated as very good or good than it was for the objective assessment to be classified as adherent or suboptimally adherent.

Conclusion

Our results showed significant discrepancies between subjective and objective measures of adherence, which likely reflect the influence of social desirability bias in self‐reported measures and different concepts of adherence between patients/caregivers and haemophilia experts. Additionally, our results allow us to hypothesize that studies on adherence to prophylaxis in haemophilia relying exclusively on information from self‐reports and questionnaires may substantially overestimate adherence levels.
Assessment of glucose kinetics with real‐time continuous glucose monitoring during labor
Authors: Maki Jota , Eto Eriko , Tamada Shoko , Mitsui Takashi , Hayata Kei , Nakamura Keiichiro , Hiramatsu Yuji , Masuyama Hisashi
Published: July 2019

Aim

Changes in glucose levels during labor have not been sufficiently investigated in pregnant women. Using real‐time continuous glucose monitoring, we aimed to assess glucose kinetics during labor among pregnant women with gestational diabetes mellitus (PwGDM), and those with normal glucose tolerance (PwNGT).

Methods

Japanese PwGDM and PwNGT who had planned a transvaginal delivery at Okayama University Hospital were enrolled. The correlation between changes in glucose levels during labor among the PwGDM and PwNGT groups at four time periods was assessed: (i) active phase of 1st stage of labor; (ii) 2nd stage of labor; (iii) postpartum 0–12 h; and (iv) postpartum 12–48 h.

Results

In total, 18 and 22 PwGDM and PwNGT, respectively, were enrolled. During labor, both groups had similar changes in glucose levels over time, which peaked during period 3. The main effect of glucose level changes was the labor period (P < 0.001), not the presence of gestational diabetes mellitus. Furthermore, differences in glucose levels in the PwGDM group were observed between periods 1 and 2 (P = 0.037), 1 and 3 (P = 0.024), 3 and 4 (P = 0.005); differences in glucose levels in the PwNGT group were observed between periods 3 and 4 (P = 0.024).

Conclusion

During labor, both PwGDM and PwNGT groups showed similar changes in glucose levels over time. During delivery, the PwGDM who regularly measured their own glucose levels could be managed using the same nutritional management methods as those for PwNGT.
Potential roles of the CCL17‐CCR4 axis in immunopathogenesis of oral lichen planus
Authors: Shan Jing , Shen Chen , Fang Jiaxiang , Li Shan , Fan Yuan
Published: July 2019

Background

Oral lichen planus (OLP) is a T cell–mediated chronic inflammatory disease. C‐C chemokine receptor type 4 (CCR4) and its cognate C‐C motif chemokine ligand 17 (CCL17) play a key role in T‐cell activation and trafficking, but their implication in OLP pathogenesis has not been explored. Our study was designed to analyze the expression and function of the CCL17‐CCR4 axis in OLP.

Methods

The mRNA expression levels of CCL17 and CCR4 in the circulating T cells of OLP subjects were examined by quantitative real‐time PCR. The protein levels of CCL17 and CCR4 in the peripheral blood of OLP subjects were detected by enzyme‐linked immunosorbent assay (ELISA) and Simple Western assay, respectively. The functional relevance of increased expression of CCL17 and CCR4 in OLP was demonstrated in proliferation, apoptosis, and migration assays.

Results

The mRNA and protein expression levels of CCL17 and CCR4 in the peripheral blood of patients with OLP were significantly upregulated compared with those of controls. CCL17 induced the migration of OLP T cells. In addition, blocking CCR4 with a small molecule CCR4 antagonist not only inhibited the proliferation and migration of OLP T cells but also promoted the apoptosis of OLP T cells.

Conclusion

Our findings indicate that the CCL17‐CCR4 axis might be responsible for the inflammatory infiltration of T cells in OLP.
Multiracial identity and racial complexity in sociolinguistic variation
Authors: Holliday Nicole R.
Published: July 2019

What is the relationship between ethnolinguistic communities and ways of speaking? Who is an authentic speaker of an ethnolinguistic variety? In a time where scholarly and public conceptualizations of race and ethnicity are variable and rapidly changing, potential effects on both self‐identification and ways of speaking present an area ripe for study. However, linguistics and allied fields have often overlooked individuals and communities that do not neatly conform to well‐defined racial categories. As multiracially identified individuals are one of the fastest growing demographic groups in the United States, researchers will necessarily need to address the way that traditional methodologies have excluded individuals and groups who fall outside of these racial and ethnic categories. This presents a unique challenge for sociolinguistics in particular, since we are interested in how people draw on linguistic variation to perform aspects of their identities, including their races and ethnicities. This article examines the ways in which race and ethnicity have been traditionally conceptualized in linguistics and allied fields and draws on research from other social sciences to see how they have begun to study individuals who fall outside of traditionally preexisting social categories. The article also briefly discusses the results of one of the first major sociolinguistic studies on multiracially identified participants, which found substantial effects of self‐conceptualization and self‐identification on linguistic behavior of these participants, a result which informs how future work should consider individuals who identify as two or more races. Finally, it will address future directions for research at the intersection of personal identity, race, and language.
The energy transition in transport using alternative fuels: Can new technologies achieve policy targets?
Authors: Alshammari Yousef M.
Published: July 2019

COP21 resulted in a major global agreement to reduce greenhouse gas emission to limit the Earth’s rising temperature to <2°C. Transport has a key role in the transition to a clean low carbon energy system. The aim of this work was to develop optimum scenarios for the implementation of alternative low carbon road transport fuels to replace conventional fuels of gasoline and diesel using the systems analysis model MESSAGE. The results show that technological breakthroughs to enhance efficiency and cost reduction of solar fuels will enable them to compete with gasoline and diesel in meeting the demand for road transport fuels. It also found that that production of synthetic fuels can significantly contribute to reducing consumption of crude oil while reducing CO2 emission by 80 per cent by 2050. Compared with previous literature, our work considers synfuels from fossil fuels can compete with biomass‐derived fuels, and it shows potential transition scenarios in the road transport sector to replace gasoline and diesel in fossil fuel‐dependent economies considering Saudi Arabia as a case study. Solar fuels appear as the most promising for reducing emission, albeit at a high price. Carbon abatement costs are found to range between $121 and $517/Ton, between 2015 and 2050. Feasible implementation of solar and synthetic fuels was also found to depend on the targeted CO2 emission, fuel efficacy, penetration of public transport and economic growth.
Prevention of transfusion‐transmitted cytomegalovirus infection using leukoreduced blood components in patients receiving seronegative umbilical cord blood transplantation
Authors: Shigemura Tomonari , Yanagisawa Ryu , Komori Kazutoshi , Morita Daisuke , Kurata Takashi , Tanaka Miyuki , Sakashita Kazuo , Nakazawa Yozo
Published: July 2019

BACKGROUND

Leukoreduced blood components have been widely implemented to prevent transfusion‐transmitted cytomegalovirus (TT‐CMV) in transplantation. Recent progress in leukoreduction technology has helped reduce the risk of TT‐CMV in hematopoietic stem cell transplantation; however, its efficacy in umbilical cord blood transplantation (CBT) has not been systematically studied.

STUDY DESIGN AND METHODS

We retrospectively analyzed the incidence of CMV infection in patients treated with CBT who received prestorage leukoreduced, CMV‐unselected blood components between 2007 and 2017 in a single Japanese pediatric center. Patients were monitored for CMV antigenemia at least once weekly.

RESULTS

In total, 71 patients treated with CBT were identified. Two patients were excluded because of unknown CMV serostatus or early death after CBT. Of the remaining 69 patients, 24 developed CMV antigenemia. Among them, 3 received granulocyte transfusions (3 of 3; 100%), 2 were infants with severe combined immunodeficiency who had been infected with CMV before CBT (2 of 2; 100%), and 19 were CMV‐seropositive patients (19 of 23, 82.6%). Conversely, of the remaining 45 patients in whom CMV antigenemia did not develop, 41 were seronegative (0 of 41; 0%) and were transfused with a total of 925 leukoreduced, CMV‐unselected blood components. Among the 41 patients, 9 (22%) received in vivo T‐cell depletion with antithymocyte globulin. None of the patients in the seronegative group has subsequently shown evidence of CMV infection or developed CMV disease.

CONCLUSION

Using prestorage leukoreduction, no cases of CMV infection were detected in seronegative CBT patients. Our findings showed the safety of leukoreduction in preventing TT‐CMV in this patient group.
Haptic Neurofeedback Device for Parkinson’s Patients
Authors: Krigbaum Joseph , Rascon Alvaro , Patil Harsh , Jameson Shannon , Polygerinos Panagiotis
Published: July 2019

A method for the design and development of a feedback device for the treatment of focal dystonic symptoms of Parkinson’s patients is described in this work. This device utilizes haptic feedback produced via a soft pneumatic actuator incorporating zero-volume chambers and channels, to signal to the patient that they are falling into a dystonic pattern so that they themselves can manually break out of the pattern preserving and prolonging the use of the afflicted limb, in this case the hand. The system of detection for the dystonic symptoms is a conductive rubber stretch sensor that detects changes to the circumference of the forearm as the muscles begin to involuntarily contract. The signal from the sensor then feeds into a microcontroller that will activate the onboard pump that will in-turn pulse the soft pneumatic actuator producing a gentle but noticeable haptic sensation on the patient’s arm.
MobileGyro: Android Application for Bluetooth Gyroscope Tracking With Potential for Impact in Rehabilitative Processes
Authors: Scott Noah , Li Rui , Tse Zion
Published: July 2019

According to the CDC, 795,000 Americans are diagnosed with a stroke each year. Out of the all of the technology used to track the gait of a stroke patient, the Inertial Measurement Unit (IMU) is growing in recognition and use. These are often used as wearable sensors for rehabilitation, with their small size and cost effectiveness. The purpose of this research is to detail the innovation of an android application with the ability to receive IMU data and present it through medically significant visual displays. The data from a device is received via bluetooth, and is transmitted in terms of angles roll (x axis), pitch (y axis) and yaw (z axis). The application displays this data to allow the user to track the position of the IMU in live time. The medical professional has the ability to input a desired set of angles, and track the proximity of a connected device to the target position. The data is presented visually through the coronal, transverse & sagittal plane. When roll and pitch angles from the app were compared to angular values measured on a protractor, the average difference was +/− 0.366° and +/− 0.436°, in roll and pitch respectively. Along with the average accuracy being less than a 0.5° difference, the application has the ability to connect and track 3 IMU devices simultaneously. The data can be stored and exported. The greatest limitation is angular presentation latency. This creation has the potential to catalyze creation of an app that can track a high number of devices simultaneously, with high accuracy and low signal latency. The ability to track and position wearable IMU sensors using a smartphone or tablet offers an exciting future in rehabilitation, especially for recovering stroke patients.
Novel Bio-Synthetic Graft for Tracheal Reconstruction in Pediatric Patients With Congenital Tracheal Stenosis: In Vitro Studies of Axial, and Bending Biomechanics
Authors: Karkhanis Teja , Zafar Farhan , Juarez Brian , Morales David Luis-Simon , Haridas Balakrishna
Published: July 2019

Congenital Tracheal Stenosis (CTS) is a rare birth defect requiring surgical interventions when it affects more than 30% of the trachea. Slide tracheoplasty, the current standard of care, is associated with reinterventions including the need for intraluminal stenting leading to increased airway infections. We propose a novel Bio-Synthetic Graft for long segment tracheal reconstructions in CTS patients. Preliminary bench performance testing, using lamb tracheas, shows that the Bio-Synthetic Graft reconstructed tracheas have comparable radial, axial and bending stiffness in hyperextension to healthy tracheas and resist collapse when subjected to bending in flexion. These results suggest that Bio-Synthetic Graft could be a promising alternative to existing solutions for long segment CTS.
Design of the Playskin Air™: A User-Controlled, Soft Pneumatic Exoskeleton
Authors: Li Bai , Greenspan Ben , Mascitelli Thomas , Raccuglia Michael , Denner Kayleigh , Duda Raymond , Lobo Michele A.
Published: July 2019

Many children have an upper extremity disability leaving them unable to explore the environment around them. Hard exoskeletons can provide support to lift a child’s arms up against gravity, but these devices are generally large and obtrusive leading to low adherence. Children often prefer to have limited arm function rather than wearing such a device. Our lab has previously designed a passive soft exoskeleton to lift children’s arms, but this did not allow for user control and was limited in the length and weight of arm it could support. Building off of this research, we have created the preliminary design for a user-controlled pneumatic soft exoskeleton that may allow users to independently raise and lower their arms.
Survey As a Contextual Design Method Applied to Breastfeeding Wearables for Mothers Caring for Infants in NICUs
Authors: Clarke-Sather Abigail R. , Naylor Lindsay
Published: July 2019

Preterm and critically ill infants are treated in neonatal intensive care units (NICUs), where human milk is increasingly recommended and prescribed to this population as a medical intervention [1]. However, due to the medical acuity and complex character of caring for preterm infants, sometimes feeding at the breast is not possible. When feeding at the breast is not possible medical devices or commercial products may influence a mothers’ decision to express human milk for her NICU infant. Feeding human milk to infants cared for in NICUs reduces rates of mortality by decreasing instances of necrotizing enterocolitis (NEC) especially for extremely low birthweight infants [2] and is implicated in reducing incidence and severity of retinopathy of prematurity [3].
A New Device Preventing Air Embolism During the Angiography, Air Trap Device: An In-Vitro Experimental Air Emboli Study
Authors: Un Haluk
Published: July 2019

Air embolism occurs when an air bubble enters the arterial system through the catheters. This can happen due to different reasons such as lack of attention, connection failure, or inexperience. This situation results in tissue damage in vital organs such as the heart and brain which may lead to death. To our knowledge, there is no technology preventing an air embolus from happening. Doctors try to prevent this complication with their attention and catheter control. In this project, a new air-trap device that prevents air embolus was tested in-vitro in air embolism model. Experimental results with a prototype showed that the new design was successful. Air embolism was blocked at various pressure-speed ranges. Air Trap device can be used to prevent air embolism by cardiologists, interventional radiologists and cardiovascular surgeons that perform a percutaneous intervention.
A Simple Manual Roller Wheel Insertion Tool for Electrode Array Insertion in Minimally Invasive Cochlear Implant Surgery
Authors: Narasimhan Narendran , Riojas Katherine E. , Bruns Trevor L. , Mitchell Jason E. , Webster Robert J. , Labadie Robert F.
Published: July 2019

Image-guided, minimally-invasive cochlear implant surgery is a novel “keyhole” surgical approach for placing a cochlear implant electrode array eliminating the need for a wide-field mastoidectomy approach. Image guidance is used for path planning which is followed by the construction of a customized micro-stereotactic frame to drill a narrow channel from the skull surface to the cochlea. Herein, we present an insertion tool that uses roller wheels to advance the electrode array through the narrow tunnel and into the cochlea. Testing in a phantom revealed that when compared to insertions with surgical forceps, the new insertion tool was on average 26s faster, produced complete insertions more often (i.e. in 6/6 trials, vs. 1/6), and reduced array buckling (0/6 trials vs. 5/6). The tool provides a viable solution to complete the last step of this novel, minimally-invasive procedure. It also provides the advantage over previously developed manual insertion tools of enabling the surgeon to blindly actuate the roller wheel tool to advance the electrode into the tunnel. This allows the surgeon to visualize and guide insertion into the cochlea from a more advantageous visual perspective.
Measurement and Comparision of Multi-Electrode Placement for Bioelectrical Impedance Analysis
Authors: West Daniel , Choi JungHun
Published: July 2019

The purpose of this examination was to determine a) how bioimpedance scanning generates data about the human body and b) compare the Bodystat Multiscan 5000 and the Skulpt Chisel. The Bodystat Multiscan 5000 is bioelectrical impedance spectroscopy (BIS) device that performs a scan of 50 measurements, from 5 kHz to 1000 kHz. This scan generates a 2d Cole analysis plot that compares the resistance and reactance of the scanned muscle group. Higher frequencies measure the amount of intracellular fluid (ICF), and lower frequencies measure the amount of extracellular fluid (ECF). Lower values for the resistance and reactance relate to a greater level of fitness for the scanned area. The Skulpt Chisel is an electrical impedance myography (EIM) that performs a single 50 kHz measurement. This scan determines the muscle quality and percent body fat of the scanned muscle group. The test subject was scanned with each device. Each plane was scanned three times with the Bodystat Multiscan 5000, and scanned five times with the Skulpt Chisel. The data was recorded to Excel and analyzed using MATLAB. The Bodystat Multiscan measurements for the surfaces were examined at a frequency of 50 kHz to be comparable to the Skulpt Chisel data. The surfaces are recorded in descending order of magnitude for resistance: medial, 22.14 Ω; anterior, 20.31 Ω; posterior, 17.89 Ω; lateral, 12.6 Ω. The Cole Analysis for the right thigh at 45-degree intervals are recorded in descending order of magnitude for resistance: medial/posterior, 23.89 Ω; posterior/lateral, 23.06 Ω; anterior/medial, 21.09 Ω; lateral/anterior, 16.13 Ω. The Skulpt Chisel surfaces are recorded in an increasing order of magnitude, the first value being muscle quality and the second value being percent body fat: lateral, 81.12, 13.1%; posterior, 62.22, 16.46%; anterior, 50.88, 19.24%; medial, 42.16, 23.16%. The data display an inverse relationship between resistance/reactance and muscle quality, and a direct relationship between resistance/reactance and percent body fat. The larger the magnitude of the resistance/reactance recorded for a muscle group, the lower the level of muscle quality will be. This leads to a larger percent body fat value.
Insertion Force of Polydopamine-Coated Needle on Phantom Tissues
Authors: Patel Kavi I. , Gidde Sai T. R. , Li Haoqi , Podder Tarun , Ren Fei , Hutapea Parsaoran
Published: July 2019

Surgical needles are commonly used by medical specialists to reach target locations inside of the body for disease diagnosis or other medical interventions, such as biopsy, brachytherapy, thermal ablation, and drug delivery. Insertion of the needle in human body parts with a larger needle often results in severe tissue damage. Tissue damage could potentially be reduced by decreasing the insertion force caused mainly by the friction on the interface of needle and tissues. Here we propose the use of polydopamine (PDA) coating to reduce the friction force. In addition to its excellent biocompatibility, polydopamine has desirable adhesion, lubrication, biodegradability and, thermal stability properties. Our preliminary results on some needle prototypes show that by coating the needle with polydopamine, the insertion force can be reduced by 20–25%.
Design and Development of an Adaptive Bone Fracture Fixation System
Authors: Herbert Christopher , Sivarasu Sudesh
Published: July 2019

The study aims to design and develop an Adaptive Bone Fracture Fixation System for the purpose of enhancing the control over fracture fixation as well as to permit quick device installation. The external ring fixator was designed to employ the use of bolted-nut hinges and rapid-gradual lengthening longitudinal elements to allow for full assembly expansion and progressive or immediate shape adjustment. The ring fixator was stress tested via direct loading (compression and tension) to determine if it can support the average human body weight [max 3.5 kN]. The study had verified that the device possesses intricate designs that would enhance the functionality of the external ring fixator, however these designs would limit the structural integrity of the bone fracture fixation system.
Presurgical Planning for L Dorsi Position Optimization: Combined Simulation and Cadaver Study
Authors: Thompson Seth , Roche Stephen , Henderson Dan , Sivarasu Sudesh
Published: July 2019

A study to determine the optimal insertion point of the latissimus dorsi muscle for treatment of rotator cuff tears using in-silico biomechanical models. A cadaver trial was used to validate the simulation results. The optimal area for insertion for improving glenohumeral rotation throughout a range of flexion was found to be the center of the greater tuberosity.
A Deep Learning Approach for the Automatic Identification of the Left Atrium Within CT Scans
Authors: Deakyne Alex , Gaasedelen Erik , Iaizzo Paul A.
Published: July 2019

Recent advancements in deep learning have led to the possibility of increased performance in computer vision tools. A major development has been the usage of Convolutional Neural Networks (CNN) for automatically detecting features within a given image. Architectures such as YOLO1 have obtained incredibly high performances for the real-time detection of every-day objects within images. However to date, there have been few reports of deep learning applied to detect anatomical features within CT scans; especially those within the cardiovascular space. We propose here an automatic anatomical feature detection pipeline for identifying the features of the left atrium using a CNN. Slices of CT scans were fed into a single neural network which predicted the four bounding box coordinates that encapsulate the left atrium. The network can be optimized end-to-end and generate predictions at great speed, achieving a validation smooth L1 loss of 11.95 when predicting the left atrial bounding boxes.
Design Tradeoffs in the Development of a Wearable Soft Exoskeleton for Upper Limb Mobility Disorders
Authors: Foo Esther , Woelfle Heidi , Holschuh Brad
Published: July 2019

This paper investigates the tradeoffs between design variables important for the development of a mobility support soft exoskeleton for horizontal shoulder adduction. The soft exoskeleton utilizes discreet shape memory alloy (SMA) spring actuators to generate the required torque to move the arm segment, while preserving the qualities of a soft, wearable garment solution. A pilot benchtop test involving varying power input, actuator anchor position, actuator orientation, and added weight, was investigated to evaluate their effects against the degree of motion the soft exoskeleton allows. The results show that the power input, actuator anchor position, and simulated limb weight each affect the ultimate horizontal adduction angle the exoskeleton is able to induce. Further, the project highlights a crucial point in regard to the tradeoffs between functionality and wearability: when actuator orientation was investigated, we found a decrement in functionality (as measured by maximum achievable horizontal adduction angle) when the actuators were constrained close to the body. This shows that when aiming to improve the hypothetical system’s wearability/usability, the effective torque that can be generated is reduced. Together these findings demonstrate important design considerations while developing a wearable, soft exoskeleton system that is capable of effectively supporting movement of the body while maintaining the comfort and discreetness of a regular garment.
Functional and numerical responses of Neoseiulus californicus (McGregor) to eggs and nymphs of Oulenziella bakeri and Tetranychus urticae
Authors: Zhu Rui , Guo Jian-Jun , Yi Tian-Ci , Xiao Rong , Jin Dao-Chao
Published: July 2019

The predatory mite, Neoseiulus californicus (McGregor), is an important biological control agent of Tetranychus urticae Koch in greenhouse crops. Oulenziella bakeri is an important alternative prey for the commercial production of N. californicus. To confirm that the predatory relationship between N. californicus and O. bakeri is beneficial to the reproduction of N. californicus, the functional and numerical responses of N. californicus to O. bakeri and T. urticae were compared when exposed to six prey densities (2, 4, 8, 16, 32 and 64 individuals) under laboratory conditions. An analysis of the logistic regression showed that the adult female N. californicus displayed a type II functional response when fed on O. bakeri and T. urticae eggs and nymphs. The proportion of the consumed prey by N. californicus to the total supplied prey declined, even though the absolute number of predation events increased as the prey density increased. The Holling disc equation revealed that N. californicus had greater attack rates on the eggs (0.86-1.03) and nymphs (0.73-0.93) of T. urticae than those of O. bakeri, which were (0.55–0.73) and (0.71–0.96), respectively. N. californicus had longer handling times for the eggs (0.05–0.09) and nymphs (0.07–0.12) of O. bakeri compared with those of T. urticae, which were (0.03–0.05) and (0.04–0.07), respectively. The numbers of eggs laid by N. californicus feeding on eggs and nymphs of T. urticae were greater than those feeding on O. bakeri; but as the density increased, the difference in the oviposition rates between the predators feeding on two mites decreased. The comparison of the functional and numerical responses of the predator to O. bakeri and T. urticae revealed that the former is a good alternative food in the commercial production of N. californicus.
Empty peptide-receptive MHC class I molecules for efficient detection of antigen-specific T cells
Authors: Saini Sunil Kumar , Tamhane Tripti , Anjanappa Raghavendra , Saikia Ankur , Ramskov Sofie , Donia Marco , Svane Inge Marie , Jakobsen Søren Nyboe , Garcia-Alai Maria , Zacharias Martin , Meijers Rob , Springer Sebastian , Hadrup Sine Reker
Published: July 2019

Disulfide-stabilized MHC class I are empty peptide-receptive molecules that rapidly load peptide and improve T cell detection. See the related Research Article by

Moritz
et al
.

in this issue.
Ambient pH Alters the Protein Content of Outer Membrane Vesicles, Driving Host Development in a Beneficial Symbiosis
Authors: Lynch Jonathan B. , Schwartzman Julia A. , Bennett Brittany D. , McAnulty Sarah J. , Knop Mirjam , Nyholm Spencer V. , Ruby Edward G.
Published: July 2019

Beneficial bacteria communicate with their hosts through a variety of means. These communications are often carried out by a combination of molecules that stimulate responses from the host and are necessary for development of the relationship between these organisms. Naturally produced bacterial outer membrane vesicles (OMVs) contain many of those molecules and can stimulate a wide range of responses from recipient organisms. Here, we describe how a marine bacterium,
Vibrio fischeri
, changes the makeup of its OMVs under conditions that it experiences as it goes from its free-living lifestyle to associating with its natural host, the Hawaiian bobtail squid. This work improves our understanding of how bacteria change their signaling profile as they begin to associate with their beneficial partner animals.
Recovery of Gram-Negative Bacteria from Aerobic Blood Culture Bottles Containing Antibiotic Binding Resins after Exposure to β-Lactam and Fluoroquinolone Concentrations
Authors: Chen Iris H. , Nicolau David P. , Kuti Joseph L.
Published: July 2019

Blood culture bottles containing antibiotic binding resins are routinely used to minimize artificial sterilization in the presence of antibiotics. However, the resin binding kinetics can differ between antibiotics and concentrations.
Characterising innovations in maternal and newborn health based on a common theory of change: lessons from developing and applying a characterisation framework in Nigeria, Ethiopia and India
Authors: Makowiecka Krystyna , Marchant Tanya , Betemariam Wuleta , Chaturvedi Anuraag , Jana Laboni , Liman Audu , Mathewos Bereket , Muhammad Fatima B , Semrau Katherine , Wunnava Sita Shankar , Sibley Lynn M , Berhanu Della , Gautham Meenakshi , Umar Nasir , Spicer Neil , Schellenberg Joanna
Published: July 2019

Government leadership is key to enhancing maternal and newborn survival. In low/middle-income countries, donor support is extensive and multiple actors add complexity. For policymakers and others interested in harmonising diverse maternal and newborn health efforts, a coherent description of project components and their intended outcomes, based on a common theory of change, can be a valuable tool. We outline an approach to developing such a tool to describe the work and the intended effect of a portfolio of nine large-scale maternal and newborn health projects in north-east Nigeria, Ethiopia and Uttar Pradesh in India. Teams from these projects developed a framework, the ‘characterisation framework’, based on a common theory of change. They used this framework to describe their innovations and their intended outcomes. Individual project characterisations were then collated in each geography, to identify what innovations were implemented where, when and at what scale, as well as the expected health benefit of the joint efforts of all projects. Our study had some limitations. It would have been enhanced by a more detailed description and analysis of context and, by framing our work in terms of discrete innovations, we may have missed some synergistic aspects of the combination of those innovations. Our approach can be valuable for building a programme according to a commonly agreed theory of change, as well as for researchers examining the effectiveness of the combined work of a range of actors. The exercise enables policymakers and funders, both within and between countries, to enhance coordination of efforts and to inform decision-making about what to fund, when and where.
Effect of frailty on quality of life in elderly patients after hip fracture: a longitudinal study
Authors: van de Ree Cornelis L P , Landers Maud J F , Kruithof Nena , de Munter Leonie , Slaets Joris P J , Gosens Taco , de Jongh Mariska A C
Published: July 2019

Objectives

The aims of this study were to examine the pattern of changes over time in health status (HS) and quality of life (QoL) in the first year after hip fracture and to quantify the association between frailty at the onset of hip fracture and the change in HS and QoL 1 year later. The major hypothesis was that frailty, a clinical state of increased vulnerability, is a good predictor of QoL in patients recovering from hip fracture.

Design

Prospective, observational, follow-up cohort study.

Setting

Secondary care. Ten participating centres in Brabant, the Netherlands.

Participants

1091 patients entered the study and 696 patients completed the study. Patients with a hip fracture aged 65 years and older or proxy respondents for patients with cognitive impairment were included in this study.

Main outcome measures

The primary outcomes were HS (EuroQol-5 Dimensions questionnaire) and capability well-being (ICEpop CAPability measure for Older people). Prefracture frailty was defined with the Groningen Frailty Indicator (GFI), with GFI ≥4 indicating frailty. Participants were followed up at 1 month, 3 months, 6 months and 1 year after hospital admission.

Results

In total, 371 patients (53.3%) were considered frail. Frailty was negatively associated with HS (β −0.333; 95% CI −0.366 to −0.299), self-rated health (β −21.9; 95% CI −24.2 to −19.6) and capability well-being (β −0.296; 95% CI −0.322 to −0.270) in elderly patients 1 year after hip fracture. After adjusting for confounders, including death, prefracture HS, age, prefracture residential status, prefracture mobility, American Society of Anesthesiologists grading and dementia, associations were weakened but remained significant.

Conclusions

We revealed that frailty is negatively associated with QoL 1 year after hip fracture, even after adjusting for confounders. This finding suggests that early identification of prefracture frailty in patients with a hip fracture is important for prognostic counselling, care planning and the tailoring of treatment.

Trial registration number

NCT02508675
Regional variation of avoidable hospitalisations in a universal health care system: a register-based cohort study from Finland 1996−2013
Authors: Manderbacka Kristiina , Arffman Martti , Satokangas Markku , Keskimäki Ilmo
Published: July 2019

Objectives

A persistent finding in research concerning healthcare and hospital use in Western countries has been regional variation in the medical practices. The aim of the current study was to examine trends in the regional variation of avoidable hospitalisations, that is, hospitalisations due to conditions treatable in ambulatory care in Finland in 1996–2013 and the influence of different healthcare levels on them.

Setting

Use of hospital inpatient care in 1996–2013 among the total population in Finland.

Participants

Altogether 1 931 012 hospital inpatient care episodes among all persons residing in Finland identified from administrative registers in Finland in 1996−2013 and alive in 1 January 1996.

Outcome measures

We examined hospitalisations due to avoidable causes including vaccine-preventable hospitalisations, hospitalisations due to complications of chronic conditions and acute conditions treatable in ambulatory care. We calculated annual age-adjusted rates per 10 000 person-years. Multilevel models were used for studying time trends in regional variation.

Results

There was a steep decline in avoidable hospitalisation rates during the study period. The decline occurred almost exclusively in hospitalisations due to chronic conditions, which diminished by about 60%. The overall correlation between hospital district intercepts and slopes in time was −0.46 (p<0.05) among men and −0.20 (ns) among women. Statistically highly significant diminishing variation was found in hospitalisations due to chronic conditions among both men (−0.90) and women (−0.91). The variation was mainly distributed to the hospital district level.

Conclusions

The results suggest that chronic conditions are managed better in primary care in the whole country than before. Further research is needed on whether this is the case or whether this has more to do with supply of hospital care.
Children’s unmet palliative care needs: a scoping review of parents’ perspectives
Authors: Constantinou Georgina , Garcia Rebecca , Cook Erica , Randhawa Gurch
Published: July 2019

Background

Children with life-limiting conditions often have complex needs, making it challenging for services to provide satisfactory care. Few studies consider whether services actually meet families’ needs by exploring and identifying the parents’ perspectives of unmet needs.

Aim

To identify what published evidence is available on the unmet needs of children with life-limiting conditions and their families, from the perspective of parents, internationally.

Eligibility criteria

Inclusion criteria: papers from the perspective of parents of children aged 0–19 years, who have a life-limiting condition and are receiving palliative care.Exclusion criteria: those papers not written in English, not reporting primary research and discussing children who died from stillbirth, accidental or unexpected circumstance.

Charting methods

A scoping review was conducted in accordance with the methods of Arksey and O’Malley.

Sources of evidence

The electronic databases PubMed, MEDLINE, CINAHL and PsycINFO were searched. Key terms included: parent, needs, met/unmet/satisfaction, palliative/supportive/end of life care, life-limiting/life-threatening illness, infants/children/young people.

Results

Total hit indicated 5975 papers for screening. Fifty-five papers met the scoping review criteria. The majority used mixed-methods approaches inclusive of: questionnaires, self-report measures, in-depth interviews, focus groups, case record analysis and art-based workshops. Unmet needs included: respite care, coordination and organisation of care, psychological support and professional communication skills.

Conclusions

The findings suggest many unmet needs from the parent’s perspective, across several aspects of the Quality Standards and Children’s Palliative Care Frameworks. Further research is needed which explores the parent’s unmet needs in palliative care services.
Research progress and debates on gaming disorder
Authors: Wang Qianjin , Ren Honghong , Long Jiang , Liu Yueheng , Liu Tieqiao
Published: July 2019

Gaming disorder has become a significant issue in mental healthcare. While gaming is an important form of entertainment, excessive gaming may cause serious consequences for players. At present, there are still controversies in the academic community concerning the public health problems related to gaming disorder. This article attempts to expound the definition, epidemiology, aetiology, diagnosis, treatment and prevention of gaming disorder, in order to contribute to future conceptualization of gaming disorder.
Single production of composite electrons at future SPPC-based lepton–hadron colliders
Authors: Caliskan A.
Published: July 2019

We consider the production of excited electrons with spin-1/2 at future SPPC-based electron–proton colliders with center-of-mass energies of 8.4, 11.6, 26.6, and 36.8 TeV. These exotic particles are predicted in the composite models. We calculate the production cross sections and concentrate on the photon decay channel of the excited electrons with the process of ep → e∗X → eγX. The pseudo rapidity and transverse momentum distributions of the electrons and photons in the final state have been plotted to determine the kinematical cutoffs best suited for discovery of the excited electrons. By applying these cutoffs we compute 2σ, 3σ, and 5σ contour plots of the statistical significance of the expected signal in the parameter space (L, m∗), where L denotes the integrated luminosity of the collider and m∗ is the mass of the composite electrons.
Principal subspaces of twisted modules for certain lattice vertex operator algebras
Authors: Penn Michael , Sadowski Christopher , Webb Gautam
Published: July 2019

This is the third in a series of papers studying the vertex-algebraic structure of principal subspaces of twisted modules for lattice vertex operator algebras. We focus primarily on lattices [Formula: see text] whose Gram matrix contains only non-negative entries. We develop further ideas originally presented by Calinescu, Lepowsky, and Milas to find presentations (generators and relations) of the principal subspace of a certain natural twisted module for the vertex operator algebra [Formula: see text]. We then use these presentations to construct exact sequences involving this principal subspace, which give a set of recursions satisfied by the multigraded dimension of the principal subspace and allow us to find the multigraded dimension of the principal subspace.
Rectify the effect of measurement in survival probability of the ground vibrational state in diatomic molecule
Authors: Nath Bikram , Rahaman Sariful , Mondal Chandan Kumar
Published: July 2019

We have proposed a methodology that uses secondary electromagnetic field to overcome the effect of measurement on quantum dynamics. Our aim is also to find out some characteristics of the used secondary (recovery) field. We have applied the methodology to reduce the quantum Zeno effect (ZE), a consequence of repeated measurements in survival probability of ground vibrational state. As the model systems, we choose HBr[Formula: see text] and HI. The study is done with variation in frequency, pulse shape and other parameters of the secondary field. In all cases, suitable secondary field for which the Zeno effect is minimum is found near 0 [Formula: see text] 1 vibrational transition frequency. Suitable time gap between the measurement and the application of secondary field depends on the shape of the secondary field. When the secondary field is optimized, the recovery is more than 90% which almost nullify the Zeno effect.
Algorithm 995
Authors: Pardue Juliette , Chernikov Andrey
Published: July 2019

A bottom-up approach to parallel anisotropic mesh generation is presented by building a mesh generator starting from the basic operations of vertex insertion and Delaunay triangles. Applications focusing on high-lift design or dynamic stall, or numerical methods and modeling test cases, still focus on two-dimensional domains. This automated parallel mesh generation approach can generate high-fidelity unstructured meshes with anisotropic boundary layers for use in the computational fluid dynamics field. The anisotropy requirement adds a level of complexity to a parallel meshing algorithm by making computation depend on the local alignment of elements, which in turn is dictated by geometric boundaries and the density functions— one-dimensional spacing functions generated from an exponential distribution. This approach yields computational savings in mesh generation and flow solution through well-shaped anisotropic triangles instead of isotropic triangles. The validity of the meshes is shown through solution characteristic comparisons to verified reference solutions. A 79% parallel weak scaling efficiency on 1,024 distributed memory nodes, and a 72% parallel efficiency over the fastest sequential isotropic mesh generator on 512 distributed memory nodes, is shown through numerical experiments.
Ambiguity as a Resource to Inform Proto-Practices
Authors: Sanches Pedro , Höök Kristina , Sas Corina , Ståhl Anna
Published: July 2019

Skin conductance is an interesting measure of arousal level, largely unfamiliar to most end-users. We designed a mobile application mirroring end-users’ skin conductance in evocative visualizations, purposefully made ambiguous to invite rich interpretations. Twenty-three participants used the system for a month. Through the lens of a practice-based analysis of weekly interviews and the logged data, several quite different—sometimes even mutually exclusive—interpretations or
proto-practices
arose: as stress management; sports performance; emotion tracking; general life logging; personality representation; or behavior change practices. This suggests the value of a purposefully open initial design to allow for the emergence of broader proto-practices to be followed by a second step of tailored design for each identified goal to facilitate the transition from proto-practice to practice. We contribute to the HCI discourse on ambiguity in design, arguing for balancing openness and ambiguity with scaffolding to better support the emergence of practices around biodata.
Concurrent Think-Aloud Verbalizations and Usability Problems
Authors: Fan Mingming , Lin Jinglan , Chung Christina , Truong Khai N.
Published: July 2019

The concurrent think-aloud protocol—in which participants verbalize their thoughts when performing tasks—is a widely employed approach in usability testing. Despite its value, analyzing think-aloud sessions can be onerous because it often entails assessing all of a user's verbalizations. This has motivated previous research on developing
categories
to segment verbalizations into manageable units of analysis. However, the way in which a category might relate to usability problems is currently unclear. In this research, we sought to address this gap in our understanding. We also studied how
speech features
might relate to usability problems. Through two studies, this research demonstrates that certain patterns of verbalizations are more telling of usability problems than others and that these patterns are robust to different types of test products (i.e., physical devices and digital systems), access to different types of information (i.e., video and audio modality), and the presence or absence of a visualization of verbalizations. The implication is that the verbalization and speech patterns can potentially reduce the time and effort required for analysis by enabling evaluators to focus more on the important aspects of a user's verbalizations. The patterns could also potentially be used to inform the design of systems to automatically detect when in the recorded think-aloud sessions users experience problems.