bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Three Alternative Bicycle Infrastructure Quality-of-Service Metrics
Authors: Parks Jamie , Tanaka Alison , Ryus Paul , Monsere Christopher M. , McNeil Nathan , Goodno Mike
Published: February 2014

Cities throughout the United States are increasingly interested in the design of bicycle facilities to attract new riders and improve the comfort of existing riders. In particular, transportation agencies increasingly use treatments such as cycle tracks, buffered bike lanes, and colored pavement to supplement or replace traditional facilities (e.g., bike lanes). To respond to this trend, transportation professionals require evaluation metrics that effectively assess design options and provide decision-support in the choice of bicycle facilities that best match local context. Recent research has produced several bicycle evaluation tools [e.g., bicycle level of service (BLOS)] that attempt to fill this need. This paper presents the results of a comprehensive, real-world comparison of three leading bicycle evaluation tools: Highway Capacity Manual 2010 (HCM) BLOS, Danish Road Directorate BLOS, and the San Francisco, California, Bicycle Environmental Quality Index. Each evaluation tool was applied to a before–after evaluation of two bicycle facility installations in Washington, D.C. The tools were assessed with a consistent set of evaluation criteria, which included data and time requirements, sensitivity to key inputs, intuitiveness of the results, and soundness of the tool's theoretical basis. Intercept surveys of facility users were used to compare the tool outputs with actual user preferences. The results suggest several shortcomings in the HCM BLOS methodology that make it unsuited for assessing bicycle design options that include cycle tracks and other emerging bicycle facility types. Additional research is needed to develop a nationally accepted bicycle evaluation tool to reflect the growing variety of bicycle facilities in the United States.
Development of Surface Roughness Standards for Pathways Used by Wheelchairs
Authors: Duvall Jonathan , Cooper Rory , Sinagra Eric , Stuckey Dianna , Brown Joshua , Pearlman Jonathan
Published: February 2014

More than 2 million people in the United States use a wheelchair for mobility. These Americans not only rely on their assistive technology to complete simple, daily tasks, but they also depend on functional and accessible sidewalks to do so. Although the Americans with Disabilities Act Accessibility Guidelines established by the Access Board provide suggestions for pathways, they are subjective and not measurable. This ambiguity results in public pathways with many bumps and cracks, which can lead to harmful whole body vibrations (WBVs) for wheelchair users. WBVs with a root mean squared (RMS) value greater than 1.6 m/s2 for more than a 1-h period may result in back and neck pain or muscle fatigue. For the development of a standard for surface roughness, subjective and objective information needs to be gathered and analyzed. Sixty-one subjects were recruited to travel over nine simulated wooden surfaces with varying roughnesses that were modeled after outdoor surfaces. A subset of the subjects also traveled over six outdoor surfaces. With the use of their own chairs, subjects traveled over each surface while accelerometers recorded vibrations at the seat, footrest, and backrest. After they traveled over each surface, subjects were asked to fill out a short questionnaire on the acceptability of each surface. The vibrations were converted to RMS accelerations. Both RMS accelerations and subject surface ratings were compared with surface roughness. As surface roughness increased, RMS accelerations increased, and subject surface ratings decreased. Some surfaces generated RMS accelerations above the 1.6 m/s2 threshold; this result suggested that some sidewalks caused harmful vibrations to wheelchair users.
Relationship between Rider Trajectory and Injury Outcome in Motorcycle-to-Barrier Crashes
Authors: Daniello Allison , Cristino Danielle , Gabler Hampton C.
Published: February 2014

In collisions with traffic barriers, motorcyclists have a much higher risk of fatality than other road users. Many databases focus on the vehicle when reporting the sequence of events; however, in motorcycle collisions, the vehicle and rider often separate and follow different trajectories. The aim of this study was to determine how rider trajectory influences injury outcome. Rider trajectories in barrier collisions were determined through an analysis of police accident reports from New Jersey (2007 to 2011). Seven trajectories were identified: upright, sliding, vaulting, ejected (same side landing), ejected (side unknown), ejected into barrier, and separated before barrier impact. Google Earth Street View was used to verify the barrier type in each collision. Of the 442 single-vehicle motorcycle-to-barrier collisions reported in New Jersey, police accident reports were analyzed for 430 crashes and the barriers were identified for 342 of these crashes (77.4% of all crashes). In the analyzed crashes, 361 riders and passengers were involved. In these crashes, riders most often struck the barrier upright without being ejected from the motorcycle. Barrier type and occurrence on an entrance or exit ramp were found to have a significant effect on the distribution of rider trajectory outcomes. Additionally, being ejected from the motorcycle after striking the barrier increased the odds of serious injury by 2.91 times (95% confidence interval: 1.31 to 6.46).
TreeVersity
Authors: Guerra-Gómez John Alexis , Buck-Coleman Audra , Pack Michael L. , Plaisant Catherine , Shneiderman Ben
Published: February 2014

Transportation data sets of all kinds are hierarchical in nature and therefore are easily represented in tree structures. Visually comparing the changes in these hierarchical data sets over time can be extremely difficult, even when the trees are relatively small. TreeVersity is a novel inter active visualization that allows users to detect and analyze changes in the structure and value of various components of the tree. TreeVersity uses dual comparison techniques (side by side and explicit differences) coupled with a tabular representation to help users understand and explore changes to the tree over time. TreeVersity uses carefully selected color palettes to show positive or negative absolute and relative value changes and glyphs that show these changes preattentively. A study illustrated the value of this visualization technique through various short case studies based on federal transportation budget data, airline maintenance budget data, and transportation publication data. Hypotheses for TreeVersity's future relevance for congestion trend analysis are provided.
Novel technique for preoperative pedicle localization in spinal surgery with challenging anatomy
Authors: Young Richard M. , Prasad Vikram , Wind Joshua J. , Olan Wayne , Caputy Anthony J.
Published: February 2014

Accurately localizing a spine level in the thoracic spine is often not easily achieved with the existing imaging modalities available in the operating room. The coordination of the preoperative imaging pathology with intraoperative imaging is even more difficult in patients with challenging anatomy. Using standard percutaneous techniques, the authors placed a radiopaque embolization coil into the pedicle of interest under biplanar fluoroscopy in 1 patient. Thoracic spine MRI along with scout MRI was then performed to confirm coil marker placement in relation to the actual spine pathology prior to surgical intervention. No complications were observed during placement of the radiopaque marker. Intraoperatively, the marker was immediately and easily visualized, leading to a confident identification of the correct thoracic spinal level. The preoperative placement of a radiopaque marker into the vertebral pedicle of the identified pathological level combined with postplacement MRI verification provides an advantage over previously proposed techniques in the literature.
Patient-specific thresholds of intracranial pressure in severe traumatic brain injury
Authors: Lazaridis Christos , DeSantis Stacia M. , Smielewski Peter , Menon David K. , Hutchinson Peter , Pickard John D. , Czosnyka Marek
Published: February 2014

Object

Based on continuous monitoring of the pressure reactivity index (PRx), the authors defined individualized intracranial pressure (ICP) thresholds by graphing the relationship between ICP and PRx. These investigators hypothesized that an “ICP dose” based on individually assessed ICP thresholds would correlate more closely with the 6-month outcome when compared with ICP doses derived by the recommended universal thresholds of 20 and 25 mm Hg.

Methods

This study was a retrospective analysis of prospectively collected data from 327 patients with severe traumatic brain injury.

Results

Individualized thresholds were visually identified from graphs of PRx versus ICP; PRx > 0.2 was the cutoff. Intracranial pressure doses were then computed as the cumulative area under the curve above the defined thresholds in graphing ICP versus time. The term “Dose 20” (D20) was used to refer to an ICP threshold of 20 mm Hg; the markers D25 and DPRx were calculated similarly. Separate logistic regression models were fit with death as the outcome and each dose as the predictor, both alone and adjusted for covariates. The discriminative ability of each dose for mortality was assessed by receiver operating characteristic AUC analysis in which 5-fold cross-validation was used. A clearly identifiable PRx-based threshold was possible in 224 patients (68%). The DPRx (AUC 0.81, 95% CI 0.74–0.87) was found to have the highest area under the curve (AUC) over both D20 (0.75, 95% CI 0.68–0.81) and D25 (0.77, 95% CI 0.70–0.83); in the cross-validation model, DPRx remained the best discriminator of mortality (DPRx: AUC 0.77 [95% CI 0.68–0.89]; D20: 0.72 [95% CI 0.66–0.81]; and D25: 0.65 [95% CI 0.56–0.73]).

Conclusions

The authors explored the importance of different ICP thresholds for outcome by calculating patient-specific ICP doses based on the continuous monitoring of cerebrovascular pressure reactivity. They found that these individualized doses of intracranial hypertension were stronger predictors of death than doses derived from the universal thresholds of 20 and 25 mm Hg. The PRx could offer a method that can be directed toward individualizing the ICP threshold.
Trigeminal neuralgia occurs and recurs in the absence of neurovascular compression
Authors: Lee Albert , McCartney Shirley , Burbidge Cole , Raslan Ahmed M. , Burchiel Kim J.
Published: February 2014

Object

Vascular compression of the trigeminal nerve is the most common factor associated with the etiology of trigeminal neuralgia (TN). Microvascular decompression (MVD) has proven to be the most successful and durable surgical approach for this disorder. However, not all patients with TN manifest unequivocal neurovascular compression (NVC). Furthermore, over time patients with an initially successful MVD manifest a relentless rate of TN recurrence.

Methods

The authors performed a retrospective review of cases of TN Type 1 (TN1) or Type 2 (TN2) involving patients 18 years or older who underwent evaluation (and surgery when indicated) at Oregon Health & Science University between July 2006 and February 2013. Surgical and imaging findings were correlated.

Results

The review identified a total of 257 patients with TN (219 with TN1 and 38 with TN2) who underwent high-resolution MRI and MR angiography with 3D reconstruction of combined images using OsiriX. Imaging data revealed that the occurrence of TN1 and TN2 without NVC was 28.8% and 18.4%, respectively. A subgroup of 184 patients underwent surgical exploration. Imaging findings were highly correlated with surgical findings, with a sensitivity of 96% for TN1 and TN2 and a specificity of 90% for TN1 and 66% for TN2.

Conclusions

Magnetic resonance imaging detects NVC with a high degree of sensitivity. However, despite a diagnosis of TN1 or TN2, a significant number of patients have no NVC. Trigeminal neuralgia clearly occurs and recurs in the absence of NVC.
Predictors of outcome in civilian gunshot wounds to the head
Authors: Aarabi Bizhan , Tofighi Babak , Kufera Joseph A. , Hadley Jeffrey , Ahn Edward S. , Cooper Carnell , Malik Jacek M. , Naff Neal J. , Chang Louis , Radley Michael , Kheder Ashker , Uscinski Ronald H.
Published: February 2014

Object

Civilian gunshot wounds to the head (GSWH) are often deadly, but some patients with open cranial wounds need medical and surgical management and are potentially good candidates for acceptable functional recovery. The authors analyzed predictors of favorable clinical outcome (Glasgow Outcome Scale scores of 4 and 5) after GSWH over a 24-month period.

Methods

The authors posited 2 questions: First, what percentage of civilians with GSWH died in the state of Maryland in a given period of time? Second, what were the predictors of favorable outcome after GSWH? The authors examined demographic, clinical, imaging, and acute care data for 786 civilians who sustained GSWH. Univariate and logistic regression analyses were used to analyze the data.

Results

Of the 786 patients in this series, 712 (91%) died and 74 (9%) completed acute care in 9 trauma centers. Of the 69 patients admitted to one Maryland center, 46 (67%) eventually died. In 48 patients who were resuscitated, the Injury Severity Score was 26.2, Glasgow Coma Scale (GCS) score was 7.8, and an abnormal pupillary response (APR) to light was present in 41% of patients. Computed tomography indicated midline shift in 17%, obliteration of basal cisterns in 41.3%, intracranial hematomas in 34.8%, and intraventricular hemorrhage in 49% of cases. When analyzed for trajectory, 57.5% of bullet slugs crossed midcoronal, midsagittal, or both planes. Two subsets of admissions were studied: 27 patients (65%) who had poor outcome (25 patients who died and 2 who had severe disability) and 15 patients (35%) who had a favorable outcome when followed for a mean period of 40.6 months. Six patients were lost to follow-up.

Univariate analysis indicated that admission GCS score (p < 0.001), missile trajectory (p < 0.001), surgery (p < 0.001), APR to light (p = 0.002), patency of basal cisterns (p = 0.01), age (p = 0.01), and intraventricular bleed (p = 0.03) had a significant relationship to outcome. Multivariable logistic regression analysis indicated that GCS score and patency of the basal cistern were significant determinants of outcome. Exclusion of GCS score from the regression models indicated missile trajectory and APR to light were significant in determining outcome.

Conclusions

Admission GCS score, trajectory of the missile track, APR to light, and patency of basal cisterns were significant determinants of outcome in civilian GSWH.
Limitations in the Classification of Childhood-onset Rheumatoid Arthritis
Authors: Ferrell Emily G. , Ponder Lori A. , Minor Lauren S. , Angeles-Han Sheila T. , Kennedy Christine W. , Rouster-Stevens Kelly A. , Rohani-Pichavant Mina , Vogler Larry B. , Prahalad Sampath
Published: February 2014

Objective.

Rheumatoid factor-positive polyarthritis (RF+ poly) is the juvenile idiopathic arthritis (JIA) category that resembles adult seropositive rheumatoid arthritis (RA). We studied children with RF+ and/or anticyclic citrullinated peptide antibody (anti-CCP)+ JIA to determine what proportion of those children meet International League of Associations for Rheumatology (ILAR) criteria for RF+ poly JIA and to assess for significant differences between children who meet RF+ poly criteria and those who are classified in other categories.

Methods.

Charts of children with JIA who were RF+ and/or anti-CCP+ were reviewed. Children with RF+ poly JIA were compared to children in other categories. Statistical analysis was performed using chi-square, Fisher’s exact test, and the Student’s t-test.

Results.

Of 56 children with RF+ and/or anti-CCP+ JIA, 34 (61%) met ILAR criteria for RF+ poly JIA. Twelve children had RF–/anti-CCP+ JIA with low anti-CCP titers. When these 12 children were excluded, there were few significant differences between children who met criteria for RF+ poly and those who were classified in other categories. The American College of Rheumatology/European League Against Rheumatism criteria for RA identified more RF+ children than did the ILAR RF+ poly classification (100% vs 77%).

Conclusion.

A number of children with RF+ arthritis were excluded from the RF+ poly JIA classification, though many demographic features and disease measures were similar to those of children who met criteria for RF+ poly JIA. We propose prioritization of RF/anti-CCP positivity over specific exclusions, along with inclusion of anti-CCP, in future revisions of the JIA classification criteria, to improve the sensitivity of diagnosing childhood-onset RA.
De la désindustrialisation à la re-industrialisation.
Authors: Lambert Olivier
Published: February 2014

La zone d’activités de Peynier-Rousset s’affirme comme un pôle industriel prospère tourné vers la microélectronique et les nouvelles technologies. Créée en 1961, elle a pris un virage décisif avec l’arrivée de l’industrie des semi-conducteurs au début des années 1980. Son exemple est d’autant plus intéressant que cette zone se situe dans un espace économique – le bassin de Gardanne – marqué par la désindustrialisation et la disparition des activités minières. À partir de son étude, il nous est ainsi permis de nous interroger sur le processus de reconversion à l’œuvre au sein des territoires industriels en prise avec la désagrégation de leur tissu traditionnel.
Sedation and Its Association With Posttraumatic Stress Disorder After Intensive Care
Authors: Rock Loretta F.
Published: February 2014

Overuse of sedation in patients treated with mechanical ventilation can increase duration of ventilation, duration of delirium, and time to discharge. Although current principles of care include implementation of sedation protocols and/or daily interruptions in sedation to improve patients’ outcomes, these strategies remain underused. Historically, a barrier to use of protocols has been a perception that being awake and aware while intubated is intrinsically distressing and could cause psychological harm. Evidence of a link between lighter sedation and decreased signs and symptoms of posttraumatic stress disorder has partially dispelled these fears and even prompted the adoption of no-sedation (eg, analgosedation) strategies. Published studies on posttraumatic stress disorder and sedation are limited by small sample size, heterogeneous sedation practices, and inadequate follow-up. Despite limitations, current data suggest contemporary sedation practices to keep patients calm and comfortable but awake, as appropriate, are not associated with increased rates or severity of posttraumatic stress disorder.
The Importance of Tracheostomy Progression in the Intensive Care Unit
Authors: Morris Linda L. , McIntosh Erik , Whitmer Andrea
Published: February 2014

A plan to progress a tracheostomy toward decannulation should be initiated unless the tracheostomy has been placed for irreversible conditions. In most cases, tracheostomy progression can begin once a patient is free from ventilator dependence. Progression often begins with cuff deflation, which frequently results in the patient’s ability to phonate. A systematic approach to tracheostomy progression involves assessing (1) hemodynamic stability, (2) whether the patient has been free from ventilator support for at least 24 hours, (3) swallowing, cough strength, and aspiration risk, (4) management of secretions, and (5) toleration of cuff deflation, followed by (6) changing to a cuffless tube, (7) capping trials, (8) functional decannulation trials, (9) measuring cough strength, and (10) decannulation. Critical care nurses can facilitate the process and avoid unnecessary delays and complications.
Addition of Acute Care Nurse Practitioners to Medical and Surgical Rapid Response Teams: A Pilot Project
Authors: Kapu April N. , Wheeler Arthur P. , Lee Byron
Published: February 2014

Background

Vanderbilt University Hospital’s original rapid response team included a critical care charge nurse and a respiratory therapist. A frequently identified barrier to care was the time delay between arrival of the rapid response team and arrival of the primary health care team.

Objective

To assess the impact of adding an acute care nurse practitioner to the rapid response team.

Methods

Acute care nurse practitioners were added to surgical and medical rapid response teams in January 2011 to diagnose and order treatments on rapid response calls.

Results

In 2011, the new teams responded to 898 calls, averaging 31.8 minutes per call. The most frequent diagnoses were respiratory distress (18%), postoperative pain (13%), hypotension (12%), and tachyarrhythmia (10%). The teams facilitated 360 transfers to intensive care and provided 3056 diagnostic and therapeutic interventions. Communication with the primary team was documented on 97% of the calls. Opportunities for process improvement were identified on 18% of the calls. After implementation, charge nurses were surveyed, with 96% expressing high satisfaction associated with enhanced service and quality.

Conclusions

Teams led by nurse practitioners provide diagnostic expertise and treatment, facilitation of transfers, team communication, and education.
A structural model of job resources, organisational and individual strengths use and work engagement
Authors: Botha Cheri , Mostert Karina
Published: February 2014

Orientation: Organisations will not be able to maintain a competitive advantage by merely focusing on the development of their employees’ weaknesses. Employees should also be provided with sufficient job resources and opportunities to develop and use their strengths, as this could lead to work engagement.Research purpose: To test a structural model of job resources, perceived organisational support for strengths use, proactive behaviour towards strengths use and work engagement amongst South African employees.Motivation for the study: To gain more knowledge and a better understanding of the outcomes of following an organisational and individual strength-based approach focused on the use of strengths within the South African context.Research approach, design and method: A quantitative approach with cross-sectional research design was used. An availability sample (N = 401) of employees from various occupational groups in South Africa was used. Structural equation modelling was used to test the model.Main findings: The results indicated that perceived organisational support for strengths use and employees’ proactive behaviour towards strengths use were strongly and positively associated with work engagement in the structural model.Practical/managerial implications: Knowledge of using strengths from an organisational and individual perspective could assist organisations in gaining a better understanding of the relationship with work engagement.Contribution/value-add: This study adds to the limited research on using strengths from both an organisational and individual perspective and possible outcomes within the South African context.
Effect of incorporation of silane in the bonding agent on the repair potential of machinable esthetic blocks
Authors: Zaghloul Hanaa , Elkassas Dina Wafik , Haridy Mohamed Fouad
Published: February 2014

Objective: To investigate the repair potential of CAD/CAM (computer-aided design/computer-aided manufacturing) ceramic and composite blocks using a silane-containing bonding agent with different repair protocols. Materials and Methods: Twenty-four discs were constructed from CAD/CAM ceramic and composite blocks. The discs were divided into six groups according to surface pre-treatment employed; GI: Diamond stone roughening (SR), GII: SR+ silanization (SR+S), GIII: Hydrofluoric acid etching (HF), GIV: HF+ silanization (HF+S), GV: Silica coating (SC), GVI: SC+ silanization (SC+S). Silane-containing bonding agent (Single Bond Universal adhesive, 3M ESPE) was applied to the pre-treated discs. Prior to light curing, irises were cut from tygon tubes (internal diameter = 0.8 mm and height = 0.5 mm) and mounted on each treated surface. Nanofilled resin composite (Filtek Z350XT, 3M ESPE) was packed into the cylinder lumen and light-cured (n = 10). The specimens were subjected to microshear bond strength testing (μ-SBS) using universal testing machine. Failure modes of the fractured specimens were analyzed using field emission scanning electron microscope (FESEM). Eight representative discs were prepared to analyze the effect of surface treatments on surface topography using FESEM. μ-SBS results were analyzed using ANOVA and Tukeys post-hoc test. Results: Three-way ANOVA results showed that the materials, surface pre-treatment protocols, and silanization step had a statistically significant effect on the mean μ-SBS values at P ≤ 0.001. For ceramic discs, the groups were ranked; GIV (24.45 ± 7.35)> GVI ((20.18 ± 2.84)> GV (7.14 ± 14)= GII (6.72 ± 1.91)=GI (6.34 ± 2.21)=GIII (5.72 ± 2.18). For composite discs, groups were ranked; GI (24.98 ± 7.69)=GVI (24.84 ± 7.00) >GII (15.85 ± 5.29) =GV (14.65 ± 4.5)= GIV (14.24 ± 2.95)≥ GIII ((9.37 ± 2.78). Conclusion: The additional silanization step cannot be omitted if the repair protocol comprises of either hydrofluoric acid etching or silica coating for both CAD/CAM esthetic restorative materials. However, this step can be suppressed by using silane-containing adhesive with diamond stone roughened repair protocol.
Surface and mineral changes of enamel with different remineralizing agents in conjunction with carbon-dioxide laser
Authors: Mohan Ajit George , Ebenezar A. V. Rajesh , Ghani Mohamed Fayas , Martina Leena , Narayanan Ashwin , Mony Bejoy
Published: February 2014

Aim: The aim of this study was to evaluate the surface/mineral changes on enamel before and after the application of acidulated phosphate fluoride (APF) gel, fluoride enhanced hydroxyapatite gel and propolis in conjunction with carbon-dioxide (CO2) laser. Materials and Methods: Crowns of 40 human maxillary central incisors were collected and were divided into four groups of 10 each: Topical fluoride application only, topical fluoride application followed by CO2 laser irradiation, CO2 laser irradiation followed by topical fluoride application and CO2 laser irradiation before and after topical fluoride application. The 10 crowns in each group was again sectioned into four equal parts of mesio-incisal, disto-incisal, mesio-cervical and disto-cervical sections rendering 40 samples in each group. Each group was again subdivided into four subgroups: Subgroup C - untreated enamel surface (control). Subgroup A - APF gel application, subgroup R - fluoride enhanced hydroxyapatite gel application and subgroup P - propolis application. The surface morphology of the test samples were analyzed by scanning electron microscopy and mineral changes by energy dispersion X-ray spectrophotometer. Results: Total mineral content is maximum in Group 4A (CO2 laser irradiation before and after APF gel application) and calcium/phosphate ratio is highest in Group 4R (CO2 laser irradiation before and after Remin-Pro application). Group 2A (APF gel application followed by CO2 laser irradiation) has the maximum fluoride retention. Conclusion: Laser irradiation of enamel through a topically applied APF gel is effective in the prophylaxis and management of dental caries.
Retrieving tropospheric nitrogen dioxide from the Ozone Monitoring Instrument: effects of aerosols, surface reflectance anisotropy, and vertical profile of nitrogen dioxide
Authors: Lin J.-T. , Martin R. V. , Boersma K. F. , Sneep M. , Stammes P. , Spurr R. , Wang P. , Van Roozendael M. , Clémer K. , Irie H.
Published: February 2014

Abstract. Retrievals of tropospheric nitrogen dioxide (NO2) from the Ozone Monitoring Instrument (OMI) are subject to errors in the treatments of aerosols, surface reflectance anisotropy, and vertical profile of NO2. Here we quantify the influences over China via an improved retrieval process. We explicitly account for aerosol optical effects (simulated by nested GEOS-Chem at 0.667° long. × 0.5° lat. and constrained by aerosol measurements), surface reflectance anisotropy, and high-resolution vertical profiles of NO2 (simulated by GEOS-Chem). Prior to the NO2 retrieval, we derive the cloud information using consistent ancillary assumptions. We compare our retrieval to the widely used DOMINO v2 product, using MAX-DOAS measurements at three urban/suburban sites in East China as reference and focusing the analysis on the 127 OMI pixels (in 30 days) closest to the MAX-DOAS sites. We find that our retrieval reduces the interference of aerosols on the retrieved cloud properties, thus enhancing the number of valid OMI pixels by about 25%. Compared to DOMINO v2, our retrieval better captures the day-to-day variability in MAX-DOAS NO2 data (R2 = 0.96 versus 0.72), due to pixel-specific radiative transfer calculations rather than the use of a look-up table, explicit inclusion of aerosols, and consideration of surface reflectance anisotropy. Our retrieved NO2 columns are 54% of the MAX-DOAS data on average, reflecting the inevitable spatial inconsistency between the two types of measurement, errors in MAX-DOAS data, and uncertainties in our OMI retrieval related to aerosols and vertical profile of NO2. Sensitivity tests show that excluding aerosol optical effects can either increase or decrease the retrieved NO2 for individual OMI pixels with an average increase by 14%. Excluding aerosols also complexly affects the retrievals of cloud fraction and particularly cloud pressure. Employing various surface albedo data sets slightly affects the retrieved NO2 on average (within 10%). The retrieved NO2 columns increase when the NO2 profiles are taken from MAX-DOAS retrievals (by 19% on average) or TM4 simulations (by 13%) instead of GEOS-Chem simulations. Our findings are also relevant to retrievals of other pollutants (e.g., sulfur dioxide, ormaldehyde, glyoxal) from UV–visible backscatter satellite instruments.
Simplifying the calculation of light scattering properties for black carbon fractal aggregates
Authors: Smith A. J. A. , Grainger R. G.
Published: February 2014

Abstract. Black carbon fractal aggregates have complicated shapes that make the calculation of their optical properties particularly computationally expensive. Here, a method is presented to estimate fractal aggregate light scattering properties by optimising simplified models to full light scattering calculations. It is found that there are no possible spherical models (at any size or refractive index) that well represent the light scattering in the visible, or near-thermal infrared. As such, parameterisations of the light scattering as a function of the number of aggregate particles is presented as the most pragmatic choice for modelling distributions of black carbon when the large computational overheads of rigorous scattering calculations cannot be justified. This parameterisation can be analytically integrated to provide light scattering properties for log-normal distributions of black carbon fractal aggregates and return extinction cross-sections with 0.1% accuracy for typical black carbon size distributions. Scattering cross-sections and the asymmetry parameter can be obtained to within 3%.
Acceptable Cardiac Safety Profile of Neoadjuvant 5-Fluorouracil, Epirubicin, Cyclophosphamide and Celecoxib (FEC-C) for Breast Cancer: A Subanalysis of Biomarkers for Cardiac Injury
Authors: Chow Louis WC , Loo Wings TY , Yip Adrian YS , Ng Elizabeth LY
Published: February 2014

Purposes

This substudy aimed to examine the changes in biomarkers for cardiac injury in patients who received neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide with concurrent celecoxib (FEC-C).

Methods

Thirty-four female patients with histologically confirmed locally advanced breast cancer preoperatively received 3 cycles of FEC-C (500 mg/m2, 75 mg/m2, 500 mg/m2) with concurrent celecoxib (400 mg bid). Blood samples were drawn from patients on day (D) 0, D3, D21, D42, and D63 (end of therapy), and the serum levels of lactate dehydrogenase (LDH) and plasma levels of cardiac troponin I (cTnI) and N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) were measured with commercially available test kits.

Results

All patients tolerated this regimen well. Neither life-threatening toxicity nor clinical symptoms of cardiac damage were observed. Serum LDH increased significantly from baseline after 3 cycles of FEC-C (p<0.0001), but the change was possibly brought about by chemotherapy-induced liver derangement. However, NT-proBNP decreased significantly (p=0.009), while cTnI increased nonsignificantly (p=0.078) after 3 cycles of FEC-C compared to baseline, although this increase was still regarded as normal.

Conclusions

Short-term use of the FEC-C regimen has proven to be effective in locally advanced breast cancer, with an acceptable cardiac safety profile.
Application of Interleukin-1 Genes and Proteins to Monitor the Status of Chronic Periodontitis
Authors: Hao Liang , Li Jin-le , Yue Yuan , Tian Ye , Wang Min , Loo Wings TY , Cheung Mary NB , Chow Louis WC , Liu Qing , Yip Adrian YS , Ng Elizabeth LY
Published: February 2014

It has been widely reported that periodontitis may lead to bone tissue and teeth loss and result in failure of prosthodontics or implants. Interleukin-1 (IL-1) is a potent proinflammatory cytokine that plays an essential role during the pathogenesis of periodontitis. However, the gene polymorphisms of IL-1α, IL-1β and IL-1RN and the relationship between these protein expressions in healthy people and patients with chronic periodontitis (CP) in China have not been fully elucidated. We investigated the gene polymorphisms and protein expression of IL-1α, IL-1β and IL-1RN in healthy subjects and CP patients, and our data suggest that these gene polymorphisms are associated with CP. The frequency of the C/C genotype of IL-1α was 55% in CP patients, while in the control group it was 20% (p<0.0001). The C/C genotype of IL-1β was also higher in CP patients (51%) than in controls (21%) (p<0.0001). For the 2/2 genotype of IL-1RN, CP patients showed a 30% frequency, while in controls this was 15% (p<0.0001). Protein levels evaluated by enzyme-linked immunosorbent assay demonstrated a significant difference in secretion between patients and controls for IL-1α and IL-1β. These results indicate that genotype and protein production of IL-1α, IL-1β and IL-1RN are associated with CP in a Chinese population, and might be putative risk indicators for chronic periodontitis.
Terrain-surface Estimation from Body Configurations of Passive Linkages
Authors: Chugo Daisuke , Kawabata Kuniaki , Kaetsu Hayato , Asama Hajime , Mishima Taketoshi
Published: February 2014

A passive linkage mechanism is used for increasing the mobile performance of a wheeled vehicle on uneven ground. The mechanism changes its shape according to the terrain and enables all the wheels to remain grounded while the vehicle operates over rough terrain. This means that the shape of the passive linkage mechanism must correspond to that of the terrain surface, so that the vehicle can estimate the shape of the surface while passing over it. This paper proposes a new terrain-surface estimation scheme that uses a passive linkage mechanism. Our key concept is to enable changes in the vehicle body's configuration to correspond to those in the terrain's shape. Using this concept, our mobile platform estimates the shape of terrain surfaces without using external sensors; the estimated surface shapes are used to adjust the reference velocities of individual wheels, thereby improving the mobile performance of the vehicle. We test our proposed scheme by experiments using a prototype vehicle.
An Optimal Calibration Method for a MEMS Inertial Measurement Unit
Authors: Fang Bin , Chou Wusheng , Ding Li
Published: February 2014

An optimal calibration method for a micro-electro-mechanical inertial measurement unit (MIMU) is presented in this paper. The accuracy of the MIMU is highly dependent on calibration to remove the deterministic errors of systematic errors, which also contain random errors. The overlapping Allan variance is applied to characterize the types of random error terms in the measurements. The calibration model includes package misalignment error, sensor-to-sensor misalignment error and bias, and a scale factor is built. The new concept of a calibration method, which includes a calibration scheme and a calibration algorithm, is proposed. The calibration scheme is designed by D-optimal and the calibration algorithm is deduced by a Kalman filter. In addition, the thermal calibration is investigated, as the bias and scale factor varied with temperature. The simulations and real tests verify the effectiveness of the proposed calibration method and show that it is better than the traditional method.
Trends in cancer incidence in Lithuania between 1991 and 2010
Authors: Vincerževskienė Ieva , Krilavičiūtė Agnė , Smailytė Giedrė
Published: February 2014

Background. Analysis of time trends in cancer incidence provides an estimate of the burden of cancer in a certain population and is a useful tool for planning cancer control. Identification of changing epidemiological patterns in cancer is crucial in formulating future healthcare clinical tools, evaluating prognostic and therapeutic models, and generating new hypotheses on disease aetiology and prevention.
Materials and methods. Patients diagnosed with cancer in Lithuania between 1991 and 2010 were considered into analysis. Crude rates and age-standardized incidence rates for both sexes were calculated, as well as annual percent change with 95% confidence intervals for selected cancer sites using the Joinpoint Regression Analysis.
Results. With the major exceptions of male lung cancer and stomach cancer in both sexes, cancer incidence has increased for most cancer sites in the last two decades in Lithuania. The strongest rises in incidence were seen for prostate cancer in men and thyroid cancer in women. Overall cancer incidence in men was strongly influenced by newly diagnosed prostate cancer cases.
Conclusions. This up-to-date analysis provides a basis for establishing priorities to cancer control actions in Lithuania. These results show increase in incidence rates in Lithuania of all cancers combined among both men and women. Trends in cancer incidence rates for males were heavily influenced by trends in prostate cancer which is the most common cancer among men. Increasing cancer incidence requires targeted interventions on risk factors control, early diagnosis, and improved management and pharmacological treatment for selected cancer sites.
Integrative Nanomedicine: treating Cancer with Nanoscale Natural Products
Authors: Bell Iris R. , Sarter Barbara , Koithan Mary , Banerji Prasanta , Banerji Pratip , Jain Shamini , Ives John
Published: February 2014

Finding safer and more effective treatments for specific cancers remains a significant challenge for integrative clinicians and researchers worldwide. One emerging strategy is the use of nanostructured forms of drugs, vaccines, traditional animal venoms, herbs, and nutraceutical agents in cancer treatment. The recent discovery of nanoparticles in traditional homeopathic medicines adds another point of convergence between modern nanomedicine and alternative interventional strategies. A way in which homeopathic remedies could initiate anticancer effects includes cell-to-cell signaling actions of both exogenous and endogenous (exosome) nanoparticles. The result can be a cascade of modulatory biological events with antiproliferative and pro-apoptotic effects. The Banerji Protocols reflect a multigenerational clinical system developed by homeopathic physicians in India who have treated thousands of patients with cancer. A number of homeopathic remedy sources from the Banerji Protocols (eg, Calcarea phosphorica; Carcinosin—tumor-derived breast cancer tissue prepared homeopathically) overlap those already under study in nonhomeopathic nanoparticle and nanovesicle tumor exosome cancer vaccine research. Past research on antineoplastic effects of nano forms of botanical extracts such as Phytolacca, Gelsemium, Hydrastis, Thuja, and Ruta as well as on homeopathic remedy potencies made from the same types of source materials suggests other important overlaps. The replicated finding of silica, silicon, and nano-silica release from agitation of liquids in glassware adds a proven nonspecific activator and amplifier of immunological effects. Taken together, the nanoparticulate research data and the Banerji Protocols for homeopathic remedies in cancer suggest a way forward for generating advances in cancer treatment with natural product–derived nanomedicines.
Overview of the Publications from the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study
Authors: Hamre Harald Johan , Kiene Helmut , Ziegler Renatus , Tröger Wilfried , Meinecke Christoph , Schnürer Christof , Vögler Hendrik , Glockmann Anja , Kienle Gunver Sophia
Published: February 2014

Anthroposophic medicine is a physician-provided complementary therapy system that was founded by Rudolf Steiner and Ita Wegman. Anthroposophic therapy includes special medicinal products, artistic therapies, eurythmy movement exercises, and special physical therapies. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational multicenter study of 1631 outpatients starting anthroposophic therapy for anxiety disorders, asthma, attention deficit hyperactivity disorder, depression, low back pain, migraine, and other chronic indications under routine conditions in Germany.

AMOS incorporated two features proposed for the evaluation of integrative therapy systems: (1) a sequential approach, starting with the whole therapy system (use, safety, outcomes, perceived benefit), addressing comparative effectiveness and proceeding to the major system components (physician counseling, anthroposophic medicinal products, art therapy, eurythmy therapy, rhythmical massage therapy) and (2) a mix of different research methods to build an information synthesis, including pre-post analyses, prospective comparative analyses, economic analyses, and safety analyses of individual patient data. AMOS fostered two methodological innovations for the analysis of singlearm therapy studies (combined bias suppression, systematic outcome comparison with corresponding cohorts in other studies) and the first depression cost analysis worldwide comparing primary care patients treated for depression vs depressed patients treated for another disorder vs nondepressed patients.

A total of 21 peer-reviewed publications from AMOS have resulted. This article provides an overview of the main research questions, methods, and findings from these publications: anthroposophic treatment was safe and was associated with clinically relevant improvements in symptoms and quality of life without cost increase; improvements were found in all age, diagnosis, and therapy modality groups and were retained at 48-month follow-up; nonrespondent bias, natural recovery, regression to the mean, and adjunctive therapies together could explain a maximum of 37% of the improvement.
Carrier mobility characteristics of (100), (110), and (551) oriented atomically flattened Si surfaces for fin structure design of multi-gate metal–insulator–silicon field-effect transistors
Authors: Kuroda Rihito , Nakao Yukihisa , Teramoto Akinobu , Sugawa Shigetoshi , Ohmi Tadahiro
Published: February 2014

This paper reports on the carrier mobility characteristics of (100), (110), and (551) oriented atomically flattened Si surfaces for the fin structure design of multi-gate metal–insulator–silicon FETs (MuGFETs). At the atomic scale flatness level, the hole mobility is sensitive at the relatively high effective electric field region around 1 MV/cm and the hole mobility improvement is more than the that of electron. On the flattened (551) surface, both electron and hole mobility values are higher than those of the (110) surface. The mobility-based MuGFET assessment on speed and noise margin is proposed, and its result indicates that the (551) facet (100) top surfaces fin type has the best figure-of-merit of all the investigated combinations of fin types at the intermediate facet height to top surface width ratio of 1.2 to 7.5.
Observation and suppression of quantized spin waves in microfabricated permalloy elements
Authors: Yamamoto Tatsuya , Seki Takeshi , Ono Shimpei , Takanashi Koki
Published: February 2014

We report the observation and suppression of quantized spin wave modes in a microfabricated rectangular permalloy (Py) element. The Py element was located on a coplanar waveguide and was connected to a Cu wire. The quantized Damon–Eshbach spin wave and the perpendicular standing spin wave modes appeared in the resonance spectra for the Py elements. Those non-uniform magnetization dynamics were suppressed when the non-uniformity of the radio frequency magnetic field for the excitation was reduced by changing the design of the device structure.
Health Care Resource Use for Modern First-Line Treatments in Metastatic Renal Cell Carcinoma
Authors: Shah Neil J. , Shinde Reshma , Moore Kristin J. , Sainski-Nguyen Amy , Le Lisa B. , Cao Feng , Song Rui , Singhal Puneet , Motzer Robert J.
Published: July 2024

Importance

Immuno-oncology agents have changed the treatment paradigm for metastatic renal cell carcinoma (mRCC). Such therapies improve survival but can impose considerable health care resource use (HCRU) and associated costs, necessitating their examination.

Objective

To compare HCRU, costs, and clinical outcomes among patients receiving first-line pembrolizumab plus axitinib (P+A) or ipilimumab plus nivolumab (I+N).

Design, Setting, and Participants

This retrospective cohort study used data from an administrative claims database on patients with mRCC receiving first-line P+A or I+N that was initiated between January 2018 and May 2020. Data were analyzed from February 2021 to July 2022.

Exposure

First-line P+A or I+N.

Main Outcome and Measures

HCRU and costs during the first 90 days, full first-line treatment, and full follow-up periods were assessed. Using Kaplan-Meier analysis, time on treatment, overall survival, time to first emergency department (ED) visit, and time to first inpatient stay were compared.

Results

Among 507 patients, there were 126 patients receiving P+A (91 male [72.2%]; mean [SD] age, 67.93 [9.66] y) and 381 patients receiving I+N (271 male [71.1%]; mean [SD] age, 66.52 [9.94] years). The median time on treatment was longer for the P+A compared with I+N group (12.4 months [95% CI, 8.40 months to not estimable] vs 4.1 months [95% CI, 3.07 to 5.30 months]; P < .001). The median time to first ED visit was longer for the P+A than I+N group (7.2 months [95% CI 3.9 to 11.1 months ] vs 3.3 months [95% CI, 2.6 to 3.9 months]; P = .005), as was time to first inpatient stay (9.0 months [95% CI 6.5 months to not estimable] vs 5.6 months [95% CI, 3.9 to 7.9 months]; P = .02). During the first 90 days, a lower proportion of the P+A than N+I group had ED visits (43 patients [34.1%] vs 182 patients [47.8%] and inpatient stays (24 patients [19.1%) vs144 patients [37.8%]; P < .001). During full follow-up, mean total adjusted costs were similar for P+A and I+N groups, but adjusted 12-month estimated total costs were higher for P+A than I+N groups ($325 574 vs $ 263 803; P = .03).

Conclusions and Relevance

In this study, treatment with P+A was associated with longer time on treatment, time to first ED visit, and inpatient stay, while 12-month estimated costs were higher for the P+A group. This is among the first clinical studies to evaluate economic burden associated with modern treatments for mRCC.