bluuebunny/crossref_metadata_2025 huggingface dataset:
The 2014 Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) Part II: Psychometric Adequacy for Categorical Measurement of Selected DSM-5 Disorders
Authors: Boyle Michael H. , Duncan Laura , Georgiades Katholiki , Wang Li , Comeau Jinette , Ferro Mark A. , Van Lieshout Ryan J. , Szatmari Peter , MacMillan Harriet L. , Bennett Kathryn , Janus Magdalena , Lipman Ellen L. , Kata Anna
Published: October 2018

Objectives:

To compare the reliability and convergent validity of parent assessments from the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID —a structured diagnostic interview) and the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) symptom checklist for classifying conduct disorder (CD), conduct disorder or oppositional defiant disorder (CD-ODD), attention-deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and separation anxiety disorder (SAD) based on DSM-5 criteria.

Methods:

Data came from 283 parent-youth dyads aged 9 to 18 years. Parents and youth completed the assessments separately on 2 different occasions 7 to 14 days apart. After converting the OCHS-EBS scale scores to binary disorder classifications, we compare test-retest reliability estimates and use structural equation modelling (SEM) to compare estimates of convergent validity for the same disorders assessed by each instrument.

Results:

Average test-retest reliabilities based on κ were 0.71 (MINI-KID) and 0.67 (OCHS-EBS). The average β coefficients for 3 latent measures comprising the following indicators—parent perceptions of youth mental health need and impairment, diagnosis of specific disorders based on health professional communications and youth taking prescribed medication, and youth classifications of disorder based on the MINI-KID—were 0.67 (MINI-KID) and 0.69 (OCHS-EBS).

Conclusion:

The OCHS-EBS and MINI-KID achieve comparable levels of reliability and convergent validity for classifying child psychiatric disorder. The flexibility, low cost, and minimal respondent burden of checklists for classifying disorder make them well suited for studying disorder in the general population and screening in clinical settings.
Geotechnical properties of products of alternative fuel combustion and co-firing with hard coal in the context of their use as solidifying dense mixtures
Authors: Stefaniak Sebastian , Kmiecik Ewa , Miszczak Ewa , Plewa Franciszek , Twardowska Irena
Published: October 2018

Efforts directed to reduction of greenhouse gas emissions have led to the introduction of new firing/co-firing technologies and alternative fuels in the coal-based power industry. This has resulted in the formation of combustion products with new properties that can affect the reuse of these wastes and/or pose a hazard to the environment. One of the power-plant fly ash (FA) reuse options is its application as a solidifying dense mixture with water for backfilling mine workings or in engineering constructions. In this comparative study, geotechnical properties of three groups of FA were evaluated: (i) weathered and freshly generated ash from hard coal combustion in conventional pulverized coal boilers without (C-PCA, C-PFA) and with selective non-catalytic reduction installations for NO x reduction (NC-PFA); (ii) FA from hard coal co-firing with alternative fuels: off gases (GC-PFA) or biomass (BC-PFA) in pulverized coal boilers; (iii) FA from coal (C-FFA) or biomass combustion (B-FFA) in fluidized-bed boilers. The transportability, bonding and solidification properties, uniaxial compression strength, and rewetting of dense mixtures were evaluated by measurements of volumetric density, fluidity, water retention capacity, bonding time, solidification time, uniaxial compression test, and slakeability at the background of the FA chemical composition. Calcareous C-FFA > B-FFA displayed the best geotechnical properties. Other materials showed poorer geotechnical properties than FFA and could be aligned in the order BC-PFA > GC-PFA > NC-PFA > C-PFA > C-PCA.
News publishing across platforms: Gatekeeping for print, web, Facebook and Twitter
Authors: Paskin Danny
Published: October 2018

The minimal research on how news outlets are currently publishing across different platforms is limited in scope and has conflicting conclusions. Based on gatekeeping theory, this quantitative study expands that literature by comparing what The New York Times publishes in print, on its website and on social networking sites such as Facebook and Twitter. Results show both significant similarities and differences across platforms, and raise questions about the industry, and about news gatekeeping theory.
Right Heart Thrombi: Patient Outcomes by Treatment Modality and Predictors of Mortality: A Pooled Analysis
Authors: Islam Marjan , Nesheim David , Acquah Samuel , Kory Pierre , Kourouni Ismini , Ramesh Navitha , Ehrlich Madeline , Bajpayee Gargi , Steiger David , Filopei Jason
Published: October 2018

Rationale:

Right heart thrombi (RiHT) is characterized by the presence of thrombus within the right atrium or right ventricle (RV). Current literature suggests pulmonary embolism (PE) with RiHT carries a high mortality. Guidelines lack recommendations in managing RiHT. We created a pooled analysis on RiHT and report on our institutional experience in managing RiHT. We aimed to evaluate whether patient characteristics and differing treatment modalities predict mortality.

Methods:

We created a pooled analysis of case reports and series of patients with RiHT and PE between January 1956 and 2017. We also reviewed a series of consecutive patients with RiHT identified from our institutional PE registry. Age, shock, RV dysfunction, clot mobility, treatment modality, and hospital outcome had to be reported.

Results:

We identified 316 patients in our pooled analysis. Patients received the following therapies: no treatment 15 (5%), systemic anticoagulation 73 (23%), systemic thrombolysis 108 (34%), surgical embolectomy 101 (32%), catheter-directed therapy 11 (3%), and systemic thrombolysis with surgery 8 (3%). In-hospital mortality was 18.7%. Univariate analysis showed age and shock reduced odds of survival. Multivariate analysis showed shock reduced odds of survival (odds ratios [OR] 0.36, 95% confidence interval [CI]: 0.19-0.72, P ≤ .01) while age, RV dysfunction, and clot-mobility did not affect mortality. In a reduced multivariate analysis adjusting for shock, treatment modality, and clot location alone, systemic thrombolysis increased odds of survival when compared to systemic anticoagulation (OR 2.72, 95% CI: 1.11-6.64, P = .02). Our institutional series identified 18 patients, where in-hospital mortality was 22.2%, 18 (100%) had RV dysfunction, and 5 (28%) had shock. Patients received the following therapies: systemic anticoagulation 8 (44.4%), systemic thrombolysis 4 (22.2%), surgical embolectomy 4 (22.2%), and catheter-directed thrombolysis 2 (11.1%).

Conclusion:

Presence of shock in RiHT is an independent predictor of mortality. Systemic thrombolysis may offer increased odds of survival when compared to systemic anticoagulation. Our findings should be interpreted with caution as they derive from retrospective reports and subject to publication bias.
Prevalence and Risk Factors for Augmented Renal Clearance in a Population of Critically Ill Patients
Authors: Baptista João Pedro , Martins Paulo Jorge , Marques Margarida , Pimentel Jorge Manuel
Published: October 2018

Background:

Critically ill patients show a high, albeit variable, prevalence of augmented renal clearance (ARC). This condition has relevant consequences on the elimination of hydrophilic drugs. Knowledge of risk factors for ARC helps in the early identification of ARC. The aims of this study were evaluation of (1) risk factors for ARC and (2) the prevalence of ARC in critically ill patients over a period of 1 year.

Methods:

A retrospective cohort study was performed for all consecutive patients admitted to our intensive care unit (ICU). Augmented renal clearance was defined by a creatinine clearance ≥130 mL/min/1.73 m2. “Patient with ARC” was defined as a patient with a median of creatinine clearance ≥130 mL/min/1.73 m2 over the period of admission. Four variables were tested, Simplified Acute Physiology Score II (SAPS II), male gender, age, and trauma as cause for ICU admission. An analysis (patient based and clearance based) was performed with logistic regression.

Results:

Of 475 patients, 446 were included in this study, contributing to 454 ICU admissions and 5586 8-hour creatinine clearance (8h-CLCR). Overall, the prevalence of patients with ARC was 24.9% (n = 113). In a subset of patients with normal serum creatinine levels, the prevalence was 43.0% (n = 104). Of the set of all 8h-CLCR measurements, 25.4% (1418) showed ARC. In the patient-based analysis, the adjusted odds ratio was: 2.0 (confidence interval [CI]:1.1-3.7; P < .05), 0.93 (CI: 0.91-0.94; P < .01), 2.7 (CI: 1.4-5.3; P < .01), and 0.98 (CI: 0.96 -1.01; P = .15), respectively, for trauma, age, male sex, and SAPS II. In the clearance-based analysis, the adjusted odds ratio were 1.7 (CI: 1.4-1.9; P < .01), 0.94 (CI: 0.932-0.942; P < .01), and 2.9 (CI: 2.4-3.4; P < .01), respectively, for trauma, age, and male sex.

Conclusions:

Trauma, young age, and male sex were independent risk factors for ARC. This condition occurs in a considerable proportion of critical care patients, which was particularly prevalent in patients without evidence of renal dysfunction.
A novel approach for dynamic flow simulation of gas pipelines using teaching–learning-based optimization algorithm
Authors: Pourfard Ali , Khanmirza Esmaeel , Madoliat Reza
Published: October 2018

Simulation of a natural gas network operation is a prerequisite for optimization and control tasks. Treating gas in a transient manner is necessary for accurate simulation of gas networks. However, solving the governing nonlinear partial differential equations of pipe flows is a challenging task. In this paper, a novel approach is proposed based on using an intelligent algorithm called teaching–learning-based optimization. This approach simplifies transient simulation of gas networks with a specified type of boundary conditions. Teaching–learning-based optimization estimates different values for network inlet flow rates. Then by knowing the inlet boundary conditions of the network, the discretized flow equations become linear and the flow equations of each pipe can be solved independently. Thus, the network outlet flow variables can be easily obtained. The differences of obtained and actual network outlet flow rates are considered as a cost function or error. Finally, this intelligent algorithm determines the optimum inlet flow rates at each time level, which minimize the error. The proposed approach is implemented on the in-service gas network. To validate the simulation results, a conventional gradient-based method called trust region dogleg is also used for simulation of the gas network. The comparison of numerical results confirms the accuracy and efficiency of this approach, while it is more computationally efficient. Moreover, the substitution of teaching–learning-based optimization with another powerful intelligent optimization algorithm would not improve the performance of the proposed approach.
A proof-of-concept-to-confirmatory multiple adaptation design in the development of an anti-viral treatment
Authors: Fan Xiaoyin F , Gallo Paul , Su Guoqin , Menton Ronald , Segal Florencia
Published: October 2018

In the clinical development of some new infectious disease drugs, early clinical pharmacology trials may predict with high confidence that the efficacious doses are well below the range of the safety margin. In this case, a dose-ranging study may be unnecessary after a proof-of-concept (PoC) study testing the highest dose. A multi-stage adaptive design spanning both PoC and confirmatory stages is proposed in this context. The design incorporates two interim analyses allowing strategies for stopping, continuing, or expanding the study. A conditional power threshold for a binary endpoint is proposed to assess futility. Additional components of early efficacy and sample size adjustment are also included to enhance the design's flexibility and robustness. Design operating characteristics are evaluated by numerical calculation. We show that the proposed streamlined trial design has the same statistical rigor as a conventional phase 3 clinical trial with adequate power and a properly controlled type 1 error rate. Additional adaptive design options are also investigated and discussed.
How Dynamic Brain Networks Tune Social Behavior in Real Time
Authors: Silston Brian , Bassett Danielle S. , Mobbs Dean
Published: October 2018

During social interaction, the brain has the enormous task of interpreting signals that are fleeting, subtle, contextual, abstract, and often ambiguous. Despite the signal complexity, the human brain has evolved to be highly successful in the social landscape. Here, we propose that the human brain makes sense of noisy dynamic signals through accumulation, integration, and prediction, resulting in a coherent representation of the social world. We propose that successful social interaction is critically dependent on a core set of highly connected hubs that dynamically accumulate and integrate complex social information and, in doing so, facilitate social tuning during moment-to-moment social discourse. Successful interactions, therefore, require adaptive flexibility generated by neural circuits composed of highly integrated hubs that coordinate context-appropriate responses. Adaptive properties of the neural substrate, including predictive and adaptive coding, and neural reuse, along with perceptual, inferential, and motivational inputs, provide the ingredients for pliable, hierarchical predictive models that guide our social interactions.
Uncovering the Neuroanatomy of Core Language Systems Using Lesion-Symptom Mapping
Authors: Mirman Daniel , Thye Melissa
Published: October 2018

Recent studies have integrated noninvasive brain-imaging methods and advanced analysis techniques to study associations between the location of brain damage and cognitive deficits. By applying data-driven analysis methods to large sets of data on language deficits after stroke (aphasia), these studies have identified the cognitive systems that support language processing—phonology, semantics, fluency, and executive functioning—and their neural basis. Phonological processing is supported by dual pathways around the Sylvian fissure, a ventral speech-recognition component and a dorsal speech-production component; fluent sentence-level speech production relies on a more anterior frontal component, and the semantic system relies on a hub in the anterior temporal lobe and frontotemporal white-matter tracts. The executive function system was less consistently localized, possibly because of the kinds of brain damage tested in these studies. This review synthesizes the results of these studies, showing how they converge with contemporary models of primary systems that support perception, action, and conceptual knowledge across domains, and highlights some divergent findings and directions for future research.
Access to Medicines and Performance of the Indian Pharmaceutical Industry: Examining India’s Experience in the New Patent Regime1
Authors: Jafar K. , Sajna P.
Published: October 2018

The advocates of intellectual property rights project strong patent regime as an effective way to promote research and development (R&D) activities leading to innovation while others argue that they may adversely affect local industries in developing countries and result in monopoly pricing that may compromise on larger interests including public healthcare. The process patent regime has enabled Indian pharmaceutical firms to strengthen their technological capability and performance in domestic and global markets. As the country reintroduced product patent protection in 2005, Indian ‘copycats’ could not follow their reverse engineering technology anymore. Being a developing country and ‘pharmacy of the Global South’, India’s experience offers global dimensions to these debates. This article makes an attempt to reflect on India’s experience with the new patent regime; it looks into the pattern of R&D, trade and trend of product patenting in the pharmaceutical sector and revisits public health concerns.
Entrapment and institutional collusion: Domestic violence police reports and the ‘couple rule’ in social security law
Authors: Sleep Lyndal
Published: October 2018

In Australia’s heavily targeted social welfare apparatus, couples are assessed jointly for their eligibility for social security payment. Specific guidelines for deciding if a social security recipient is a member of a couple are provided by the ‘couple rule’ in section 4(3) of the Social Security Act 1991 (Cth). A plethora of information is used by the Department to decide if a social security recipient is a member of a couple for social security purposes. Of particular concern is the use of domestic violence police reports as evidence of a couple relationship. This article argues that the current use of police domestic violence reports in ‘couple rule’ decisions is problematic. This is because it effectively entraps women in violent relationships, provides a financial barrier to leaving and is used by perpetrators to further control their victims.
Codes vs regulations: How best to enforce animal welfare in New Zealand?
Authors: Rodriguez Ferrere Marcelo B
Published: October 2018

In a suite of new regulations, New Zealand has introduced a series of infringement offences designed to better enforce animal welfare. In doing so, however, those regulations relegate existing enforcement mechanisms, including codes of welfare. This article will compare and contrast the status quo with the new system, and query whether these regulations are in fact the best way of improving animal welfare enforcement.
An Analysis of Lung Cancer Screening Beliefs and Practice Patterns for Community Providers Compared to Academic Providers
Authors: Khairy Marjon , Duong Duy K. , Shariff-Marco Salma , Cheng Iona , Jain Jennifer , Balakrishnan Anupama , Liu Lynn , Gupta Aarti , Chandramouli Ranjani , Hsing Ann , Leung Ann , Singh Baldeep , Nair Viswam S.
Published: October 2018

Despite guidelines recommending annual low-dose computed tomography (LDCT) screening for lung cancer, uptake remains low due to the perceived complexity of initiating and maintaining a clinical program—problems that likely magnify in underserved populations. We conducted a survey of community providers at Federally Qualified Health Centers (FQHCs) in Santa Clara County, California, to evaluate provider-related factors that affect adherence. We then compared these findings to academic providers’ (APs) LDCT screening knowledge, behaviors, and attitudes at an academic referral center in the same county. The 4 FQHCs enrolled care for 80 000 patients largely of minority descent and insured by Medi-Cal. Of the 75 FQHC providers (FQHCPs), 36 (48%) completed the survey. Of the 36 providers, 8 (22%) knew screening criteria. Fifteen (42%) FQHCPs discussed LDCT screening with patients. Compared to 36 APs, FQHCPs were more concerned about harms, false positives, discussion time, patient apathy, insurance coverage, and a lack of expertise for screening and follow-up. Yet, more FQHCPs thought screening was effective (27 [75%] of 36) compared to APs ( P = .0003). In conclusion, provider knowledge gaps are greater and barriers are different for community clinics caring for underserved populations compared to their academic counterparts, but practical and scalable solutions exist to enhance adoption.
It’s Not Just Black or White: Effects of Ambivalence on Residents’ Support for a Mega-Event
Authors: Chen Zengxiang , Wang Yuan , Li Xiang (Robert) , Lawton Laura
Published: October 2018

Residents can simultaneously possess positive and negative evaluations of mega-events hosted in their communities. The coexistence of positive and negative evaluations is attitudinal ambivalence. The extent to which ambivalence influences resident support for tourism development or mega-events has not been examined empirically. This article investigates residents’ ambivalence toward the 2010 Shanghai Expo and empirically tests the effects of ambivalence on residents’ intentions to support mega-events. Results show that Shanghai residents experienced the highest level of ambivalence during the event, and ambivalence negatively affected residents’ support of mega-events in general. Also, ambivalence was found to moderate the relationship between event satisfaction and support intention. The positive influence of satisfaction on support intention was found to be significant only when ambivalence was low.
Tools for managing feline problem behaviors: Pheromone therapy
Authors: Vitale Kristyn R
Published: October 2018

Practical relevance:

Cats are one of the most common companion animals in the world. However, relatively little scientific research has been conducted on cat behavior. With problem behaviors a leading reason for relinquishment of cats to shelters, or abandonment outdoors, solutions to address feline behavioral problems can have important welfare benefits. Because naturally occurring pheromones produce measurable species-specific responses in cats, the use of synthetic pheromone products consisting of the same compounds may activate a specific behavioral response in the receiving individual, allowing humans to better communicate with cats and manage feline problem behavior.

Aims:

In this article the scientific background for naturally occurring feline pheromones and semiochemicals and their impact on cat behavior is reviewed. This is used as a foundation to explore the three feline synthetic pheromones currently available and the empirical evidence that exists for their effectiveness. From this information, several recommendations for veterinarians and behavior professionals on the application of feline pheromone therapy in the home and veterinary clinic setting are presented.

Evidence base:

The efficacy of synthetic pheromones as a tool for the management of problem behaviors is a relatively new area of research and only fairly recently has the need to implement more rigorous research methodology been recognized.
The Path to New Halogenated Quinolines With Enhanced Activities Against Staphylococcus epidermidis
Authors: Huigens Robert W
Published: October 2018

Antibiotic-resistant bacteria and surface-attached bacterial biofilms play a significant role in human disease. Conventional antibiotics target actively replicating free-floating, planktonic cells. Unfortunately, biofilm communities are endowed with nonreplicating persister cells that are tolerant to antibiotics. Innovative approaches are necessary to identify new molecules able to eradicate resistant and tolerant bacterial cells. Our group has discovered that select halogenated quinolines (HQs) can eradicate drug-resistant, gram-positive bacterial pathogens and their corresponding biofilms. Interestingly, the HQ scaffold is synthetically tunable and we have discovered unique antibacterial profiles through extensive analogue synthesis and microbiologic studies. We recently reported the synthesis of 14 new HQs to investigate the impact of ClogP values on antibacterial and biofilm eradication activities. We conducted diverse synthetic modifications at the 2-position of the HQ scaffold in an attempt to enhance water solubility and found new compounds that display enhanced activities against Staphylococcus epidermidis. In particular, HQ 2 (ClogP = 3.44) demonstrated more potent antibacterial activities against methicillin-resistant S epidermidis (MRSE) 35984 planktonic cells (minimum inhibitory concentration = 0.59 µM) compared with methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus isolates while demonstrating potent MRSE biofilm eradication activities (minimum biofilm eradication concentration = 2.35 µM). We believe that HQ could play a critical role in the development of next-generation antibacterial therapeutics.
On studying algorithms ethnographically: Making sense of objects of ignorance
Authors: Lange Ann-Christina , Lenglet Marc , Seyfert Robert
Published: October 2018

In this article, we make sense of financial algorithms as new objects of concern for organizational ethnography. We conceive of algorithms as ‘objects of ignorance’ jeopardizing traditional ethnography from the perspective of its categories and methods. We investigate the organizational politics taking place within high-frequency trading – a sub-field of algorithmic trading where automated decision-making without human direction has reached a peak, and show that financial algorithms raise particular epistemic and methodological challenges for practitioners and ethnographers alike. Consequently, we develop a typology for various interpretations of algorithms as ethnographic objects, accounting for their structural ignorance and shedding light on a continuum of the changing human-machine/trader-algorithm relation. To this end, we use the concepts of ‘quasi-object’ and ‘quasi-subject’ as developed by Michel Serres, and make the point that in order to study financial algorithms ethnographically, we need to think anew the dynamic relationship they embody, and acknowledge their constitutive heterogeneity.
Does patient education improve compliance to routine diabetic retinopathy screening?
Authors: Moinul Prima , Barbosa Joshua , Qian Jenny , Chen Mei Lin , Mohaghegh Mohammad , Kaur Harneel , Holmes Julie , Radman Heather , Robinson Tammy , Chaudhary Varun
Published: October 2018

Introduction

Diabetic retinopathy (DR) screening relies on adherence to follow-up eye care. This article assesses if a model of patient education and tele-retina screening among high-risk patients with DR can achieve increased rates of compliance within a one-year follow-up.

Methods

Between May 2014 and May 2016, DR screening was conducted in a cohort of 101 patients with diabetes in Southern Ontario. Optical coherence tomography and fundus photography images were used to visualize the retina remotely. Enrolled patients participated in an educational seminar at the screening site with the expressed purpose of enhancing patient understanding of DR. A chi-squared test was used to assess patient compliance to follow-up examinations within 6–12 months, while pre-to post-screening HbA1c levels were compared using a dependent t-test.

Results

Of 101 patients who completed the study, 33 patients (32.6%) have never previously been screened for DR. Baseline compliance to annual screening increased from 36 patients (35.6%) to 51 patients (50.5%) after the tele-retina programme ( p = 0.03). Eighty-nine patients (88%) were referred to an optometrist for ongoing care compared with 12 patients (11.9%) to an ophthalmologist for management of DR. Overall, 100 patients (99.0%) were satisfied with the tele-retina screening. There was no significant change in pre- to-post screening HbA1c levels ( p = 0.91).

Discussion

Patient education-focused tele-retina screening for DR significantly increased compliance to follow-up in a high-risk, non-compliant patient population. Management of diabetes as captured by HbA1c levels remain unchanged in the cohort indicating a need for ongoing inter-professional collaboration in education and vision screening.
Compressed Sensing With a Gaussian Scale Mixture Model for Limited View Photoacoustic Computed Tomography In Vivo
Authors: Meng Jing , Liu Chengbo , Kim Jeesu , Kim Chulhong , Song Liang
Published: October 2018

Photoacoustic computed tomography using an ultrasonic array is an attractive noninvasive imaging modality for many biomedical applications. However, the potentially long data acquisition time of array-based photoacoustic computed tomography—usually due to the required time-multiplexing for multiple laser pulses—decreases its applicability for rapid disease diagnoses and the successive monitoring of physiological functions. Compressed sensing is used to improve the imaging speed of photoacoustic computed tomography by decreasing the amount of acquired data; however, the imaging quality can be limited when fewer measurements are used, as traditional compressed sensing considers only the sparsity of the signals in the imaging process. In this work, an advanced compressed sensing reconstruction framework with a Wiener linear estimation-based Gaussian scale mixture model was developed for limited view photoacoustic computed tomography. In this method, the structure dependencies of signals in the wavelet domain were incorporated into the imaging framework through the Gaussian scale mixture model, and an operator based on the Wiener linear estimation was designed to filter the reconstruction artifacts. Phantom and human forearm imaging were performed to verify the developed method. The results demonstrated that compressed sensing with a Wiener linear estimation-based Gaussian scale mixture model more effectively suppressed the reconstruction artifacts of sparse-sampling photoacoustic computed tomography and recovered photoacoustic images with a higher contrast-to-noise ratio and edge resolution than the traditional compressed sensing method. This work may promote the development of low-cost photoacoustic computed tomography techniques with rapid data acquisition and enhance the performance of photoacoustic computed tomography in various biomedical studies.
Analytical method comparison on critical force of the stepped column model of telescopic crane
Authors: Yao Fenglin , Meng Wenjun , Zhao Jie , She Zhanjiao , Shi Guoshan
Published: October 2018

The calculation of the critical force of the stepped column model of telescopic boom crane is the key to stability calculation of all-terrain crane. In slightly bending theory, differential equation can be built up, and then the deflection curve of ideal column can be obtained. Using this curve and the Rayleigh–Ritz method, the Euler force of the ideal column can be obtained. For n-stepped columns, Euler forces and the effective length coefficients can be acquired using the deflection curve of the ideal column and parabolic curve, respectively, combined with the Rayleigh–Ritz method. Differential equations of the n-stepped telescopic boom are established based on the vertical and horizontal buckling theory. The recursive formula of the stability of the n-stepped telescopic boom is deduced by the mathematical induction method. For the transcendental equation in the recursive formula, combined with the structural force characteristics and supplementary formulas, the Levenberg–Marquardt numerical optimization algorithm is used to solve the equations with n unknowns. Length coefficients obtained by the three methods are compared using GB3811-2008 and ANSYS 17.0. The results show that the accuracy of the numerical algorithm is the highest, and the first two algorithms will produce large errors when the stepped columns have more steps.
The role of the operating department practitioner on board Role 2 Afloat
Authors: Stables A , Seal G , Mercer S J
Published: October 2018

The Role 2 Afloat (R2A) is the Royal Navy (RN)'s Damage Control Resuscitation (DCR), including Damage Control Surgery, capability at sea. There are currently three operating department practitioners (ODP) in the deployed team. This article describes the role of the ODP in this team and the training which is required to fulfil this role.
Regulation of Advanced Critical Care Practitioners: Past, present and future
Authors: Campbell Johan
Published: October 2018

The role of Advanced Critical Care Practitioners was included in the Department of Health’s recent consultation document on the regulation of Medical Associate Professions. This prompted the author, an Advanced Critical Care Practitioner, to examine the regulation of Advanced Critical Care Practitioners in the past, present and future. National competence frameworks have been developed. However, there continued to be criticism on the lack of regulation and title protection of Advanced Critical Care Practitioners. This article discusses the response of governing bodies to the consultation and its potential future implications for Advanced Critical Care Practitioners.
It takes two to tango
Authors: Moss Bernard R , Moss Sheila
Published: October 2018

This article explores ways in which simulated patients (SPs) can help with preparation for the Clinical Skills Assessment (CSA) of the MRCGP exam by sharpening up communication skills, keeping patients safe and making the most of the 10 minutes allotted. However, for this to work, candidates need to take the process seriously and appreciate the care and attention given by SPs to enhance learning and understanding in exam preparation. The article concludes with some useful hints and tips to improve performance in the CSA.
Insights into the evaluation and management of dyspepsia: recent developments and new guidelines
Authors: Black Christopher J. , Houghton Lesley A. , Ford Alexander C.
Published: October 2018

Dyspepsia is a very common gastrointestinal (GI) condition worldwide. We critically examine the recommendations of recently published guidelines for the management of dyspepsia, including those produced jointly by the American College of Gastroenterology and the Canadian Association of Gastroenterology, and those published by the UK National Institute for Health and Care Excellence. Dyspepsia is a symptom complex, characterized by a range of upper GI symptoms including epigastric pain or burning, early satiety, and post-prandial fullness. Although alarm features are used to help prioritize access to upper GI endoscopy, they are of limited utility in predicting endoscopic findings, and the majority of patients with dyspepsia will have no organic pathology identified at upper GI endoscopy. These patients are labelled as having functional dyspepsia (FD). The Rome IV criteria, which are used to define FD, further subclassify patients with FD as having either epigastric pain syndrome or post-prandial distress syndrome, depending on their predominant symptoms. Unfortunately, the Rome criteria perform poorly at identifying FD without the need for upper GI endoscopy. This has led to the investigation of alternative diagnostic approaches, including whether a capsaicin pill or combined serum biomarkers can accurately identify patients with FD. However, there is insufficient evidence to support either of these approaches at the present time. Patients with FD should be tested for H. pylori infection and be prescribed eradication therapy if they test positive. If they continue to have symptoms following this, then a trial of treatment with a proton pump inhibitor (PPI) should be given for up to 8 weeks. In cases where symptoms fail to adequately respond to PPI treatment, a tricyclic antidepressant may be of benefit, and should be continued for 6 to 12 months in patients who respond. Prokinetics demonstrate limited efficacy for treating FD, but could be considered if other strategies have failed. However, there are practical difficulties due to their limited availability in some countries and the risk of serious side effects. Patients with FD who fail to respond to drug treatments should be offered psychological therapy, where available. Overall, with the exception of recommendations relating to H. pylori testing and the prescription of PPIs, which are made on the basis of high-quality evidence, the evidence underpinning other elements of dyspepsia management is largely of low-quality. Consequently, there are still many aspects of the evaluation and management of dyspepsia that require further research.
Europe, the US and the Iran deal: The need to resolve transatlantic disagreements
Authors: Schwammenthal Daniel
Published: October 2018

The importance of the transatlantic relationship and the seriousness of the Iranian threat demand that Europe and the US try their utmost to resolve their disagreement over the Joint Comprehensive Plan of Action—also known as the ‘Iran nuclear deal’ or simply the ‘Iran deal’. For the EU this means reviewing the legal and political context of Washington’s withdrawal from the nuclear deal and acknowledging the agreement’s shortcomings. European leaders themselves have identified Iran’s aggression as a major security threat and have also confirmed that the deal is not ‘sufficient’. This being the case, the article argues that, to counter Iran’s nuclear ambitions and regional aggression, the EU ought to cooperate with the US even after the latter’s withdrawal from the deal.
After homo sovieticus: Democratic governance gaps and societal vulnerabilities in the EU’s eastern neighbourhood
Authors: Merheim-Eyre Igor
Published: October 2018

This article explores three intertwining issues facing the countries in the EU’s eastern neighbourhood: (1) the continued legacy of homo sovieticus or the ‘Soviet Man’, (2) the state of democratic governance and (3) societal vulnerabilities. Existing since the collapse of the Soviet Union, they can be seen as both barriers to reform as well as vulnerabilities exploited by domestic and foreign actors for the purposes of division and subversion. The article argues that if the EU or the wider transatlantic community wants to support the countries of the eastern neighbourhood on their road to security, democracy and prosperity, we must place the dignity of the individual at the heart of our policies. This requires (a) fostering deeper social and cultural capital, and (b) ensuring that we strengthen the resilience of society rather than that of autocratic leaders and oligarchic structures.
Platelet-Rich Plasma Promotes Migration, Proliferation, and the Gene Expression of Scleraxis and Vascular Endothelial Growth Factor in Paratenon-Derived Cells In Vitro
Authors: Imai Sosuke , Kumagai Ken , Yamaguchi Yasuteru , Miyatake Kazuma , Saito Tomoyuki
Published: October 2018

Background:

Platelet-rich plasma (PRP) is a treatment option for tendon injury because of its effective tendon-healing properties. At the early stage of tendon repair, paratenon-derived cells (PDCs) are thought to play a more important role than tendon proper–derived cells (TDCs). However, there has been no study investigating the effects of PRP on PDCs.

Hypothesis:

PRP promotes the migration, proliferation, and differentiation of PDCs in vitro.

Study Design:

Controlled laboratory study.

Methods:

TDCs and PDCs were isolated from the tendon proper and paratenon of rat Achilles tendons and were cultured to the third passage. PRP was prepared from the rats using the double-spin method. Third-passage TDCs and PDCs were cultured in Dulbecco’s modified Eagle medium with 2% fetal bovine serum (control group) or 2% fetal bovine serum plus 5% PRP (PRP group), and cell migration, proliferation, and differentiation were evaluated. The relative mRNA expression levels of scleraxis (Scx), tenomodulin (Tnmd), collagen type I alpha 1 (Col1a1), collagen type III alpha 1 (Col3a1), and vascular endothelial growth factor A (VEGF) were examined by quantitative real-time reverse transcription polymerase chain reaction.

Results:

The cell migration rate was significantly higher in the PDCs of the PRP group than in the control group (1.4-fold increase; P = 0.02). Cell proliferation was significantly higher in the PDCs of the PRP group (2.2-fold increase; P < 0.01). In the PDCs, the gene expression levels of Scx, Col1a1, and VEGF were significantly increased by PRP (Scx: 2.0-fold increase, P = 0.01; Col1a1: 5.3-fold increase, P = 0.01; VEGF: 7.8-fold increase, P = 0.01), but the gene expression level of Tnmd, a factor for tendon maturation, was significantly reduced by PRP (0.11-fold decrease; P = 0.02).

Conclusion:

In vitro PRP promoted migration, proliferation, and tenogenic differentiation with the upregulation of Scx in PDCs. PRP also upregulated the expression of the angiogenic marker VEGF.

Clinical Relevance:

Our results suggest that PRP treatment in vitro may enhance the tendon-healing properties of PDCs at the initial stage of tendon repair.
Reformulated mineral trioxide aggregate components and the assessments for use as future dental regenerative cements
Authors: Moon Ho-Jin , Lee Jung-Hwan , Kim Joong-Hyun , Knowles Jonathan C , Cho Yong-Bum , Shin Dong-Hoon , Lee Hae-Hyoung , Kim Hae-Won
Published: October 2018

Mineral trioxide aggregate, which comprises three major inorganic components, namely, tricalcium silicate (C3S), dicalcium silicate (C2S), and tricalcium aluminate (C3A), is promising regenerative cement for dentistry. While mineral trioxide aggregate has been successfully applied in retrograde filling, the exact role of each component in the mineral trioxide aggregate system is largely unexplored. In this study, we individually synthesized the three components, namely, C3S, C2A, and C3A, and then mixed them to achieve various compositions (a total of 14 compositions including those similar to mineral trioxide aggregate). All powders were fabricated to obtain high purity. The setting reaction of all cement compositions was within 40 min, which is shorter than for commercial mineral trioxide aggregate (~150 min). Over time, the pH of the composed cements initially showed an abrupt increase and then plateaued (pH 10–12), which is a typical behavior of mineral trioxide aggregate. The compression and tensile strength of the composed cements increased (2–4 times the initial values) with time for up to 21 days in an aqueous medium, the degree to which largely depended on the composition. The cell viability test with rat mesenchymal stem cells revealed no toxicity for any composition except C3A, which contained aluminum. To confirm the in vivo biological response, cement was retro-filled into an extracted rat tooth and the complex was re-implanted. Four weeks post-operation, histological assessments revealed that C3A caused significant tissue toxicity, while good tissue compatibility was observed with the other compositions. Taken together, these results reveal that of the three major constituents of mineral trioxide aggregate, C3A generated significant toxicity in vitro and in vivo, although it accelerated setting time. This study highlights the need for careful consideration with regard to the composition of mineral trioxide aggregate, and if possible (when other properties are satisfactory), the C3A component should be avoided, which can be achieved by the mixture of individual components.
Magnetic ion channel activation of TREK1 in human mesenchymal stem cells using nanoparticles promotes osteogenesis in surrounding cells
Authors: Henstock James R , Rotherham Michael , El Haj Alicia J
Published: October 2018

Magnetic ion channel activation technology uses superparamagnetic nanoparticles conjugated with targeting antibodies to apply mechanical force directly to stretch-activated ion channels on the cell surface, stimulating mechanotransduction and downstream processes. This technique has been reported to promote differentiation towards musculoskeletal cell types and enhance mineralisation. Previous studies have shown how mesenchymal stem cells injected into a pre-mineralised environment such as a foetal chick epiphysis, results in large-scale osteogenesis at the target site. However, the relative contributions of stem cells and surrounding host tissue has not been resolved, that is, are the mesenchymal stem cells solely responsible for the observed mineralisation or do mechanically stimulated mesenchymal stem cells also promote a host-tissue mineralisation response? To address this, we established a novel two-dimensional co-culture assay, which indicated that magnetic ion channel activation stimulation of human mesenchymal stem cells does not significantly promote migration but does enhance collagen deposition and mineralisation in the surrounding cells. We conclude that one of the important functions of injected human mesenchymal stem cells is to release biological factors (e.g., cytokines and microvesicles) which guide the surrounding tissue response, and that remote control of this signalling process using magnetic ion channel activation technology may be a useful way to both drive and regulate tissue regeneration and healing.
Feasibility, acceptability and potential effectiveness of an information technology-based, pharmacist-led intervention to prevent an increase in anticholinergic and sedative load among older community-dwelling individuals
Authors: van der Meer Helene G. , Wouters Hans , Teichert Martina , Griens Fabiënne , Pavlovic Jugoslav , Pont Lisa G. , Taxis Katja
Published: October 2018

Background:

Anticholinergic/sedative medications are frequently used by older people, despite their negative impacts on cognitive and physical function. We explore the feasibility, acceptability and potential effectiveness of an innovative information technology (IT)-based intervention to prevent an increase in anticholinergic/sedative load in older people.

Methods:

This was a prospective study in 51 Dutch community pharmacies. Pharmacists used an IT-based tool to identify patients aged ⩾65 years, with existing high anticholinergic/sedative loads (drug burden index ⩾2) and a newly initiated anticholinergic/sedative medication. We determined the following. Feasibility: number of eligible patients identified. Acceptability: pharmacists’ satisfaction with the intervention, pharmacists’ time investment and patients’ willingness to reduce medication use. Potential effectiveness: number of recommendations, rate of agreement of general practitioners (GPs) with proposed recommendations and factors associated with agreement. To evaluate the latter, pharmacists conducted medication reviews and proposed recommendations to GPs for 5–10 patients selected by the IT-based tool.

Results:

We included 305 patients from 47 pharmacies. Feasibility: a mean of 17.0 (standard deviation, 8.8) patients were identified per pharmacy. Acceptability: 43 pharmacists (91.5%) were satisfied with the intervention. The median time investment per patient was 33 min (range 6.5–210). Of 35 patients, 30 (85.7%) were willing to reduce medication use. Potential effectiveness: pharmacists proposed 351 recommendations for 212 patients (69.5%). GPs agreed with recommendations for 108 patients (35.4%). Agreement to stop a medication was reached in 19.8% of recommendations for newly initiated medications (37 of 187) and for 15.2% of recommendations for existing medications (25 of 164). Agreement was more likely for recommendations on codeine [odds ratio (OR) 3.30; 95% confidence interval (CI) 1.14–9.57] or medications initiated by a specialist (OR 2.85; 95% CI 1.19–6.84) and less likely for pharmacies with lower level of collaboration with GPs (OR 0.15; 95% CI 0.02–0.97).

Conclusion:

This innovative IT-based intervention was feasible, acceptable and potentially effective. In one-third of patients an increase in anticholinergic/sedative load was prevented within reasonable time investment.