bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of 6 DOF Supernumerary Robotic Fingers Integrated with 3D Animation
Authors: Ariyanto Mochammad , Setiawan Joga D. , Munadi  , Ismail Rifky , Arifin Zainal
Published: March 2018

The paper presents the development of wearable robot called supernumerary robotic fingers (SRF) that can be integrated with 3D Animation. The robot comprises of two parts, robotic finger (RF) and robotic thumb (RT). RF is located next to little finger, and RT is located next to the thumb. The robot is driven by modified glove sensor. 3D CAD model is exported into SimMechanics for 3D Animation purpose under MATLAB/Simulink environment. Forward kinematics of the robot is studied using SimMechanics and the trajectory of each robotic fingertip will be calculated. Based on the experimental result, the robot and its 3D animation can be operated by a healthy person in real time. The robot can assist in object manipulation with ten-inch tablet using single human hand.
Design of a Low-Cost Fixed Wing UAV
Authors: Ariyanto Mochammad , Setiawan Joga D. , Prabowo Teguh , Haryanto Ismoyo , Munadi
Published: March 2018

This research will try to design a low cost of fixed-wing unmanned aerial vehicle (UAV) using low-cost material that able to fly autonomously. Six parameters of UAV’s structure will be optimized based on basic airframe configuration, wing configuration, straight wing, tail configuration, fuselage material, and propeller location. The resulted and manufactured prototype of fixed-wing UAV will be tested in autonomous fight tests. Based on the flight test, the developed UAV can successfully fly autonomously following the trajectory command. The result shows that low-cost material can be used as a body part of fixed-wing UAV.
Effect of quenching agent on dimension stability of Al 6061-Al2O3composite
Authors: Ilham Akbar Hammar , Surojo Eko , Ariawan Dody
Published: March 2018

Al 6061-Al2O3composite is a lightweight materials that can be used as an alternative material in automotive parts. T6 heat treatment is generally used on aluminium alloy series 6xxx . On T6 heat treatment process, material heated to temperature for obtaining a single phase of α, quenched and then continued by artificial ageing. Quenching is critical step because distortion can be occur in material. The aim of this research is to investigated effect of quenching agent and electroless coating treatment of Al2O3in distortion at Al 6061-Al2O3composite . The distortion was measured by dimensional change in the specimen. Coordinate Measuring Machine (CMM) was used to measured distortion based on coordinate change. Lower distortion are occur on 10E and 10N specimens. Electroless coating process on the reinforcement is more effective to obtain lower distortion on Al 6061-Al2O3composite. The severity (H) of quenchant influenced distortion on specimen. Higher H value produce higher distortion on Al 6061-Al2O3composite.
Development of force feedback in steering systems for virtual driving simulator
Authors: Setiawan Joga Dharma , Baharom Masri B. , Bin Abdul Wali M. Ammar
Published: March 2018

In steer-by-wire (SBW) vehicles, the elimination of the rigid mechanical column shaft would require the system to generate an artificial feedback torque which should produce similar driving feeling and behavior as to the conventional steering system. The objective of this study is to evaluate the characteristics of force feedback inside SBW vehicle for driving simulator utilizing Logitech G27 steering wheel. The model of the system is developed in Matlab/Simulink/3D Animation. A J-turn test is performed to see the resulting handwheel torque and its effect on the vehicle dynamic. The evaluation shows that the results are reasonable such that the driver of the simulator can feel the similar forces coming from the real road.
Design and Construction of Spud Housing for Floating Dock
Authors: Hasanudin Hasanudin , Yulianto Ardi Nugroho
Published: March 2018

A floating dock is a type of pontoon for dry docking ships, possessing floodable buoyancy chambers. The Floating docks have more advantages than the other type of ship docking for maintenance. The purpose of the research study is to design and calculate of spud housing construction for floating dock. The spud housing is used to keep of floating dock in the safe condition. Mild steel material is used to construction of spud housing with yield point 235 x 106 N/m2. Design calculations were done by finite element analysis (FEA). The minimum stress is 1042.36 N/m2 and minimum deflection is 0.447 mm. The maximum stress is 0.142 x 109 N/m2 and maximum deflection is 4.019 mm. The maximum stress is not more than yield point of material.
A Comparative Analysis of Mental Workload between Train and Bus Drivers
Authors: Soewardi Hartomo , Putra Perdana Suteja
Published: March 2018

Human error is one of the crucial problems in land transport, sea transport, and air transport that inflicting some undesirable occurrence such as delay, cancellation, or accident. This incident causes inconvenience and apprehension for passengers. Hence, drivers should avoid some errors in driving by improving alertness and reducing the excessive workload. This study presents a comparative study about mental workload between train and bus drivers based on subjective and objective criteria. NASA-TLX method is used to measure subjective variables by distributing questionnaires. While the content of a drivers’ Salivary α-amylase (SAA) is measured as an objective parameter before and after driving. 30 drivers are participated in this study who have experience for more than 3 years. Statistical analysis is conducted to test the hypothesis for a difference. The result of this study shows that bus drivers’ SAA level is significantly higher (Asymp. Sig. 0.49) than train drivers for both before (91.99 kU/l) and after (83.19 kU/l) driving activity. Similarly, weighted workload subjectively of bus drivers’ mental workload (1051) is higher than train drivers (1031) insignificantly (Asymp. Sig. 0.561).
Observational Research in Homeopathy: Improving Homoeoprophylaxis Research Outcomes
Authors: Golden Isaac
Published: March 2018

Introduction We now have a substantial evidence base supporting the effectiveness of homoeoprophylaxis (HP), but the quality of the evidence is variable. Most interventions are not controlled clinical studies but are undertaken in emergency situations to prevent loss of life and suffering using observational methodology. Methods are developed to improve the quality of future observational research into H2, with consequences for general homeopathic research.

Methods Different methods used to improve the quality of research were considered, and their ability to improve the quality of HP research was considered.

Results Randomised controlled trials (RCTs) are often not the most appropriate method to use in HP research. Observational methods are mostly suitable to study HP interventions. There are a range of techniques which can be used to improve the quality of observational research. A Homoeoprophylaxis Research Checklist is prepared for consideration.

Discussion Prospective observational studies will often provide a more relevant research framework. Research techniques to improve research quality need to be incorporated in future HP interventions to allow meaningful results to be produced.

Conclusion The use of appropriate homoeoprophylaxis programs to prevent targeted infectious diseases has an established place in homeopathy. Its ability to produce a significant and consistent level of protection has been shown time and again in large HP interventions conducted by practitioners, usually with orthodox medical training. More and better-quality research will continue to strengthen the evidence-based case for the use of HP both in short- and long-term infectious disease prevention. Using a standardised research checklist should help improve the quality of research into HP in the future.
In What Year Did Hahnemann Return to Medical Practice?
Authors: Morrell Peter
Published: March 2018

This article examines the timeline of Hahnemann's publications between 1777 and 1819 to reveal the year he most likely moved away from chemistry and returned to the study and practice of medicine.
Clinically Verified Materia Medica: An Explanation and Remedy Example
Authors: Herrick Nancy , Morrison Roger
Published: March 2018

The ‘Clinically Verified Materia Medica’ is a work in progress. It is based on cured cases only rather than the opinions of the author or other trusted authorities. Only remedies of which at least three well-documented cured cases could be found are included. The basis for this project is a trove of seven to eight thousand cured cases from the practice of Roger Morrison and colleagues as also from journals and e-journals. In this article, a case of Lac lupinum by Nancy Herrick is presented as an example.
Gemstones for Highly Sensitive People
Authors: Leupen Alex
Published: March 2018

Alex Leupen has worked in the Homeopathic Doctors Centre in Utrecht, the Netherlands, since 1990. Eight colleagues work in this centre, including Jan Scholten. Alex is an experienced teacher (the Netherlands, Belgium and Germany) on the underlying systems in the plant families, animal kingdom, sarcodes, nosodes, fungi and the periodic table of the elements pertaining to homeopathic practice. In this column, he shares clinical tips.
Patienten mit schwerer Migräne brauchen wirksame Prophylaxe
Authors: Brettschneider Helga
Published: March 2018

Migräne bedeutet für die Patienten einen hohen Leidensdruck. Besonders betroffen sind Patienten mit chronischer Migräne, die unter häufigen und langanhaltenden Attacken leiden. Dazu kommt auch in der migränefreien Zeit die ständige Angst vor der nächsten Attacke und einem erneuten Totalausfall in Familie und Beruf. Für diese Menschen ist eine Prophylaxe der Migräne von besonderer Bedeutung. Doch derzeit bekommen nur wenige Patienten, die eine Prophylaxe benötigen, eine solche Medikation (1).
Facial Fracture Patterns Associated with Traumatic Optic Neuropathy
Authors: Kelishadi Shahrooz S. , Zeiderman Matthew R. , Chopra Karan , Kelamis Joseph A. , Mundinger Gerhard S. , Rodriguez Eduardo D.
Published: March 2018

Traumatic optic neuropathy (TON) is rare. The heterogeneity of injury patterns and patient condition on presentation makes diagnosis difficult. Fracture patterns associated with TON have never been evaluated. Retrospective review of 42 patients diagnosed with TON at the R. Adams Cowley Shock Trauma Center from May 1998 to August 2010 was performed. Thirty-three patients met criteria for study inclusion of fracture patterns. Additional variables measured included patient demographics and mechanism. Cluster analysis was used to form homogenous groups of patients based on different fracture patterns. Fracture frequency was analyzed by group and study population. Visual depiction of fracture patterns was created for each group. Cluster analysis of fracture patterns yielded five common “groups” or fracture patterns among the study population. Group 1 ( n = 3, 9%) revealed contralateral lateral orbital wall (100%), zygoma (67%), and nasal bone (67%) fractures. Group 2 ( n = 7, 21%) demonstrated fractures of the frontal bone (86%), nasal bones (71%), and ipsilateral orbital roof (57%). Group 3 ( n = 14, 43%) involved fractures of the ipsilateral zygoma (100%), lateral orbital wall (29%), as well as frontal and nasal bones (21% each). Group 4 ( n = 5, 15%) consisted of mid- and upper-face fractures; 100% fractured the ipsilateral orbital floor, medial and lateral walls, maxilla, and zygoma; 80% fractured the orbital roof and bilateral zygoma. Group 5 ( n = 4, 12%) was characterized by fractures of the ipsilateral orbital floor, medial and lateral orbital walls (75% each), and orbital roof (50%). A notably high 15 of 33 patients (45%) sustained penetrating trauma. Our study demonstrates five fracture pattern groups associated with TON. Zygomatic, frontal, nasal, and orbital fractures were the most common. Fractures with a combination of frontal, nasal, and orbital fractures are particularly concerning and warrant close attention to the eye.
Die Differenzialdiagnose von Gesichtsschmerzen – meistens sekundär?
Authors: Lukic N. , Sandor P. S. , Gantenbein A. R.
Published: March 2018

Gesichtsschmerzen sind häufig und im akuten Stadium meist durch Sinusitiden oder Zahnpathologien bedingt. Bei chronischen Formen steht ursächlich der Kauapparat zuvorderst. Im Diagnoseprozess entscheiden bereits die Patienten, welchen Mediziner oder Fachspezialisten sie aufsuchen, entsprechend ist eine offene interdisziplinäre. Haltung wichtig. Der Kliniker sollte aber auch gefährlichere sekundäre Formen nicht verpassen und auch an die Manifestation von typischen primären Kopfschmerzen, wie Migräne oder Clusterkopfschmerz, im Gesichtsbereich denken. In der folgenden Übersichtsarbeit werden die wichtigsten und häufigsten Formen sekundärer und symptomatischer Gesichtsschmerzen besprochen.
Gibt es einen psychogenen Kopfschmerz?
Authors: Henkel K.
Published: March 2018

Es besteht eine hohe Komorbidität zwischen primären Kopfschmerzen und psychischen Erkrankungen. Eine gegenseitige Verstärkung und gemeinsame ätiologische Faktoren werden vermutet und wurden zum Teil nachgewiesen, so zum Beispiel bei Migräne und Depressionen. Eine nosologische Einteilung als sekundärer “Kopfschmerz zurückzuführen auf eine psychiatrische Störung“ verlangt eine hinreichende Evidenz für eine Auslösung oder wesentliche Verstärkung des Kopfschmerzes durch die psychische Erkrankung. Dieser Nachweis kann nur in Einzelfällen erfolgen. Größere systematische Untersuchungen fehlen. Die International Classification of Headache Disorders der International Headache Society erkennt auch in ihrer dritten Auflage (Beta-Version) nur die Somatisierungsstörung und die psychotische Störung als mögliche psychische Erkrankungen für die Auslösung sekundärer Kopfschmerzen an. Im Anhang der Klassifikation finden sich weitere psychische Erkrankungen, die möglicherweise sekundäre Kopfschmerzen auslösen können. Weitere prospektive und Längsschnittstudien sind nötig, um diese Zusammenhänge künftig besser beurteilen zu können.
Das reversible zerebrale Vasokonstriktionssyndrom
Authors: Kamm K. , Ruscheweyh R. , Straube A.
Published: March 2018

Das reversible zerebrale Vasokonstriktionssyndrom (RCVS) ist eine häufige, wahrscheinlich unterdiagnostizierte Ursache des Donnerschlagkopfschmerzes. Typischerweise präsentiert sich das RCVS mit einem stärksten, innerhalb von weniger als 1 Minute sein Maximum erreichenden Kopfschmerz. Dieser kann innerhalb von wenigen Wochen, oft getriggert durch körperliche Anstrengung, emotionale Belastung oder Valsalva-Manöver, immer wieder auftreten. Die Erkrankung verläuft meist monosymptomatisch, selbstlimitierend und benigne, allerdings können intrazerebrale Blutungen, Ischämien oder ein PRES komplizierend auftreten. Im folgenden Artikel sollen die typische Präsentation des RCVS, Komplikationen, Verlauf, Therapie und Pathophysiologie vorgestellt werden.
Investigation of acoustic metasurfaces with constituent material properties considered
Authors: Gerard Nikhil JRK , Li Yong , Jing Yun
Published: March 2018

This paper examines the transmission behavior of two acoustic metasurfaces and their constituent structural units while including the various material properties that could affect their functionality. The unit cells and the metasurfaces are modeled numerically, and the impact of the structural interaction and thermoviscosity on sound transmission and phase modulation is studied. Each of these effects is viewed individually in order to better understand their influence. Various cases are presented, and the change in the behavior of the metasurfaces is investigated. The deviations from the ideal desired results are examined and highlighted to show that it is important to incorporate these effects to better predict the behavior of acoustic metasurfaces.
Supply network configuration—A benchmarking problem
Authors: Brandenburg Marcus
Published: March 2018

Managing supply networks is a highly relevant task that strongly influences the competitiveness of firms from various industries. Designing supply networks is a strategic process that considerably affects the structure of the whole network. In contrast, supply networks for new products are configured without major adaptations of the existing structure, but the network has to be configured before the new product is actually launched in the marketplace. Due to dynamics and uncertainties, the resulting planning problem is highly complex. However, formal models and solution approaches that support supply network configuration decisions for new products are scant. The paper at hand aims at stimulating related model-based research. To formulate mathematical models and solution procedures, a benchmarking problem is introduced which is derived from a case study of a cosmetics manufacturer. Tasks, objectives, and constraints of the problem are described in great detail and numerical values and ranges of all problem parameters are given. In addition, several directions for future research are suggested.
Uncertainty principle in loop quantum cosmology by Moyal formalism
Authors: Perlov Leonid
Published: March 2018

In this paper, we derive the uncertainty principle for the loop quantum cosmology homogeneous and isotropic Friedmann-Lemaiter-Robertson-Walker model with the holonomy-flux algebra. The uncertainty principle is between the variables c, with the meaning of connection and μ having the meaning of the physical cell volume to the power 2/3, i.e., v2/3 or a plaquette area. Since both μ and c are not operators, but rather the random variables, the Robertson uncertainty principle derivation that works for hermitian operators cannot be used. Instead we use the Wigner-Moyal-Groenewold phase space formalism. The Wigner-Moyal-Groenewold formalism was originally applied to the Heisenberg algebra of the quantum mechanics. One can derive it from both the canonical and path integral quantum mechanics as well as the uncertainty principle. In this paper, we apply it to the holonomy-flux algebra in the case of the homogeneous and isotropic space. Another result is the expression for the Wigner function on the space of the cylindrical wave functions defined on Rb in c variables rather than in dual space μ variables.
Application of a turbulent vortex core model in the free vortex wake scheme to predict wind turbine aerodynamics
Authors: Xu Bofeng , Feng Junheng , Wang Tongguang , Yuan Yue , Zhao Zhenzhou
Published: March 2018

Developing suitably generalized models of rotor blade vortices that accurately predict their evolution continues to be a challenge for wind turbine analysis. The choice of vortex core model in a free vortex wake (FVW) method is essential to accurately predict rotor aerodynamic performance. In this work, a turbulent vortex core model (β-Vatistas model) was considered and improved. A formula was developed that approximates the key parameter β, which represents the degree of turbulence in the β-Vatistas model. The improved β-Vatistas model was used in the FVW model, and the β value was calculated based on the tip vortex circulation in each iteration. The wake flow characteristic and low speed shaft torque were calculated using the FVW model coupled with the turbulent vortex core model or two laminar vortex core models. The use of the improved β-Vatistas model provided smaller maximum vorticities at the rolled-up angle and a slower dissipation speed of the tip vortex than those calculated by two laminar vortex core models. The FVW model with the improved β-Vatistas model can accurately capture the tip vortex positions, either in the near wake or in the far wake. The results indicate that the application of the β-Vatistas turbulent vortex core model in the FVW model is feasible and can better capture the wake structure than the laminar vortex core models.
Effects of insulating vanadium oxide composite in concomitant mixed phases via interface barrier modulations on the performance improvements in metal-insulator-metal diodes
Authors: Abbas Kaleem , Kang Dae Joon
Published: March 2018

The performance of metal-insulator-metal diodes is investigated for insulating vanadium oxide (VOx) composite composed of concomitant mixed phases using the Pt metal as the top and the bottom electrodes. Insulating VOx composite in the Pt/VOx/Pt diode exhibits a high asymmetry of 10 and a very high sensitivity of 2,135V−1 at 0.6 V. The VOx composite provides Schottky-like barriers at the interface, which controls the current flow and the trap-assisted conduction mechanism. Such dramatic enhancement in asymmetry and rectification performance at low applied bias may be ascribed to the dynamic control of the insulating and metallic phases in VOx composites. We find that the nanostructure details of the insulating VOx layer can be critical in enhancing the performance of MIM diodes.
Instability of liquid flows investigated for a proposed space station cooling system
Authors: Cockbill Louisa
Published: March 2018

Standard techniques reveal two new instabilities that affect liquid sheets in vacuum, important insight for cooling mechanisms used in space.
Marking the unexpected
Authors: Palakurthy Kayla
Published: March 2018

Typological discussions of mirativity often consider the relationship between mirativity and evidentiality (DeLancey 1997,2001;Aikhenvald 2004). However, in interaction speakers mobilize pragmatic extensions of miratives in ways that defy specific categorization. This study analyzes the function and distribution of the Navajo enclitic lá in a Navajo Conversational Corpus (Mithun ed 2015NSF-DEL project 0853598). The enclitic most frequently functions as an interrogative in information questions (Young & Morgan 1987), but it also encodes mirative senses including surprise, counter-expectation, discovery, and reported speech. Though the two seem synchronically unrelated, an examination of the pragmatic functions, as well as consideration of comparative Athabaskan evidence, links the polysemous enclitics as metadiscourse markers signaling contrastive focus on the unexpectedness of a proposition. These data support the interactional relevance of the semantic domain of expectation, subsuming contrastive focus and surprise (Behrens 2012).
Subject preference in Ixcatec relative clauses (Otomanguean, Mexico)
Authors: Adamou Evangelia
Published: March 2018

Subject preference in relative clauses (RCs) has been reported in typologically diverse languages, but overall one notes that the number of languages analyzed experimentally remains extremely low. This paper presents experimental and natural evidence from Ixcatec, a critically-endangered Otomanguean language. Ixcatec is relevant to the discussion on universal subject preference for having syntactically and morphologically ambiguous subject and object RCs that can offer an unconfounded result. Study 1, a picture-matching comprehension experiment, shows that 63% of the ambiguous RCs are interpreted as subject RCs. Results from reaction times show that subject RC interpretations are numerically faster than object RC interpretations, but this difference does not reach significance. Analysis of a three-hour, free-speech corpus in Study 2 indicates that transitive subject RCs are only slightly more frequent than object RCs. In conclusion, although the Ixcatec data support universal subject preference, they also show how this preference is weaker than predicted.
The microRNA-200 family coordinately regulates cell adhesion and proliferation in hair morphogenesis
Authors: Hoefert Jaimee E. , Bjerke Glen A. , Wang Dongmei , Yi Rui
Published: March 2018

The microRNA (miRNA)-200 (miR-200) family is highly expressed in epithelial cells and frequently lost in metastatic cancer. Despite intensive studies into their roles in cancer, their targets and functions in normal epithelial tissues remain unclear. Importantly, it remains unclear how the two subfamilies of the five-miRNA family, distinguished by a single nucleotide within the seed region, regulate their targets. By directly ligating miRNAs to their targeted mRNA regions, we identify numerous miR-200 targets involved in the regulation of focal adhesion, actin cytoskeleton, cell cycle, and Hippo/Yap signaling. The two subfamilies bind to largely distinct target sites, but many genes are coordinately regulated by both subfamilies. Using inducible and knockout mouse models, we show that the miR-200 family regulates cell adhesion and orientation in the hair germ, contributing to precise cell fate specification and hair morphogenesis. Our findings demonstrate that combinatorial targeting of many genes is critical for miRNA function and provide new insights into miR-200’s functions.
Genus three curves and 56 nodal sextic surfaces
Authors: van Geemen Bert , Zhao Yan
Published: March 2018

Catanese and Tonoli showed that the maximal cardinality for an even set of nodes on a sextic surface is 56 and they constructed such nodal surfaces. In this paper we give an alternative, rather simple, construction for such surfaces starting from non-hyperelliptic genus three curves. We illustrate our method by giving explicitly the equation of such a sextic surface starting from the Klein curve.
Density of positive closed currents, a theory of non-generic intersections
Authors: Dinh Tien-Cuong , Sibony Nessim
Published: March 2018

We introduce a notion of density which extends both the notion of the Lelong number and the theory of intersection for positive closed currents on Kähler manifolds. For an arbitrary finite family of positive closed currents on a compact Kähler manifold we construct cohomology classes which represent their intersection even when a phenomenon of dimension excess occurs. An example is the case of two algebraic varieties whose intersection has dimension larger than the expected number. The theory allows us to solve problems in complex dynamics. Basic calculus on the density of currents is established.
The Colonization Process of Sunflower by a Green Fluorescent Protein-Tagged Isolate of Verticillium dahliae and its Seed Transmission
Authors: Zhang Y. , Zhang J. , Gao J. , Zhang G. , Yu Y. , Zhou H. , Chen W. , Zhao J.
Published: March 2018

Sunflower Verticillium wilt is a widespread and destructive disease caused by the soilborne pathogen Verticillium dahliae. To better understand the process of infection and seed transmission of the fungus, sunflower roots were inoculated with a V. dahliae strain (VdBM9-6) labeled with green fluorescent protein (GFP) and monitored microscopically. After 24 to 96 h postinoculation (hpi), conidia germinated and developed into mycelium on root hairs, elongation zones, and caps of lateral roots. Mycelium colonized vascular bundles of lateral roots and taproots at 7 days postinoculation (dpi). At 10 weeks postinoculation (wpi), the epidermal cells, cortical tissues, and vascular elements of stem, petiole, and leaf veins were colonized by mycelium. By 12 wpi, strong GFP signals were detected not only on different tissues of inflorescence but also on testa of seed and a small fraction of pollen grains. A GFP signal was not observed on cotyledon tissues in the seed. Additionally, the colonization of V. dahliae on testa was also confirmed with MNP-10 selection medium, indicating that the testa of seed is the main carrier for the long distance transmission of sunflower yellow wilt.
Evaluating the Sensitivity and Efficacy of Fungicides with Different Modes of Action Against Botryosphaeria dothidea
Authors: Song Yingying , Li Lili , Li Chao , Lu Zengbin , Men Xingyuan , Chen Fajun
Published: March 2018

Botryosphaeria dothidea, the causal agent of apple ring rot, is an important fungal plant pathogen that can cause serious reductions in crop yield, and fungicides still play a crucial role in management. In the present study, the sensitivity of B. dothidea to fludioxonil, fluazinam, and pyrisoxazole was assessed in 162 isolates. Moreover, the protective and curative activity of the three fungicides on detached apple fruit as well as the control efficacy in the field were determined. The results showed that the mean 50% effective concentration (EC50) values (± standard deviation) were 0.01 ± 0.008, 0.04 ± 0.03, and 0.02 ± 0.01 μg ml−1, with individual EC50 values of 0.002 to 0.05, 0.003 to 0.19, and 0.005 to 0.26 μg ml−1 for fludioxonil, fluazinam, and pyrisoxazole, respectively. In addition, the frequency distributions of EC50 values were both unimodal curves. However, significant correlations (P < 0.05) were found between fludioxonil and iprodione, between fluazinam and iprodione, as well as between pyrisoxazole and difenoconazole. In field trials conducted during 2016 and 2017, the control efficacy ranged from 75.91 to 87.41% when fludioxonil was applied at 100 to 150 mg active ingredient (a.i.) kg−1, 81.90 to 85.13% when fluazinam was applied at 400 mg a.i. kg−1, and 77.43 to 80.97% when pyrisoxazole was applied at 400 mg a.i. kg−1. The control efficacy of the fungicides in storage was higher than 60%, with the exception of fluazinam. These results demonstrated that fludioxonil, fluazinam, and pyrisoxazole have considerable potential to control apple ring rot.
Phylogeny and Pathogenicity of Celoporthe Species from Plantation Eucalyptus in Southern China
Authors: Wang Wen , Liu QianLi , Li GuoQing , Liu FeiFei , Chen ShuaiFei
Published: March 2018

The family of Cryphonectriaceae (Diaporthales) includes many important tree pathogens, such as those that cause severe cankers on Eucalyptus trees. Recently, stem canker and cracked bark were observed on 8-year-old Eucalyptus grandis × E. urophylla trees in a plantation in southern China. Fruiting structures typical of Cryphonectriaceae fungi were observed on the surface of the diseased tissues. In this study, the isolated fungi were identified based on DNA sequence analyses and morphological characteristics, and their pathogenicity was tested on three Eucalyptus clones. DNA sequence comparisons of the internal transcribed spacer (ITS) regions (including the intervening 5.8S nrRNA gene), two regions of β-tubulin (BT2/BT1), and partial translation elongation factor1-α (TEF-1α), indicated that these isolates represent Celoporthe syzygii and one previously undescribed species. The undescribed species was also morphologically distinct from the other species of Celoporthe. The new species was described and named C. cerciana sp. nov. The results of this study based on the ITS, BT2/BT1, and TEF-1α sequences indicated that more than one haplotype was isolated from the same Eucalyptus tree. The findings of a previous study, whereby C. eucalypti was isolated from the same plantation as that of this study, revealed the high species diversity of Celoporthe within a single plantation, which is associated with a single Eucalyptus sp. in southern China. The results further suggested that hybridization may occur between C. syzygii and C. eucalypti. In addition to the Eucalyptus trees, C. syzygii was also isolated from native Melastoma candidum in the same Eucalyptus plantation. The inoculation results showed that these fungi isolated from E. grandis × E. urophylla and M. candidum are pathogenic to all three tested E. grandis hybrid clones. Significant differences in tolerance were observed between the tested Eucalyptus clones, suggesting that disease-tolerant Eucalyptus genotypes can be selected for disease management.
The Efficacy of Renin Inhibitors in Primary Hypertension
Authors: Pich Jacqueline
Published: March 2018

Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
Ostomy Care at Home
Authors: Kirkland-Kyhn Holly , Martin Sanaz , Zaratkiewicz Sunniva , Whitmore Morgan , Young Heather M.
Published: March 2018

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.

The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet—Information for Family Caregivers—that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.
L5/S1 Fusion Rates in Degenerative Spine Surgery
Authors: Schroeder Gregory D. , Kepler Christopher K. , Millhouse Paul W. , Fleischman Andrew N. , Maltenfort Mitchell G. , Bateman Dexter K. , Vaccaro Alexander R.
Published: March 2018

Study Design:

Systematic review.

Objective:

To determine the fusion rate of an anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), and axial arthrodesis at the lumbosacral junction in adult patients undergoing surgery for 1- and 2-level degenerative spine conditions.

Summary of Background Data:

An L5/S1 interbody fusion is a commonly performed procedure for pathology such as spondylolisthesis with stenosis; however, it is unclear if 1 technique leads to superior fusion rates.

Materials and Methods:

A systematic search of MEDLINE was conducted for literature published between January 1, 1992 and August 17, 2014. All peer-reviewed articles related to the fusion rate of L5/S1 for an ALIF, TLIF, or axial interbody fusion were included.

Results:

In total, 42 articles and 1507 patients were included in this systematic review. A difference in overall fusion rates was identified, with a rate of 99.2% (range, 96.4%–99.8%) for a TLIF, 97.2% (range, 91.0%–99.2%) for an ALIF, and 90.5% (range, 79.0%–97.0%) for an axial interbody fusion (P=0.005). In a paired analysis directly comparing fusion techniques, only the difference between a TLIF and an axial interbody fusion was significant. However, when only cases in which bilateral pedicle screws supported the interbody fusion, no statistical difference (P>0.05) between the 3 techniques was identified.

Conclusions:

The current literature available to guide the treatment of L5/S1 pathology is poor, but the available data suggest that a high fusion rate can be expected with the use of an ALIF, TLIF, or axial interbody fusion. Any technique-dependent benefit in fusion rate can be eliminated with common surgical modifications such as the use of bilateral pedicle screws.
Eligibility of Outpatient Spine Surgery Candidates in a Single Private Practice
Authors: Chin Kingsley R. , Pencle Fabio J.R. , Coombs André V. , Packer Corrine F. , Hothem Elijah A. , Seale Jason A.
Published: March 2018

Study Design:

Level III.

Purpose:

To retrospectively review the eligibility of surgical patients meeting predetermined outpatient surgery criteria in a single-surgeon private practice.

Summary of Background Data:

There is a burgeoning awareness among patients, surgeons, and insurers of the cost benefits and safety of outpatient spine surgeries. At the end of 2014, Centers for Medicare & Medicaid Services have released its final 2015 payment rules and codes for spinal decompression and fusion. This move confirms the safety of procedures being performed in the ambulatory surgery centers (ASCs).

Methods:

We conducted a database review between 2008 and 2014 and identified 1625 orthopedic procedures. All nonsurgical spine procedures were excluded from the study. Eligibility for outpatient spine surgery was based on criteria generated from a combination of published standard of care for major operations and the chief surgeon’s experience. A matched cohort based on type of surgery in each facility of all spine surgery patients was created, group 1 (hospital patients) and group 2 (ASC patients).

Results:

A total of 708 patients underwent spinal surgery during this time period with a 53% female population. A total of 557 of 708 (79%) patients were eligible for outpatient spine surgery. There were 210 surgical procedures in group 1 (inpatient) comprised of 72 decompression and 138 fusion procedures. In group 2 (outpatient), there were 347 procedures made up of 150 patients undergoing decompression and 197 undergoing fusion or disc replacement. To confirm that hospital procedures are eligible to be performed in the ASC, the χ2 test was performed. We found that ASC-eligible hospital patients can indeed be done in an ASC (P=0.037).

Conclusions:

Outpatient spine surgery is feasible in 79% of patients in this single-surgeon private practice. On the basis of these results, a majority of spine procedures can be performed in an outpatient setting following our eligibility criteria.
Understanding Business Models in Health Care
Authors: Sharan Alok D. , Schroeder Gregory D. , West Michael E. , Vaccaro Alexander R.
Published: March 2018

The increasing focus on the costs of care is forcing health care organizations to critically look at their basic set of processes and activities, to determine what type of value they can deliver. A business model describes the resources, processes, and cost assumptions that an organization makes that will lead to the delivery of a unique value proposition to a customer. As health care organizations are beginning to transform their structure in preparation for a value-based delivery system, understanding business model theory can help in the redesign process.
The Service-Profit Chain in Spine Surgery
Authors: Sharan Alok D. , Schroeder Gregory D. , West Michael E. , Vaccaro Alexander R.
Published: March 2018

Medicine has always been a service industry (as opposed to a manufacturing industry), as there is a shift from volume to value in health care, this point is becoming increasingly important. The delivery of good care extends beyond the technical aspects of performing a complex operation or prescribing the right type of medicine. Intuitively physicians have always understood the value of the physician-patient relationship, and its correlation to a good outcome. As patients are increasingly being forced to spend a greater portion of their personal income on health care through high-deductible plans and larger co-pays, physicians have to differentiate themselves through the delivery of great service beyond the delivery of superior health outcomes. Understanding the service-profit chain can help physicians succeed in the transition to a value-based health care system.
Limitations of Using Microsoft Excel Version 2016 (MS Excel 2016) for Statistical Analysis for Medical Research
Authors: Tanavalee Chotetawan , Luksanapruksa Panya , Singhatanadgige Weerasak
Published: March 2018

Microsoft Excel (MS Excel) is a commonly used program for data collection and statistical analysis in biomedical research. However, this program has many limitations, including fewer functions that can be used for analysis and a limited number of total cells compared with dedicated statistical programs. MS Excel cannot complete analyses with blank cells, and cells must be selected manually for analysis. In addition, it requires multiple steps of data transformation and formulas to plot survival analysis graphs, among others. The Megastat add-on program, which will be supported by MS Excel 2016 soon, would eliminate some limitations of using statistic formulas within MS Excel.
Posterior Cervical Foraminotomy
Authors: Dodwad Shah-Jahan M. , Dodwad Shah-Nawaz M. , Prasarn Mark L. , Savage Jason W. , Patel Alpesh A. , Hsu Wellington K.
Published: March 2018

Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy.
The Timing of Surgery and Symptom Resolution in Patients Undergoing Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disk Disease and Radiculopathy
Authors: Villavicencio Alan T. , Nelson E. Lee , Rajpal Sharad , Burneikiene Sigita
Published: March 2018

Objective:

Success rates of surgical interventions for lumbar disorders vary significantly depending on multiple factors and, among them, the duration of symptoms. It is not clear whether there is a “cutoff” time when decompression and fusion surgery becomes less effective in the conditions with chronic nerve root compression symptomatology. The main objective of this study was to analyze whether duration of symptoms has any effect on clinical outcomes and primarily resolution of radicular pain symptoms due to degenerative disk disease and stenosis with spondylolisthesis in patients undergoing transforaminal lumbar interbody fusion (TLIF).

Methods:

The prospective observational study was performed. Eighty-four patients with radicular symptoms due to degenerative disk disease and stenosis with spondylolisthesis with no previous fusion surgeries and undergoing 1- to 3-level TLIF surgery were enrolled. Fifteen patients (18%) were lost to follow-up and were excluded from this analysis leaving a total of 69 patients. Standardized questionnaires were used to analyze clinical outcomes and were administered preoperatively within 3 months of scheduled surgery, and postoperatively at 3, 6, 12, and 24 months. To emphasize the change in clinical outcome scores, the relevant scores were calculated as the ratio of minimal clinically important difference values and change scores. The change scores were calculated by subtracting the postoperative scores from the baseline scores. Multiple regression analyses were conducted to examine the relationship of the duration of symptoms and relevant minimal clinically important difference ratio values while controlling for independent variables. Further, a comparison between 2 groups of patients was performed to analyze the changes of clinical outcomes for the patients who underwent fusion within <24 months versus ≥24 months.

Results:

It was determined that the duration of symptoms was a significant predictor of better leg pain resolution (P=0.018), but not back pain resolution (P=0.27), or improvement in ODI (P=0.10) and SF-36 PCS scores (P=0.19). The patients with shorter duration of symptoms had significantly better radicular symptom resolution (P=0.032) compared with patients who waited at least 24 months or longer to undergo fusion.

Conclusions:

A shorter duration of symptoms was found to be a statistically significant predictor for better resolution of radicular symptoms in patients undergoing TLIF for painful degenerative disk disease and stenosis with spondylolisthesis.
Radiologic and Functional Outcomes in Unstable Thoracolumbar Fractures Treated With Short-segment Pedicle Instrumentation
Authors: Rojas-Tomba Facundo , Hernández-Ruiz Ángel , Menéndez-Quintanilla Ismael , García de Quevedo-Puerta David , Moriel-Durán José , Villanueva-Pareja Francisco
Published: March 2018

Study Design:

A retrospective review of radiographs, clinical charts, and health questionnaires of 40 patients.

Objective:

To evaluate the radiologic and functional results of unstable thoracolumbar fractures treated with short-segment pedicle instrumentation (SSPI).

A Summary of Background Data:

Although earlier publications report a risk of correction loss or material failure after short-segment fixation in unstable thoracolumbar fractures, more current data suggest that improvements in this technique could offer good clinical and radiologic results.

Materials and Methods:

We undertook a retrospective review of 40 patients with unstable thoracolumbar fractures treated with SSPI. Radiographs and computed tomogrphic scans were analyzed to determine fracture classification and sagittal plane deformity, estimated by the Cobb method. The rates of final kyphosis and correction loss and their relationship with the Load Sharing Classification (LSC) and the AO classification were analyzed. We reviewed the hospital charts to identify complications and outcomes. At the final follow-up, the Short-Form 36 health survey was carried out to evaluate the functional outcome. The relationship between conditions such as polytrauma, neurological compromise or fracture site, and radiological and functional outcomes was also analyzed.

Results:

We observed mean values of 5.9 degrees of final follow-up kyphosis and 5.1 degrees of correction loss. One case of material failure was seen. The severity in the LSC or the AO classification, polytrauma, neurological compromise, or fracture site had no relationship with worse radiologic or functional outcomes.

Conclusions:

SSPI shows good results in fracture reduction, with good functional outcomes despite the loss of correction seen at the final follow-up. Although no investigated variable was found to be predictive of radiographic failure, a trend was identified (P=0.07) that patients with a higher LSC had an increased loss of correction.
Cervical Disk Arthroplasty Versus Anterior Cervical Decompression and Fusion for the Treatment of 2-Level Cervical Spondylopathy
Authors: Kuang Lei , Chen Yuqiao , Wang Bing , Li Lei , Lü Guohua
Published: March 2018

Study Design:

Systematic review and meta-analysis.

Objective:

To assess the safety and efficacy of cervical disk arthroplasty (CDA) compared with anterior cervical decompression and fusion (ACDF) for the treatment of 2-level cervical spondylopathy.

Summary of Background Data:

CDA has emerged as a potential alternative to ACDF in patients with cervical disk degeneration. But there are no published systematic reviews and meta-analyses comparing CDA with ACDF for the treatment of 2-level cervical spondylopathy.

Methods:

The Pubmed, Embase, Web of science, Scopus, and Cochrane library databases were searched comparing CDA to ACDF in patients with 2-level cervical spondylopathy. Outcome measures were neck disability index, visual analog scale (VAS) of arm and neck pain, range of movement (ROM) at C2–C7, functional segment unit ROM, ROM at the operated level, and incidence of radiologic changes at adjacent levels approximately 2 years after surgery, as well as operating time and incidence of surgery-related complications. Mean difference (MD), odds ratios (OR), and their corresponding 95% confidence intervals (95% CIs) were calculated.

Results:

Six studies involving 646 patients were included. There were no significant differences in neck disability index (MD, −1.53; 95% CI −3.80 to 0.73), VAS neck pain (MD, −0.19; 95% CI −0.71 to 0.33), and VAS arm pain (MD, −0.23; 95% CI −0.61 to 0.16) between 2-level CDA and 2-level ACDF cases. ROM at C2–C7 (MD, 15.82; 95% CI, 10.66–20.99), functional segment unit ROM (MD, 8.58; 95% CI, 7.93–9.23), and ROM at the operated level (MD, 9.54; 95% CI, 7.73–11.35) were greater, but the incidence of radiologic changes at adjacent levels (OR, 0.29; 95% CI, 0.13–0.67) were lower, in 2-level CDA cases. In 2-level CDA cases, the operating time was longer (MD, 57.41; 95% CI, 24.67–90.14), but surgery-related complications rates (OR, 0.47; 95% CI, 0.30–0.74) was lower.

Conclusions:

CDA may be a safe and effective alternative to ACDF for the treatment of 2-level cervical degenerative disease.

Level of Evidence:

Level II.