bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy and comfort performance benefits of early detection of building sensor and actuator faults
Authors: Gunay Burak , Shen Weiming , Huchuk Brent , Yang Chunsheng , Bucking Scott , O’Brien William
Published: April 2018

This paper presents a building performance simulation-based investigation to better understand the energy and comfort performance benefits of early detection of common sensor and actuator faults. Five types of air-handling unit faults and four types of zone-level faults were implemented to the energy management system application of the building performance simulation tool EnergyPlus. During 50-year simulation periods, the faults were randomly permitted to affect 75 different components of an archetype medium-sized office building model. The sensitivity of the simulation results with respect to three variables was studied: fault recurrence period, fault repair period, and discomfort threshold for simulated complaints. The results indicate that the energy use intensity and the predicted percentage of dissatisfied exhibit a power–law relationship with time, in which most of the performance reductions occur in the first 10 years. If the work-orders are issued only upon occupant complaints, the faults were estimated to cause a 16–62% increase in the energy use intensity for heating, ventilation, and air-conditioning and a 11–38% increase in the predicted percentage of dissatisfied at the end of the 50-year simulation periods. The results indicate that if the faults can be detected within a month after their first appearance, almost all their detrimental effects on a building’s energy and comfort performance can be mitigated.

Practical application: The methodology and results presented in this article are of practical use for those who study on-going commissioning, fault detection and diagnostics, and energy management systems in buildings. The simulation-based parametric analysis approach can be used to estimate the range of energy and comfort savings expected through early detection of common sensor and actuator faults in commercial buildings. Insights gathered from such an analysis can be used in planning the frequency of retro-commissioning and investments for automated fault detection and diagnostics systems.
Adaptive Testing With a Hierarchical Item Response Theory Model
Authors: Wang Wenhao , Kingston Neal
Published: April 2018

The hierarchical item response theory (H-IRT) model is very flexible and allows a general factor and subfactors within an overall structure of two or more levels. When an H-IRT model with a large number of dimensions is used for an adaptive test, the computational burden associated with interim scoring and selection of subsequent items is heavy. An alternative approach for any high-dimension adaptive test is to reduce dimensionality for interim scoring and item selection and then revert to full dimensionality for final score reporting, thereby significantly reducing the computational burden. This study compared the accuracy and efficiency of final scoring for multidimensional, local multidimensional, and unidimensional item selection and interim scoring methods, using both simulated and real item pools. The simulation study was conducted under 10 conditions (i.e., five test lengths and two H-IRT models) with a simulated sample of 10,000 students. The study with the real item pool was conducted using item parameters from an actual 45-item adaptive test with a simulated sample of 10,000 students. Results indicate that the theta estimations provided by the local multidimensional and unidimensional item selection and interim scoring methods were relatively as accurate as the theta estimation provided by the multidimensional item selection and interim scoring method, especially during the real item pool study. In addition, the multidimensional method required the longest computation time and the unidimensional method required the shortest computation time.
Residential Mobility and Cognitive Function Among Middle-Aged and Older Adults in China
Authors: Xu Hanzhang , Dupre Matthew E. , Østbye Truls , Vorderstrasse Allison A. , Wu Bei
Published: April 2018

Objectives:

To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China.

Method:

We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China ( N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function.

Results:

Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates.

Discussion:

Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China.
Wernicke’s encephalopathy after cardiac surgery
Authors: Nishimura Yoshiyuki
Published: April 2018

A 76-year-old woman who had been on hemodialysis for 3 years developed ischemic mitral valve insufficiency, tricuspid insufficiency, and chronic atrial fibrillation, and underwent cardiac surgery. On the 4th postoperative day, she experienced a sudden disturbance of consciousness, aphasia, and limb ataxia. Brain computed tomography and magnetic resonance imaging showed no abnormalities. Wernicke’s encephalopathy was suspected and the patient was given vitamin B1, whereupon her symptoms gradually improved. On the 42nd postoperative day, she was free of neurological symptoms and discharged.
Topogram-based tube current modulation of head computed tomography for optimizing image quality while protecting the eye lens with shielding
Authors: Lin Ming-Fang , Chen Chia-Yuen , Lee Yuan-Hao , Li Chia-Wei , Gerweck Leo E , Wang Hao , Chan Wing P
Published: April 2018

Background

Multiple rounds of head computed tomography (CT) scans increase the risk of radiation-induced lens opacification.

Purpose

To investigate the effects of CT eye shielding and topogram-based tube current modulation (TCM) on the radiation dose received by the lens and the image quality of nasal and periorbital imaging.

Material and Methods

An anthropomorphic phantom was CT-scanned using either automatic tube current modulation or a fixed tube current. The lens radiation dose was estimated using cropped Gafchromic films irradiated with or without a shield over the orbit. Image quality, assessed using regions of interest drawn on the bilateral extraorbital areas and the nasal bone with a water-based marker, was evaluated using both a signal-to-noise ratio (SNR) and contrast-noise ratio (CNR). Two CT specialists independently assessed image artifacts using a three-point Likert scale.

Results

The estimated radiation dose received by the lens was significantly lower when barium sulfate or bismuth-antimony shields were used in conjunction with a fixed tube current (22.0% and 35.6% reduction, respectively). Topogram-based TCM mitigated the beam hardening-associated artifacts of bismuth-antimony and barium sulfate shields. This increased the SNR by 21.6% in the extraorbital region and the CNR by 7.2% between the nasal bones and extraorbital regions. The combination of topogram-based TCM and barium sulfate or bismuth-antimony shields reduced lens doses by 12.2% and 27.2%, respectively.

Conclusion

Image artifacts induced by the bismuth-antimony shield at a fixed tube current for lenticular radioprotection were significantly reduced by topogram-based TCM, which increased the SNR of the anthropomorphic nasal bones and periorbital tissues.
Determination of the Position of the Knee at the Time of an Anterior Cruciate Ligament Rupture for Male Versus Female Patients by an Analysis of Bone Bruises
Authors: Owusu-Akyaw Kwadwo A. , Kim Sophia Y. , Spritzer Charles E. , Collins Amber T. , Englander Zoë A. , Utturkar Gangadhar M. , Garrett William E. , DeFrate Louis E.
Published: April 2018

Background:

The incidence of anterior cruciate ligament (ACL) ruptures is 2 to 4 times higher in female athletes as compared with their male counterparts. As a result, a number of recent studies have addressed the hypothesis that female and male patients sustain ACL injuries via different mechanisms. The efficacy of prevention programs may be improved by a better understanding of whether there are differences in the injury mechanism between sexes.

Hypothesis/Purpose:

To compare knee positions at the time of a noncontact ACL injury between sexes. It was hypothesized that there would be no differences in the position of injury.

Study Design:

Controlled laboratory study.

Methods:

Clinical T2-weighted magnetic resonance imaging (MRI) scans from 30 participants (15 male and 15 female) with a noncontact ACL rupture were reviewed retrospectively. MRI scans were obtained within 1 month of injury. Participants had contusions associated with an ACL injury on both the medial and lateral articular surfaces of the femur and tibia. Three-dimensional models of the femur, tibia, and associated bone bruises were created via segmentation on MRI. The femur was positioned relative to the tibia to maximize bone bruise overlap, thereby predicting the bone positions near the time of the injury. Flexion, valgus, internal tibial rotation, and anterior tibial translation were measured in the predicted position of injury.

Results:

No statistically significant differences between male and female patients were detected in the position of injury with regard to knee flexion ( P = .66), valgus ( P = .87), internal tibial rotation ( P = .26), or anterior tibial translation ( P = .18).

Conclusion:

These findings suggest that a similar mechanism results in an ACL rupture in both male and female athletes with this pattern of bone bruising.

Clinical Relevance:

This study provides a novel comparison of male and female knee positions at the time of an ACL injury that may offer information to improve injury prevention strategies.
Effects of Developmental Age on Symptom Reporting and Neurocognitive Performance in Youth After Sports-Related Concussion Compared to Control Athletes
Authors: Murdaugh Donna L. , Ono Kim E. , Morris Sarah O. , Burns Thomas G.
Published: April 2018

There is increased necessity to focus research on school-aged athletes with sports-related concussion (SRC). This study assessed differences in symptom reporting and neurocognitive performance in youth athletes who sustained a sports-related concussion. A total of 1345 concussed and 3529 nonconcussed athletes (ages 8-21) completed the Immediate Post-concussive Assessment and Cognitive Testing (ImPACT). Analyses of covariance were conducted in order to assess differences in neurocognitive performance and symptom reporting between the sports-related concussion and control groups across age ranges. Longitudinal hierarchical linear modeling was employed to examine age and its relationship with rates of sports-related concussion recovery in neurocognitive performance. Results revealed athletes aged 13 to 15 had significantly lower neurocognitive performance scores compared to same-aged athletes without a history of sports-related concussion. With respect to the hierarchical linear modeling results, age was identified as a unique predictor of symptom recovery, particularly for ages 8 to 12. Results provide a better understanding of typical symptom reporting and neurocognitive outcomes for younger athletes across different ages.
Managing Regional Impacts of Trade Liberalization: Informal Practices and Collaborative Economic Development on the U.S.–Mexico Border
Authors: Pipkin Seth
Published: April 2018

How can local actors manage the regional-level impacts of trade liberalization? Most scholarship focuses on how given endowments, such as geographic location and existing industries, affect the local economic impacts of these contentious policies. This study considers local actors’ room for maneuver by focusing on a controlled case comparison of two city pairs along the Texas–Mexico border. These city pairs possessed very similar resource endowments and formal institutions prior to the enactment of the North American Free Trade Agreement, but diverged dramatically afterward in their economic growth patterns. A detailed comparison of policy implementation reveals that distinct local informal institutions were a key source of their economic divergence. The identification of the role of these “repertoires” of unwritten local habits and practices underscores the potential impact of collaborative efforts on long-term economic outcomes while adding to our understanding of the basis on which such collaborations are built.
Nonlinear dynamic analysis of an electromechanical coupling transmission system: A case study on shearers
Authors: Sheng Lianchao , Li Wei , Wang Yuqiao , Fan Mengbao , Yang Xuefeng
Published: April 2018

The operation environment of an electromechanical coupling transmission system in shearers is significantly harsher than that of electromechanical coupling transmission system for general applications. Besides, under the combined action of electrical and mechanical factors, unstable phenomenon may appear when the complicated dynamic behaviors of electromechanical coupling transmission system of a shearer occur such as bifurcation and chaos. Therefore, to solve this problem, the stability, bifurcation, and chaotic characters of electromechanical coupling transmission system with various electromagnetism stiffnesses are investigated in this paper. Then, the nonlinear dynamic equation of electromechanical coupling transmission system of a shearer is set up by taking both air-gap field energy of permanent magnet synchronous motor and coupling impact of mechanical and electrical parameters. According to the established equations, the equilibrium point and eigenvalue of the system are discussed. Meanwhile, the parameters conditions of the system Hopf bifurcation and chaotic motion are analyzed, and the homoclinic orbit of the system is determined. The results show that bifurcation and chaotic motion can be controlled effectively when reasonable parameters are concerned, which is of great practical significance to further study the vibration of the mechanical-electromagnetic coupling transmission system and the improvement of system stability.
Design optimization of a thrust chamber using a mass-based model to improve the geometrical and performance parameters of low-thrust space propulsion systems
Authors: Shafaee Maziar , Mohammad Zadeh Parviz , Elkaie Abbas , Fallah Hamed
Published: April 2018

A large portion of the wet and dry mass budget in any space system is assigned to the propulsion system. Each of these depends on the engine system design values. Any effort to decrease the mass of space systems demands an additional effort to reduce the propulsion system mass, which in turn requires a complete review of the engine design. Thus, proposing a computational model derived from the engine design and based on minimum system mass is necessary. The present computational research developed a propulsion system design strategy for liquid propulsion systems to optimize take-off mass and satisfy the thrust required under performance and structural constraints. Improvement of the geometric and performance variables and component mass using a mass-based model for optimization process is investigated. The method uses a hybrid genetic algorithm sequential quadratic programming as an optimizer. The mass-based formulation problem is solved using a hybrid optimization algorithm with a genetic algorithm as the global optimizer and sequential quadratic programming as the local optimizer starting from the solution given by the genetic algorithm. The convergence of the optimization algorithm is improved by introducing an initial solution based on genetic algorithm. Comparison of the proposed design optimization model with a real space propulsion system indicates that the performance of the proposed algorithm significantly improved the final results. While propellant mass, engine consumption rate and engine geometric dimensions decreased, specific impulse increased. All of these decreased the total mass of the space propulsion system.
Lymphomatoid papulosis presenting as a rash in a patient with HIV infection
Authors: Warren Sian , Li Vincent , Drayton Rachel , May Kenneth
Published: April 2018

A 43-year-old Malaysian man with well-controlled HIV infection on combination antiretroviral therapy presented with a six-week history of a widespread rash. The patient was otherwise well but was developing new lesions on a daily basis. Referral to Dermatology instigated punch biopsies, which revealed a diagnosis of lymphomatoid papulosis type A. This case highlights the importance of swift referral, especially in cases of spontaneous regression of symptoms, in order to obtain the correct diagnosis. In most patients, this condition tends to be chronic, with its chronicity and benign clinical course setting it apart from cutaneous anaplastic T-cell lymphoma and Hodgkin’s disease, which are major entities in the histological differential diagnosis.
Photoprotection awareness and practices among patients with systemic lupus erythematosus and its association with disease activity and severity
Authors: Abdul Kadir W D , Jamil A , Shaharir S Sazliyana , Md Nor N , Abdul Gafor A H
Published: April 2018

Objective

The objective of this paper is to determine photoprotection awareness, knowledge, practices, and its relationship with disease activity and damage in patients with systemic lupus erythematosus (SLE).

Methods

A cross-sectional study was performed. Data were acquired from in-person interviews and medical records.

Results

A total of 199 (89.6%) females and 23 (10.4%) males were recruited. Median age was 39.00 (interquartile range (IQR) 18) years, disease duration 12.12 (IQR 8) years, Fitzpatrick skin phototype III 119 (53.6%) and IV 81 (36.5%). Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) was 2.95 (IQR 4) while Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-ACR DI) was 1.20 (IQR 2). The majority 205 (92.3%) were aware of sun exposure effects on SLE. Photoprotection methods were shade seeking 209 (94.1%), sun avoidance 212 (95.5%), long pants 168 (75.7%), long sleeves 155 (69.8%), sunscreen 116 (52.3%), sunglasses 114 (51.4%) and head cover 103 (46.4%). Significantly higher photoprotection practice scores (PPS) were observed in females, Malays, and individuals with higher education level and internet accessibility. PPS were not significantly correlated with SLICC-ACR DI and SLEDAI-2 K. Independent predictors for good photoprotection practice (GPP) were ethnicity (OR = 3.66, 95% CI 1.78–7.53), awareness (OR = 3.77, 95% CI 1.09–13.08) and cutaneous involvement (OR = 2.43, 95% CI 1.11–5.28). Photoprotection methods and GPP were not predictors for disease activity or damage.

Conclusion

Photoprotection awareness and knowledge was good. Shade seeking and sun avoidance were the common photoprotection methods practised. The use of sunscreen requires improvement. Photoprotection awareness and cutaneous manifestation were predictors for GPP. Neither photoprotection methods nor GPP were associated with disease activity or damage.
The clinical manifestations and response to treatment in South Africans with lupus nephritis
Authors: Mody P G , Mody G M , Assounga A
Published: April 2018

There are varying observations on the influence of ethnicity on the clinical spectrum and response to treatment in lupus nephritis (LN). We studied a multiethnic South African LN cohort to determine the clinical manifestations, histological involvement and response to therapy. We reviewed the records of LN patients at Inkosi Albert Luthuli Central Hospital in Durban. There were 105 patients, 92.5% females and they comprised 49.1% Indians and 45.3% African Blacks. The mean age was 31.3 ± 12.5 years, and 41.5% had LN at first presentation of lupus. The most common histological classes were Class V alone in 34.9%, Class IV (± Class V) in 25.5% and Class III (±Class V) in 22.6%. The estimated glomerular filtration rate was reduced (<30 ml/min) at presentation in 15 (14.2%). Eighty-seven patients received therapy for LN. A response to induction therapy was noted in 81.6% and maintenance therapy (12 months) in 73.6%. Response to mycophenolate mofetil (MMF) was 80.4% and 68.4% during induction and maintenance therapy, respectively. There was no ethnic difference in the histological class or response to MMF but African Blacks had more severe renal disease at presentation. In conclusion, our multiethnic LN cohort shows a high prevalence of membranous LN and good response to treatment.
Longitudinal analysis of varicella-zoster virus-specific antibodies in systemic lupus erythematosus: No association with subclinical viral reactivations or lupus disease activity
Authors: Rondaan C , van Leer C C , van Assen S , Bootsma H , de Leeuw K , Arends S , Bos N A , Westra J
Published: April 2018

Systemic lupus erythematosus (SLE) patients are at high risk of herpes zoster. Previously, we found increased immunoglobulin (Ig)G levels against varicella-zoster virus (VZV) in SLE patients compared to controls, while antibody levels against diphtheria and cellular immunity to VZV were decreased. We aimed to test our hypothesis that increased VZV-IgG levels in SLE result from subclinical VZV reactivations, caused by stress because of lupus disease activity or immunosuppressive drug use.

Methods

Antibody levels to VZV (IgG, IgA, IgM), total IgG and VZV-DNA were longitudinally determined in the serum of 34 SLE patients, using enzyme-linked immunosorbent assay and polymerase chain reaction. Clinical data were retrieved from medical records. Reactivation of VZV was defined as an at least fivefold rise in VZV-IgG or presence of VZV-IgM or VZV-DNA. Generalized estimating equations (GEE) were used to longitudinally analyse associations between antibody levels, lupus disease activity and medication use. Systemic Lupus Erythematosus Disease Activity Index, anti-double-stranded DNA and complement levels were used as indicators of lupus disease activity.

Results

A VZV reactivation was determined in 11 patients (33%). In at least five of them, herpes zoster was clinically overt. No association between SLE disease activity or medication use and VZV-specific antibody levels was found. There was a weak association between total IgG and VZV-IgG.

Conclusions

Our results indicate that increased VZV-IgG levels in SLE do not result from frequent subclinical VZV reactivations, and are not associated with lupus disease activity. Increased VZV-IgG can only partially be explained by hypergammaglobulinaemia.
Proposal of improvement in patients with urinary tract infection in emergency department: Adding HCO3− to quick sepsis-related organ failure assessment (qSOFA) with a cut-off value of 1
Authors: Kim Ah Jin , Kang Soo , Suh Young Ju , Durey Areum
Published: April 2018

Background:

In 2016, the Sepsis-3 Task Force introduced a simpler algorithm, named quick sepsis-related organ failure assessment, for patients in a non-intensive care unit setting.

Objectives:

The study was designed to investigate the predictive performance of quick sepsis-related organ failure assessment for intensive care unit admission using the area under the curve of receiver operating characteristic specifically in patients of clinically diagnosed urinary tract infection in the emergency department and to compare its performance with that of systemic inflammatory response syndrome and sequential (sepsis-related) organ failure assessment.

Methods:

Retrospective analyses on adult urinary tract infection patients presenting to the emergency department between June 2015 and May 2016 were undertaken. We compared patients who were admitted to the intensive care unit to those who were not.

Results:

Of the total 220 urinary tract infection patients, 20 (9.1%) were hospitalized to the intensive care unit and there was no in-hospital mortality. Independent predictors for intensive care unit admission using multiple logistic regression were HCO3− and creatinine. The area under the curve of receiver operating characteristic values of systemic inflammatory response syndrome, quick sepsis-related organ failure assessment, and sequential (sepsis-related) organ failure assessment were 0.759, 0.752, and 0.824 on intensive care unit admission, respectively, and there was no significant difference between any of them. Interestingly, adding HCO3− to quick sepsis-related organ failure assessment improved the predictive performance compared to quick sepsis-related organ failure assessment alone (AUC: 0.844 vs 0.752, respectively; p < 0.05), and a cut-off value of 20 mmol/L for HCO3− yielded the largest area under the curve of receiver operating characteristic value. Moreover, when lowering the cut-off value of quick sepsis-related organ failure assessment to 1 and combining to HCO3−, its sensitivity was increased from 22% to 90%.

Conclusion:

Among patients presenting to the emergency department with clinically diagnosed urinary tract infection, the use of a new model, which is adding HCO3− to quick sepsis-related organ failure assessment with a lowered cut-off value of 1, resulted in greater predictive performance regarding intensive care unit admission than original quick sepsis-related organ failure assessment.
Training Needs for Adaptive Coordination: Utilizing Task Analysis to Identify Coordination Requirements in Three Different Clinical Settings
Authors: Henrickson Parker Sarah , Schmutz Jan B. , Manser Tanja
Published: April 2018

A team’s ability to coordinate and adapt their performance to meet situational demands is critical to excellent patient care. The goal of this article is to identify common coordination characteristics that enable health care action teams to ensure effective patient care and to discuss specific examples of adaptive coordination within the health care setting. Task analyses were conducted to identify situational demands, in three different clinical settings: cardiac anesthesia, pediatric sepsis simulation, and trauma resuscitation. Each task analysis identified specific coordination requirements for pertinent tasks. The research team compared these task analyses, identified emerging themes, and agreed on core coordination characteristics common across all three environments by consensus through iterative abductive analysis. Findings across these diverse clinical settings showed that expert action teams (a) continually appraise their dynamic environment, (b) identify and define points of coordination, and (c) respond to the demands of nonroutine events by making coordination highly explicit. Specific examples of adaptive coordination within the health care setting are discussed, and implications for training are articulated. Findings are also pertinent outside of health care and may contribute to the understanding of coordination behaviors within action teams across multiple settings.
Caregiver–Adolescent Disagreement on the Mental Health of Youth in Foster Care: The Moderating Role of the Caregiver Relationship
Authors: McWey Lenore M. , Cui Ming , Cooper Ashley N. , Ledermann Thomas
Published: April 2018

It is not uncommon for caregivers and adolescents to provide different perspectives of adolescents’ mental health symptoms; however, few studies have examined these discrepancies, especially between foster parents and adolescents in the child welfare system. The goal of this study was to investigate the levels of disagreement on adolescent mental health symptoms among caregivers and adolescents in foster care, to examine factors associated with caregiver–adolescent discrepancies, and the potential moderating role of caregiver–child closeness on the link between the length of time the youth lived with caregivers and discrepancies regarding adolescent mental health symptoms. These research questions were examined using two measures of adolescent–caregiver disagreement, intraclass correlations and discrepancy scores, using data from a nationally representative study of youth involved with the child welfare system. Analyses of 183 adolescent–caregiver dyads revealed caregiver–adolescent disagreement on adolescents’ internalizing and externalizing symptoms, with caregivers reporting higher levels of adolescents’ problems on average. Adolescent gender, type of maltreatment experienced, and placement type were associated with caregiver–adolescent discrepancies. Results also indicated that closeness with caregivers significantly moderated the relationship between the length of time adolescents lived with their caregivers and discrepancies on adolescent externalizing symptoms.
Surgical repair of traumatic isolated inferior rectus muscle avulsion
Authors: Zuo Xuhong , Gao Lei , Bao Lewei , Chunyan Lv
Published: April 2018

Purpose:

To report our experience in the management of avulsion of the inferior rectus muscle.

Methods:

We describe the approach we have used for surgical repair of isolated avulsion of the inferior rectus muscle in two patients who suffered orbital trauma.

Results:

In both cases, the proximal portion of the inferior rectus muscle was located successfully by the generated muscle force duction test and sutured back into its original insertion point. Infraduction was normal and orthotropia was present in all directions of gaze during 1 year of postoperative follow-up in both cases. These favorable outcomes are attributed in part to the inferior rectus muscle pulleys system and the natural history of this type of injury, which allows the lost proximal portion to be identified by generated muscle force duction test.

Conclusion:

Generated muscle force duction test can be used to locate the proximal portion of a lost inferior rectus muscle and restore its function in patients with traumatic avulsion injury involving an extraocular muscle.
Test for Non-Synergistic Interactions in Phytomedicine, Just as You Do for Isolated Compounds
Authors: Patel Areeba , Khan Farooq Ali , Sikdar Arindam , Mondal Amit , Shukla Sunil Dutt , Khurana Sukant
Published: April 2018

Phytomedicine has often been used as “alternative therapy,” which in our opinion is unfortunate as it prevents its main actions being systematically studied, side effects explored, and toxicity tested, like all single-compound-based medicine. Our group is interested in finding which traditional or modern phytomedicines actually work and which are simply “working” through placebo, standardizing phytomedicine preparations, studying their toxicity, and finding active molecules in plants for modification and chemical synthesis as single compounds. Although fluctuation in efficacy due to seasonal and geographical variations in phytomedicine remains a concern, if well regulated, even plant extracts without isolated compounds can serve medicinal needs where single-compound options are currently not great. A potential concern with such phytomedicine is frequent mixing of ingredients in commercial formulations without test of synergism. Our study on the use of 2 traditional plants for Parkinson disease shows a clear lack of synergism, and to study nonsynergism better, we developed a new visualization approach. In this commentary, using our study on Parkinson disease as an example, we make a case for better evaluation of phytomedicines, especially testing for synergistic interactions. We also critique our own exploration of oxidative stress and few behavioral parameters alone to lay grounds for what we and hopefully others can do in future to extract more information from their phytomedicine studies. We hope this commentary acts as a good warning for anyone mixing 2 phytomedicines without testing.
Influence of solvent on the yield and chemical composition of liquid products of hydrothermal liquefaction of Arthrospira platensis as revealed by Fourier transform ion cyclotron resonance mass spectrometry
Authors: Vlaskin Mikhail S , Grigorenko Anatoly V , Kostyukevich Yury I , Nikolaev Evgeny N , Vladimirov Gleb N , Chernova Nadezhda I , Kiseleva Sophia V , Popel Oleg S , Zhuk Andrey Z
Published: April 2018

Yields of liquid products (bio-oil and residual organics in aqueous solution) of hydrothermal liquefaction (at 300℃ and 60 min) of own cultivated Arthrospira platensis using different solvents have been determined. Nonpolar hexane, moderately polar dichloromethane, and relatively more polar acetonitrile have been used. High-resolution mass spectrometry based on linear quadrupole ion trap and Fourier transform mass spectrometer (LTQ FT) has been used for liquid sample characterization. Concentration of bio-oil in a unit of solvent volume after solvent extraction took the following arrangement: acetonitrile > dichloromethane > hexane. Concentration of residual organics in a unit of aqueous solution after solvent extraction took the following arrangement: hexane >dichloromethane > acetonitrile. Yield of total organics was arranged as follows: hexane > dichloromethane > acetonitrile. Content of carbon in bio-oil was increased and the content of oxygen was decreased with the increasing of solvent polarity. From mass spectrometric analysis it was established that in the positive electrospray ionization (ESI) mode the compounds containing two nitrogen atoms dominate and the considerable portion of the compounds containing single nitrogen atom are also presented for both bio-oil and residual organics samples. In the negative ESI mode the compounds containing four oxygen atoms dominated except bio-oil obtained using hexane where the compounds containing two oxygen atoms dominated. Bio-oil fraction had highly saturated compounds with low double bond equivalent values while the compounds of the residual organics fraction had large double bond equivalent values.
Convolutional neural networkscheme–based optical camera communication system for intelligent Internet of vehicles
Authors: Islam Amirul , Hossan Md Tanvir , Jang Yeong Min
Published: April 2018

The evolution of the Internet of vehicles and growing use of mobile devices has created a demand for new wireless communication technologies. Optical camera communication, which uses light-emitting diodes as transmitters and cameras as receivers, has emerged as a promising alternative. Since light-emitting diodes and cameras are already exploring in traffic lights, vehicles, and public lightings, optical camera communication has the potential to intelligently handle transport systems. Although other technologies have been proposed or developed in both academia and industry, they are not yet mature enough to uphold the huge requirements of the Internet of vehicles. This study introduces a new intelligent Internet of vehicles system based on optical camera communication combined with convolutional neural networks. Optical camera communication is a promising candidate for maintaining interference-free and more robust communication, for supporting the Internet of vehicles. Convolutional neural network is introduced for precise detection and recognition of light-emitting diode patterns at long distances and in bad weather conditions. We propose an algorithm to detect the interested light-emitting diode signals (i.e. regions-of-interest), measure the distance using a stereo-vision technique to find out the desired targets, and simulate our proposed scheme using a MATLAB Toolbox. Thus, our system will provide great advantages for next-generation transportation systems.
A Survey of Fellowship-Trained Upper Extremity Surgeons on Treatment of Lateral Epicondylitis
Authors: Niedermeier Steven R. , Crouser Nisha , Speeckaert Amy , Goyal Kanu S.
Published: April 2018

Background: The aim of the study is to investigate current management strategies for lateral epicondylitis by fellowship-trained upper extremity surgeons. Methods: A 17-question survey of treatment approaches and outcomes related to lateral epicondylitis was sent to 3354 surgeons using the American Society for Surgery of the Hand and American Shoulder and Elbow Surgeons member databases. Results: Six hundred twelve upper extremity surgeons completed the survey. The 6 most frequently prescribed nonoperative treatments for lateral epicondylitis were home exercise program/stretching (81%), nonsteroidal anti-inflammatory drugs (75%), steroid injection (71%), counterforce bracing (68%), formal physical therapy (65%), and wrist brace (47%). Less commonly performed nonoperative treatment measures included platelet-rich plasma injection (16%), Tenex procedure (6%), and iontophoresis (2%). Conclusions: There is a lack of consensus in the literature for the management of lateral epicondylitis, which is reflected by individual variation in clinical treatment among the experts. Future prospective randomized control studies are needed to establish evidence-based practice standards for this common diagnosis.
Appreciative Inquiry
Authors: Hung Lillian , Phinney Alison , Chaudhury Habib , Rodney Paddy , Tabamo Jenifer , Bohl Doris
Published: April 2018

Purpose:

In this action study, researchers worked with a team of interdisciplinary practitioners to co-develop knowledge and practice in a medical unit of a large urban hospital in Canada. An appreciative inquiry approach was utilized to guide the project. This article specifically focuses on examining the research experiences of practitioners and their accounts on how the research influenced their practice development to enact person-centered care.

Method:

The project took place in the hospital’s medical unit. A total of 50 staff participants attended focus groups including nursing staff, allied health practitioners, unit leaders, and physicians. One senior hospital administrator was interviewed individually. In total, 36 focus groups were conducted to bring participants together to co-vision and co-develop person-centered care.

Results:

Analysis of the data produced three themes: (a) appreciating the power of co-inquiry, (b) building team capacity, and (c) continuous development. Furthermore, 10 key enablers for engaging staff in the research process were developed from the data. A conceptual tool, “team Engagement Action Making” (TEAM) has been created to support others to do similar work in practice development.

Conclusion:

An appreciative inquiry approach has the potential to address gaps in knowledge by revealing ways to take action. Future research should further investigate how the appreciative inquiry approach may be used to support bridging research and practice.
A Disposable Tear Glucose Biosensor—Part 5: Improvements in Reagents and Tear Sampling Component
Authors: Lin Chi En , Ito Yuka , Deng Anna , Johns Jared , Matloff Daniel , Cook Curtiss B. , Sode Koji , La Belle Jeffrey T.
Published: April 2018

A tear glucose (TG) sensor with an integrated tear sampler can provide a noninvasive method for calibrating the continuous TG contact lens and monitoring glucose. Expanding from previous work, an improved TG sensor that implements dried reagents, genetically modified glucose dehydrogenase (GDH), and a tear sampler was developed and compared against the TG sensor prepared with commercial GDH. It was found that neither sensor was affected by the tear interferents: ascorbic acid, acetaminophen, and uric acid. The sensor prepared with commercial GDH generated higher current. This suggests that using enzymes with lower Km may be advantageous when operating in low glucose environments like tears. The improved TG sensor also demonstrated the potential of integrating Schirmer’s test strip as a tear sampler for self-monitoring of TG.
The Course of Adjustment Disorder Following Involuntary Job Loss and Its Predictors of Latent Change
Authors: Lorenz Louisa , Perkonigg Axel , Maercker Andreas
Published: April 2018

Adjustment disorders (AjDs) usually resolve after the precipitating life event and its consequences are terminated. However, they bear the risk for the development of severe mental illness. The present study investigates the natural course of AjD as defined for International Classification of Diseases, 11th version (ICD-11). A total of 303 individuals who involuntarily lost their jobs were assessed initially after the job loss and 6 months later. Latent class latent change analysis and multinomial logistic regression were performed. Two groups showed low ( n = 149, 49.2%) and medium ( n = 108, 35.6%) symptom severity at initial assessment that declined over time. The third group ( n = 46, 15.2%) showed a high initial response and a small effect of worsening of symptoms. Female gender, higher age, first dismissal, impaired social functioning, dysfunctional disclosure, less social support, and less social acknowledgment were associated with belonging to the latter group. It might be beneficial to target individuals at high risk with interventions that aim at the improvement of skills relevant for stress management.
Relationship between synovial inflammatory cytokines and progression of osteoarthritis after hip arthroscopy: Experimental assessment
Authors: Fukushima Kensuke , Inoue Gen , Uchida Kentaro , Fujimaki Hisako , Miyagi Masayuki , Nagura Naoshige , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi
Published: April 2018

Purpose:

Synovial membrane inflammation is the most commonly presenting finding during hip arthroscopy and may have a role in the pathomechanism of hip osteoarthritis (OA). The aim of this study was to determine the relationship between synovial cytokine levels and progression of OA after hip arthroscopy.

Methods:

We prospectively examined 20 patients (20 hips) who underwent arthroscopic hip surgery. For all patients, radiographs and severity of pain were evaluated preoperatively. During arthroscopy, we harvested a sample of the synovial membrane and determined the levels of six typical inflammatory cytokines with real-time polymerase chain reaction. We compared the levels of these cytokines in patients who showed OA progression and non-progression after hip arthroscopy.

Results:

Although the average age of patients who showed OA progression postoperatively tended to be higher, there were no significant differences in characteristics involving clinical assessment between patients who showed OA progression and those who showed non-progression. Intraoperative tumour necrosis factor α (TNFα) expression was significantly higher in patients who showed OA progression postoperatively ( p = 0.042).

Conclusions:

Elevation of TNFα level might be a predictor of OA progression after hip arthroscopy.
Electronically Verified Use of Internet-Based, Multimedia Decision Aids by Adolescents With Type 1 Diabetes and Their Caregivers
Authors: Wysocki Tim , James Lauren , Milkes Amy , Taylor Alex , Pierce Jessica , Brinkman William B. , Carakushansky Mauri , Ross Judith , Hirschfeld Fiona
Published: April 2018

Decision aids (DAs) are central to shared decision making (SDM) interventions, yet little is known about patients’ actual DA use. Adequate utilization of DAs could optimize SDM effectiveness. Electronic DAs enable more objective tracking and analysis of actual DA utilization than do paper DAs. This report is part of an ongoing randomized controlled SDM trial enrolling adolescents with type 1 diabetes and their caregivers ( n = 153) who were considering use of an insulin pump or continuous glucose monitor. Extensive stakeholder engagement guided creation of two online DAs. After completing baseline measures, 133 dyads were randomized to SDM (access to the pertinent DA) or Usual Care (clinic routines for preparing candidates for adopting these devices). Utilization data showed that 80% of caregivers and 66% of youths logged into a DA at least once; youths and caregivers, respectively, dedicated a mean of 44.7 and 55.0 minutes to website use and viewed 72.2% and 77.4% of the DA content. Median total duration from enrollment to last DA logout was 48.2 days for adolescents and 45.6 days for caregivers. Bivariate comparisons showed that non-Hispanic, Caucasian females from households with higher socioeconomic status were significantly more likely to login to the assigned DA at least once. Hierarchical multiple regression showed that adolescent males with lower levels of health literacy demonstrated fewer DA logins ( F = 2.59; P < 0.009), but identified no significant predictors of adolescents’ or caregiver’ duration of DA use or proportion of DA content viewed. Future SDM trials should seek to promote DA use, especially by non-White adolescents, perhaps with direct assistance with the initial DA login. Trials employing electronic DAs should routinely report and analyze utilization data.
Does compact development promote a seismic-resistant city? Application of seismic-damage statistical models to Taichung, Taiwan
Authors: Wang Chih-Hao
Published: April 2018

This study examines whether compact development promotes a seismic-resistant city. A statistical model is used to simulate seismic damages under four spatial structure scenarios for Taichung, Taiwan. The existing floor areas of various land uses are allowed to be reallocated for reshaping the spatial structure of the city. This provides an opportunity to find an urban structure that would best resist seismic impacts similar to what have occurred during the past 100 years. The results suggest a polycentric compact form for seismic mitigation. This form, derived from the vision of Taichung, would have less seismic damages by shifting floor areas from the city center to three proposed subcenters, far away from most seismic impacts. One weakness is the seismic impacts from the north. The results also reveal that a monocentric compact form would incur more damages because the downtown area is essentially seismic-vulnerable. This paper advocates the application of a stricter building code in the downtown area. The local government should also not render additional building bulk as an incentive for urban renewal.
Can somatic GATA2 mutation mimic germ line GATA2 mutation?
Authors: Sekhar Mallika , Pocock Rachael , Lowe David , Mitchell Christopher , Marafioti Teresa , Dickinson Rachel , Collin Matthew , Lipman Marc
Published: April 2018

Key Points

Somatic GATA2 mutation is associated with immunodeficiency and pulmonary alveolar proteinosis in a patient with myeloproliferative neoplasm.
Bearing the cost of the American dream: reflecting on street homelessness in America
Authors: Ramanuj Parashar P.
Published: April 2018

This paper is a British psychiatrist's personal reflection of the treatment of homeless people in American societies. Drawing upon theories of social distance, exclusion, discrimination and internalised stigma, this reflective piece suggests that homelessness is one price that certain societies pay to invest in the notion of individualised success and self-sufficiency. In reflecting on his own dissonance, the author argues that these societal processes exert a powerful influence on us as individuals, even if we as psychiatrists might think that our understanding confers on us a certain level of understanding.