bluuebunny/crossref_metadata_2025 huggingface dataset:
Ablation of the great saphenous vein with F-care versus Closurefast endovenous radiofrequency therapy: Double-blinded prospective study
Authors: Bitargil Macit , Kılıç Helin E
Published: March 2020

Objectives

F-care (endovenous radiofrequency, F Care Systems, Antwerp, Belgium) is a relatively new radiofrequency ablation technique for the treatment of venous insufficiency. There is a lack of published data about F-care in literature. This study aimed to prospectively compare the F-care method with conventional endovenous radiofrequency ablation Closurefast method for the management of incompetent great saphenous veins.

Methods

Between June 2015 and December 2018, 114 patients with incompetent varicose veins were treated either with the F-care or Closurefast. The pre-, intra-, postprocedural, and follow-up data of the patients were collected and prospectively compared.

Results

The average ablated vein length was 23.1 ± 4 cm in the F-care group and 26.6 ± 4 cm in the Closurefast group ( P =  0.01). The average procedure time was 17.4 ± 4 min (range: 10–30 min) in the F-care group, and 17.1 ± 3 min (range: 11–27 min) in the Closurefast group ( P =  0.77). The one-month total occlusion rates in the F-care and Closurefast groups were 96.2% and 98.1%, respectively ( P =  0.5). The one-year full occlusion rates in the F-care and Closurefast groups were 71.7% and 90.6%, respectively ( P =  0.013). In both the F-care and Closurefast groups, the venous clinical severity scores declined significantly with no difference between groups. There was no significant difference between adverse events following F-care treatment compared with Closurefast treatment ( P ≤  0.05).

Conclusions

The F-care system was as safe and fast, but the one-year closure rate was significantly lower when compared to the other method. There was no significant difference between the adverse effects of both approaches. Further large-scale, multi-center prospective studies with long-term outcomes are required to identify the effectiveness of F-care treatment modality for patients with saphenous vein insufficiency.
Algebraic approach towards the exploitation of “softness”: the input–output equation for morphological computation
Authors: Komatsu Mizuka , Yaguchi Takaharu , Nakajima Kohei
Published: March 2020

Recently, soft robots that consist of soft and deformable materials have received much attention for their adaptability to uncertain environments. Although these robots are difficult to control with a conventional control theory owing to their complex body dynamics, research from different perspectives attempts to actively exploit these body dynamics as an asset rather than a drawback. This approach is called morphological computation, in which the soft materials are used for computation that includes a new kind of control strategy. In this article, we propose a novel approach to analyze the computational properties of soft materials based on an algebraic method, called the input–output equation used in systems analysis, particularly in systems biology. We mainly focus on the two scenarios relevant to soft robotics, that is, analysis of the computational capabilities of soft materials and design of the input force to soft devices to generate the target behaviors. The input–output equation directly describes the relationship between inputs and outputs of a system, and hence by using this equation, important properties, such as the echo state property that guarantees reproducible responses against the same input stream, can be investigated for soft structures. Several application scenarios of our proposed method are demonstrated using typical soft robotic settings in detail, including linear/nonlinear models and hydrogels driven by chemical reactions.
City library network knowledge management for social cohesion: The case of Santa Coloma de Gramenet, Barcelona, Spain
Authors: Giménez Daniel García , Alsina Lluis Soler
Published: March 2020

In Santa Coloma de Gramenet (Catalonia, Spain) there is a network of four public libraries. They belong to the City, with technical assistance, strategic orientation and financial support from the provincial government, Diputació de Barcelona. These four libraries have been built in different historical periods and located in neighbourhoods with very unequal social backgrounds. They have been working on adapting their services to their neighbourhoods and as a network they have been moving on along the differences. Even so, the current information society challenges require a city library project in order to guarantee social cohesion and equal opportunities. This article tries to explain the strategy to achieve those goals, based on knowledge management and networking, transversal workshops and a shared communication circuit that so far has allowed this urban library network to extend and to renew services as well as to empower vulnerable sectors in accordance with the United Nations 2030 Agenda.
Prediction of Pedestrian Crossing Intentions at Intersections Based on Long Short-Term Memory Recurrent Neural Network
Authors: Zhang Shile , Abdel-Aty Mohamed , Yuan Jinghui , Li Pei
Published: March 2020

Traffic violations of pedestrians at intersections are major causes of road crashes involving pedestrians, especially red-light crossing behaviors. To predict the pedestrians’ red-light crossing intentions, video data from real traffic scenes are collected. Using detection and tracking techniques in computer vision, some pedestrians’ characteristics, including location information, are generated. A long short-term memory neural network is established and trained to predict pedestrians’ red-light crossing intentions. The experimental results show that the model has an accuracy rate of 91.6% based on internal testing at one signalized crosswalk. This model can be further implemented in the vehicle-to-infrastructure communication environment and prevent crashes because of the pedestrians’ red-light crossing behaviors.
Delirium in Meningitis and Encephalitis: Emergence and Prediction in a 6-Year Cohort
Authors: Dittrich Tolga , Marsch Stephan , Rüegg Stephan , De Marchis Gian Marco , Tschudin-Sutter Sarah , Sutter Raoul
Published: March 2020

Background/Objective:

Data regarding delirium in patients presenting with infections of the central nervous system, such as meningitis and/or encephalitis (ME), are scarce. We aimed to determine the frequency and early predictors of delirium in the acute phase of ME.

Methods:

We assessed clinical, radiologic, and laboratory data of patients with ME at a Swiss academic medical center from 2011 to 2017. The highest Intensive Care Delirium Screening Checklist (ICDSC) score was assessed within 24 hours around lumbar puncture. Multivariable logistic regression was performed to identify predictors of delirium (ICDSC ≥4).

Results:

Among 330 patients with ME, infectious pathogens were identified in 41%. An ICDSC >1 was found in 28% with and 19% without identified infectious pathogens. Delirium was diagnosed in 18% with and 14% without infectious pathogens and significantly associated with prolonged in-hospital treatment and mechanical ventilation, more frequent administration of neuroleptics and anesthetics (in 96% with delirium vs 35% without), complications, and less recovery to premorbid functional baseline. Low serum albumin at presentation was the only independent predictor of delirium (area under the receiver–operating curve [AUROC] = 0.792) in patients with pathogens. In patients with infections, the AUROC was smallest for encephalitis (AUROC = 0.641) and larger for patients with meningeal infections (meningitis AUROC = 0.807; meningoencephalitis AUROC = 0.896).

Conclusions:

Delirium in the context of ME is seen in almost every fifth patient and linked to prolonged treatment, complications, and incomplete recovery. Among clinical, radiologic, and laboratory parameters, the good calibration and discrimination of low albumin serum concentrations for the prediction of delirium in patients with ME seem promising, especially if meninges are affected.
Iodinated poly(p-dioxanone) as a facile platform for X-ray imaging of resorbable implantable medical devices
Authors: Zhao Fan , Xu Haiyan , Xue Wen , Li Yan , Sun Jing , Wang Fujun , Jiang Guansen , Li Lingchen , Wang Lu
Published: March 2020

Currently, implantable fibrous medical devices still suffer from invisibility under current clinical imaging techniques. To address this problem, 2, 3, 5-triiodobenzoic acid (TIBA) was recruited as a contrast agent, and then a set of iodinated poly( p-dioxanone) (PPDO) fibers was fabricated via melt-spinning hybrid blends of PPDO with TIBA (PPDO/TIBA). The impact of TIBA content on the rheological behavior of blends was evaluated firstly. The physical, chemical, and thermal properties of PPDO/TIBA fibers were investigated accordingly by SEM, FTIR, DSC, and TGA. Moreover, the radiopaque property of PPDO/TIBA hybrid fibers as a potential radio-opacifying platform for medical devices was verified in vitro and in vivo. Finally, the accumulated release results of the hybrid fibers during in vitro degradation indicate the continual X-ray visibility of the hybrid fibers maintains for 22 days. This intriguing iodinated platform may pave the way for constructing fibrous materials with in-situ X-ray tracking property.
A Decision Support Model for Salary Structure Design
Authors: Kassa Biniyam Asmare
Published: March 2020

This article presents a simple mathematical model for salary structure design that enhances clarity and allows for reasonable trade-off between internal equity and external market competitiveness considerations in salary structure design. Practical use of the model is illustrated with an actual application in one organization.
A National Survey of Veterans Treatment Court Actors
Authors: Luna Samantha , Redlich Allison D.
Published: March 2020

Several controversies surround Veterans Treatment Courts (VTCs), such as excluding veterans who commit violent offenses and requiring a direct relationship between a veteran’s charges and mental health diagnosis. The aim of this study was to examine VTC actors’ perceptions of these issues via a national survey. VTC Judges, Coordinators, and Veterans Affairs liaisons were presented two randomly assigned hypothetical clients and asked their perceptions of the hypothetical clients’ eligibility for VTC. The violent crime committed by the clients and their mental health diagnoses were manipulated in these scenarios. Participants were also asked for their perceptions of VTC issues and to describe the current practices of their VTCs. Results indicated participants were supportive of the domestic violence client’s participation in VTC, regardless of diagnosis, however most were not supportive of the involuntary manslaughter clients’ participation. Implications for future research and policy are discussed.
Opioids, Race, and Drug Enforcement: Exploring Local Relationships Between Neighborhood Context and Black–White Opioid-Related Possession Arrests
Authors: Donnelly Ellen A. , Wagner Jascha , Stenger Madeline , Cortina Hannah G. , O’Connell Daniel J. , Anderson Tammy L.
Published: March 2020

Opioid abuse has redefined drug problems in communities and shifted police activities to redress substance use. Changing neighborhood context around opioid issues may affect arrests and racial disparities in their imposition. This study presents a spatial analysis of arrests involving Blacks and Whites for possession of heroin, synthetic narcotics, and opium offenses. We identify the ecological conditions associated with opioid-related arrests using geographically weighted regression (GWR) methods that illuminate local patterns by allowing coefficients to vary across space. GWR models reveal spatial and racial differences in opioid-related possession arrest rates. Calls for police service for overdoses increase White arrests in more advantaged, rural communities. Economic disadvantage and racial diversity in neighborhoods more strongly elevate possession arrest rates among Blacks relative to Whites. Overdose calls predict Black arrests in poorer urban areas. Findings underscore police responsiveness to opioid problems and Black–White differences in how opioid users interact with the criminal justice system.
Geometric design, meshing simulation, and stress analysis of pure rolling cylindrical helical gear drives
Authors: Chen Zhen , Zeng Ming , Fuentes-Aznar Alfonso
Published: March 2020

The geometric design, meshing performance, and mechanical behavior of pure rolling helical gear drives are presented. Parametric equations for contact curves on the pinion and gear are determined by coordinate transformation of the active designed pure rolling meshing line for the whole cycle of meshing. Moreover, parametric equations for the tooth surfaces of helical gears with convex-to-convex meshing type are derived according to the motion of generatrices in the transverse section along the calculated contact curves. Then, the basic design parameters are analyzed and formulas for calculation of the geometric size are given. The meshing performance and mechanical behavior, including contact patterns, loaded function of transmission errors, and variation of stresses for two pitch angles of meshing are compared with those of a reference design of micro-geometry modified involute helical gears. Besides, the influence of basic design parameters on tooth contact analysis and stress analysis is studied. The analysis of the results shows that the proposed pure rolling helical gears have the advantage of reducing the relative sliding between tooth surfaces and the possibility of designing pure rolling helical gears with a small number of teeth, though the contact strength of the surfaces is impaired. However, if the appropriate design parameters and Hermite curve parameters for the fillets are properly evaluated as proposed here, the mechanical behavior of the proposed pure rolling helical gear drive, in terms of contact patterns and variation of bending stresses can be superior to that of the micro-geometry modified involute helical gear drives.
Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil
Authors: Silveira MF , Bruni MP , Stauffert D , Golparian D , Unemo M
Published: March 2020

The frequently asymptomatic sexually transmitted infections (STIs) caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) are poorly diagnosed in Brazil and can lead to severe complications/sequelae without timely detection and treatment. We investigated prevalence of CT, NG, and MG infections and associated demographic, behavioral, and clinical factors in consecutive women attending a gynecology and obstetrics outpatient clinic in Pelotas, Southern Brazil. Vaginal swab samples were prospectively obtained from asymptomatic and symptomatic women (n = 498) from August 2015 to December 2016 and tested with Aptima Combo2 and Aptima M. genitalium assays (Hologic). The prevalence of CT, NG, and MG was 6.8% (34/498), 1.0% (5/498), and 4.2% (21/498), respectively. Three (0.6%) cases of CT and NG co-infection and one (0.2%) case of CT and MG co-infection were identified. The risk factors associated with these bacterial STIs were youth (<30 years), no steady sexual partner, infection with additional STI, and lack of income. Bacterial STIs, particularly CT and MG, were prevalent among women, including pregnant women (60% of positive cases), in Pelotas, Brazil. Sensitive and specific diagnostic testing and early treatment are essential to control STIs, limit transmission chains, avoid future complications/sequelae, and reduce health and cost burdens on the population.
The legend of Saint Alan: Larnaudie and Stiegler in the Oversight Committee Room
Authors: Watt Calum
Published: March 2020

Ten years on from the 2008 global financial crisis, this article sets in dialogue two French treatments – by the novelist Mathieu Larnaudie and the philosopher Bernard Stiegler – of footage of the 2008 testimony of Alan Greenspan, former chairman of the US Federal Reserve, before the United States House of Representatives Committee on Oversight and Government Reform. The article introduces and compares the concepts of ‘effondrement’ and ‘prolétarisation’ developed by the two writers in relation to the Greenspan hearing, and analyses how both understand the question of ideology as it emerges in the hearing. Informed by interviews conducted by the author with Larnaudie and Stiegler, the piece concludes by discussing the notion common to both writers that Greenspan is a ‘saint’ of the crisis.
Recent advancements in self-healing polymers, polymer blends, and nanocomposites
Authors: Idumah Christopher I
Published: March 2020

Polymer composites for structural applications are prone to damage emanating from cracks which are formed deep within the material where detection is not easy and repairing almost not feasible. Material cracking results in mechanical deterioration of pre-reinforced polymer composites utilized in microelectronic polymer-based components which can result in electrical failure. Micro-cracking occurring as a result of thermally and mechanically induced fatigue is additionally an established challenge in polymer performance. Self-healing composites are materials exhibiting capability of automatically recovering when damaged. They derive their inspiration through biological systems peculiar to the human skin which exhibit a natural tendency to undergo healing by themselves. Irrespective of their application, the instance cracks are formed within a polymeric composite and the structural integrity of the material is remarkably compromised. Therefore, this article elucidates very recently emerging advancements on self-healing composites. Challenges, prospects, future market disposition, and application of self-healing composites are also presented.
Estimation of damping in riveted short cantilever beams
Authors: Siva Sankara Rao Yemineni , Mallikarjuna Rao Kutchibotla , Subba Rao V V
Published: March 2020

In layered and riveted structures, vibration damping happens because of a micro slip that occurs because of a relative motion at the common interfaces of the respective jointed layers. Other parameters that influence the damping mechanism in layered and riveted beams are the amplitude of initial excitation, overall length of the beam, rivet diameter, overall beam thickness, and many layers. In this investigation, using the analytical models such as the Euler–Bernoulli beam theory and Timoshenko beam theory and half-power bandwidth method, the free transverse vibration analysis of layered and riveted short cantilever beams is carried out for observing the damping mechanism by estimating the damping ratio, and the obtained results from the Euler–Bernoulli beam theory and Timoshenko beam theory analytical models are validated by the half-power bandwidth method. Although the Euler–Bernoulli beam model overestimates the damping ratio value by a very less fraction, both the models can be used to evaluate damping for short riveted cantilever beams along with the half-power bandwidth method.
Family Perceptions of Quality of Life for Pediatric Home Ventilator Patients
Authors: Shesser Lynn , Brodecki Darcy , Lebet Ruth
Published: March 2020

Home mechanical ventilation is an alternative to institutional management for some children with chronic or degenerative respiratory and neuromuscular disorders. Over the past 20 years, Children’s Hospital of Philadelphia has enhanced its Home Care Home Ventilator Program, designed to transition hospitalized children requiring long-term mechanical ventilation safely home. Program goals include supporting patient safety, medical stability, and caregiver competence while promoting quality of life. This longitudinal quality improvement project examined perceived quality of life for families with children discharged home for the first time on mechanical ventilation. We sought to identify unmet needs related to this transition. A self-report quality-of-life survey adapted from several validated tools was completed by the primary caregiver at 3 specific times over 6 months. Repeated-measures general linear modeling examined changes over time in caregivers’ perceptions of quality of life and confidence in meeting their child’s ongoing healthcare needs. After completing the inpatient portion of the program, followed by 6 months caring for their child at home with support from the hospital’s Home Care Department and Technology Dependence Center, caregivers reported more time to attend to their own needs and family activities, less financial burden, less anxiety, and perceived improvements in their child’s health and quality of life compared with hospitalization. Based on our findings, one program change was implemented: the Home Care social worker now meets with the family prior to discharge.
Identification and Characterization of Carnitine Palmitoyltransferase 1 (cpt 1) Genes in Nile Tilapia, Oreochromis niloticus
Authors: Bayır Mehtap , Arslan Gökhan , Bayır Abdulkadir
Published: March 2020

Four cpt 1 genes ( cpt 1α1a, cpt 1α2a, cpt 1α2b, and cpt 1β) were identified in the Nile tilapia genome. Two transmembrane helix domains (TMH) were identified for Cpt 1α1a, Cpt 1α2a, and Cpt 1β, while Cpt 1α2b had only one TMH domain. Evidence was found of conserved gene synteny between cpt 1 genes from Nile tilapia and the cpt 1/CPT 1 genes of zebrafish and human. Phylogenetic analysis showed that Nile tilapia Cpt 1 sequences clustered in distinct clades with their orthologous Cpt 1/CPT 1 from other vertebrates. Nile tilapia cpt 1α1a, cpt 1α2a, cpt 1α2b, and cpt 1β contain 18 coding exons encoding polypeptides of 771, 784, 788, and 786 amino acids in length, respectively. The cpt 1 genes were determined in all the tested tissues with varying tissue distribution patterns. These findings suggest that (1) cpt 1α1a, cpt 1α2a, and cpt 1α2b arose in the Nile tilapia genome as a result of the teleost-specific whole-genome duplication; (2) nonfunctionalization is the most likely cause of the loss of cpt 1α1b in the Nile tilapia genome; (3) the different tissue-specific transcription of cpt 1α2a and cpt 1α2b may be either due to the sub- or the neo-functionalization of transcriptional control side.
Mixed-blood: Indigenous-Black identity in colonial Canada
Authors: Beals Ann Marie , Wilson Ciann L
Published: March 2020

In thinking through Indigenous-Blackness in colonial Canada, we explored the ramifications of the intersections of mixed-blood Indigenous-Black identity with colonialism, racism, gender, and social determinants of health, and how the outcomes of such intersections manifest as erasure, racism, and fractured identity. This critical research is nested within the larger Proclaiming Our Roots project, which uses an arts-based community-based methodology to respect and represent local and global Indigenous ontologies and epistemologies, and utilizes digital oral storytelling, community mapping, and semi-structured interviews as research methods. Community members gathered in workshops held in Toronto and Halifax/Dartmouth, Canada, as these are sites where Indigenous and Black communities came together in the face of white colonial oppression. Community members and researchers told their stories and reshaped their geographies as acts of resistance. This work brings to the forefront Indigenous-Black identity, and how Indigenous-Black people manoeuvre within Western settler society.
Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)
Authors: Smith Anthony C , Thomas Emma , Snoswell Centaine L , Haydon Helen , Mehrotra Ateev , Clemensen Jane , Caffery Liam J
Published: March 2020

The current coronavirus disease 2019 (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as a means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change management effort and the redesign of conventional models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.
‘I Think I Stick Out a Bit’: The Classification of Reproductive Decision-Making
Authors: Saunders Kristina
Published: March 2020

This article provides an empirical insight into the operation of neoliberal, postfeminist, and middle-class norms which intersect to classify reproduction as imperative for some women, while for ‘others’ it is classified as inappropriate and in need of regulation. This valuation constructs an idealized reproductive citizen and a hierarchy of decisions about having children, while the inequalities and different material conditions that structure reproductive decisions and trajectories are ignored. This article will therefore demonstrate how the middle-class, neoliberal, and postfeminist subject of value operates in relation to reproduction in a social, political, and gendered context that emphasizes choice, individual responsibility, and self-investment and future planning. However, evidence of resistance to classification will also be shown, which provides an insight into how this valued reproductive citizen is negotiated.
The Role of Endoscopic and Surgical Treatment in Chronic Pancreatitis
Authors: Udd M. , Kylänpää L. , Kokkola A.
Published: March 2020

Chronic pancreatitis is a long-term illness leading to hospital admissions and readmission. This disease is often caused by heavy alcohol consumption and smoking. Patients with chronic pancreatitis suffer from acute or chronic pain episodes, recurrent pancreatitis, and complications, such as pseudocysts, biliary duct strictures, and pancreatic duct fistulas. Pancreatic duct strictures and stones may increase intraductal pressure and cause pain. Endoscopic therapy is aiming at decompressing the pressure and relieving the pain, most commonly with pancreatic duct stents and pancreatic duct stone retrieval. Early surgery is another option to treat the pain. In addition, endotherapy has been successful in treating complications related to chronic pancreatitis. The therapy should be individually chosen in a multidisciplinary meeting. Endoscopic therapy and surgery as treatment options for chronic pancreatitis are discussed in this review.
Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the MANTA Vascular Closure Device During Percutaneous EVAR and TEVAR Procedures
Authors: Krajcer Zvonimir , Wood David A. , Strickman Neil , Bernardo Nelson , Metzger Chris , Aziz Mark , Bacharach J. Michael , Nanjundappa Aravinda , Campbell John , Lee Jason T. , Dake Michael D. , Lumsden Alan , Nardone Samuel
Published: March 2020

Purpose: To evaluate the safety and effectiveness of the MANTA percutaneous vascular closure device in patients undergoing percutaneous endovascular aneurysm repair (PEVAR) or thoracic endovascular aortic repair (TEVAR). Materials and Methods: The SAFE MANTA Study ( ClinicalTrials.gov identifier NCT02908880) was a prospective, single-arm, multicenter trial in patients undergoing endovascular interventions using large-bore sheaths (transcatheter aortic valve replacement, PEVAR, or TEVAR) at 20 sites in North America. Patient selection intended to test the MANTA device in populations without morbid obesity, severe calcification, or a severely scarred femoral access area. Of the 263 patients enrolled in the primary analysis cohort, 53 (20.2%) patients (mean age 74.9±8.9 years; 41 men) underwent PEVAR (n=51) or TEVAR (n=2) procedures and form the cohort for this subgroup analysis. Per protocol a single MANTA device was deployed in all PEVAR/TEVAR cases. Results: The mean time to hemostasis in the PEVAR/TEVAR cohort was 35±91 seconds, with a median time of 19 seconds vs 24 seconds in the overall SAFE MANTA population. The MANTA device met the definition for technical success in 52 (98%) of 53 PEVAR/TEVAR cases compared with 97.7% in the overall SAFE MANTA population. One (1.9%) major complication (access-site stenosis) occurred in this subgroup compared to 14 (5.3%) events in the SAFE population. In the PEVAR/TEVAR group, 1 pseudoaneurysm was noted prior to discharge, another at 30-day follow-up, and one at 60 days. One (1.9%) of the 3 minor pseudoaneurysms was treated with ultrasound-guided compression and the other 2 required no treatment. Conclusion: The MANTA device demonstrated a short time to hemostasis and low complication rates compared with published literature results of other percutaneous closure devices. Time to hemostasis and complication rates were comparable between the PEVAR/TEVAR patients and the full SAFE MANTA study cohort. The MANTA device provides reliable closure with a single percutaneous device for PEVAR/TEVAR procedures.
On-Site–Modified Sheath to Overcome the Undesirable Catheterization of the Profunda Femoris Artery During Antegrade Femoral Access
Authors: Ysa August , Lobato Marta , Arruabarrena Amaia , Quintana Ana M. , Gómez Roberto , Ortiz de Salazar Leire , Metcalfe Matthew , Fonseca Juan L.
Published: March 2020

Purpose: To present a simple method to avoid favored passage of a guidewire into the profunda femoris artery (PFA) after antegrade puncture of the common femoral artery. Technique: A 6-F conventional introducer sheath with a radiopaque distal marker is placed on the nurse’s table with its side port orientated to the 12 o’clock position. A small (2–2.5 mm) oval fenestration is created on the superior aspect of the sheath about 3 cm from its tip with a size 11 surgical blade. The modified introducer is passed over the angled 0.035-inch guidewire into the PFA and gently retrieved until the tip marker is ~3 cm from the femoral bifurcation. The dilator is removed, and the guidewire is withdrawn to the level of the fenestration, manipulated through it, and advanced further into the superficial femoral artery under fluoroscopic guidance. Conclusion: When repeated passage of the guidewire down the PFA persists despite conventional manipulation of the wire or needle, an on-site modification of the sheath is an easy alternative approach for the catheterization of the superficial femoral artery.
Machine Learning Methods Predict Individual Upper-Limb Motor Impairment Following Therapy in Chronic Stroke
Authors: Tozlu Ceren , Edwards Dylan , Boes Aaron , Labar Douglas , Tsagaris K. Zoe , Silverstein Joshua , Pepper Lane Heather , Sabuncu Mert R. , Liu Charles , Kuceyeski Amy
Published: March 2020

Background. Accurate prediction of clinical impairment in upper-extremity motor function following therapy in chronic stroke patients is a difficult task for clinicians but is key in prescribing appropriate therapeutic strategies. Machine learning is a highly promising avenue with which to improve prediction accuracy in clinical practice. Objectives. The objective was to evaluate the performance of 5 machine learning methods in predicting postintervention upper-extremity motor impairment in chronic stroke patients using demographic, clinical, neurophysiological, and imaging input variables. Methods. A total of 102 patients (female: 31%, age 61 ± 11 years) were included. The upper-extremity Fugl-Meyer Assessment (UE-FMA) was used to assess motor impairment of the upper limb before and after intervention. Elastic net (EN), support vector machines, artificial neural networks, classification and regression trees, and random forest were used to predict postintervention UE-FMA. The performances of methods were compared using cross-validated R2. Results. EN performed significantly better than other methods in predicting postintervention UE-FMA using demographic and baseline clinical data (median [Formula: see text] P < .05). Preintervention UE-FMA and the difference in motor threshold (MT) between the affected and unaffected hemispheres were the strongest predictors. The difference in MT had greater importance than the absence or presence of a motor-evoked potential (MEP) in the affected hemisphere. Conclusion. Machine learning methods may enable clinicians to accurately predict a chronic stroke patient’s postintervention UE-FMA. Interhemispheric difference in the MT is an important predictor of chronic stroke patients’ response to therapy and, therefore, could be included in prospective studies.
Path planning optimization of six-degree-of-freedom robotic manipulators using evolutionary algorithms
Authors: Baressi Šegota Sandi , Anđelić Nikola , Lorencin Ivan , Saga Milan , Car Zlatan
Published: March 2020

Lowering joint torques of a robotic manipulator enables lowering the energy it uses as well as increase in the longevity of the robotic manipulator. This article proposes the use of evolutionary computation algorithms for optimizing the paths of the robotic manipulator with the goal of lowering the joint torques. The robotic manipulator used for optimization is modelled after a realistic six-degree-of-freedom robotic manipulator. Two cases are observed and these are a single robotic manipulator carrying a weight in a point-to-point trajectory and two robotic manipulators cooperating and moving the same weight along a calculated point-to-point trajectory. The article describes the process used for determining the kinematic properties using Denavit–Hartenberg method and the dynamic equations of the robotic manipulator using Lagrange–Euler and Newton–Euler algorithms. Then, the description of used artificial intelligence optimization algorithms is given – genetic algorithm using random and average recombination, simulated annealing using linear and geometric cooling strategy and differential evolution. The methods are compared and the results show that the genetic algorithm provides best results in regard to torque minimization, with differential evolution also providing comparatively good results and simulated annealing giving the comparatively weakest results while providing smoother torque curves.
Rapid adaptation to fully intelligible nonnative-accented speech reduces listening effort
Authors: Brown Violet A , McLaughlin Drew J , Strand Julia F , Van Engen Kristin J
Published: March 2020

In noisy settings or when listening to an unfamiliar talker or accent, it can be difficult to understand spoken language. This difficulty typically results in reductions in speech intelligibility, but may also increase the effort necessary to process the speech even when intelligibility is unaffected. In this study, we used a dual-task paradigm and pupillometry to assess the cognitive costs associated with processing fully intelligible accented speech, predicting that rapid perceptual adaptation to an accent would result in decreased listening effort over time. The behavioural and physiological paradigms provided converging evidence that listeners expend greater effort when processing nonnative- relative to native-accented speech, and both experiments also revealed an overall reduction in listening effort over the course of the experiment. Only the pupillometry experiment, however, revealed greater adaptation to nonnative- relative to native-accented speech. An exploratory analysis of the dual-task data that attempted to minimise practice effects revealed weak evidence for greater adaptation to the nonnative accent. These results suggest that even when speech is fully intelligible, resolving deviations between the acoustic input and stored lexical representations incurs a processing cost, and adaptation may attenuate this cost.
Estimating the glomerular filtration rate in pregnancy: The evaluation of the Nanra and CKD-EPI serum creatinine-based equations
Authors: Gao Michael , Vilayur Eswari , Ferreira David , Nanra Ranjit , Hawkins Joan
Published: March 2020

Aim

To compare the performance of the Nanra and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimating glomerular filtration rate in pregnancy against the 24 h urine creatinine clearance.

Methods

Pregnant women had 24 h urine collections with simultaneous serum creatinine levels. Measured 24 h urine creatinine clearance was compared to two equations: Nanra and CKD-EPI. Level of concordance was measured, with an a priori bias acceptance of ±15 ml/min/1.73 m2.

Results

A total of 53 synchronous urine and serum creatinine samples were analysed. The Nanra equation had a bias of −13.4 ml/min/1.73 m2 while the CKD-EPI equation had bias of 14.2 ml/min/1.73 m2. Both equations showed a high degree of proportional error and had poor agreement with 24 h urine creatinine clearance.

Conclusions

None of the equations were shown to reliably measure the estimated glomerular filtration rate in pregnant women. A valid serum creatinine-based estimated glomerular filtration rate equation in pregnancy is yet to be established.
Culturally Responsive Assessments of Spatial Analytical Skills and Abilities: Development, Field Testing, and Implementation
Authors: Maker C. June
Published: March 2020

A persistent problem in education is underrepresentation of certain cultural and linguistic groups such as American Indian, African American, and Hispanic, in special programs for exceptionally talented students, especially in science, technology, engineering, and mathematics (STEM). The spatial analytical task, a performance-based assessment with demonstrated reliability and validity as an instrument to identify exceptionally talented students, was included with new instruments created in the Cultivating Diverse Talent in STEM (CDTIS) project. A continuum of problems, including closed, semi-open, and open-ended, was an important component of the measures, enabling the assessment of creative problem solving as well as assessment of skills such as seeing how things fit together visually and in space; through mental images, on paper, and in physical objects or forms. The spatial analytical assessment was implemented as part of a battery of instruments to identify students to participate in a special internship program. Ratings of students on the spatial analytical assessment who were identified for the internship program using the new assessments were higher than ratings for students identified using conventional methods, which demonstrates that the assessment will be a useful tool for selecting students from diverse cultural groups. The assessment has multiple purposes in addition to its use as an identification tool: evaluation of special programs, planning differentiated instruction, and as a pre- and post-measure of student gains. The test–retest reliability, and construct, concurrent, and predictive validity for secondary students need continued investigation in future studies.
Clinical Outcomes after Arthroscopic Treatment of Synovial Chondromatosis in the Hip
Authors: Zhang Xin , Gao Guanying , Wang Jianquan , Xu Yan
Published: March 2020

Purpose

Evaluate the clinical outcomes after arthroscopic treatment of synovial chondromatosis (SC) of the hip.

Materials and Methods

We evaluated patients who underwent arthroscopic management for SC of the hip from November 2008 to March 2017. Radiographic evaluation was made before and after surgery. The modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), visual analogue scale (VAS) score, and patient self-reported satisfaction were collected and analyzed before and after surgery. Complications and recurrence that occurred after surgery were recorded.

Results

Forty-one patients (27 men and 14 women) were the study cohort. The mHHS improved from 67.0 to 83.7, HOOS-Symptoms improved from 78.8 to 93.3, HOOS-Pain improved from 80.9 to 93.6, HOOS-Activity Limitations–Daily Living improved from 84.5 to 95.1, HOOS-Sport improved from 50.3 to 80.6, and HOOS-Quality of Life improved from 62.2 to 86.7. VAS scores decreased from 3.9 to 1.1. All results demonstrated significant improvement ( P < 0.05). Thirty-three (80.5%) patients thought the outcome of surgery was “excellent,” 7 (17.0%) thought it was “good,” 1 (2.4%) thought it was “fair,” and no one thought it was “poor”. Two patients underwent revision surgery.

Conclusion

Hip arthroscopy for SC treatment of the hip showed good clinical results, good satisfaction from patients, and low recurrent prevalence.
Exercise and fluid challenge during right heart catheterisation for evaluation of dyspnoea
Authors: Ewert Ralf , Heine Alexander , Müller‐Heinrich Annegret , Bollmann Tom , Obst Anne , Desole Susanna , Knaak Christine , Stubbe Beate , Opitz Christian F. , Habedank Dirk
Published: March 2020

This prospective study compared exercise test and intravenous fluid challenge in a single right heart catheter procedure to detect latent diastolic heart failure in patients with echocardiographic heart failure with preserved ejection function. We included 49 patients (73% female) with heart failure with preserved ejection function and pulmonary artery wedge pressure ≤15 mmHg. A subgroup of 26 patients had precapillary pulmonary hypertension. Invasive haemodynamic and gas exchange parameters were measured at rest, 45° upright position, during exercise, after complete haemodynamic and respiratory recovery in lying position, and after rapid infusion of 500 mL isotonic solution. Most haemodynamic parameters increased at both exercise and intravenous fluid challenge, with the higher increase at exercise. Pulmonary vascular resistance decreased by –0.21 wood units at exercise and –0.56 wood units at intravenous fluid challenge (p = 0.3); 20% (10 of 49) of patients had an increase in pulmonary artery wedge pressure above the upper limit of 20 mmHg at exercise, and 20% above the respective limit of 18 mmHg after intravenous fluid challenge. However, only three patients exceeded the upper limit of pulmonary artery wedge pressure in both tests, i.e. seven patients only at exercise and seven other patients only after intravenous fluid challenge. In the subgroup of pulmonary hypertension patients, only two patients exceeded pulmonary artery wedge pressure limits in both tests, further five patients at exercise and four patients after intravenous fluid challenge. A sequential protocol in the same patient showed a significantly higher increase in haemodynamic parameters at exercise compared to intravenous fluid challenge. Both methods can unmask diastolic dysfunction at right heart catheter procedure, but in different patient groups.
Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries
Authors: Kotseva Kornelia , De Backer Guy , De Bacquer Dirk , Rydén Lars , Hoes Arno , Grobbee Diederick , Maggioni Aldo , Marques-Vidal Pedro , Jennings Catriona , Abreu Ana , Aguiar Carlos , Badariene Jolita , Bruthans Jan , Cifkova Renata , Davletov Kairat , Dilic Mirza , Dolzhenko Maryna , Gaita Dan , Gotcheva Nina , Hasan-Ali Hosam , Jankowski Piotr , Lionis Christos , Mancas Silvia , Milićić Davor , Mirrakhimov Erkin , Oganov Rafael , Pogosova Nana , Reiner Željko , Vulić Duško , Wood David ,   the EUROASPIRE V Investigators
Published: March 2020

Background

European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in 2016–2018. The main objective was to determine whether the 2016 Joint European Societies’ guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice.

Methods

The method used was a cross-stional survey in 78 centres from 16 European countries. Patients without a history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering treatments were identified and interviewed ≥ 6 months after the start of medication.

Results

A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 ± 11.6 years) interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5% obese (body mass index ≥30 kg/m2) and 63.8% centrally obese (waist circumference ≥88 cm for women, ≥102 cm for men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%.

Conclusion

The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus, the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology programmes is substantial.
Use of Alcohol, Tobacco, and Caffeine and Suicide Attempts: Findings From a Nationally Representative Cross-sectional Study
Authors: Cho Myong Sun
Published: March 2020

In this study, the association between students’ substance use and suicide attempts in the past 1 year was examined using secondary data from the 13th Korea Risk Behavior Web-based Survey. Participants were 7th- to 12th-grade students and 50.9% were male. A binominal logistic regression analysis was used to investigate the association between past experience of substance use (alcohol, tobacco, and caffeine) and suicide attempts after controlling for sociodemographic and psychological factors. Compared with no use, daily use of alcohol (odds ratio [OR] = 8.00), caffeine (OR = 2.13), and tobacco (OR = 1.41) was associated with increased odds of suicide attempts. These results indicate that school-based suicide prevention programs should cover awareness, surveillance, and treatment referral for these 3 substances. Moreover, mental health professionals should monitor intake of these substances when evaluating risk of suicide attempts in youth.