bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency Urbanism in Sabra, Beirut
Authors: Knudsen Are John
Published: September 2019

Since the mid-1980s, generations of displaced people have sought refuge in the ramshackle buildings that were once the Gaza-Ramallah Hospital, a multi-story hospital complex built by the Palestinian Liberation Organization (plo). Damaged during the civil war, today the buildings blend in with the run-down Sabra-Shatila neighbourhood in Beirut’s “misery belt.” This paper charts the buildings’ history and main characters: the lodgers, landlords, and gatekeepers who respectively lease, rent, and control the dilapidated buildings’ dark corridors, cramped flats, and garbage-strewn stairways. The multi-story buildings are examples of emergency urbanism whereby displaced people seek refuge in cities, and their story can be read as a vertical migration history of people escaping conflict, displacement, and destitution. Examining the buildings as archives of spatial and political histories provides a genealogy of displacement and emplacement that can inform the study of emergency urbanism and point to solutions in cities for refugees lacking access to affordable housing.
Are Anthroposophists Environmentalists?
Authors: Breda Nadia
Published: September 2019

Can anthroposophists be considered environmentalists? Based on the author’s recent ethnographic research, this article seeks to delineate the profile of the anthroposophical environmentalist, a figure belonging to a particular form of environmentalism. In the last two centuries, anthroposophy (founded by Rudolf Steiner, 1861-1925) has elaborated a universalistic narrative named “spiritual science.” Today, through a “salvific approach” and a “karstic life,” anthroposophy informs different, blended, environmental practices intertwined with ecological and social issues that include spirituality, anti-modernism, human-nonhuman relationships and alternative sciences. Consequently, the ecological movements inspired by anthroposophy have a wide and increasing diffusion globally and this, in turn, stimulates anthropology to produce appropriate ethnographic knowledge of this form of environmentalism.
The Mak Pasar: Engaging with the Difficulty of Reality in a Recurring Conflict-ridden Thailand’s Far South
Authors: Yong Kee Howe
Published: September 2019

Pictures of women eking out a living at open-air markets in conflict zones are often used worldwide to elicit sympathy and outrage. Their chilies, synecdoche here for the commodities they sell at the open-air markets, constitutes another stereotypical image of these women living on the margins of the economy. However, what remains missing in most analyses is the focus on the lives and livelihoods of these women who bear the hardships of maintaining family life in precarious circumstances. This article focuses on the effects of the latest insurgency in Thailand’s far south on a group of women food vendors (mak pasar) as they engage with the difficulty of reality. It also touches on their cynical subjectivities towards how the government has been handling the conflict and their ambivalence towards the insurgency.
Factors that affect mortality in local patients who ingested common household cleansing products and required intubation
Authors: Shan Liu , Kwan Leong Au Yeung , Choi Kin Man David , Chi Keung Chan
Published: September 2019

Introduction:

Ingestion of common household cleansing products resulting in a need for intubation is not uncommon in Hong Kong. The objective of this study was to determine the factors that affect the mortality in this group of patients.

Methods:

This was a retrospective cohort study conducted in the Hong Kong Poison Information Centre, encompassing data from all Accident and Emergency Departments in Hong Kong over the period of 1 January 2008 to 31 January 2019. This study was conducted by recruiting all patients who had ingested common household cleansing products and required intubation in the same hospital admission. The outcome was death. The study aimed to look at risk factors associated with mortality.

Results:

Seventy‐seven patients were included in the final analysis. The median age was 53 years. The mortality rate was 21%. Univariate analysis (at p < 0.05) indicated that (1) older age, (2) ingestion to intubation time more than 12 h, (3) not admitted to intensive care unit, (4) complication of chest infection, (5) complication of fast atrial fibrillation, and (6) complication of acute kidney injury were factors associated with higher mortality rate. Among these, older age and development of acute kidney injury were statistically significant (p < 0.05) on multivariate analysis.

Conclusion:

Among patients who ingested household cleansing products and required intubation, older age and development of acute kidney injury were factors strongly associated with mortality.
Xylose utilization stimulates mitochondrial production of isobutanol and 2-methyl-1-butanol in Saccharomyces cerevisiae
Authors: Zhang Yanfei , Lane Stephan , Chen Jhong-Min , Hammer Sarah K. , Luttinger Jake , Yang Lifeng , Jin Yong-Su , Avalos‬ José L.
Published: September 2019

Background

Branched-chain higher alcohols (BCHAs), including isobutanol and 2-methyl-1-butanol, are promising advanced biofuels, superior to ethanol due to their higher energy density and better compatibility with existing gasoline infrastructure. Compartmentalizing the isobutanol biosynthetic pathway in yeast mitochondria is an effective way to produce BCHAs from glucose. However, to improve the sustainability of biofuel production, there is great interest in developing strains and processes to utilize lignocellulosic biomass, including its hemicellulose component, which is mostly composed of the pentose xylose.

Results

In this work, we rewired the xylose isomerase assimilation and mitochondrial isobutanol production pathways in the budding yeast Saccharomyces cerevisiae. We then increased the flux through these pathways by making gene deletions of BAT1, ALD6, and PHO13, to develop a strain (YZy197) that produces as much as 4 g/L of BCHAs (3.10 ± 0.18 g isobutanol/L and 0.91 ± 0.02 g 2-methyl-1-butanol/L) from xylose. This represents approximately a 28-fold improvement on the highest isobutanol titers obtained from xylose previously reported in yeast and the first report of 2-methyl-1-butanol produced from xylose. The yield of total BCHAs is 57.2 ± 5.2 mg/g xylose, corresponding to ~ 14% of the maximum theoretical yield. Respirometry experiments show that xylose increases mitochondrial activity by as much as 7.3-fold compared to glucose.

Conclusions

The enhanced levels of mitochondrial BCHA production achieved, even without disrupting ethanol byproduct formation, arise mostly from xylose activation of mitochondrial activity and are correlated with slow rates of sugar consumption.
Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report
Authors: Yuzawa-Tsukada Naoko , Tanaka Toshikazu D. , Morimoto Satoshi , Yoshimura Michihiro
Published: September 2019

Background

A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve.

Case presentation

We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve.

Conclusions

Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.
Energy Availability Is Associated With Luteinizing Hormone Pulse Frequency and Induction of Luteal Phase Defects
Authors: Koltun Kristen J , De Souza Mary Jane , Scheid Jennifer L , Williams Nancy I
Published: September 2019

Objective

Determine the interrelations between reductions in energy availability (EA), luteinizing hormone (LH) pulse frequency, and the induction of menstrual disturbances in previously sedentary, ovulatory women.

Methods

Secondary analysis of a randomized controlled trial consisting of a 3-month controlled diet and supervised exercise program. EA was calculated daily by measured energy intake (kcal) and exercise energy expenditure (kcal) normalized to fat-free mass (kg) and averaged during baseline and each of 3 intervention menstrual cycles. Blood samples were obtained every 10 minutes for 24 hours in the early follicular phase before the intervention and after 3 months of diet and exercise (n = 14). LH pulse dynamics were assessed by Cluster. Linear mixed models determined whether EA predicts LH pulse frequency and LH pulse frequency predicts luteal phase defects (LPDs).

Results

Subjects were 20 ± 1 years old, 165.1 ± 1.4 cm tall, and weighed 58.9 ± 1.5 kg. LH pulse frequency decreased from 0.82 ± 0.06 pulses/h to 0.63 ± 0.09 pulses/h (P = 0.048) as a result of the intervention which produced modest (-3.2 ± 0.6 kg) weight loss. EA, averaged across a menstrual cycle, predicted LH pulse frequency (P = 0.003) such that a single-unit decrease in EA was associated with a 0.017 pulses/h decrease in LH pulse frequency. LH pulse frequency in cycles with LPDs was 49% of that observed in cycles with no menstrual disturbances and for every 0.1-unit decrease in LH pulse frequency, the odds of having an LPD were 22× greater than having an optimal ovulatory cycle (P = 0.01).

Conclusions

Modest reductions in EA over a prolonged period are associated with decreased LH pulse frequency and the induction of menstrual disturbances.
A Robust Pairing Model for Airline Crew Scheduling
Authors: Antunes David , Vaze Vikrant , Antunes António Pais
Published: September 2019

Delays and disruptions in airline operations annually result in billions of dollars of additional costs to airlines, passengers, and the economy. Airlines strive to mitigate these costs by creating schedules that are less likely to get disrupted or schedules that are easier to repair when there are disruptions. In this paper, we present a robust optimization model for the crew pairing problem, which generates crew schedules that are less likely to get disrupted. Our model allows adding robustness without requiring detailed knowledge of the underlying delay distributions. Moreover, our model allows us to capture in detail the delay propagation through crew connections and the complex cost structure of the pay-and-credit crew salary scheme, thus enabling us to find a good trade-off between the deterministic component of the planned costs on the one hand and the expected delay and disruption costs on the other hand. Our robust crew pairing model is based on a deterministic crew pairing model formulated as a mixed-integer linear program. The robust version that we propose retains the linearity of the constraints and objective function and thus can be handled by commercial solvers, which facilitates its implementation in practice. We propose and implement a new solution algorithm for solving our model to optimality. Several optimal solutions with varying robustness levels are compared for the network of a moderate-size airline in the United States. We test the model’s solutions in a simulation environment using real-world delay data. Our simulation results show that the robust crew pairing solutions lead to lower delays and fewer instances of operational infeasibilities, thus requiring fewer recovery actions to address them. We find that, with the inclusion of robustness, it is possible to generate crew pairing solutions that significantly reduce the delay and disruption costs with only a small increase in planned costs.
Pregnant women's knowledge and perceptions of caesarean section in Lagos state, Nigeria
Authors: Abazie Ogechi H. , Abdul-Kareem Aishat Yetunde
Published: September 2019

Background

Caesarean section is a surgical procedure in which one or more incisions are made through a mother's (laparotomy) and uterus (hysterotomy) to deliver babies. It is one of the most important operations performed in obstetrics and gynaecology.

Aim

To assess women's knowledge and perceptions of caesarean section in three selected primary health care centres in Mushin Local Government Area, Lagos.

Method

This was a non-experimental descriptive study. A simple random sampling technique was used to select 128 respondents in the three selected health care centres. Data were manually collected and analysed electronically with the use of SPSS version 20 computer software.

Result

Of the respondents, 41.9% were aged range of 30–34 years, while only 2.4% were aged 40 years and above. The majority of the respondents (79.8%) had a good knowledge of caesarean section although 68.5% had negative perceptions of caesarean section. There was a significant association between respondents' knowledge of caesarean section and their perception (P<0.05).

Conclusions

The majority of the women in this study had a good knowledge of caesarean section, although more than half of the respondents had negative perceptions of caesarean section. The majority of respondents were unwilling to undergo caesarean section even when it was indicated.
A rare differential for sinusitis and visual loss
Authors: Lee JDE , Gill C , Muzaffar J , Ahmed S , Amel-Kashipaz R
Published: September 2019

Erdheim–Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affected an ex-RAF pilot’s vision. After extensive investigation of the elusive diagnosis, repeating of a molecular test using polymerase chain reaction analysis allowed for identification of a mutation (BRAF V600) ultimately leading to the diagnosis of Erdheim–Chester disease.
Elsabet
Authors: Grisolía Ambrosini Felipe
Published: September 2019

Narración galardonada con el premio Vida y Salud de Narrativa que describe, desde la perspectiva del fenómeno de la emigración, una de las prácticas de violencia de género más radicales: la mutilación genital femenina.
Construcción cultural de la sexualidad en un grupo de mujeres. Implicaciones para el ámbito de los cuidados
Authors: Hernandez-Ascanio José , Ventura Puertos Pedro
Published: September 2019

A pesar de la importancia manifiesta que la sexualidad ocupa en la trayectoria vital de cualquier individuo, los temas relacionados con este ámbito han permanecido tradicionalmente ocultos. Esto ha sido aún más evidente y taxativo en el caso de las mujeres, donde la cuestión de la sexualidad ha sido tradicionalmente un espacio de control y de resistencia.La ausencia de estudios sobre sexualidad es igualmente manifiesta en el ámbito del cuidado, cuyos profesionales han manifestado un tardío interés por esta cuestión, pese a ser reconocido como un espacio condicionador de la salud y el bienestar integral de los sujetos. Cuando se han llevado a acabo abordajes en esta temática por dichos profesionales se ha hecho desde una perspectiva fundamentalmente biomédica, sin tener en cuenta el papel condicionante que ejercen las construcciones socio – culturales sobre la misma.El presente trabajo, a partir de un estudio de carácter cualitativo, pretende poner de manifestó cuales son los principales constructos con los que las mujeres gestionan el ámbito de la sexualidad, con la finalidad de aportar a los profesionales del cuidado herramientas útiles en el abordaje de su desempeño profesional aplicado a este ámbito en concreto.
Ultraviolet B Phototherapy Intervention in Patients with Multiple Sclerosis: A Prospective, Randomized Pilot Trial
Authors: Motl Robert W. , Niemiro Grace M. , Lisio Michael De , Sommer Sarah , Riskin Barry J. , Riskin Barry J. , Best-Popescu Catherine A , Best-Popescu Catherine A
Published: September 2019

Background
There is substantial evidence, from well-conducted epidemiological studies, that low vitamin D levels are correlated with increased risk for MS, and multiple case control studies have implicated the involvement of vitamin D deficiency in MS etiology. Narrow-band Ultraviolet B (NB-UVB; 300nm - 311 nm) induced vitamin D production has not previously been studied in a multiple sclerosis (MS) randomized placebo-controlled trial (RCT).

Objectives
To investigate NB-UVB induced vitamin D production, immunomodulation and MS symptomology following NB-UVB phototherapy in a MS cohort.

Methods
Using a blinded RCT study design, twelve individuals 18 years or older with MS were enrolled and assigned (1:1) into individualized NB-UVB dose (10-30kJ/m) phototherapy, or into placebo treatment, delivered 3 times per week, for 8-weeks. Serum vitamin D levels, walking performance, strength, cognitive function, mood and circulating progenitor cells (CPCs: CD34+CD45dim), monocyte populations (Intermediate CD14+CD16+, Classical CD14+CD16-), and T regulatory cell (CD4+/CD25+/FoxP3+Tregs) count were assesed. The data were analyzed by 2 x 3 mixed factor ANOVA.

Results
A statistically significant condition by time interaction on vitamin D levels (F=7.14, p<.005, partial η2=.42) was identified. NB-UVB phototherapy may provide immunomodulation in a select group of MS individuals.

Conclusion
UVB phototherapy corrects vitamin D deficiency. This study adds to the growing research investigating UVB treatment in MS.
Changes in Adult Rats’ Testis structure Induced by Hypothyroidism and Alleviating Role of L-Carnitine
Authors: Hegazy Abdelmonem Awad , Morsy Manal Mohammad , Moawad Rania Said , Elsayed Gehad Mohammad
Published: September 2019

Background Hypothyroidism is a metabolic disorder affecting the functions of many tissues in the body including the testis. Testis is rich in the polyunsaturated fatty acids content and lacks strong intrinsic antioxidant system making it prone to such oxidative stress. L-carnitine (LC) regulates long chain fatty acids metabolism; and is considered a valuable antioxidant factor. Aim It was to evaluate the effect of hypothyroidism induced by propylthiouracil (PTU) on rats’ testes and the possible protective role of LC. Methods Forty-eight adult male albino rats were used in this work. The animals were divided into three groups with sixteen animals in each. Group 1 (Control): Animals were kept without medications. Group 2 (PTU-treated): was subjected to administration of PTU; while group 3 (PTU and LC) received both PTU and LC. By the end of the experiment “30 days”, blood samples were taken for hormonal assay; then animals were anaesthetized and sacrificed. Specimens were homogenized for biochemical analysis; epididymal content of each rat was obtained immediately for semen analysis. Testes’ specimens were harvested, prepared and examined by light microscope examination. Results Induced hypothyroidism was noticed to cause histopathological, morphometric and biochemical changes in rat’s testes. LC protected the testicular specimens against such changes; it also improved the seminal quality and quantity as well as testicular structure and biochemistry. Conclusion Hypothyroidism could result in hazards to the structure of testis. Fortunately co-administration of LC might reduce such hazards.
How Long a Motivation May Last?
Authors: Habibzadeh Nasim
Published: September 2019

Motivation is a kind of goal which ones could have over short or long terms in life. It could include both intrinsic and extrinsic types. Intrinsic motivations are composed of long term goals which associated with the internal individual‘s motivation whereas extrinsic motivations are empowered by external environments. Correspondingly, with considering the individual endurances, the type of hardships in different types of motivations is varied. In this between, the individual devotion in relation to their goal is determinate factors. Some people devoted their entire life to their goals, so how determinate you are?
Política, Estado y Administración Pública en las Provincias Argentinas
Authors: Bazza Alcides
Published: September 2019

Buenos Aires, Prometeo Libros, 2018
Association of SLC1A2 and SLC17A7 polymorphisms with major depressive disorder in a Thai population
Authors: Thaweethee Benjamard , Suttajit Sirijit , Thanoi Samur , Dalton Caroline F. , Reynolds Gavin P. , Nudmamud-Thanoi Sutisa
Published: September 2019

Background

Major depressive disorder (MDD) is a common psychiatric disorder with high prevalence and high risk of suicide. Genetic variation of glutamate transporters may associate with MDD and suicide attempt.

Objectives

To evaluate polymorphisms of excitatory amino acid transporter 2 gene (SLC1A2; rs752949, rs1885343, rs4755404, and rs4354668) and vesicular glutamate transporter 1 gene (SLC17A7; rs1043558, rs2946848, and rs11669017) in patients with MDD with and without suicide attempt, and determine the association of these polymorphisms with age of onset and severity of MDD.

Methods

DNA was extracted from blood taken from patients with MDD (n = 100; including nonsuicidal [n = 50] and suicidal [n = 50] subgroups) and controls (n = 100). Genotyping was conducted using TaqMan single-nucleotide polymorphism (SNP) genotyping.

Results

We found a significant difference in SLC17A7 rs2946848 genotype distribution between patients in the MDD and control groups (P = 0.016). Moreover, significant differences in SLC1A2 rs752949 (P = 0.022) and SLC17A7 rs2946848 (P = 0.026) genotype distributions were observed between patients in the nonsuicidal MDD and suicidal MDD groups. SLC1A2 rs1885343 A allele carriers showed significantly lower age of onset than GG genotype (P = 0.049). Furthermore, the severity of MDD indicated by the Hamilton Depression Rating Scale (HDRS) score of G allele carriers of SLC1A2 rs4755404 was significantly greater than the CC genotype (P = 0.013).

Conclusions

Polymorphisms of SLC1A2 and SLC17A7 may contribute to the risk of MDD and/or suicide attempt. An association of an SLC1A2 polymorphism with the severity of MDD was apparent.
Toric log del Pezzo surfaces with one singularity
Authors: Dais Dimitrios I.
Published: September 2019

This paper focuses on the classification (up to isomorphism) of all toric log Del Pezzo surfaces with exactly one singularity, and on the description of how they are embedded as intersections of finitely many quadrics into suitable projective spaces.
Three-dimensional connected groups of automorphisms of toroidal circle planes
Authors: Creutz Brendan , Ho Duy , Steinke Günter F.
Published: September 2019

We contribute to the classification of toroidal circle planes and flat Minkowski planes possessing three-dimensional connected groups of automorphisms. When such a group is an almost simple Lie group, we show that it is isomorphic to PSL(2, ℝ). Using this result, we describe a framework for the full classification based on the action of the group on the point set.
Obtaining the sGAG distribution profile in articular cartilage color images
Authors: Iglesias Carla , Luo Lu , Martínez Javier , Kelly Daniel J. , Taboada Javier , Pérez Ignacio
Published: September 2019

The articular cartilage tissue is an essential component of joints as it reduces the friction between the two bones. Its load-bearing properties depend mostly on proteoglycan distribution, which can be analyzed through the study of the presence of sulfated glycosaminoglycan (sGAG). Currently, sGAG distribution in articular cartilage is not completely known; it is calculated by means of laboratory tests that imply the inherent inaccuracy of a manual procedure. This paper presents an easy-to-use desktop software application for obtaining the sGAG distribution profile in tissue. This app uses color images of stained cartilage tissues taken under a microscope, so researchers at the Trinity Centre for Bioengineering (Dublin, Ireland) can understand the qualitative distribution of sGAG with depth in the studied tissues.
Improvement of Stroke Volume Estimation with Bioimpedance Measurement by LSTM Network Approach Based on ECG during Ergometry
Authors: Urban Mike , Tigges Timo , Klum Michael , Pielmus Alexandru , Orglmeister Reinhold
Published: September 2019

Stroke volume (SV) and cardiac output (CO) estimations with non-invasive approaches like thoracic electrical bioimpedance (TEB) measurement become state of the art in clinical practice. Despite the advantages like low costs, low risk of infection and relatively easy application, there are also disadvantages like the sensitivity to movement artifacts and, electrode displacement mistakes. The bioimpedance signal acquired with a tetrapolar measurement has a relatively weak signal strength compared with another common recorded signal, e.g., the electrocardiogram (ECG). For reconstruction and filtering of the dZ/dt signal, different approaches exist like ensemble averaging (EA), scaled fourier linear combiner (SFLC), wavelet denoising and adaptive filter. We propose an artificial neural network with long short-term memory (LSTM) layer for signal reconstruction during ergometry. The LSTM network performs well compared with other algorithms, e.g., with better amplitude (C point) reconstruction. The SV estimation with the LSTM network was at least comparable or even better than the estimation based on SFLC.
Wireless retina implant with large visual field
Authors: Velten Thomas , Knoll Thorsten , Stracke Frank , Le Harzic Ronan , Olsommer Yves , Jaeger Tino , Rammensee Michael , Kurz Oliver , Klesy Stephan , Januschowski Kai , Sermeus Loic , Szurman Peter
Published: September 2019

We present the concept of a novel epiretinal prosthesis, consisting of a foil-based, miniaturized electronics with wireless optical energy and signal transmission and integrated electrostimulation. The aim is achieving a wideangle projection to create a large visual field. The implant having a diameter of 14 mm consists of a mosaic-like array of thinned silicon-based photodiodes combined with a polyimide foil. This thin implant, realized on a flexible foil for the first time, adapts to the curvature of the eye. Thin-film stimulation electrodes on the foil are electrically connected to the photodiodes. The influence of the electrode geometry on the electrical current density at the location of electrostimulation is investigated by computer simulations. First experiments towards realization of via holes in a 10 μm thick polyimide layer were successful and led to vias with inclined sidewalls and rounded openings. This shape is advantageous concerning uninterrupted conductor paths leading from the photodiodes to the stimulation electrodes.
Evaluation of an IEEE 11073 SDC Connection of two KUKA Robots towards the Application of Focused Ultrasound in Radiation Therapy
Authors: Berger Johann , Unger Michael , Landgraf Lisa , Melzer Andreas
Published: September 2019

The integration of surgical robotics into the operating room requires reliable and flexible communication with other medical devices. The IEEE 11073 SDC standard can provide the necessary requirements to deploy robotics for the application of focused ultrasound in radiation therapy. The aim of this work was to implement and evaluate an SDC compliant connection between two collaborative robots. For this purpose, the KUKA LBR iiwa 7 R800 was adapted and the connectivity modelled and then tested successfully with 42 transmittable properties. Latency measurements were conducted to evaluate the network stability, resulting in a median round trip time of 10.13 ms.
First Steps towards Localized Opening of the Blood-Brain-Barrier by IR Laser Illumination Through the Rodent Skull
Authors: Schlett Paul , Mottaghi Soheil , Buchholz Oliver , Hofmann Ulrich G.
Published: September 2019

Glioblastoma, an aggressive malign tumor of the brain, is one of the most shattering diagnoses due to its very poor prognosis and limited treatment options. These options mainly consist of surgical or radiation therapeutic removal of as much tumor mass as possible, which unfortunately is almost always incomplete. Even worse, chemotherapy is of little use, as the special setup of the brain′s vessels severely limits the transit into the parenchyma of elsewhere efficient cytostatica. This Blood-Brain-Barrier (BBB) is for quite some time the target of sophisticated and nano-particle based transport mechanisms, however it is reported, that a boost of permeability for most of the brain can be achieved based on moderate temperature increase. One means to locally and reversibly increase the brain′s temperature and thus potentially opening the BBB may be achieved by illuminating the skull with infrared laser light, thus causing punctual heating and heat diffusion into the cortex. In extension of the common laser light guiding by glass fibres, we use a micro-positioned simple optics to focus a 1470 nm laser beam of approximately 500 µm in diameter on the skull. The apparent opening of the BBB is evidenced by the localized spread of Evans Blue injected into the tail vein of said rat, binding to Albumin (64,6 kDa) in the body. This marker molecule is usually blocked from passing through the intact BBB, but under IR illumination for half a minute, it appeared in post mortem visible blobs. Temperature profiles and potential tissue damage are now under investigation by high speed thermal camera and post mortem histology.
Cytotoxicity and Sterilization Resistance of Electronic Components for Disposable Smart Biomedical Devices
Authors: Werner Valerie M. K. , Strömsdörfer Daniel , Nga Bui Viet , Wittenburg Niklas von , Eblenkamp Markus
Published: September 2019

The design of Smart Biomedical Devices will be a defining element of future research in the context of intelligent medical devices for the Internet of Medical Things (IoMT). A prerequisite for serving the disposable market is the use of cost-effective electronic components and the highest reliability of the developed products in terms of biocompatibility and bioprotection. In the study, resistors, capacitors, and light-emitting diodes, different in their materials and construction forms, were examined. The selected types represented electronic components as they are commonly installed on electronic system from the segment of low-cost standard components. These were subjected to steam sterilization with up to 50 cycles, gamma sterilization, and a CCK-8 assay to test in vitro cytotoxicity. Functional failure could not be determined for any component. Gamma sterilization did not result in significant changes in resistance values, but in capacitors with barium titanate as dielectric. Non-cytotoxic electronic components could be identified. The results show that certain electronic standard components are suitable for disposable Smart Biomedical Devices.
Automatic differentiation between Veress needle events in laparoscopic access using proximally attached audio signal characterization
Authors: Schaufler Anna , Sühn T. , Esmaeili N. , Boese A. , Wex C. , Croner R. , Friebe M. , Illanes A.
Published: September 2019

The access to the abdomen and the creation of a pneumoperitoneum is an initial and particularly critical step of minimally invasive laparoscopic procedures. Insertion instruments such as the Veress needle need to be introduced blindly into the abdominal cavity, which is associated with inadvertent visceral and vascular injuries. To ensure safe positioning of the instrument, information about the entry path advancement of the tip through the abdominal wall is needed. The main objective of this work is to demonstrate the capability to acquire information about intracorporeal tissuetool interactions of the Veress needle tip, utilizing acoustic emissions recorded at the extracorporeal end of the needle. In an experimental setup, a Veress needle was inserted in a multitissue- layer phantom with a defined insertion speed. Acoustic emissions were recorded with a MEMS microphone attached to the extracorporeal end of the needle. In addition, the counteraction forces during insertion of the needle were measured and a video of the experiment was recorded as reference. With this setup, an audio database of characteristical insertion events was generated. For the classification of characteristic audio events and detection of tissue-layer crossing, features were calculated in the time and frequency domain. Subsequently, a feature dimensionality reduction was performed. The distribution clustering of the audio database in the three-dimensional feature subspace allows a distinction between certain characteristic audio events. The preliminary results show the capability of this acoustic emission based method to detect events related to the insertion of a Veress needle, such as tissue-layer crossing.
A microphysiological system to investigate the pressure dependent filtration at an artificial glomerular kidney barrier
Authors: Schmieder Florian , Behrens Stefan , Reustle Nina , Franke Nathalie , Sonntag Frank , Sradnick Jan , Hohenstein Bernd
Published: September 2019

Chronic kidney disease (CKD) is a global health problem that affects around 11 to 13% of the world’s population and more than 18% of European citizens. Characteristic syndromes of CKD during all stages of the disease are proteinuria and ongoing glomerular dysfunction caused by cellular damages at the glomerular filtration barrier. While some rare cases of the disease are correlated to genetic depositions the majority of cases are caused by diabetes, glomerulosclerosis, high blood pressure and glomerulonephritis. Thus, recapitulating the interplay of high blood pressure and changes at the glomerular filtration barrier in vitro seems an adequate way to mimic CKD. Here we present a microphysiological system of the glomerular filter that is capable to simulate high blood pressure at the glomerular filtration barrier in vitro. It consists of a closed loop microfluidic circuit with an integrated pneumatically driven heart like micro pump that constantly circulates the cell culture media at the blood site of the glomerular barrier. The ThinCert™ insert could be reversibly integrated into a holder system that ensures the correct position of the insert within the microfluidic circuit. By using different modulations of the integrated pneumatic micro pump different physiological and pathophysiological conditions e.g. hypertonic stress, like in CKD, could be applied. The influence of hypertonic conditions on the filtration above the barrier was studied by changes of TEER values and measurement of the flux of fluorescent labelled albumin through the cellular barrier.
Simulation of Breathing Patterns and Classification of Sensor Data for the early detection of impending Sudden Infant Death
Authors: Munz Michael , Wolf Nicolas
Published: September 2019

In this work, a methodology for the classification of breathing patterns in order to prevent sudden infant death (SID) incidents is presented. The basic idea is to classify breathing patterns which might lead to SID prior to an incident. A thorax sensor is proposed, which is able to simulate breathing patterns given by certain parameters. A sensor combination of conductive strain fabric and an inertial measurement unit is used for data acquisition. The data is then classified using a neural network.
Numerical simulation of the functionality of a stent structure for venous valve prostheses
Authors: Schubert Julia , Schümann Kerstin , Kischkel Sabine , Schmidt Wolfram , Grabow Niels , Stiehm Michael , Pfensig Sylvia , Schmitz Klaus-Peter , Keiler Jonas , Wree Andreas
Published: September 2019

Chronic venous insufficiency (CVI) is a common disease characterized by impaired venous drainage leading to congestion in the lower limbs. Currently, there are no artificial or biological venous valve prostheses commercially available. Previous minimally invasive design concepts failed to achieve sufficient long term results in animal or in vitro studies. The aim was to implement structural numerical simulation of clinically relevant loading cases for minimally invasive implantable venous valve prostheses. A bicuspid valve design was chosen as it showed superior results compared to tricuspid valves in previous studies. The selfexpanding support structure was developed by using diamond-shaped elements. Using finite-element analysis (FEA), various loading cases, including expansion and crimping of the stent structure and the release into a venous vessel, were simulated. A hyperelastic constitutive law for the vascular model was generated from uniaxial tensile test data of unfixated human vein walls. This study also compared numerical and experimental results regarding compliance and tensile tests to validate the vein material model. The calculated performance concerning expansion and crimping, as well as the release of the stent into a venous vessel, demonstrated the suitability of the stent design for minimally invasive application.
Actinomycin D for fibrosis management in ophthalmic implant surgery
Authors: Brietzke Andreas , Eickner Thomas , Grabow Niels , Reske Thomas , Matschegewski Claudia , Guthoff Rudolf , Stahnke Thomas
Published: September 2019

Implants that feature a drug delivery system loaded with antifibrotic active drugs provide a promising approach to address postoperative complications caused by fibrosis. This study is intended to clarify whether Actinomycin D has an impact specifically on components of the extracellular matrix (ECM) and its formation in human primary fibroblasts of the Tenon capsule (hTF). Furthermore, the suitability of this agent in poly(N-vinylpyrrolidone)- poly(methylmethacrylate)(PVP-co-PMMA) as a drug delivery model is evaluated in drug incorporation and release studies. RT-qPCR revealed a significant downregulation of the fibrotic marker genes ACTA2, COL1A1 and FN1 in cells stimulated with TGF- β1 and additionally treated with Actinomycin D. However, these findings could only be confirmed on α- SMA protein level. collagen I and Fibronectin synthesis stayed unaffected. The diffusion based incorporation of Actinomycin D into the polymer model proved to be very effective. The release of the agent was retarded with a slightly prolonged kinetic. These findings make Actinomycin D a promising antifibrotic agent in ophthalmic implant surgery.
Modeling of the Human Cerebral Collateral Circulation: Evaluation of the Impact on the Cerebral Perfusion in Case of Ischemic Stroke
Authors: Krames Lorena , Daschner Rosa , Lutz Yannick , Loewe Axel , Dössel Olaf , Cattaneo Giorgio
Published: September 2019

Stroke is the third-most cause of death in developed countries. A new promising treatment method in case of an ischemic stroke is selective intracarotid blood cooling combined with mechanical artery recanalization. However, the control of the treatment requires invasive or MRI-assisted measurement of cerebral temperature. An auspicious alternative is the use of computational modeling. In this work, we extended an existing 1D hemodynamics model including the characteristics of the anterior, middle and posterior cerebral artery. Furthermore, seven ipsilateral anastomoses were additionally integrated for each hemisphere. A potential stenosis was placed into the M1 segment of the middle cerebral artery, due to the highest risk of occlusion there. The extended model was evaluated for various degrees of collateralization (“poor”, “partial” and “good”) and degrees of stenosis (0%, 50%, 75% and 99.9%). Moreover, cerebral autoregulation was considered in the model. The higher the degree of collateralization and the degree of stenosis, the higher was the blood flow through the collaterals. Hence, a patient with a good collateralization could compensate a higher degree of occlusion and potentially has a better outcome after an ischemic stroke. For a 99.9% stenosis, an increased summed mean blood flow through the collaterals of +97.7% was predicted in case of good collateralization. Consequently, the blood supply via the terminal branches of the middle cerebral artery could be compensated up to 44.4% to the physiological blood flow. In combination with a temperature model, our model of the cerebral collateral circulation can be used for tailored temperature prediction for patients to be treated with selective therapeutic hypothermia.
Numerical simulation and in vitro examination of the flow behaviour within coronary stents
Authors: Melzer Helena-Sophie , Ahrens Ralf , Guber Andreas E. , Dohse Jakob
Published: September 2019

This paper discusses the influence of different design parameters of stents by mathematical flow simulations and flow measurements using micro-particle image velocimetry (micro-PIV). A stent strut may cause recirculation areas, which are considered to be the source of thrombosis and the process of in-stent restenosis. The simulations showed that a reduced strut height and a chamfering of the struts reduce these recirculation zones. The numerically determined results were compared with experimental investigations. For this purpose metallic stent structures were transferred into transparent channel systems made of PDMS. The experimental investigations confirm the results of numerical simulations.
Optical endovascular imaging combining endoscopy, NBI and OCT, a feasibility study
Authors: Boese Axel , Sivankutty Akhil Karthasseril , Friebe Michael
Published: September 2019

For imaging of the vascular structure, angiography is state of the art. This can be done by contrast enhanced XRay, CT or MR imaging. But these modalities typically only show the blood flow and do not allow a depiction of the vasculature itself. To provide information about the vessel walls and plaques narrowing the blood flow, catheter based intra vascular ultrasound or vascular optical coherence tomography can be used. Optical endoscopic imaging is rarely used in vascular diagnosis. But endoscopic imaging can depict superficial inflammations or defects of the intima vessel layer and the real anatomical shape of the inner vasculature e.g. at bifurcations or aneurysms. Since OCT and endoscopic imaging both need a flushing to remove the blood for a short time, a combination of both modalities seems viable. For combining the two modalities, various background studies were performed including the selection of a feasible fibre endoscope, light source and camera system. A new pull-back and flushing device was designed and created for realizing the synchronous image acquisition using the two modalities. For calibration of the system and definition of the pullback and imaging parameters, first tests on artificial phantoms were performed. Then vascular and tissue models were imaged in a combined pullback mode after using the flush for complete blood removal. Endoscopic images were acquired in a video mode. The analysis of the images was done subjectively. As expected, the OCT provided structural information of the wall. The endoscopic images in combination with pullback appear blurry in video mode. The flushing liquid hinders the automatic focusing of the camera. Thus, smaller details could not be identified but bifurcations were visible. Even though the results were not good as expected, the study showed the potential of a bimodal system and addressed the issues faced in the initial implementation.
Design of SiO2/TiO2 that Synergistically Increases The Hydrophobicity of Methyltrimethoxysilane Coated Glass
Authors: Widati Alfa Akustia , Nuryono Nuryono , Kartini Indriana
Published: September 2019

This research work presents the design of a mixture of SiO2/TiO2 that increases the surface roughness and hydrophobicity of methyltrimethoxysilane (MTMS) coated glass. The deposition of SiO2, TiO2, and MTMS were conducted using a layer by layer dip coating technique. The SiO2/TiO2 coating was derived from complete hydrolysis of tetraethylorthsilicate and titanium tetraisopropoxide. In order to evaluate and compare the performance of SiO2/TiO2/MTMS coated glass, the SiO2/SiO2/MTMS and TiO2/TiO2/MTMS were also fabricated. SiO2/TiO2/MTMS samples displayed the highest water contact angle. The topography of surfaces showed that SiO2/TiO2/MTMS exposed higher surface roughness with micro-nanoscale structures. The sequence of SiO2 and TiO2 influenced the water contact angle and the stability of the coatings. SiO2/TiO2/MTMS produced higher contact angle and stability than TiO2/SiO2/MTMS.
Exploring an Innovative Course Delivery Method for Accelerated BSN Students
Authors: Owens Rhoda A.
Published: September 2019

Background

The purpose of the pilot study was to develop and implement an innovative hybrid-delivered professional development course and explore accelerated BSN student satisfaction and perceived learning.

Methods

The convenience sample consisted of 16 accelerated BSN students at one Midwestern university. The Student Evaluation of Learning and Feedback to Instructors online survey instrument used consisted of 21 five-point Likert-scale items.

Results

Students reported that the course was organized (M = 3.96) and promoted student learning (M = 4.53) and engagement (M = 3.97). Graded material was adequate (M = 4.31). The course created a supportive adult learning environment (M = 3.84) and instructor rapport (M = 4.47). Knowledge was applied during clinical experiences.

Conclusions

Hybrid courses can facilitate student learning and satisfaction. Further research is warranted to explore innovative hybrid course delivery methods with accelerated BSN students. It is critical to ensure quality education for this special nursing population.
Effect of home-based strength training program on IGF-I, IGFBP-1 and IGFBP-3 in obese Latino boys participating in a 16-week randomized controlled trial
Authors: Kelly Louise , Holmberg Patrick M. , Schroeder E. Todd , Loza Armando , Lin Xiao , Moody Alastai , Hughes Adrienne , Gibson Ann-Marie , Kirk Alison
Published: September 2019

Introduction

Growing evidence indicates that circulating concentrations of insulin-like growth factor 1 (IGF-I), along with IGF-I relative to IGF-binding proteins (IGFBP), are associated with an increased risk of cancer. In accord, regular exercise is linked with a lower risk of cancer.

Purpose

To assess the effects of a 16-week home-based strength training (HBST) program on serum IGF-I, IGFBP-1 and IGFBP-3.

Methods

A total of 32 obese Latino adolescent males (aged 14–18 years) were randomized into a twice-weekly HBST (n = 16) or a control group (C, n = 16) for 16 weeks. The following were measured at pre- and post-intervention: IGF-I, IGFBP-1 and IGFBP-3, glucose/insulin indices by oral and/or intravenous (IV) glucose tolerance tests, strength by one-repetition maximum (1RM), dietary intake by 3-d records, body composition by DEXA and physical activity using the Actigraph GT1X. The generalized linear model (GLM) was used to assess differences in changes among outcome measures between the HBST and C groups.

Results

Exercise adherence in the HBST group was 89%. IGF-1 showed a trend for significant within-subject improvements (p = 0.078) but no significant within-subject or between-subject differences for IGFBP-1, IGFBP-3 two-glucose, fasting glucose or 2-h glucose (p > 0.05). There was a significant decrease (p > 0.05) in fasting glucose in the C group (p = 0.02) and also in the intervention group (p = 0.03) between baseline and follow-up testing. A significant difference was also found in the C group for 2-h glucose with an increase at follow-up testing (p = 0.04).

Conclusions

Though not statistically significant (p < 0.05), the results indicated that a 16-week HBST program decreased IGF-I and increased IGFBP-1, along with IGFBP-3, concentrations among overweight/obese Latino boys. However, further studies should consider increasing either the dose or the duration of the intervention to elicit greater improvements in this at-risk pediatric population.