bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of a new interatomic potential to investigate the thermodynamic properties of hypo-stoichiometric mixed oxide fuel U1−y
Pu
y
O2−x
Authors: Takoukam-Takoundjou C , Bourasseau E , Rushton M J D , Lachet V
Published: August 2020

The behaviour of stoichiometric U1−y
Pu
y
O2 compounds used as nuclear fuel is relatively well understood. Conversely, the effects of stoichiometry deviation on fuel performance and fuel stability are intricate and poorly studied. In order to investigate what affect these have on the thermophysical properties of hypo-stoichiometric U1−y
Pu
y
O2−x
mixed oxide fuel, new interaction parameters based on the many-body CRG (Cooper–Rushton–Grimes) potential formalism were optimized. The new potential has been fitted to match experimental lattice parameters of U0.70Pu0.30O1.99 (O/M = 1.99) and U0.70Pu0.30O1.97 (O/M = 1.97), where M represents the total amount of metallic cations, through a rigorous procedure combining classical molecular dynamic and classical molecular Monte Carlo simulation methods. This new potential provides an excellent description of the U1−y
Pu
y
O2−x
system. Concerning lattice parameter, although fitted on only one Pu content (30%) and two stoichiometries (1.99 and 1.97), our potential allows good predictions compared to available experimental results as well as to available recommendations in wide ranges of O/M ratio, Pu content and temperature. For the U0.70Pu0.30O2−x
hypo-stoichiometric system (30% Pu content and O/M ratio ranging from 1.94 to 2.00), some direct properties (lattice parameter and enthalpy) and some derivative properties (linear thermal expansion coefficient and specific heat) were systematically investigated from room temperature up to the expected melting temperatures and a good agreement with experiments is found. Moreover, our potential shows good transferability to the plutonium sesquioxide Pu2O3 system.
Examining Grade 11 science students’ difficulties in learning
about vector operations
Authors: Tairab Hassan , Al Arabi Khaleel , Rabbani Lutfieh , Hamad Sara
Published: August 2020

Studies on student learning of scientific concepts have shown that students often
experience various difficulties in understanding basic physics concepts such as
vector quantities, as a result of formal and informal learning. The purpose of
the present study is to document Grade 11 students’ difficulties in
understanding vectors and their associated concepts. Specifically, the study
tried to find answers to questions about the overall level of difficulty
experienced by Grade 11 students about vectors, the nature of these
difficulties, and their association with operations, such as scalars, adding
vectors graphically, determining vector magnitude and direction, and multiplying
vectors by numbers. Altogether, 58 Grade 11 students participated in this study.
The study employed a specifically adapted test to assess participants’
understanding of vectors in relation to: (1) identifying whether students can
distinguish between vectors and scalars, (2) adding vectors graphically, (3)
determining the vector magnitude and direction, and (4) multiplying vectors by
numbers. The findings suggested that, although most students were able to
distinguish between vectors and scalars, they had experienced various
difficulties in understanding operations in relation to adding vectors,
graphically and mathematically, determining vector magnitudes and directions,
and multiplying vectors by numbers. The findings were discussed within the
recent UAE educational reform policy.
Electrical asymmetry effect in inhomogeneously magnetized capacitively coupled plasmas
Authors: Sun Jing-Yu , Zhang Quan-Zhi , Liu Jia-Rui , Song Yuan-Hong , Wang You-Nian
Published: August 2020

The electrical asymmetry effect combined with the magnetic asymmetry effect in a geometrically symmetric argon discharge is investigated using a one-dimensional particle-in-cell simulation with a Monte Carlo collision model. Both the asymmetry effects can induce an asymmetric plasma response with a consequent dc self-bias. It is found that these two asymmetry effects work independently of each other to some extent, which greatly enhances the flexibility for controlling the ion properties of interest, e.g. ion flux Γi and mean ion energy

E

i

at electrodes on the weak magnetic field side. On one hand, Γi can be modulated by tuning the gradient of the magnetic field, while the angle distribution on electrodes remains approximately unaffected for a fixed phase angle θ on the weak magnetic field side with a small shift in ion energy peak. On the other hand,

E

i

can be modulated by adjusting θ, while Γi only slightly fluctuates at a fixed gradient of magnetic field. Besides, the confinement effect of magnetic field on electron motion induces enhanced ionization rate and plasma density near the sheath edge on the strong magnetic field side.
Gels, jets, mosquitoes, and magnets: a review of implantation strategies for soft neural probes
Authors: Apollo Nicholas V , Murphy Brendan , Prezelski Kayla , Driscoll Nicolette , Richardson Andrew G , Lucas Timothy H , Vitale Flavia
Published: August 2020

Implantable neuroelectronic interfaces have enabled breakthrough advances in the clinical diagnosis and treatment of neurological disorders, as well as in fundamental studies of brain function, behavior, and disease. Intracranial electroencephalography (EEG) mapping with stereo-EEG (sEEG) depth electrodes is routinely adopted for precise epilepsy diagnostics and surgical treatment, while deep brain stimulation has become the standard of care for managing movement disorders. Intracortical microelectrode arrays for high-fidelity recordings of neural spiking activity have led to impressive demonstrations of the power of brain-machine interfaces for motor and sensory functional recovery. Yet, despite the rapid pace of technology development, the issue of establishing a safe, long-term, stable, and functional interface between neuroelectronic devices and the host brain tissue still remains largely unresolved. A body of work spanning at least the last 15 years suggests that safe, chronic integration between invasive electrodes and the brain requires a close match between the mechanical properties of man-made components and the neural tissue. In other words, the next generation of invasive electrodes should be soft and compliant, without sacrificing biological and chemical stability. Soft neuroelectronic interfaces, however, pose a new and significant surgical challenge: bending and buckling during implantation that can preclude accurate and safe device placement. In this topical review, we describe the next generation of soft electrodes and the surgical implantation methods for safe and precise insertion into brain structures. We provide an overview of the most recent innovations in the field of insertion strategies for flexible neural electrodes such as dissolvable or biodegradable carriers, microactuators, biologically-inspired support structures, and electromagnetic drives. In our analysis, we also highlight approaches developed in different fields, such as robotic surgery, which could be potentially adapted and translated to the insertion of flexible neural probes.
How to ‘downsize’ a complex society: an agent-based modelling approach to assess the resilience of Indus Civilisation settlements to past climate change
Authors: Angourakis Andreas , Bates Jennifer , Baudouin Jean-Philippe , Giesche Alena , Ustunkaya M Cemre , Wright Nathan , Singh Ravindra N , Petrie Cameron A
Published: August 2020

The development, floruit and decline of the urban phase of the Indus Civilisation (c.2600/2500-1900 BC) provide an ideal opportunity to investigate social resilience and transformation in relation to a variable climate. The Indus Civilisation extended over most of the Indus River Basin, which includes a mix of diverse environments conditioned, among other factors, by partially overlapping patterns of winter and summer precipitation. These patterns likely changed towards the end of the urban phase (4.2 ka BP event), increasing aridity. The impact of this change appears to have varied at different cities and between urban and rural contexts. We present a simulation approach using agent-based modelling to address the potential diversity of agricultural strategies adopted by Indus settlements in different socio-ecological scenarios in Haryana, NW India. This is an ongoing initiative that consists of creating a modular model, Indus Village, that assesses the implications of trends in cropping strategies for the sustainability of settlements and the resilience of such strategies under different regimes of precipitation. The model aims to simulate rural settlements structured into farming households, with sub-models representing weather and land systems, food economy, demography, and land use. This model building is being carried out as part of the multi-disciplinary TwoRains project. It brings together research on material culture, settlement distribution, food production and consumption, vegetation and paleoenvironmental conditions.
Coordinated river infrastructure decisions improve net social-ecological benefits
Authors: Roy Samuel G , Daigneault Adam , Zydlewski Joseph , Truhlar Allison , Smith Sean , Jain Shaleen , Hart David
Published: August 2020

We explore the social, ecological, economic, and technical dimensions of sustainable river infrastructure development and the potential benefits of coordinating decisions such as dam removal and stream crossing improvement. Dam removal is common practice for restoring river habitat connectivity and ecosystem health. However, stream crossings such as culverts are often 15 times more abundant than dams and may pose similar ecological impacts. Using multi-objective optimization for a model system of 6100 dams and culverts in Maine, USA, we demonstrate substantial benefit-cost improvements provided by coordinating habitat connectivity decisions. Benefit-cost efficiency improves by two orders of magnitude when coordinating more decisions across wider areas, but this approach may cause inequitable resource distribution. Culvert upgrades improve roadway safety and habitat connectivity, creating cost-effective opportunities for coordinating and cost-sharing projects between conservationists and safety managers. Benefit-cost trends indicate significant overlaps in habitat and safety goals, encouraging flexible stakeholder collaborations and cost-sharing strategies.
Garlic-based phenolic nanopowder as antibiofouling agent in mixed-matrix membrane
Authors: Wibisono Yusuf , Putri Ade Y. , Dewi Shinta R. , Putranto Angky W. , Izza Nimatul
Published: August 2020

The mixed matrix membrane has been developed in this work by using cellulose acetate as a membrane matrix and garlic-based phenolic nanopowder as an anti-biofouling filler. The membrane prepared using the phase inversion method, utilizing dimethylformamide (DMF) as a solvent. Three variation of garlic extract (GE) nanopowder concentration of 0.5%, 0.75%, and 1% were used, respectively. The mixed matrix membranes were tested their final thickness, morphology by using SEM, tensile strength, elasticity, clean water flux, and bacterial adhesion. Anti-biofouling activities of the garlic extract nanopowders were confirmed from the Escherichia coli bacterial adhesion, which 32 cells adhered in the pristine membrane surface, whereas nanopowder concentration of 0.5%, 0.75%, and 1% mixed matrix membranes show 9, 12 and 10 cells adhered in the membrane surface, respectively. The phenolic compounds in the mixed matrix membranes were able to inhibit bacterial growth and potentially used for a safe and non-toxic tool for food processing, including juice clarification.
The effect of cold storage temperatures on respiration rate and physical quality of crownless pineapple (Ananas comosus L.)
Authors: Rahmadhanni D S D , Reswandha R , Rahayoe S , Bintoro N , Prasetyatama Y D , Karyadi J N W
Published: August 2020

Pineapple is a horticultural product with high consumption and production. Also, this fruit has a perishable characteristic. It is influenced by physiological processes, which are respiration and transpiration. It needs good handling during the post-harvest process to control the freshness and quality, especially in the storage process. Thus, it is important to know the effect of low storage temperature on the respiration rate and physical quality of pineapple. In this study, a sample conducted triplicate and observed over a period by treating crownless pineapple in cold storage and storage temperature maintain at 7°C and 90% of relative humidity. The physical quality properties are weight loss, water content, shell and flesh colour, acidity, total dissolved solids (TDS), and hardness. The respiration sample conducted a closed method with the plastic jar as a container to observe the changes of O2 and CO2 at 2, 4, 12, 24 hours intervals over 7.5 days of storage. The physical quality properties sample put in a carton box to observe the changes in the quality at 2-3 days intervals over 24 days. The resulted of respiration rate and physical properties changes slowly during storage. Some sample observed chilling injury with the black spot on the shell of the fruit. Overall, the weight loss, water content, and hardness decreased, and the colour changed from green to yellow in half of the fruit during storage.
Tomato food value chain: managing postharvest losses in Cameroon
Authors: Njume C A , Ngosong C , Krah C Y , Mardjan S
Published: August 2020

Tomato (Lycopersicon esculentum L.) production contributes to food and nutrition security, and a lucrative business for many stakeholders. Major stakeholders in the tomato food value chain (TFVC) include farmers, middlemen, wholesalers, retailers, and consumers. Farmers contribute the highest in value addition of tomato but earn the lowest profit (8.8%) compared to retailers (53.0%) with the highest, while middlemen and wholesalers earn 19.2% and 19.9%, respectively. This review is aimed at improving TFVC in Fako Division, South West Region of Cameroon, by evaluating the causes of tomato postharvest losses (PHL) and proposing suitable innovative solutions and policies adapted from existing strategies across the globe. Smallholder farmers incur a lot of PHL of tomato due to mechanical injury from the use of raffia made baskets, overfilled basket, poor transportation and logistics facilities, and harvest maturity index. Perforated plastic crates could be used to reduce losses. The government of Cameroon needs to provide a legal framework on tomato marketing to help regulate the actions of the various actors in order to redistribute profit as per the value added by each actor. Management of PHL is a collective effort of all stakeholders working together to provide high quality and quantity of tomato fruits.
Determination of transfer coefficients of a tunnel type screenhouse for thermal modelling
Authors: Muhammad F , Suhardiyanto H
Published: August 2020

Screenhouses could help the reduction of pesticide usage for sustainable agriculture production in the tropics. A screenhouse is inherently naturally ventilated by the air flowing through the screen that covers the structure. However, overheating is still a problem that often occurs inside screenhouses in the tropics. Therefore, it is important to develop a thermal model as design tool for tropical screenhouses. The objective of this study was to determine the screenhouse transmissivity and the overall heat transfer coefficient of a tunnel type screenhouse for thermal modelling. A thermal model has been developed to consider these transfer coefficients. The model was modified from thermal model proposed by Desmarais et al. Validation of the thermal model was done by comparing predicted air temperature inside the screenhouse to that of measured values. The average transmissivity of the screenhouse obtained was 0.42, while the heat transfer coefficient of the screenhouse averaged from measurement results was 51.6 W/m2 oC. The validation showed that predicted air temperature inside the screenhouse agreed well to that of the measured values. It was concluded that the thermal model could be used as a good design tool for tunnel type tropical screenhouses.
Enhancement of droplets quality for fog cooling system in a naturally-ventilated greenhouse using centrifugal and axial fans
Authors: Kendarto  , Handarto D R , Saukat M , Herwanto T , Pandiangan K
Published: August 2020

A fog cooling system (FCS) is applied to maintain the desired air temperature and humidity in a greenhouse. For the effective application of this system, sizes of fog particles belonging to the criteria of less than 60 μm in diameter and its uniformity are important parameters that need to be achieved. The objective of this research is to analyze usage of centrifugal and axial fans in order to enhance quality of fog particles that generated through 0.1-mm nozzles. Horizontally installed nozzles with both centrifugal and axial fans to create finer and more uniform fog particles was compared with horizontal nozzles with centrifugal fans only and with axial fans only. The centrifugal fans are installed 80 cm in front of nozzles while the axial fans are installed behind nozzles. The sizes of fog particles resulted by centrifugal fan, axial fan, and both axial and centrifugal fans are 11.90 μm 5.280 μm and 2.69 μm respectively. The use of both fans produces the most delicate fog particles. Electricity consumption for both fans is the smallest compare to the other electrical appliances on FCS (relay, pump, pressure release valve). Additional electricity power consumption per hour due to the use of both fans is 25 W.
Detection of human fatigue level based on changes in skin color using RGB sensor
Authors: Priambudi F A , Herodian S , Saulia L
Published: August 2020

Decreased work capacity could be caused by fatigue, which is a state of decreased efficiency and endurance. Fatigue can be measured using various methods, one of them is based on heart rate. Measurement of fatigue levels based on heart rate has been widely carried out, one of them is the use of contactless measurement. The objective of this research was to detect human fatigue levels using an RGB sensor based on changes in skin color with image processing technology. This research started from testing of the data intake system, followed by image data retrieval in the form of images before and after physical activity and fatigue levels data using the step test method. Image data capture is performed using an RGB sensor in the form of a Kinect 360 and mirrorless camera, while fatigue levels data used a pulse monitor. The next step was processing data using a simple linear regression method to see the level of correlation between the results of image processing in the form of changes in the RGB color of the skin with changes in fatigue levels based on changes in heart rate. The results of simple linear regression showed significant RGB color changes toward changes in fatigue levels with a correlation value reaching 0.8 when using mirrorless camera then Kinect 360. This result showed that the use of mirrorless camera is better. The average correlation value of 20 subjects at all points above 0.6 on the two sensors used. Each of the RGB color components had a significant change. This showed that there was a relationship between changes in RGB with fatigue level changes so that the method of detecting fatigue levels based on changes in skin color can be done.
Simulation on vapour compression heat pump system for rough rice drying
Authors: Nelwan L O , Setiawan R P A , Yulianto M , Irfandi  , Fachry M , Biksono D
Published: August 2020

In this study, a simulation of a vapor compression heat pump system for bed drying of rough rice have been carried out for various thicknesses in the range of 20-50 cm and various drying air mass flow rates in the range of 0.06 - 0.22 kg/s-m2. The modelling used was grouped into two parts, i.e. the determination of temperature and humidity of the air coming out of the heat pump and the drying process of the rough rice using these air conditions. Parameters related to flow rate and energy were expressed in units of cross-sectional area of the drying bed. Simulation results showed significant differences in drying time and temperature for various thicknesses and air mass flow rates but their energy consumptions were similar. Under these conditions the drying temperature and drying time obtained ranged between 34-45°C and 8-15 hours, respectively while the specific energy consumption was relatively low i.e. in the range of 1.07-1.36 MJ/kg of evaporated water for all the scenarios tested. The specific drying air mass flow rate of 0.3 and 0.5 kg/s/m3 did not provide significant differences in specific energy consumption. For the field applications, the selection of conditions for thickness and the appropriate air mass flow rate will depend on the user preference including the ease of mixing, drying time or energy consumption.
Energy Usage Analysis on The Production Process of Canned Crab Meat (Portunus pelagicus)
Authors: Hartulistiyoso E , Akmal M
Published: August 2020

The energy usage anlaysis has been done on the production of canned crab meat (Portunus pelagicus). The analysis was based on the walktrough and detailed energy auditing at a canned crab meat production company located in Indramayu, Indonesia. It aims at obtaining the specific energy consumption used to produce canned crab meat and its saving opportunity. The result showed that the energy specific varied depending on the operated capacity, from 10.04 MJ/kg to 31.73 MJ/kg, with the evarage of 16.21 MJ/kg. The primary energy consumption were including diesel fuel 9.95 MJ/kg (61.4 %), electricity 5.91 MJ/kg (36.5 %), and human biological energy 0.34 MJ/kg (2.1 %). The largest energy was consumed at pasteurisation process, amounted 10.21 MJ/kg. Energy saving can be gained in amount of 5.38 MJ/kg of crabs if the process is running in full capacity using two pasteurization tanks.
A simple method to determine patterns of wet and dry seasons
Authors: Setiawan B I
Published: August 2020

The objective of this paper is to describe a simple method to determine patterns of wet and dry seasons based on historical climate data. Here, the daily rainfall and evapotranspiration were used as input variables, each of which was accumulated over one year. The accumulated data was then estimated using a continuous equation in the form of a 6th order polynomial equation. Nets of the first derivate of the rainfall minus that of evapotranspiration were used to determine wet and dry periods. Here, the wet period occurs when the nets are positive, and the dry period occurs when the nets are negative. Later, algorithms were developed to point the start, end, and peak of, and to calculate the available rainwater in each period. The method was applied here to determine patterns of wet and dry seasons in Serang Regency, Banten Province, Indonesia. The climate data was collected from a local climate station managed by the National Agency for Meteorology, Climatology, and Geophysics from 1978 to 2018 (41 years). There were three wet periods and three dry periods. On average, the dry season started from 107±67 J-day to 263±113 J-day and was followed by the wet season till 121±57 J-day. In the dry season, the rainwater was deficit about -353 mm. Whereas, in the wet season, rainwater was surplus about 576 mm. And, in the whole season, the rainwater was surplus up to 223 mm, which may be conservable to anticipate water deficit in the dry season.
Watershed based model for water allocation
Authors: Baskoro DAP , Purwanto MYJ , Solahudin M
Published: August 2020

The city of Bekasi is located downstream of the Bekasi watershed, which currently cannot reach the target of access to clean water. Access to clean water in Bekasi City according to USAID (2017) only reaches 31.44%, thus it has not yet reached the target of Sustainable Development Goals (SDGs). Moreover, many upstream areas of the watershed have been grown as a satellite city that plans to harvest more water to meet their needs. And also urban and rural areas in the whole watershed have population growth that needs a water supply. Increasing water demand due to population in upstream and downstream areas can cause water conflicts if not managed wisely. A water allocation study by making a model of the Bekasi watershed could explain better water allocation solution. This study’s purpose is to make a model for meeting the raw water demand of both urban and rural areas within Bekasi watershed. The more allocation of water in the upstream part of the Bekasi watershed (Sentul City) shows a decrease in the long-term water availability of water supply in the downstream watershed (Bekasi City). The development area of the upper part of Bekasi watershed should be evaluated properly and policy settings for water allocation can be analyzed using the dynamic model built.
Key articles and guidelines for the emergency medicine clinical pharmacist: 2011-2018 update
Authors: Acquisto Nicole M , Slocum Giles W , Bilhimer Matthew H , Awad Nadia I , Justice Stephanie Baker , Kelly Gregory F , Makhoul Therese , Patanwala Asad E , Peksa Gary D , Porter Blake , Truoccolo Donna M Shuler , Treu Cierra N , Weant Kyle A , Thomas Michael C
Published: August 2020

Purpose

To summarize recently published research reports and practice guidelines on emergency medicine (EM)–related pharmacotherapy.

Our author group was composed of 14 EM pharmacists, who used a systematic process to determine main sections and topics for the update as well as pertinent literature for inclusion. Main sections and topics were determined using a modified Delphi method, author and peer reviewer groups were formed, and articles were selected based on a comprehensive literature review and several criteria for each author-reviewer pair. These criteria included the document “Oxford Centre for Evidence-based Medicine – Levels of Evidence (March 2009)” but also clinical implications, interest to reader, and belief that a publication was a “key article” for the practicing EM pharmacist. A total of 105 articles published from January 2011 through July 2018 were objectively selected for inclusion in this review. This was not intended as a complete representation of all available pertinent literature. The reviewed publications address the management of a wide variety of disease states and topic areas that are commonly found in the emergency department: analgesia and sedation, anticoagulation, cardiovascular emergencies, emergency preparedness, endocrine emergencies, infectious diseases, neurology, pharmacy services and patient safety, respiratory care, shock, substance abuse, toxicology, and trauma.

Conclusion

There are many important recent additions to the EM-related pharmacotherapy literature. As is evident with the surge of new studies, guidelines, and reviews in recent years, it is vital for the EM pharmacist to continue to stay current with advancing practice changes.
The influence of warming and biotic interactions on the potential for range expansion of native and nonnative species
Authors: von Holle Betsy , Weber Sören E , Nickerson David M
Published: August 2020

Plant species ranges are expected to shift in response to climate change, however, it is unclear how species interactions will affect range shifts. Because of the potential for enemy release of invasive nonnative plant species from species-specific soil pathogens, invasive plants may be able to shift ranges more readily than native plant species. Additionally, changing climatic conditions may alter soil microbial functioning, affecting plant–microbe interactions. We evaluated the effects of site, plant–soil microbe interactions, altered climate, and their interactions on the growth and germination of three congeneric shrub species, two native to southern and central Florida (Eugenia foetida and E. axillaris), and one nonnative invasive from south America (E. uniflora). We measured germination and biomass for these plant species in growth chambers grown under live and sterile soils from two sites within their current range, and one site in their expected range, simulating current (2010) and predicted future (2050) spring growing season temperatures in the new range. Soil microbes (microscopic bacteria, fungi, viruses and other organisms) had a net negative effect on the invasive plant, E. uniflora, across all sites and temperature treatments. This negative response to soil microbes suggests that E. uniflora’s invasive success and potential for range expansion are due to other contributing factors, e.g. higher germination and growth relative to native Eugenia. The effect of soil microbes on the native species depended on the geographic provenance of the microbes, and this may influence range expansion of these native species.
A Characterization of Secant Varieties of Severi Varieties Among Cubic Hypersurfaces
Authors: Fu Baohua , Jeong Yewon , Zak Fyodor L
Published: August 2020

It is shown that an irreducible cubic hypersurface with nonzero Hessian and smooth singular locus is the secant variety of a Severi variety if and only if its Lie algebra of infinitesimal linear automorphisms admits a nonzero prolongation.
Real-world Experience with Remote Electrical Neuromodulation in the Acute Treatment of Migraine
Authors: Tepper Stewart J , Lin Tamar , Montal Tal , Ironi Alon , Dougherty Carrie
Published: August 2020

Objective

Remote electrical neuromodulation (REN) is a nonpharmacological acute migraine treatment that stimulates upper-arm peripheral nerves. The aim of this investigation was to evaluate the effectiveness and safety of REN for acute treatment of migraine in a real-world setting.

Methods

Real-world data were collected from patients who were using REN (Nerivio®, Theranica Bio-Electronics Ltd., Israel) between October 1, 2019, and March 31, 2020. Patients recorded their symptoms at baseline, two hours, and 24 hours post-treatment. Patients were stratified based on the type of visit and provider; in-person visits with headache specialists (HS group) or virtual visits with nonheadache specialists (NHS group). Efficacy outcome focused on intra-individual consistency of response across multiple attacks.

Results

We found that 58.9% (662/1,123) of the patients in the HS group and 74.2% (23/31) of the patients in the NHS group experienced pain relief at two hours in at least 50% of their treated attacks and 20.0% (268/1,339) of the patients in the HS group and 35.6% (16/45) of the patients in the NHS group experienced pain freedom at two hours in at least 50% of their treated attacks. The effects of REN on associated symptoms and improvement in function were also consistent in both groups. The incidence of device-related adverse events was very low (0.5%).

Conclusions

Real-world data confirm that REN results in meaningful clinical benefits with minimal side effects. REN may provide an effective drug-free treatment option for achieving consistent relief from migraine symptoms and may reduce the use of acute medications.
Medical Students’ Perspectives on Empathy: A Systematic Review and Metasynthesis
Authors: Costa-Drolon Emmanuel , Verneuil Laurence , Manolios Emilie , Revah-Levy Anne , Sibeoni Jordan
Published: August 2020

Purpose

Some evidence indicates that physician empathy declines during medical training, which has made it the subject of much research. Qualitative studies are relevant in this context, focusing as they do on how students themselves conceive and understand empathy during medical school. The aim of this study was to explore medical students’ perspectives on empathy by conducting a metasynthesis, including a systematic review of the literature and analysis of included studies.

Method

The authors systematically searched 4 databases through June 17, 2019, for qualitative studies reporting medical students’ perspectives on empathy in medical school. They assessed article quality using the Critical Appraisal Skills Program, and they applied thematic analysis to identify key themes and synthesize them.

Results

The authors included 35 articles from 18 countries in their analysis. Four main themes emerged: (1) Defining empathy, with a lack of understanding of the concept; (2) Teaching empathy, with a focus on the hidden curriculum and clinical supervisors; (3) Willingness to be an empathetic doctor, with ambivalence expressed by some study participants; and (4) Evolution of empathy during medical school, specifically its decline.

Conclusions

Medical students are beset by theoretical confusion regarding the concept of empathy, and they express doubts about its utility and relevance. Instruction should focus on simpler concepts such as listening, and schools should leverage clinical supervisors’ strong influence on students’ empathy. Prioritizing certain types of knowledge (clinical facts) during medical education has a globally negative effect on medical students’ empathy.
Observation of the Sedative Effect of Dexmedetomidine Combined With Midazolam Nasal Drops Before a Pediatric Craniocerebral MRI
Authors: Wu Zhi-Feng , He Li , Lai Yu , Li Si-Jie , Zhang Yu-Ping
Published: August 2020

Objective:

This study aimed to investigate the sedative effect of dexmedetomidine combined with midazolam nasal drops before a pediatric craniocerebral magnetic resonance imaging (MRI).

Methods:

Eighty children who needed an MRI examination were enrolled in the present study and randomly divided into 2 groups: the observation group (dexmedetomidine combined with midazolam nasal drops) and the control group. After the children were given the medication, their heart rate, blood oxygen saturation (SpO2), and respiratory rate were continuously monitored and the adverse reactions such as nausea and vomiting, cough, restlessness, heart rate slowdown, and respiratory depression were observed.

Results:

The difference in the onset time between the 2 groups was not statistically significant (P > 0.05), but the duration was significantly longer in the observation group than in the control group (P < 0.01) and the examination success rate were significantly higher in the observation group than in the control group (P < 0.05).

Conclusion:

The protocol of 3 μg/kg of a dexmedetomidine injection combined with 0.3 mg/kg of midazolam nasal drops is safe, easy to operate, and has a high success rate, which is worthy of clinical promotion.
A Global Evaluation of Surgical Techniques and Results of Unilateral Cleft Lip Repairs
Authors: Volk Angela S. , Davis Matthew J. , Dempsey Robert F. , Masoumy Mohamad , Desai Priya K. , Hubli Eric , Buchanan Edward P.
Published: August 2020

Background:

Variations in the clinical presentation of the unilateral cleft lip resulted in numerous surgical repair techniques used around the world. No universally accepted method exists to evaluate aesthetic surgical results. The purpose of this study is to use the Hubli lip grading system, developed by Smile Train, to evaluate the aesthetic results of unilateral cleft lip repairs based on the surgical technique used.

Methods:

A retrospective review was conducted of unilateral cleft lip repair operations performed by Smile Train surgeons throughout Africa, Americas, Asia Pacific, and Europe and Middle East between 2014 and 2018. Using the Hubli lip grading criteria, factoring in cleft severity, acceptable outcomes were identified and compared with the surgical technique used.

Results:

Eight thousand forty-one unilateral cleft lip repairs were reviewed. The majority utilized the rotational advancement technique (n = 5541, 68.9%) with a statistically significant percentage of acceptable outcomes (92.1%), followed by an acceptance rate of 91.9% with variations of the z-plasty technique, 90.5% with the straight-line repair and its variations, and 88.4% using “other” techniques (P < 0.05). The rotational advancement had the highest acceptable outcomes for complete cleft lips (94.7%, P < 0.0001), associated alveolar clefting (94.2%, P < 0.05), and concomitant clefting of the hard and/or soft palate (94.3%, P < 0.05).

Conclusion:

Regardless of surgical technique used, Smile Train surgeons maintain high rates of successful surgical outcomes. Results of our study will help complement and support existing medical infrastructure and training systems Smile Train employs for surgeons working with comprehensive cleft care teams around the world.
Management of Severe Midface Retrusion With Distraction Osteogenesis in Patients With Cleft Lip and Alveolus
Authors: Agurto Pamela , Castellon Loreto , Fuenzalida Carlos , Jerez Daniel , Mayorga Jaime
Published: August 2020

A cleft lip, palate, and alveolus is one of the most common birth defects. Depending on the type of cleft, multiple surgeries may be required throughout the growth stage. Traditionally, an orthodontic-surgical approach has been adopted to treat maxillary retrusion. Osteodistraction it is the surgical choice in patients with severe midface retrusion that require maxillary advancement. Our objective is to present our experience using this orthodontic and surgical approach.
Induction of Ventral Spinal V0 Interneurons from Mouse Embryonic Stem Cells
Authors: Pardieck Jennifer , Harb Manwal , Sakiyama-Elbert Shelly
Published: August 2020

The ventral spinal population of V0 interneurons (INs) contribute to the coordinated movements directed by spinal central pattern generators (CPGs), including respiratory circuits and left-right alternation. One challenge in studying V0 INs has been the limited number of cells that can be isolated from primary sources for basic research or therapeutic use. However, derivation from a pluripotent source, such as has been done recently for other IN populations could reduce this issue. However, there is currently no protocol to specifically derive V0 interneurons from embryonic stem cells or induced pluripotent stem cells. To generate an induction protocol, mouse embryonic stem cells (mESCs) were grown in suspension culture and then exposed to retinoic acid (RA) and collected at different time points to measure mRNA expression of the V0 progenitor transcription factor marker, Dbx1, and post-mitotic transcription factor marker, Evx1. The cultures were also exposed to the sonic hedgehog signaling pathway agonist purmorphamine (purm) and the Notch signaling pathway inhibitor N-{N-(3,5-difluorophenacetyl-L-alanyl)}-(S)-phenylglycine-t-butyl-ester (DAPT) to determine if either of these pathways contribute to V0 IN induction, specifically the ventral (V0V) subpopulation. From the various parameters tested, the final protocol that generated the greatest percentage of cells expressing V0V IN markers was an 8 day protocol using 4 days of suspension culture to form embryoid bodies followed by addition of 1 μM RA from days 4 to 8, 100 nM purm from days 4 to 6, and 5 μM DAPT from days 6 to 8. This protocol will allow investigators to obtain V0 IN cultures for use in in vitro studies, such as those examining CPG microcircuits, electrophysiological characterization, or even for transplantation studies in injury or disease models.
Effect of overripe banana in developing high dietary fibre and low glycaemic index cookie
Authors: Ng Yee Vern , Tengku Ismail Tengku Alina , Wan Ishak Wan Rosli
Published: August 2020

Purpose

Demand for dietary fibre-enriched and low sugar bakery products is increasing rapidly due to current high incidence of type 2 diabetes mellitus. Overripe banana has been discarded due to its low quality and appearance. However, overripe banana exhibits rich sources of natural sweetener and dietary fibre which could potentially be used as a novel food ingredient in bakery product. Thus, the study aims to determine the nutritional properties, sensory acceptability and glycaemic index (GI) value of chocolate cookies formulated with overripe banana sweetener (OBS) as partial replacement (10, 15 and 20%) for table sugar and utilization of overripe banana residue (OBR) as partial replacement (8%) for wheat flour.

Design/methodology/approach

Nutritional composition was analysed using AOAC methods and sensory acceptability using 7-point hedonic scaling method. In Vivo GI determination was continued according to FAO/WHO method.

Findings

Incorporation of OBR and OBS significantly (p < 0.05) increased nutritional values of chocolate cookies. Chocolate cookies formulated with 8% OBR +20% OBS recorded the highest TDF (7.80%) and ash (1.47%) content. Sucrose content of chocolate cookies was reduced significantly with increasing level of OBS. Sensory scores for control and 8% OBR-incorporated cookie were not significant difference for all the sensory attributes. Moreover, incorporation of OBS up to 15% produced higher scores in term of aroma, flavour and overall acceptance. Three formulations of chocolate cookies (control, 8% OBR and 8% OBR +15% OBS) were selected for GI testing and recorded GI values of 63, 56 and 50, respectively.

Originality/value

Overripe banana can be used as a food ingredient in developing high fibre and low-GI cookie.
When are employees idea champions? When they achieve progress at, find meaning in, and identify with work
Authors: De Clercq Dirk , Pereira Renato
Published: August 2020

Purpose

Drawing from conservation of resources (COR) theory, this study investigates the relationship between employees' perceived career progress and their championing behavior and particularly how this relationship might be invigorated by two critical personal resources at the job (work meaningfulness) and employer (organizational identification) levels.

Design/methodology/approach

Quantitative data were collected from a survey administered to 245 employees in an organization that operates in the oil industry.

Findings

Beliefs about organizational support for career development are more likely to stimulate idea championing when employees find their job activities meaningful and strongly identify with the successes and failures of their employing organization.

Practical implications

This study offers organizations deeper insights into the personal circumstances in which positive career-related energy is more likely to be directed toward the active mobilization of support for novel ideas.

Originality/value

As a contribution to extant championing research, this research details how employees' perceived career progress spurs their relentless efforts to push novel ideas, based on their access to complementary personal resources.
Etiologies of delayed diagnosis and six‐month outcome of patients with newly diagnosed advanced lung cancer with respiratory failure at initial presentation
Authors: Tseng How‐Yang , Shen Yi‐Cheng , Lin Yen‐Sung , Tu Chih‐Yen , Chen Hung‐Jen
Published: August 2020

Background

This study aimed to evaluate the characteristics of patients with newly diagnosed advanced lung cancer who initially presented with respiratory failure.

Methods

This was a retrospective study which analyzed patients in the intensive care unit (ICU) with newly diagnosed advanced lung cancer who were placed on mechanical ventilation (MV). We defined newly diagnosed lung cancer as pathological or molecular results for treatment decisions not yet determined when the patient was admitted to ICU.

Results

During the 14‐year inclusion period, 845 lung cancer patients requiring MV were screened. A total of 56 newly diagnosed extensive lung cancer patients were analyzed. Cancer‐related to central airway obstruction (n = 29, 51.8%) was the leading cause of respiratory failure. The significant etiologies of delay in the diagnosis of lung cancer were diagnostic error, mistaking cancer for tuberculosis, and missed hilar lesions. The six‐month survival rate was only 7.1% (n = 4). The sequential organ failure assessment (SOFA) score was significantly associated with mortality (HR = 1.142, 95% CI = 1.012–1.288, P = 0.031). The six‐month survival rate in patients receiving suitable targeted therapy and accepting chemotherapy and best supportive care was 40% (2/5), 0% (0/7), and 4.5% (2/44), respectively.

Conclusions

Patients with newly diagnosed advanced lung cancer with acute life‐threatening respiratory failure have poor outcomes. Cancer‐related to central airway obstruction is a leading cause of respiratory failure. Diagnostic errors such as tuberculosis and missed hilar lesions are the two main etiologies of a delay in diagnosis. The SOFA score is correlated with mortality. Targeted therapy can raise the six‐month survival rates in patients with oncogenic mutation adenocarcinoma, who survive after presentation in a critical condition.
CYP2D6 genotype may moderate measures of brain structure in methamphetamine users
Authors: Dean Andy C. , Nurmi Erika L. , Morales Angelica M. , Cho Arthur K. , Seaman Lauren C. , London Edythe D.
Published: August 2020

Chronic methamphetamine use is linked to abnormalities in brain structure, which may reflect neurotoxicity related to metabolism of the drug. As the cytochrome P450 2D6 (CYP2D6) enzyme is central to the metabolism of methamphetamine, genotypic variation in its activity may moderate effects of methamphetamine on brain structure and function. This study explored the relationship between CYP2D6 genotype and measures of brain structure and cognition in methamphetamine users. Based on the function of genetic variants, a CYP2D6 activity score was determined in 82 methamphetamine‐dependent (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM‐IV] criteria) and 79 healthy‐control participants who completed tests of cognitive function (i.e., attention, memory, and executive function); most were also evaluated with structural magnetic resonance imaging (MRI) (66 methamphetamine‐dependent and 52 controls). The relationship between CYP2D6 activity score and whole brain cortical thickness differed by group (interaction p = 0.024), as increasing CYP2D6 activity was associated with thinner cortical thickness in the methamphetamine users (β = −0.254; p = 0.035), but not in control subjects (β = 0.095; p = 0.52). Interactions between CYP2D6 activity and group were nonsignificant for hippocampal volume (ps > 0.05), but both hippocampi showed trends similar to those observed for cortical thickness (negative relationships in methamphetamine users [ps < 0.05], and no relationships in controls [ps > 0.50]). Methamphetamine users had lower cognitive scores than control subjects (p = 0.007), but there was no interaction between CYP2D6 activity score and group on cognition (p > 0.05). Results suggest that CYP2D6 genotypes linked to higher enzymatic activity may confer risk for methamphetamine‐induced deficits in brain structure. The behavioral consequences of these effects are unclear and warrant additional investigation.
Underutilisation of psychiatric care among refugee adolescents in Stockholm
Authors: Berg Lisa , Ljunggren Gunnar , Hjern Anders
Published: August 2020

Aim

Refugee children have been shown to underutilise psychiatric services in Scandinavia. The aim of this study was to investigate determinants of psychiatric care utilisation in adolescents in refugee families.

Methods

The study used regional data on healthcare use linked to sociodemographic data from national registers in a total population of 93 537 adolescents in the Stockholm County born in 1995‐2000, including 18 831 with a refugee background. Cox regression analyses were fitted to estimate Hazard ratios (HRs) of psychiatric care utilisation in the age‐span 11‐18 years.

Results

Psychiatric care use was lower in the large majority of adolescents in refugee families that originated in low‐ and middle‐income countries, with adjusted HRs 0.34 (95% CI 0.28‐0.42) and 0.51 (95% CI 0.46‐0.56), respectively, compared with the Swedish majority population. Among the foreign‐born refugee adolescents, psychiatric care use increased with duration of residence in Sweden and was higher in children who obtained residency as asylum seekers compared with those who settled in family reunification.

Conclusion

Adolescents in newly settled refugee families with a background in low‐ and middle‐income countries should be a priority in mental health assessment of refugee children and referral to psychiatric care facilitated for children in need.