bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptations for Teaching Children with Special Educational Needs in ESL Context
Authors: Rezabala Martha Elena Alonzo , Holguín Jhonny Saulo Villafuerte
Published: December 2019

Public policy for inclusive education in Ecuador favors the entry of students with Special Education Needs into conventional schools. However, teachers require to develop adaptations to improve their work with students who have such conditions. This research aims to study the contribution of audiovisuals in adaptations and modifications for teaching English Language to a child reported with attention-deficit. This case of study refers to a boy attending the 4th Grade of elementary school in Manta-Ecuador. The research team designed a 10-sessions educational intervention for stimulating the child attention and improving his communication skills in English as a foreign language. A mixture of qualitative and quantitative research methodologies is applied to determine the participant’s English language skills evolution. This work also introduces teaching strategies that convine games and technology to support the vocabulary acquisition process of children with physical or intellectual disabilities. Results show how the videos catch and keep the participant’s attention during more time; and how the voice self-recording supports his listening and speaking practice. Such circumstance opens multiple possibilities to innovate the current adaptations and modifications for improving the teaching and learning process of children with special educational needs in ESL context.
Influence of Assumed Strain Hardening Relation on Plastic Stress-Strain Response Identification From Conical Indentation
Authors: Zhang Yupeng , Needleman Alan
Published: December 2019

Instrumented indentation tests provide an attractive means for obtaining data to characterize the plastic response of engineering materials. One difficulty in doing this is that the relation between the measured indentation force versus indentation depth response and the plastic stress-strain response is not unique. Materials with very different uniaxial stress-strain curves can give essentially identical curves of indentation force versus indentation depth. Zhang et al. (2019, “Identification of Plastic Properties From Conical Indentation Using a Bayesian-Type Statistical Approach,” ASME J. Appl. Mech., 86, p. 011002) numerically generated “experimental” conical indentation data and showed that using surface profile data and indentation force versus indentation depth data together with a Bayesian-type statistical analysis permitted the uniaxial plastic stress-strain response to be identified even for materials with indistinguishable indentation force versus indentation depth curves. The same form of hardening relation was used in the identification process as was used to generate the “experimental” data. Generally, a variety of power law expressions have been used to characterize the uniaxial plastic stress-strain response of engineering materials, and, of course, the form that gives the best fit for a material is not known a priori. Here, we use the same Bayesian statistics-based analysis but consider four characterizations of the plastic uniaxial stress-strain response and show that the identification of the hardening relation parameters and the associated uniaxial stress-strain response is not very sensitive to the form of the power law strain hardening relation chosen even with data that have significant noise.
A new species of Amblydromalus Chant & McMurtry (Acari: Mesostigmata: Phytoseiidae) from Brazil, with a key to Brazilian species of the genus

Authors: Demite Peterson R. , Cavalcante Ana Cristina C. , Lofego Antonio C.
Published: December 2019

A new species, Amblydromalus itacoatiarensis sp. nov. is described and illustrated based on adults of both sexes. It was found in association with plants in natural and agro-ecosystems, in Amazonas state, Brazil. A key to Brazilian species of the genus is provided.
Description of four new species of the genus Neumania Lebert, 1879 (Acari, Hydrachnidia, Unionicolidae) from China

Authors: Ding Zhuhui , Guo Jianjun , Yi Tianci , Jin Daochao
Published: December 2019

Four new species of the water mite genus Neumania Lebert are described from the Hanma National Nature Reserve, Genhe City, the Inner Mongolia Autonomous Region, China. Neumania (Neumania) vitrea Ding & Jin n. sp., based on male and female adults and distinguished by its transparent body; Neumania (Neumania) multiseta Ding & Jin n. sp., based on male and female adults and differentiated from related species by the numerous swimming setae on IV-Leg-4–5 of male; Neumania (Neumania) villosa Ding & Jin n. sp., based on adults of both sexes and deutonymphs, initially found both in running and standing waters and distinguished by a well sclerotized body and integument covered with dense fine spines; Neumania (Neumania) tumeroglandula Ding & Jin n. sp., also based on adults of both sexes and deutonymphs, and distinguished by its giant glands of the fourth pair of lateroglandularia.
Two new species of eriophyid mites (Trombidiformes: Eriophyoidea) associated with Clematis orientalis (Ranunculaceae) from East Iran

Authors: Honarmand Arash , Sadeghi-namaghi Hussein , Lillo Enrico De
Published: December 2019

During the field study of eriophyoid mites from Clematis orientalis L. (Ranunculaceae) in semi-arid and arid environment in East Iran (Birjand, South Khorasan, Iran, from 2016 to 2017), two new eriophyid mite species (Trombidiformes: Eriophyidae) were collected. They are Epitrimerus birjandica sp. nov. and Aculus clemachinensis sp. nov.; they are illustrated and described herein. Both new species seemed to be vagrants on the green parts. The checklist of eriophyid mites associated with Ranunculaceae throughout the world was provided.
Pulsed laser deposition nickel oxide on crystalline silicon as hole selective contacts
Authors: Zhao Jing , Ho-Baillie Anita , Bremner Stephen P.
Published: December 2019

In this work, the authors report the use of pulsed laser deposition to fabricate nickel oxide layers on silicon and assess the applicability of this structure as a hole selective contact. Films were deposited at temperatures of 300, 500, 700, and 900 °C. Results from reflective high energy electron diffraction patterns indicate increasing crystallinity with temperature up to 500 °C. However, layers deposited at 900 °C are amorphous. Nevertheless, results from atomic force microscopy, contact resistance measurements, and photoluminescence lifetime imaging indicate that films deposited at 900 °C have the best film smoothness, lowest specific contact resistivity, and highest lifetimes, and therefore, they are best suited for hole selective contact applications. Kelvin probe force microscopy and x-ray photoelectron spectroscopy were also carried out to study the effects of deposition temperature.
Evaluation of residual defects created by plasma exposure of Si substrates using vertical and lateral pn junctions
Authors: Sato Yoshihiro , Shibata Satoshi , Urabe Keiichiro , Eriguchi Koji
Published: December 2019

Defect creation in both the vertical and lateral directions of Si substrates during plasma processing has become a critical problem in the fabrication of three-dimensional structural devices. In this study, the authors present pn junction structures that can be used to evaluate defects in both the vertical and lateral directions of a Si substrate. Samples with these pn junction structures were exposed to fluorocarbon plasma; after plasma exposure, a chemical dry etching process was employed to determine the influence of residual species on damaged layer formation, and capacitance–voltage measurements were conducted to detect the formation of defects in the Si substrate. The results confirmed that defects created by plasma exposure act as carrier trapping sites. Spectroscopic ellipsometry and time-of-flight secondary ion mass spectrometry revealed that the damaged layers were tens of nanometers thick, and cathodoluminescence analysis identified the presence of “latent” defects in the damaged layer even after furnace annealing. Moreover, current–voltage measurements of devices with different pn junction distances revealed that leakage current in both the vertical and lateral directions increased with decreasing pn junction distance. The experimental results of this study demonstrate that plasma-induced damage (PID) creates defects in both the vertical and lateral directions; lateral defects are assumed to be caused by the stochastic straggling of incident ions, which has been predicted by molecular dynamic simulations. The implementation of devices with lateral pn junctions is essential in improving the understanding of PID mechanisms and designing future electronic devices that are sensitive to latent defects.
Ebstein’s anomaly with ‘reversible’ functional pulmonary atresia
Authors: Rato João , R Sousa Ana , Teixeira Ana , Anjos Rui
Published: December 2019

We present the case of an infant with prenatal diagnosis, at 32 weeks gestation, of Ebstein’s anomaly without anterograde flow from right ventricular to pulmonary atresia (PA)—functional PA with flow reversal in the ductus arteriosus. Prostaglandin E1 was started after birth. Chest X-ray showed severe cardiomegaly and echocardiogram confirmed Ebstein’s anomaly with a thickened non-opening pulmonary valve without anterograde flow but with mild regurgitation. Multidisciplinary team decision was to progressively reduce prostaglandins and have an expectant attitude. Peripheral oxygen saturation above 85% was maintained and serial echocardiograms documented progressive reduction of the ductus arteriosus and the opening of the pulmonic valve cusps, with the development of anterograde flow. The newborn was discharged at day 19 of life without the need for any intervention, and at last follow-up remains asymptomatic, with anterograde normal flow in the pulmonary valve.
Complex chest wall wound managed by a novel technique of thoracoplasty
Authors: Mishra Biplab , Joshi Mohit Kumar , Tiwari Raja , Uniyal Madhur
Published: December 2019

Thoracoplasty is a procedure to collapse the chest wall over a residual space in the thoracic cavity in order to abolish and avoid the complications associated with this dead space. Although effective in achieving this, the procedure is crippled by poor cosmetic appearance and functional outcome. We report a case of recalcitrant complex chest wall defect with a large cavity, marred by visible heart and poor availability of local muscles, that was successfully managed by a novel technique of thoracoplasty with acceptable postoperative appearance and function.
Primitive neuroectodermal tumour of the kidney presenting as diplopia secondary to skull metastasis
Authors: Rajaian Shanmugasundaram , Pragatheeswarane Murugavaithianathan , Krishnamurthy Karrthik , Chakravarthy Narasimhachar Srinivas
Published: December 2019

A 20-year-old man presented to the department of neurology with diplopia, occipital headache and right flank pain for 1-week duration. CT of the brain revealed skull metastasis with heterogeneously enhancing dural-based mass lesion at the occipital region. Positron emission tomography revealed tracer avid soft tissue mass involving the upper pole of the right kidney with loss of fat planes with the inferior surface of the liver. Multidisciplinary team approach was discussed. He underwent palliative nephrectomy with lymph nodal mass excision. Biopsy from the renal mass was suggestive of primitive neuroectodermal tumour. He developed progressive liver metastases in spite of adjuvant chemotherapy denoting very aggressive disease.
Transcholecystic approach for distal common bile duct stricture in a non-dilated biliary system: an alternative route
Authors: Rahman Syed , Krokidis Miltiadis , Paraskevopoulos Ioannis
Published: December 2019

A 63-year-old patient was admitted to intensive treatment unit with biliary sepsis due to a small distal common bile duct stone. Endoscopic retrograde cholangiopancreatography was initially attempted for insertion of a biliary stent but failed due to the presence of a periampullary diverticulum. Referral to interventional radiology for percutaneous drainage was considered the next alternative even though there was no dilatation of intrahepatic ducts. Due to complete absence of intrahepatic duct dilatation, the traditional percutaneous transhepatic route was considered rather challenging. An alternative percutaneous approach via the gallbladder and subsequent catheterisation of the duodenum via the distal common bile duct was successfully performed instead without complication. We would like to describe this technique as an alternative option for drainage of the non-dilated biliary system in patients with sepsis.
Primary Sjogren’s syndrome: a great masquerader
Authors: Kumar Naveen , Surendran Deepanjali , Srinivas Bheemanathi Hanuman , Bammigatti Chanaveerappa
Published: December 2019

A 41-year-old woman presented with paresthesia and inability to walk for 7 days. She had history of fatigue, polyarthralgia and difficulty in swallowing food for the last 1 year. She became edentulous over the last 5 years and wore dentures for the same. She appeared pale, emaciated and had oral thrush. She had areflexic quadriparesis with weakness more in lower limbs compared with upper limbs. With the initial diagnosis of Guillian-Barre syndrome, she was given five cycles of plasmapheresis following which there was a significant improvement in power. Sjogren’s syndrome was suspected based on edentulous state in a middle-aged woman with multisystem involvement. Evaluation with Schirmer’s test, parotid scintigraphy and labial minor salivary gland biopsy confirmed the diagnosis. She was treated with steroids following which a dramatic improvement in haemoglobin and total leucocyte count was noted. We report a varied presentation of primary Sjogren’s syndrome.
Signet-ring cell adenocarcinoma of unknown primary presenting with superior vena cava (SVC) syndrome: rare type of cancer
Authors: Bagaporo Larrazabal, Jr Ramon , Cheng Paula Victoria Catherine , David-Wang Aileen , Requiso Daryl
Published: December 2019

A 53-year-old man presented with a 3-month history of progressive, non-productive cough followed by occasional swelling of the face and upper extremities. Physical examination on admission revealed prominent superficial vessels at the neck and upper extremity swelling. Bronchoscopy revealed the superior segment of the right lower lobe was narrow but without visible mass; cell block and biopsy done revealed signet-ring cell carcinoma with an immunohistochemistry pattern favouring the primary site of malignancy as either gastric or of the pancreaticobiliary tree. However, CT scan of the abdomen and pelvis with triple contrast revealed only slight gastric wall thickening; the pancreas was unremarkable. The patient underwent radiotherapy with noted improvement of symptoms. He was then discharged with plans for further work-up on an outpatient basis. This work highlights the importance of a comprehensive histopathological and immunohistochemical work-up which can help predict a site of origin to be able to provide the appropriate management.
Pregnancy and coeliac disease
Authors: Boers Kim , Vlasveld Tom , van der Waart Roxy
Published: December 2019

Coeliac disease (CD) is a small bowel disorder known for its intestinal manifestations like diarrhoea and weight loss. Less known are the extraintestinal manifestations of CD like haematological abnormalities but also altered female reproduction and pregnancy outcomes. Especially, undiagnosed CD may lead to adverse reproductive outcomes such as intrauterine growth restriction, stillbirth and preterm birth. In diagnosed and treated CD, adverse pregnancy outcomes might be prevented.
Comparing different definitions of prediabetes with subsequent risk of diabetes: an individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes
Authors: Lee Crystal Man Ying , Colagiuri Stephen , Woodward Mark , Gregg Edward W , Adams Robert , Azizi Fereidoun , Gabriel Rafael , Gill Tiffany K , Gonzalez Clicerio , Hodge Allison , Jacobs Jr David R , Joseph Joshua J , Khalili Davood , Magliano Dianna J , Mehlig Kirsten , Milne Roger , Mishra Gita , Mongraw-Chaffin Morgana , Pasco Julie A , Sakurai Masaru , Schreiner Pamela J , Selvin Elizabeth , Shaw Jonathan E , Wittert Gary , Yatsuya Hiroshi , Huxley Rachel R
Published: December 2019

Objective

There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful.

Research design and methods

We conducted an individual participant meta-analysis using longitudinal data included in the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox regression models were used to obtain study-specific HRs for incident diabetes associated with each prediabetes definition. Harrell’s C-statistics were used to estimate how well each prediabetes definition discriminated 5-year risk of diabetes. Spline and receiver operating characteristic curve (ROC) analyses were used to identify alternative cut-points.

Results

Sixteen studies, with 76 513 participants and 8208 incident diabetes cases, were available. Compared with normoglycemia, current prediabetes definitions were associated with four to eight times higher diabetes risk (HRs (95% CIs): 3.78 (3.11 to 4.60) to 8.36 (4.88 to 14.33)) and all definitions discriminated 5-year diabetes risk with good accuracy (C-statistics 0.79–0.81). Cut-points identified through spline analysis were fasting plasma glucose (FPG) 5.1 mmol/L and glycated hemoglobin (HbA1c) 5.0% (31 mmol/mol) and cut-points identified through ROC analysis were FPG 5.6 mmol/L, 2-hour postload glucose 7.0 mmol/L and HbA1c 5.6% (38 mmol/mol).

Conclusions

In terms of identifying individuals at greatest risk of developing diabetes within 5 years, using prediabetes definitions that have lower values produced non-significant gain. Therefore, deciding which definition to use will ultimately depend on the goal for identifying individuals at risk of diabetes.
Diabetic retinopathy as an independent predictor of subclinical cardiovascular disease: baseline results of the PRECISED study
Authors: Simó Rafael , Bañeras Jordi , Hernández Cristina , Rodríguez-Palomares José , Valente Filipa , Gutierrez Laura , González-Alujas Teresa , Ferreira Ignacio , Aguadé-Bruix Santiago , Montaner Joan , Seron Daniel , Genescà Joan , Boixadera Anna , García-Arumí José , Planas Alejandra , Simó-Servat Olga , García-Dorado David
Published: December 2019

Objective

Detection of subclinical cardiovascular disease (CVD) has significant impact on the management of type 2 diabetes. We examined whether the assessment of diabetic retinopathy (DR) is useful for identifying patients at a higher risk of having silent CVD.

Research design and methods

Prospective case–control study comprising 200 type 2 diabetic subjects without history of clinical CVD and 60 age-matched non-diabetic subjects. The presence of subclinical CVD was examined using two parameters: (1) calcium coronary score (CACs); (2) composite of CACs >400 UA, carotid plaque ≥3 mm, carotid intima–media thickness ratio >1, or the presence of ECG changes suggestive of previous asymptomatic myocardial infarction. In addition, coronary angio-CT was performed. DR was assessed by slit-lamp biomicroscopy and retinography.

Results

Type 2 diabetic subjects presented higher CACs than non-diabetic control subjects (p<0.01). Age, male gender, and the presence of DR were independently related to CACs >400 (area under the receiver operating characteristic curve (AUROC) 0.76). In addition, an inverse relationship was observed between the degree of DR and CACs <10 AU. The variables independently associated with the composite measurement of subclinical CVD were age, diabetes duration, the glomerular filtration rate, microalbuminuria, and the presence of DR (AUROC 0.71). In addition, a relationship (p<0.01) was observed between the presence and degree of DR and coronary stenosis.

Conclusions

The presence and degree of DR is independently associated with subclinical CVD in type 2 diabetic patients. Our results lead us to propose a rationalized screening for coronary artery disease in type 2 diabetes based on prioritizing patients with DR, particularly those with moderate–severe degree.
Impact of glycemic traits, type 2 diabetes and metformin use on breast and prostate cancer risk: a Mendelian randomization study
Authors: Au Yeung Shiu Lun , Schooling Catherine Mary
Published: December 2019

Objectives

Observational studies suggest glycemic traits and type 2 diabetes are positively associated, and metformin inversely associated with breast and prostate cancer risk. However, observational studies are susceptible to unmeasured confounding while studies of metformin use are also vulnerable to immortal time bias. The use of Mendelian randomization may reduce confounding due to random allocation of relevant genetic markers at birth, and may reduce immortal time bias (for metformin-related variants analysis) since the start of exposure is at birth.

Research design and methods

We identified strong genetic predictors of fasting glucose, glycated hemoglobin, and type 2 diabetes from the Meta-Analyses of Glucose and Insulin-related traits Consortium and Diabetes Genetics Replication And Meta-analysis Consortium (n=140 595 for glucose; n=123 665 for HbA1c; n=898 130 for type 2 diabetes) and ofAMPK-instrumented HbA1c reduction as a proxy of metformin and applied them to large genome-wide association studies of breast cancer (Breast Cancer Association Consortium; BCAC) and prostate cancer (Prostate Cancer Association Group to Investigate Cancer-Associated Alterations in the Genome; PRACTICAL). We used inverse variance weighting to obtain estimates. Sensitivity analyses included use of MR-Egger, weighted median, exclusion of pleiotropic instruments, and validation using UK Biobank (breast cancer only).

Results

There was no association of fasting glucose (OR 1.03 per mmol/L, 95% CI 0.85 to 1.25), HbA1c (OR 1.02 per %, 95% CI 0.73 to 1.45), or type 2 diabetes (OR 0.98 per log odds, 95% CI 0.95 to 1.01) with breast cancer in BCAC, with similar findings from UK Biobank. There was no association of fasting glucose (OR 0.93 per mmol/L, 95% CI 0.73 to 1.17), HbA1c (OR 0.90 per %, 95% CI 0.58 to 1.40) or type 2 diabetes (OR 1.02 per log odds, 95% CI 0.97 to 1.07) with prostate cancer in PRACTICAL. No strong evidence was observed forAMPK-instrumented HbA1c reduction on cancer risk.

Conclusion

Glycemic traits and type 2 diabetes unlikely cause breast and prostate cancer. Whether metformin can be repurposed for cancer prevention remains unclear.
Validating Joint External Evaluation reports with the quality of outbreak response in Ethiopia, Nigeria and Madagascar
Authors: Garfield Richard , Bartee Maureen , Mayigane Landry Ndriko
Published: December 2019

To date more than 100 countries have carried out a Joint External Evaluation (JEE) as part of their Global Health Security programme. The JEE is a detailed effort to assess a country’s capacity to prevent, detect and respond to population health threats in 19 programmatic areas. To date no attempt has been made to determine the validity of these measures. We compare scores and commentary from the JEE in three countries to the strengths and weaknesses identified in the response to a subsequent large-scale outbreak in each of those countries. Relevant indicators were compared qualitatively, and scored as low, medium or in a high level of agreement between the JEE and the outbreak review in each of these three countries. Three reviewers independently reviewed each of the three countries. A high level of correspondence existed between score and text in the JEE and strengths and weaknesses identified in the review of an outbreak. In general, countries responded somewhat better than JEE scores indicated, but this appears to be due in part to JEE-related identification of weaknesses in that area. The improved response in large measure was due to more rapid requests for international assistance in these areas. It thus appears that even before systematic improvements are made in public health infrastructure that the JEE process may assist in improving outcomes in response to major outbreaks.
Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude
Authors: Sousa Kelienny de Meneses , Pimenta Isac Davidson Santiago Fernandes , Fernández Elorriaga María , Saturno-Hernandez Pedro Jesus , Rosendo Tatyana Maria Silva de Souza , de Freitas Marise Reis , Medeiros Wilton Rodrigues , Martins Quenia Camille Soares , Gama Zenewton André da Silva
Published: December 2019

Objective

To evaluate the quality of delivery care in maternity wards in Brazil and Mexico based on good practices (GP) and adverse events (AE), in order to identify priorities for improvement.

Design

A multicentre cross-sectional study with data collection from medical records between 2015 and 2016 to compare indicators of maternal and neonatal GP and EA based on the Safe Childbirth Checklist and standardised obstetric quality indicators. Two Brazilian and five Mexican maternity wards participated in the study. Descriptive statistics and χ2tests were performed to assess performance and significant differences between the hospitals investigated.

Sampling

We analysed 720 births in Brazil and 2707 in Mexico, which were selected using a systematic random sampling of 30 medical records every fortnight for 12 2-week periods in Brazil and 18 2-week periods in Mexico. We included women and their newborns, excluding those with congenital malformations.

Results

The Mexican hospitals showed greater adherence to GP (58.2%) and a lower incidence of AE (12.9%) than the participating institutions in Brazil (26.8% compliance with GP and 16.0% AE). In spite of these differences, the relative importance of particular quality problems and type of AE are similar in both countries. Tertiary hospitals, caring for women at higher risk, have significantly (p<0.001) higher rates of AE (27.2% in Brazil and 29.6% in Mexico) than institutions attending women at lower risk, where the frequency of AE ranges from 4.7% to 11.2%. Differences were significant (p<0.001) for most indicators of GP and AE.

Conclusion

Data from outcome and process measures revealed similar types of failures in the quality of childbirth care in both countries and indicate the need of rationalising the use of antibiotics for the mother and episiotomy, encouraging greater adherence to partograph and to the use of magnesium sulfate for the treatment of severe preeclampsia/eclampsia.
Safety of switching from vitamin K antagonist to non-vitamin K antagonist oral anticoagulant in frail elderly with atrial fibrillation: rationale and design of the FRAIL-AF randomised controlled trial
Authors: Joosten Linda P T , van Doorn Sander , Hoes Arno W , Nierman Melchior C , Wiersma Nynke M , Koek Huiberdina L , Hemels Martin E W , Huisman Menno V , Roes Kit C , van den Bor Rutger M , Buding Wim F , Rutten Frans H , Geersing Geert-Jan
Published: December 2019

Introduction

Clinical guidelines recommend non-vitamin K antagonist oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) for stroke prevention in most patients with atrial fibrillation (AF). Frail elderly were under-represented in the landmark NOAC-trials, leaving a knowledge gap on the optimal anticoagulant management (VKA or NOAC) in this increasing population. The aim of the Frail-AF (FRAIL-AF) study is to assess whether switching from international normalised ratio (INR)-guided VKA-management to a NOAC-based treatment strategy compared with continuing VKA-management is safe in frail elderly patients with AF.

Methods and analysis

The FRAIL-AF study is a pragmatic, multicentre, open-label, randomised controlled clinical trial. Frail elderly (age ≥75 years plus a Groningen Frailty Indicator score ≥3) who receive VKA-treatment for AF in the absence of a mechanical heart valve or severe mitral valve stenosis will be randomised to switch to a NOAC-based treatment strategy or to continue INR-guided VKA-management. Patients with severe renal impairment (estimated glomerular filtration rate <30 mL/min/1.73 m2) will be excluded from randomisation. Based on existing trial evidence in non-frail patients, we will aim to explore whether NOAC-treatment is superior to VKA-therapy in reducing major or clinically relevant non-major bleeding events. Secondary outcomes include minor bleeding, the composite of ischaemic and haemorrhagic stroke, health-related quality of life and cost-effectiveness. The follow-up period for all subjects is 12 months.

Ethics and dissemination

The protocol was approved by the Medical Research Ethics Committee of the University Medical Center Utrecht, the Netherlands and by the Central Committee on Research Involving Human Subjects, the Netherlands. All patients are asked written informed consent. Results are expected in 2022 and will be disseminated through peer-reviewed journals as well as presentations at national and international conferences.

Trial registration number

EudraCT: 2017-000393-11; The Netherlands Trial Registry: 6721 (FRAIL-AF study).
Housing situation and healthcare for patients in a psychiatric centre in Berlin, Germany: a cross-sectional patient survey
Authors: Schreiter Stefanie , Heidrich Sascha , Zulauf Jamie , Saathoff Ute , Brückner Anne , Majic Tomislav , Rössler Wulf , Schouler-Ocak Meryam , Krausz Michael R , Bermpohl Felix , Bäuml Josef , Gutwinski Stefan
Published: December 2019

Objective

To determine the housing situation among people seeking psychiatric treatment in relation to morbidity and service utilisation.

Design

Cross-sectional patient survey.

Setting

Psychiatric centre with a defined catchment area in Berlin, Germany, March–September 2016.

Participants

540 psychiatric inpatients including day clinics (43.2% of all admitted patients in the study period (n=1251)).

Main outcome measures

Housing status 30 days prior the interview as well as influencing variables including service use, psychiatric morbidity and sociodemographic variables.

Results

In our survey, 327 participants (68.7%) currently rented or owned an own apartment; 62 (13.0%) reported to be homeless (living on the street or in shelters for homeless or refugees); 87 (18.3%) were accommodated in sociotherapeutic facilities. Participants without an own apartment were more likely to be male and younger and to have a lower level of education. Homeless participants were diagnosed with a substance use disorder significantly more often (74.2%). Psychotic disorders were the highest among homeless participants (29.0%). Concerning service use, we did neither find a lower utilisation of ambulatory services nor a higher utilisation of hospital-based care among homeless participants.

Conclusions

Our findings underline the need for effective housing for people with mental illness. Despite many sociotherapeutic facilities, a concerning number of people with mental illness is living in homelessness. Especially early interventions addressing substance use might prevent future homelessness.
Current clinical utilisation of wearable motion sensors for the assessment of outcome following knee arthroplasty: a scoping review
Authors: Small Scott R , Bullock Garrett S , Khalid Sara , Barker Karen , Trivella Marialena , Price Andrew James
Published: December 2019

Objectives

Wearable motion sensors are used with increasing frequency in the evaluation of gait, function and physical activity within orthopaedics and sports medicine. The integration of wearable technology into the clinical pathway offers the ability to improve post-operative patient assessment beyond the scope of current, questionnaire-based patient-reported outcome measures. This scoping review assesses the current methodology and clinical application of accelerometers and inertial measurement units for the evaluation of patient activity and functional recovery following knee arthroplasty.

Design

This is a systematically conducted scoping review following Joanna Briggs Institute methodology for scoping reviews and reported consulting the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews. A protocol for this review is registered with the Open Science Framework (https://osf.io/rzg9q).

Data sources

CINAHL, EMBASE, MEDLINE and Web of Science databases were searched for manuscripts published between 2008 and 2019.

Eligibility criteria

We included clinical studies reporting the use of any combination of accelerometers, pedometers or inertial measurement units for patient assessment at any time point following knee arthroplasty.

Data extraction and synthesis

Data extracted from manuscripts included patient demographics, sensor technology, testing protocol and sensor-based outcome variables.

Results

45 studies were identified, including 2076 knee arthroplasty patients, 620 patients with end-stage osteoarthritis and 449 healthy controls. Primary aims of the identified studies included functional assessment, physical activity monitoring and evaluation of knee instability. Methodology varied widely between studies, with inconsistency in reported sensor configuration, testing protocol and output variables.

Conclusions

The use of wearable sensors in evaluation of knee arthroplasty procedures is becoming increasingly common and offers the potential to improve clinical understanding of recovery and rehabilitation. While current studies lack consistency, significant opportunity exists for the development of standardised measures and protocols for function and physical activity evaluation.
Exploring the experiences of people in Ontario, Canada who have trouble affording medicines: a qualitative concept mapping study
Authors: Yaphe Hannah , Adekoya Itunuoluwa , Steiner Liane , Maraj Darshanand , O'Campo Patricia , Persaud Nav
Published: December 2019

Objectives

The experiences of people who report cost-related medicine non-adherence are not well documented. We aimed to present experiences relating to accessing medicines reported by the participants in a randomised controlled trial of free medicine distribution.

Methods

The trial consisted of primary care patients from a large urban family practice and three rural family practices who reported cost-related medicine non-adherence. Participants were randomly allocated to continue their poor access (control) or to receive free and easily accessible medicines (intervention). As part of data collection for the first year of the trial, participants were asked closed and open-ended questions to assess their adherence to medication, health outcomes and their experiences in relation to medicine accessibility. We conducted a qualitative concept mapping study in which we analysed and summarised participants’ responses to the open-ended question on a concept map to visually present their experiences relating to accessing medicines.

Results

Of the 524 trial participants contacted, 198 (38%) responded to the open-ended question. The concept map contains clusters that represent eight types of experiences of participants related to medicine access including stress, relationship with doctor, health impact, quality of life, sacrificing other essentials, medicines are expensive, financial impact and adherence. These experiences fall under two major themes, experiences relating to personal finances and experiences relating to well-being, which are bridged by a central cluster of adherence.

Conclusions

The experiences shared by the participants demonstrate that access to medicines impacts people’s finances and well-being as well as their adherence to prescribed medicines. These results indicate that effects on personal finances and general well-being should be measured for interventions and policy changes aimed at improving medicine access.

Trial registration number

This article is linked to the Carefully Selected and Easily Accessible at No Charge Medicines (CLEAN Meds) randomised controlled trial (trial registration number: NCT02744963).
Lipoprotein particles and coronary artery calcium in middle-aged US-White and Japanese men
Authors: Mahajan Hemant , Zaid Maryam , Mackey Rachel , Kadota Aya , Vishnu Abhishek , Fujiyoshi Akira , Vasudha Ahuja , Hisamatsu Takashi , Evans Rhobert , Okamura Tomonori , Miura Katsuyuki , Kuller Lewis , Ueshima Hirotsugu , Sekikawa Akira
Published: December 2019

Objective

This cross-sectional study examined whether contrasting distributions of nuclear magnetic resonance (NMR)-measured lipoproteins contribute to differences in the prevalence of subclinical atherosclerosis measured using coronary artery calcium (CAC) between the two groups of middle-aged males: the US-residing Caucasian (US-White) and Japan-residing Japanese (Japanese).

Methods

In a population-based study of 570 randomly selected asymptomatic men aged 40–49 years (270 US-White and 300 Japanese), we examined the relationship between race/ethnicity, NMR-measured lipoproteins and CAC (measured by Electron Beam CT and quantified using the Agatston method) using multivariable robust Poisson regression adjusting for traditional and novel risk factors for coronary heart disease (CHD).

Results

The US-White compared with the Japanese had significantly different NMR-measured lipoprotein particle distributions. The US-White had a significantly higher prevalence of CAC≥10 (CAC-prevalence) compared with the Japanese adjusting for CHD risk factors (prevalence ratio (PR)=2.10; 95% CI=1.24 to 3.48), and this difference was partially attenuated (~18%) with further adjustment for lipoprotein levels (PR=1.73; 95% CI=1.02 to 3.08). There was no reclassification improvement with further addition of lipoproteins particle concentrations/size to a model that already included traditionally measured lipids (low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), cardiovascular risk factors, and inflammatory markers (net reclassification improvement index=−2% to 3%).

Conclusions

Variations in the distribution of NMR-measured lipoprotein particles partially accounted for the difference in the CAC-prevalence between middle-aged US-White and Japanese men.
The higher education space: connecting degree programs from individuals’ choices
Authors: Candia Cristian , Encarnação Sara , Pinheiro Flávio L.
Published: December 2019

Data on the applicants’ revealed preferences when entering higher education is used as a proxy to build the Higher Education Space (HES) of Portugal (2008–2015) and Chile (2006–2017). The HES is a network that connects pairs of degree programs according to their co-occurrence in the applicants’ preferences. We show that both HES network structures reveal the existence of positive assortment in features such as gender balance, application scores, unemployment levels, academic demand/supply ratio, geographical mobility, and first-year drop-out rates. For instance, if a degree program exhibits a high prevalence of female candidates, its nearest degree programs in the HES will also tend to exhibit a higher prevalence when compared to the prevalence in the entire system. These patterns extend up to two or three links of separation, vanishing, or inverting for increasing distances. Moreover, we show that for demand/supply ratio and application scores a similar pattern occurs for time variations. Finally, we provide evidence that information embedded in the HES is not accessible by merely considering the features of degree programs independently. These findings contribute to a better understanding of the higher education systems at revealing and leveraging its non-trivial underlying organizing principles. To the best of our knowledge, this is the first network science approach for improving decision-making and governance in higher education systems.
Summary of the “Workshop on Beam Acceleration in Crystals and Nanostructures” (Fermilab, June 24–25, 2019)
Authors: Shiltsev V. D. , Tajima T.
Published: December 2019

Here we present a short summary of the “Workshop on Beam Acceleration in Crystals and Nanostructures” which has taken place at Fermilab on June 24–25, 2019.
Ultimate colliders for particle physics: Limits and possibilities
Authors: Shiltsev V. D.
Published: December 2019

The future of the world-wide HEP community critically depends on the feasibility of the concepts for the post-LHC Higgs factories and energy frontier future colliders. Here we overview the accelerator options based on traditional technologies and consider the need for plasma colliders, particularly, muon crystal circular colliders. We briefly address the ultimate energy reach of such accelerators, their advantages, disadvantages and limits in the view of perspectives for the far future of the accelerator-based particle physics and outline possible directions of R&D to address the most critical issues.
Improved mechanical properties of Cu–Sn–Zn–TiO2 coatings
Authors: Wang Yuxin , Gao Weidong , He Zhen , Zhang Shengping , Yin Li
Published: December 2019

This study applied the pulse electrodeposition and duplex electrodeposition techniques to improve the mechanical properties of Cu–Sn–Zn–TiO2 nanocomposite coatings. The phase constituents and surface morphologies of prepared coatings were characterized. The cross-sectional information was recorded. The mechanical properties were determined by microhardness and wear tests. All the prepared coatings presented a nodular surface. Both the addition of TiO2 particles and nickel inner layer refined the coating surface. The pulse electrodeposition led to increased microhardness, while the addition of nickel inner layer further increased the mechanical performance. The best mechanical performance was achieved for the duplex Cu–Sn–Zn–TiO2/Ni nanocomposite coating prepared via pulse electrodeposition.
Effect of composition and structures on the elastic modulus of SiC fibers
Authors: Wang Yongshou , Wang Yifei , Wang Yingde
Published: December 2019

High modulus SiC fibers can be used in complex working environment with alternating heat and cold. In this paper, SiC fibers with various oxygen contents and crystal size were fabricated by polymer-derived ceramics routes. The effects of oxygen content and crystal size on the elastic modulus of SiC fibers were studied in detail. It was found that the elastic modulus of SiC fibers can be improved by reducing the oxygen content and increasing the crystal size of SiC fibers when the crystal size was less than 2 nm. When the oxygen content decreased from 21.5 wt.% to 11.7 wt.%, the elastic modulus of SiC fibers was increased from 131 GPa to 167 GPa. Particularly, the highest elastic modulus of CVC treated hypoxic SiC fibers is close to 200 GPa when the crystallite size is about 2 nm.
Surface modification of TiO2 for visible light photocatalysis: Experimental and theoretical calculations of its electronic and optical properties
Authors: Ariyanti Dessy , Mukhtar Surayya , Ahmed Nisar , Liu Zhuofeng , Dong Junzhe , Gao Wei
Published: December 2019

Surface modification has been used as a method to create defects on [Formula: see text] materials, which can improve their desirable properties. In this paper, defected [Formula: see text] nano-powder was successfully synthesized by chemical reduction using [Formula: see text] as the reducing agent at 300–400[Formula: see text] under argon atmosphere. High defect concentration can be produced by increasing process temperature. The modified [Formula: see text] shows good visible light absorption and photocatalytic activity on degradation of Rhodamine B (4–9 times higher than the pristine [Formula: see text]) with the visible light irradiation. Further XPS analysis and theoretical studies using full potential linearized augmented plane wave (FP-LAPW) method as implemented in wien2k code revealed the existence of oxygen vacancy and [Formula: see text] in the modified samples. These types of defects were responsible for the modifications of the electronic and optical properties of [Formula: see text], resulting in the improved photocatalytic activity in visible light irradiation.
Framework for Automatic Selection of Kernels based on Convolutional Neural Networks and CkMeans Clustering Algorithm
Authors: Hamouda Maissa , Ettabaa Karim Saheb , Bouhlel Med Salim
Published: December 2019

Convolutional neural networks (CNN) can learn deep feature representation for hyperspectral imagery (HSI) interpretation and attain excellent accuracy of classification if we have many training samples. Due to its superiority in feature representation, several works focus on it, among which a reliable classification approach based on CNN, used filters generated from cluster framework, like k Means algorithm, yielded good results. However, the kernels number to be manually assigned. To solve this problem, a HSI classification framework based on CNN, where the convolutional filters to be adaptatively learned from the data, by grouping without knowing the cluster number, has recently proposed. This framework, based on the two algorithms CNN and kMeans, showed high accuracy results. So, in the same context, we propose an architecture based on the depth convolution al neural networks principle, where kernels are adaptatively learned, using CkMeans network, to generate filters without knowing the number of clusters, for hyperspectral classification. With adaptive kernels, the proposed framework automatic kernels selection by CkMeans algorithm (AKSCCk) achieves a better classification accuracy compared to the previous frameworks. The experimental results show the effectiveness and feasibility of AKSCCk approach.
Insulin Resistance Associated with Plasma Xanthine Oxidoreductase Activity Independent of Visceral Adiposity and Adiponectin Level: MedCity21 Health Examination Registry
Authors: Kurajoh Masafumi , Fukumoto Shinya , Murase Takayo , Nakamura Takashi , Ishihara Takuma , Go Hirofumi , Yamamoto Kouji , Nakatani Shinya , Tsuda Akihiro , Morioka Tomoaki , Mori Katsuhito , Imanishi Yasuo , Inaba Masaaki , Emoto Masanori
Published: December 2019

Background. Higher levels of uric acid production have been reported in individuals with visceral fat obesity, and obesity is known to enhance xanthine oxidoreductase (XOR) activity, although the precise mechanism remains unclear. We investigated the associations of visceral fat area (VFA), serum adiponectin level, and insulin resistance with plasma XOR activity using our novel highly sensitive assay based on [13C2,15N2] xanthine and liquid chromatography/triple quadrupole mass spectrometry. Methods. This cross-sectional study included 193 subjects (92 males and 101 females) registered in the MedCity21 health examination registry. Plasma XOR activity, serum adiponectin level, and VFA obtained by computed tomography were measured, and insulin resistance was determined based on the homeostasis model assessment (HOMA-IR) index. Results. The mean values for VFA, log HOMA-IR, and log plasma XOR activity were 76.8 ± 45.8 cm2, 0.14 ± 0.30, and 1.50 ± 0.44 pmol/h/mL, respectively. Multiple regression analysis showed that HOMA-IR was significantly (p=0.020) associated with plasma XOR activity independent of other factors, including VFA and adiponectin level, as well as age, sex, alcohol drinking habit, smoking habit, alanine transaminase, HbA1c, and eGFR. The “sex∗HOMA−IR” interaction was not significant (p=0.89), indicating that sex difference does not have an effect on the relationship between HOMA-IR and plasma XOR activity. Conclusions. Our results indicate that insulin resistance is associated with plasma XOR activity and that relationship is independent of visceral adiposity and adiponectin level, suggesting that the development of insulin resistance resulting from increased visceral adiposity and/or reduced serum adiponectin contributes to increased uric acid production by stimulating XOR activity.