bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of a Spatial RRSS Mechanism for Path Generation Using the Numerical Atlas Method
Authors: Liu Wenrui , Sun Jianwei , Chu Jinkui
Published: June 2019

An open path synthesis method for a spatial revolute-revolute-spherical-spherical (RRSS) mechanism is presented in this paper. The mathematical model for the trajectory curve is established. The characteristics of an RRSS mechanism in a standard installation position are revealed: the projection points of the coupler curve on the Oxy plane rotate by the corresponding input angles around the z-axis, and the generated points lie on an ellipse. Based on this finding, a 17-dimensional path generation problem can be translated into two lower-dimensional matching recognition problems and one actual size and installation position calculation problem. The path generation can be achieved by three steps. First, a database of four dimensional rotation angle parameters is established. By comparing the similarities between the mechanism feature curve of the prescribed open curve and its corresponding mechanism feature ellipse (MFE), the angles of installation, the initial angle of the input link, and the elliptic feature parameters of the desired RRSS mechanism can be approximately determined. Then, a 13-dimensional dynamic self-adapting numerical atlas database is established, which contains six basic dimensional types (BDTs) and seven wavelet feature parameters, and the BDTs of the desired RRSS mechanism are obtained. Finally, based on the relationship between the MFE of the prescribed curve and the BDTs of the desired RRSS mechanism, the calculation models for the actual link lengths and installation positions of the desired RRSS mechanism were established. Three examples are presented in this paper.
Design and Analysis of a High-Payload Manipulator Based on a Cable-Driven Serial-Parallel Mechanism
Authors: Liu Fei , Xu Wenfu , Huang Hailin , Ning Yinghao , Li Bing
Published: June 2019

In this paper, a lightweight high-payload cable-driven serial-parallel manipulator is proposed. The manipulator comprises one 3-degree-of-freedom (3-DOF) shoulder joint and one single-DOF elbow joint. Using a special tension-amplifying principle, which is an ingenious two-stage deceleration method, the proposed manipulator has a higher load/mass ratio than those of conventional manipulators. In this paper, the special tension-amplifying principle is discussed in detail. The shoulder and elbow joints of the proposed manipulator are driven by cables. The design of this cable-driven mechanism and the mobility of the joints are analyzed, and the structural parameters of the joints are optimized to improve the payload capacity. The size of the manipulator is close to that of a human arm because the actuators of the cable-driven mechanism can be rear-mounted. Because the elbow joint is located at the end of the shoulder joint and the driven cables of the elbow joint are coupled with the rotation of the shoulder joint, the manipulator is designed with decoupled cable routing. The overall configuration and cable routing of the manipulator are presented, and then, kinematics, joint stiffness, strength, and workspace of the manipulator are analyzed. Finally, we report on the fabrication of a physical prototype and testing of its joint stiffness, payload capacity, workspace, speed, and repeatability to verify the feasibility of our proposed manipulator.
Experimental Studies on Energy and Exergy Analysis of a Single-Pass Parallel Flow Solar Air Heater
Authors: Raam Dheep G. , Sreekumar A.
Published: June 2019

Solar air heaters (SAHs) are the simplest form of nonconcentrating thermal collectors. SAHs utilize solar thermal energy to increase the temperature of air for thermal applications of less than 80 °C. The energy efficiency of SAHs is significantly low due to poor convective heat transfer between the absorber and the air medium. In this present study, it is aimed to increase the convective heat transfer by modifying the absorber and the type of air flow inside the duct. Experimental studies were performed to study about the energy and exergy efficiencies of SAH with the absorber of longitudinal circular fins. The thermal analysis of the SAH is evaluated for five mass flow rates of 30, 45, 60, 75, and 90 kg/h m2 flowing inside the duct of thickness 100 mm. The impact of the flow rate on the absorber and air temperature, temperature difference (ΔT), energy and exergy efficiencies, irreversibility, improvement potential, sustainability, and CO2 reduction potential is studied. The experimental results show that the first and second laws of thermodynamic efficiency increase from 44.13% to 56.98% and from 24.98% to 36.62% by increasing the flow rate from 30 to 90 kg/h m2. The results conclude that the air flow duration inside the duct plays an important role in efficiency of the solar air heater. Therefore, lower flow rate is preferred to achieve maximum outlet air temperature and temperature difference.
Numerical Verification of the Schroeder–Webster Surface Types and Friction Compensation Models for a Metallic Specimen in Axisymmetric Compression Test
Authors: Shin Hyunho , Lee Jae-Ha , Kim Jong-Bong , Seo Seung-Jae , Lee Jaekun , Lee Jong-Oek , Yoon Tae-Sik , Jeong Chanseok
Published: June 2019

Three types of surfaces in the Schroeder–Webster (SW) theory, i.e., sliding, mixed, and sticking surfaces, have been verified via finite element analysis of an axisymmetric compression test for a metallic specimen. Judging from (i) the radial profile of the pressure at the top elements and (ii) the radial displacement at the top nodes, the three types of SW surfaces are not manifested in the numerical simulation. However, the SW friction compensation model developed for the SW-sliding surface is remarkably reliable in predicting the measured stress–strain curve of the barreled specimen down to the height-to-diameter ratio of 0.1. The origin of this reliability is discussed along with recommendations for using the SW friction compensation model for the SW-sliding surface.
High-resolution CLEAN-SC for acoustic source identification with spherical microphone arrays
Authors: Zhao Shuyi , Chu Zhigang , Yang Yang , Zhang Yongxiang
Published: June 2019

Spherical harmonics beamforming (SHB) with solid spherical microphone arrays can identify acoustic source in all directions simultaneously. To surpass the Rayleigh resolution limit and improve the performance of acoustic sources identification, this paper applies the high-resolution CLEAN-SC (HR-CLEAN-SC) algorithm, introduced by Sijtsma et al. for beamforming with planar arrays, to SHB. The factor of the potential resolution enhancement is typically about 1.7 compared to the Rayleigh resolution limit. Furthermore, simulations and experiments with spherical arrays demonstrate that HR-CLEAN-SC has higher spatial resolution and accuracy of both location and quantification than standard CLEAN-SC.
Arginine vasopressin receptor 1a is a therapeutic target for castration-resistant prostate cancer
Authors: Zhao Ning , Peacock Stephanie O. , Lo Chen Hao , Heidman Laine M. , Rice Meghan A. , Fahrenholtz Cale D. , Greene Ann M. , Magani Fiorella , Copello Valeria A. , Martinez Maria Julia , Zhang Yushan , Daaka Yehia , Lynch Conor C. , Burnstein Kerry L.
Published: June 2019

Antagonism of arginine vasopressin receptor 1a inhibits growth of emergent, established, and bone metastatic castration-resistant prostate cancer.
A decade of digital medicine innovation
Authors: Topol Eric J.
Published: June 2019

The field of digital medicine has matured over the past decade, but validation will require careful randomized, controlled clinical trials.
Deciphering the mechanoreceptor network of human hands
Authors: Han Li-Hsin
Published: June 2019

Machine learning based on gloves with tactile sensor arrays helps scientists understand the complex patterns of hand grasping.
Pharmacokinetics and Pharmacodynamics of the Nitroimidazole DNDI-0690 in Mouse Models of Cutaneous Leishmaniasis
Authors: Wijnant Gert-Jan , Croft Simon L. , de la Flor Raul , Alavijeh Mo , Yardley Vanessa , Braillard Stéphanie , Mowbray Charles , Van Bocxlaer Katrien
Published: June 2019

The nitroimidazole DNDI-0690 is a clinical drug candidate for visceral leishmaniasis (VL) that also shows potent
in vitro
and
in vivo
activity against cutaneous leishmaniasis (CL). To support further development of this compound into a patient-friendly oral or topical formulation for the treatment of CL, we investigated the free drug exposure at the dermal site of infection and subsequent elimination of the causative
Leishmania
pathogen.
Generation of a Prophage-Free Variant of the Fast-Growing Bacterium Vibrio natriegens
Authors: Pfeifer Eugen , Michniewski Slawomir , Gätgens Cornelia , Münch Eugenia , Müller Felix , Polen Tino , Millard Andrew , Blombach Bastian , Frunzke Julia
Published: June 2019

The fast-growing marine bacterium
Vibrio natriegens
represents an emerging model host for molecular biology and biotechnology, featuring a reported doubling time of less than 10 minutes. In many bacterial species, viral DNA (prophage elements) may constitute a considerable fraction of the whole genome and may have detrimental effects on the growth and fitness of industrial strains. Genome analysis revealed the presence of two prophage regions in the
V. natriegens
genome that were shown to undergo spontaneous induction under standard cultivation conditions. In this study, we generated a prophage-free variant of
V. natriegens
. Remarkably, the prophage-free strain exhibited a higher tolerance toward DNA damage and hypo-osmotic stress. Moreover, it was shown to outcompete the wild-type strain in a competitive growth experiment. In conclusion, our study presents the prophage-free variant of
V. natriegens
as a promising platform strain for future biotechnological applications.
Helicobacter pylori Uses the TlpB Receptor To Sense Sites of Gastric Injury
Authors: Hanyu Hikaru , Engevik Kristen A. , Matthis Andrea L. , Ottemann Karen M. , Montrose Marshall H. , Aihara Eitaro
Published: June 2019

Helicobacter pylori
is a pathogen that chronically colonizes the stomachs of approximately half of the world’s population and contributes to the development of gastric inflammation. We demonstrated previously
in vivo
that
H. pylori
uses motility to preferentially colonize injury sites in the mouse stomach. However, the chemoreceptor responsible for sensing gastric injury has not yet been identified.
Xenoantigen-Dependent Complement-Mediated Neutralization of Lymphocytic Choriomeningitis Virus Glycoprotein-Pseudotyped Vesicular Stomatitis Virus in Human Serum
Authors: Pipperger Lisa , Koske Iris , Wild Nicole , Müllauer Brigitte , Krenn Daniela , Stoiber Heribert , Wollmann Guido , Kimpel Janine , von Laer Dorothee , Bánki Zoltán
Published: June 2019

Systemic application aims to deliver oncolytic viruses to tumors as well as to metastatic lesions. However, we found that xenoantigens incorporated onto the viral surface from nonhuman production cell lines are recognized by natural antibodies in human serum and that the virus is thereby inactivated by complement lysis. Hence, to maximize the effective dose, careful selection of cell lines for virus production is crucial.
Draft Genome Sequence of the Yeast
Kodamaea ohmeri
, a Symbiont of the Small Hive Beetle
Authors: Tauber James P. , Childers Anna K. , Evans Jay D.
Published: June 2019

Kodamaea ohmeri
is a symbiont of the small hive beetle (SHB), which is a scavenger of honey bee colonies. The SHB causes absconding of the economically important honey bee (
Apis mellifera
) and deposits
K. ohmeri
in the honeycomb. We describe long-read sequencing and further analyses of the
K. ohmeri
genome.
Complete Genome Sequences of Staphylococcus epidermidis Myophages Quidividi, Terranova, and Twillingate
Authors: Freeman Miranda E. , Kenny Sarah E. , Lanier Amanda , Cater Katie , Wilhite Mary C. , Gamble Paige , O’Leary Chandler J. , Hatoum-Aslan Asma , Young Ryland F. , Liu Mei
Published: June 2019

Staphylococcus epidermidisis an opportunistic pathogen that commonly colonizes human skin and mucous membranes. We report here the complete genome sequences of threeS. epidermidisphages, Quidividi, Terranova, and Twillingate, which are members of the Twort-like group of large myophages infecting Gram-positive hosts.
Neuroimaging findings in newborns with congenital heart disease prior to surgery: an observational study
Authors: Kelly Christopher J , Arulkumaran Sophie , Tristão Pereira Catarina , Cordero-Grande Lucilio , Hughes Emer J , Teixeira Rui Pedro A G , Steinweg Johannes K , Victor Suresh , Pushparajah Kuberan , Hajnal Joseph V , Simpson John , Edwards A David , Rutherford Mary A , Counsell Serena J
Published: June 2019

Objectives

Neurodevelopmental impairment has become the most important comorbidity in infants with congenital heart disease (CHD). We aimed to (1) investigate the burden of brain lesions in infants with CHD prior to surgery and (2) explore clinical factors associated with injury.

Study design

Prospective observational study.

Setting

Single centre UK tertiary neonatal intensive care unit.

Patients

70 newborn infants with critical or serious CHD underwent brain MRI prior to surgery.

Main outcome measures

Prevalence of cerebral injury including arterial ischaemic strokes (AIS), white matter injury (WMI) and intracranial haemorrhage.

Results

Brain lesions were observed in 39% of subjects (95% CI 28% to 50%). WMI was identified in 33% (95% CI 23% to 45%), subdural haemorrhage without mass effect in 33% (95% CI 23% to 45%), cerebellar haemorrhage in 9% (95% CI 4% to 18%) and AIS in 4% (95% CI 1.5% to 12%). WMI was distributed widely throughout the brain, particularly involving the frontal white matter, optic radiations and corona radiata. WMI exhibited restricted diffusion in 48% of cases. AIS was only observed in infants with transposition of the great arteries (TGA) who had previously undergone balloon atrial septostomy (BAS). AIS was identified in 23% (95% CI 8% to 50%) of infants with TGA who underwent BAS, compared with 0% (95% CI 0% to 20%) who did not.

Conclusions

Cerebral injury in newborns with CHD prior to surgery is common.
Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study
Authors: Zylbersztejn Ania , Gilbert Ruth , Hjern Anders , Hardelid Pia
Published: June 2019

Objective

To compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI).

Design

Birth cohort study using linked administrative health databases from England and Sweden.

Setting and participants

Singleton live births between 2003 and 2012 in England and Sweden, followed up from age 31 days until the fifth birthday, death or 31 December 2013.

Main outcome measures

The main outcome measures were HR for RTI-related mortality at 31–364 days and at 1–4 years and SUDI mortality at 31–364 days in England versus Sweden estimated using Cox proportional hazards models. We calculated unadjusted HRs and HRs adjusted for birth characteristics (gestational age, birth weight, sex and congenital anomalies) and socioeconomic factors (maternal age and socioeconomic status).

Results

The English cohort comprised 3 928 483 births, 768 RTI-related deaths at 31–364 days, 691 RTI-related deaths at 1–4 years and 1166 SUDIs; the corresponding figures for the Swedish cohort were 1 012 682, 131, 118 and 189. At 31–364 days, unadjusted HR for RTI-related death in England versus Sweden was 1.52 (95% CI 1.26 to 1.82). After adjusting for birth characteristics, the HR reduced to 1.16 (95% CI 0.96 to 1.40) and for socioeconomic factors to 1.11 (95% CI 0.92 to 1.34). At 1–4 years, unadjusted HR was 1.58 (95% CI 1.30 to 1.92) and decreased to 1.32 (95% CI 1.09 to 1.61) after adjusting for birth characteristics and to 1.30 (95% CI 1.07 to 1.59) after further adjustment for socioeconomic factors. For SUDI, the respective HRs were 1.59 (95% CI 1.36 to 1.85) in the unadjusted model, and 1.40 (95% CI 1.20 to 1.63) after accounting for birth characteristics and 1.19 (95% CI 1.02 to 1.39) in the fully adjusted model.

Conclusion

Interventions that improve maternal health before and during pregnancy to reduce the prevalence of adverse birth characteristics and address poverty could reduce child mortality due to RTIs and SUDIs in England.
Is injury associated with team performance in elite Australian football? 20 years of player injury and team performance data that include measures of individual player value
Authors: Hoffman Daniel Tyler , Dwyer Dan Brian , Bowe Steven J , Clifton Patrick , Gastin Paul B
Published: June 2019

Objectives

To determine whether specific injury measures were associated with team performance in the Australian Football League (AFL).

Methods

15 289 injuries caused players from 18 teams to miss 51 331 matches between 1997 and 2016. Data were aggregated to the team level. We analysed the associations among injury measures and team performance (reaching finals/playoffs and specific ladder/table position). Injury measures per team included: injury incidence, injury severity, injury burden, player match availability and percentage of the full player roster injured. We also weighted injury measures by five measures of player value.

Results

AFL teams’ injury burden and player match availability were associated with final table position (r2=0.03, p<0.05). Player value weighted injury burden was different between finalists and non-finalists (mean difference=−8, p<0.001) and explained 12% of the variation in the table position of teams (p<0.001). For a team, nine missed matches due to injury (burden weighted by a best and fairest player rating system) was associated with one lower table position. Player match availability weighted by player value was higher for finalists than non-finalists (mean difference=1.7, p<0.01) and explained 7% of the variation in the table position of teams (p<0.001).

Discussion and potential implications

The impact of injury (burden weighted by best and fairest) explained up to 12% of the variation in final table position—this is particularly relevant to making/not making playoffs as well as home ground/travel advantages for those teams that make the one-game format of AFL playoffs (not home-away or best of seven format).
Triggers of defensive medical behaviours: a cross-sectional study among physicians in the Netherlands
Authors: Renkema Erik , Ahaus Kees , Broekhuis Manda , Tims Maria
Published: June 2019

Objectives

This study investigated whether the attitudes of physicians towards justified and unjustified litigation, and their perception of patient pressure in demanding care, influence their use of defensive medical behaviours.

Design

Cross-sectional survey using exploratory factor analysis was conducted to determine litigation attitude and perceived patient pressure factors. Regression analyses were used to regress these factors on to the ordering of extra tests or procedures (defensive assurance behaviour) or the avoidance of high-risk patients or procedures (defensive avoidance behaviour).

Setting

Data were collected from eight Dutch hospitals.

Participants

Respondents were 160 physicians and 54 residents (response rate 25%) of the hospital departments of (1) anaesthesiology, (2) colon, stomach and liver diseases, (3) gynaecology, (4) internal medicine, (5) neurology and (6) surgery.

Primary outcome measures

Respondents’ application of defensive assurance and avoidance behaviours.

Results

‘Disapproval of justified litigation’ and ‘Concerns about unjustified litigation’ were positively related to both assurance (β=0.21, p<0.01, and β=0.28, p<0.001, respectively) and avoidance (β=0.16, p<0.05, and β=0.18, p<0.05, respectively) behaviours. ‘Self-blame for justified litigation’ was not significantly related to both defensive behaviours. Perceived patient pressures to refer (β=0.18, p<0.05) and to prescribe medicine (β=0.23, p<0.01) had direct positive relationships with assurance behaviour, whereas perceived patient pressure to prescribe medicine was also positively related to avoidance behaviour (β=0.14, p<0.05). No difference was found between physicians and residents in their defensive medical behaviour.

Conclusions

Physicians adopted more defensive medical behaviours if they had stronger thoughts and emotions towards (un)justified litigation. Further, physicians should be aware that perceived patient pressure for care can lead to them adopting defensive behaviours that negatively affects the quality and safety of patient care.
Screening nursing students to identify those at high risk of poor mental health: a cross-sectional survey
Authors: Hsiung Der-Yun , Tsai Ching-Lun , Chiang Ling-Chun , Ma Wei-Fen
Published: June 2019

Objectives

This study aimed to identify those at high risk of poor mental health among nursing students and to examine the relationships and consistency among five mental health assessments.

Design

A cross-sectional design with purposive sampling was used. Four mental health screening tools plus previous mental health history/information were conducted during June 2015 to October 2016.

Setting

A nursing major university in Taiwan.

Participants

A total of 2779 participants aged between 19 and 45 years were recruited.

Main outcome measures

Five mental health risks were identified: increased risk for ultra-high risk, putative prepsychosis states, high trait anxiety, high state anxiety with genetic risk and depression.

Results

Out of the 3395 collected questionnaire, 2779 (82%) were found valid and included in the study. 612 (22%) of the participants were identified to be at mental health risk. 12 of them appeared positive in four, 79 in three, 148 in two and 373 in one of the adopted mental health screening tools. 69 participants had the experience of seeking medical help due to mental health issues, and 58% of them were identified to be at risk of mental health during the screening. Trait and state anxiety scored the highest in correlation analysis (r(2620)=0.76, p<0.001). Correlations were observed in the scores on the subscales of Chinese Version of Schizotypal Personality Questionnaire-Brief (CSPQ-B) and those of Brief self-report Questionnaire for Screening Putative Prepsychotic States (BQSPS), and the highest correlation coefficients was (r(2740)=0.70, p<0.001). Although both of the screening tools are used to assess mental illness risk at its prodromal phase, but CSPQ-B in general appeared to have more rigorous screening criteria than BQSPS.

Conclusion

For expediting early identification high risk of poor mental health, easy-to-use screening questionnaires can be adopted to assess the mental health state of nursing students whose mental well-being and overall health are of vital importance to the entire healthcare industry.
DONORS (Donation Network to Optimise Organ Recovery Study): Study protocol to evaluate the implementation of an evidence-based checklist for brain-dead potential organ donor management in intensive care units, a cluster randomised trial
Authors: Westphal Glauco Adrieno , Robinson Caroline Cabral , Biasi Alexandre , Machado Flávia Ribeiro , Rosa Regis Goulart , Teixeira Cassiano , de Andrade Joel , Franke Cristiano Augusto , Azevedo Luciano Cesar Pontes , Bozza Fernando , Guterres Cátia Moreira , da Silva Daiana Barbosa , Sganzerla Daniel , do Prado Débora Zechmeister , Madalena Itiana Cardoso , Rohden Adriane Isabel , da Silva Sabrina Souza , Giordani Natalia Elis , Andrighetto Luiza Vitelo , Benck Patrícia Spessatto , Roman Fernando Roberto , de Melo Maria de Fátima Rodrigues Buarque , Pereira Thattyane Borba , Grion Cintia Magalhães Carvalho , Diniz Pedro Carvalho , Oliveira João Fernando Picollo , Mecatti Giovana Colozza , Alves Flávio André Cardona , Moraes Rafael Barberena , Nobre Vandack , Hammes Luciano Serpa , Meade Maureen O , Nothen Rosana Reis , Falavigna Maicon
Published: June 2019

Introduction

There is an increasing demand for multi-organ donors for organ transplantation programmes. This study protocol describes the Donation Network to Optimise Organ Recovery Study, a planned cluster randomised controlled trial that aims to evaluate the effectiveness of the implementation of an evidence-based, goal-directed checklist for brain-dead potential organ donor management in intensive care units (ICUs) in reducing the loss of potential donors due to cardiac arrest.

Methods and analysis

The study will include ICUs of at least 60 Brazilian sites with an average of ≥10 annual notifications of valid potential organ donors. Hospitals will be randomly assigned (with a 1:1 allocation ratio) to the intervention group, which will involve the implementation of an evidence-based, goal-directed checklist for potential organ donor maintenance, or the control group, which will maintain the usual care practices of the ICU. Team members from all participating ICUs will receive training on how to conduct family interviews for organ donation. The primary outcome will be loss of potential donors due to cardiac arrest. Secondary outcomes will include the number of actual organ donors and the number of organs recovered per actual donor.

Ethics and dissemination

The institutional review board (IRB) of the coordinating centre and of each participating site individually approved the study. We requested a waiver of informed consent for the IRB of each site. Study results will be disseminated to the general medical community through publications in peer-reviewed medical journals.

Trial registration number

NCT03179020; Pre-results.
Investigating the relation between self-assessment and patients’ assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil
Authors: Bernardo Mônica Oliveira , Cecilio-Fernandes Dario , Lima Alba Regina de Abreu , Silva Julian Furtado , Ceccato Hugo Dugolin , Costa Manuel João , de Carvalho-Filho Marco Antonio
Published: June 2019

Objectives

This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training.

Design

A multicentric, observational, cross-sectional study.

Setting

This study was conducted in three public teaching hospitals in Brazil.

Participants

From the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females.

Primary and secondary outcome measures

Physicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE).

Results

This study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments.

Conclusions

Physicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.
Distal oesophageal spasm secondary to eosinophilic oesophagitis in a child: response to diet therapy
Authors: Ahsan Syed Daniyal , Kammermeier Jochen , Vora Rakesh , Mutalib Mohamed
Published: June 2019

We report a case of a school-age child with symptomatic distal oesophageal spasm (DES), clinical dysphagia and typical feature in high-resolution oesophageal manometry secondary to eosinophilic oesophagitis (EoE). His symptoms resolved with normalisation of oesophageal manometry after standard treatment of EoE. DES is mainly an adult disorder and rarely affect children; to the best of our knowledge, this is the first reported case in a child that document full recovery after treating the underlying EoE.
Features of phospholipase A2 receptor and thrombospondin type-1 domain-containing 7A in malignancy-associated membranous nephropathy
Authors: Zhang Changming , Zhang Mingchao , Chen Dacheng , Ren Qiang , Xu Weiwei , Zeng Caihong , Qin Weisong , Liu Zhihong
Published: June 2019

Aims

Phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) were identified as pathogenic antigens in patients with membranous nephropathy (MN). Notably, PLA2R is detected in few patients with malignancy-associated MN, and a high incidence of cancer is reported in patients with THSD7A-associated MN. Therefore, the roles of PLA2R and THSD7A in malignancy-associated MN must be clarified.

Methods

Serum anti-PLA2R antibodies and glomerular PLA2R staining were assessed in 36 patients with malignancy-associated MN, followed by examination of serum anti-THSD7A antibodies and glomerular THSD7A. THSD7A staining in cancer tissues was also assessed in 9 of the 36 patients.

Results

Twelve (33%) of 36 patients were positive for both glomerular PLA2R and serum anti-PLA2R antibodies, one of whom had enhanced glomerular THSD7A staining. Two patients were positive for either glomerular PLA2R or serum anti-PLA2R antibody. All these patients had IgG4-dominant deposits in glomeruli. Among the 22 (61%) patients who were double negative for glomerular PLA2R and serum anti-PLA2R antibodies, 17 of 20 (85%) had IgG1-dominant deposits in glomeruli, and 2 (9.1%) were positive for glomerular THSD7A staining. Serum anti-THSD7A antibody was not detected in any of the 36 patients. Among the nine patients with available cancer tissues, positive staining of THSD7A in the cancer tissues was observed in five (56%) patients, and one showed enhanced glomerular staining of THSD7A.

Conclusions

Screening of glomerular PLA2R antigen and serum anti-PLA2R antibodies is necessary in patients with malignancy-associated MN, whereas the incidence of glomerular THSD7A antigen or circulating anti-THSD7A antibodies is uncommon.
Intravenous thrombolysis pretreatment and other predictors of infarct in a new previously unaffected territory (INT) in ELVO strokes treated with mechanical thrombectomy
Authors: Goyal Nitin , Tsivgoulis Georgios , Chang Jason J , Malhotra Konark , Goyanes Juan , Pandhi Abhi , Krishnan Rashi , Ishfaq Muhammad F , Hoit Daniel , Nickele Christopher , Inoa-Acosta Violiza , Katsanos Aristeidis H , Elijovich Lucas , Alexandrov Andrei , Arthur Adam S
Published: June 2019

Introduction

One uncommon complication of mechanical thrombectomy (MT) is an infarct in a new previously unaffected territory (infarct in new territory (INT)).

Objective

To evaluate the predictors of INT with special focus on intravenous thrombolysis(IVT)pretreatmentbefore MT.

Methods

Consecutive patients with emergent large vessel occlusion (ELVO) treated with MT during a 5-year period were evaluated. INT was defined using standardized methodology proposed by ESCAPE investigators. The predictors of INT and its impact on outcomes were investigated.

Results

A total of 419 consecutive patients with ELVO received MT (mean age 64±15 years, 50% men, median baseline National Institutes of Health Stroke Scale score 16 points (IQR 11–20), 69% pretreated with IVT). The incidence of INT was lower in patients treated with combination therapy (IVTandMT) than in patients treated with MT alone, respectively (10% vs 20%; p=0.011). The INT group had more patients with posterior circulation occlusions than the group without INT (28% vs 10%, respectively; p<0.001). The rates of 3-month functional independence were lower in patients with INT (30% vs 50%; p=0.007). IVT pretreatment was not independently related to INT (OR=0.75; 95% CI 0.32 to 1.76), and INT did not emerge as an independent predictor of 3-month functional independence (OR=0.69; 95% CI 0.29 to 1.62) on multivariable logistic regression models. Location of posterior circulation occlusion was independently associated with a higher odds of INT (OR=3.33; 95% CI 1.43 to 7.69; p=0.005).

Conclusions

IVT pretreatment is not independently associated with a lower likelihood of INT in patients with ELVO treated with MT. Patients with ELVO with posterior circulation occlusion are more likely to have INT after MT.
Persistent trigeminal artery aneurysms: case report and systematic review
Authors: Diana Francesco , Mangiafico Salvatore , Valente Vinicio , Wlderk Andrea , Grillea Giovanni , Colonnese Claudio , Bartolo Marcello
Published: June 2019

Background

The persistent trigeminal artery (PTA) is an adult carotid-basilar anastomosis with debated pathologic aspects, such as its association with brain aneurysms. True trigeminal artery aneurysms are rare vascular anomalies, reported in a few case reports.

Objective

To report our experience with a ruptured trigeminal artery aneurysm and to provide a systematic review of the literature in order to analyse potential links between the anatomic configuration of the PTA and PTA aneurysm (PTAA) type, and implications of each PTAA type for the diagnostic and therapeutic approach.

Methods

We reviewed the medical literature on trigeminal artery aneurysms according to the PRISMA guidelines. Population characteristics, aneurysms features, and PTA type and side were assessed.

Results

40 previously published cases of PTAAs were included in the analysis. The mean age of subjects was 55 years, with a strong female predominance (77%). Four PTAAs were accidentally discovered, while 16 caused compressive symptoms and 20 were ruptured. Successful endovascular treatment was performed in 62% of cases.

Conclusions

PTAAs are rare vascular anomalies, underdiagnosed in the presence of a trigemino-cavernous fistula. Parent vessel occlusion seems to be the best therapeutic option for ruptured or symptomatic unruptured PTAAs in Saltzman type II and III PTAs. Patency of the parent vessel is the main target in Saltzman type I PTA.
HIV treatment cascade for older adults in rural South Africa
Authors: Rohr Julia K , Manne-Goehler Jennifer , Gómez-Olivé Francesc Xavier , Wagner Ryan G , Rosenberg Molly , Geldsetzer Pascal , Kabudula Chodziwadziwa , Kahn Kathleen , Tollman Stephen , Bärnighausen Till , Salomon Joshua A
Published: June 2019

Objectives

The HIV treatment cascade is a powerful framework for understanding progress from initial diagnosis to successful treatment. Data sources for cascades vary and often are based on clinical cohorts, population cohorts linked to clinics, or self-reported information. We use both biomarkers and self-reported data from a large population-based cohort of older South Africans to establish the first HIV cascade for this growing segment of the HIV-positive population and compare results using the different data sources.

Methods

Data came from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) 2015 baseline survey of 5059 adults aged 40+ years. Dried blood spots (DBS) were screened for HIV, antiretroviral drugs and viral load. In-home surveys asked about HIV testing, diagnosis and antiretroviral therapy (ART) use. We calculated proportions and CIs for each stage of the cascade, conditional on attainment of the previous stage, using (1) biomarkers, (2) self-report and (3) both biomarkers and self-report, and compared with UNAIDS 90-90-90 targets.

Results

4560 participants had DBS results, among whom 1048 (23%) screened HIV-positive and comprised the denominator for each cascade. The biomarker cascade showed 63% (95% CI 60 to 66) on ART and 72% (95% CI 69 to 76) of those on ART with viral suppression. Self-reports underestimated testing, diagnosis and ART, with only 47% (95% CI 44 to 50) of HIV-positive individuals reporting ART use. The combined cascade indicated high HIV testing (89% (95% CI 87 to 91)), but lower knowledge of HIV-positive status (71% (95% CI 68 to 74)).

Conclusions

Older South Africans need repeated HIV testing and sustained ART to reach 90-90-90 targets. HIV cascades relying on self-reports are likely to underestimate true cascade attainment, and biomarkers provide substantial improvements to cascade estimates.
Pollination elicits an accelerated reduction in nocturnal scent emission by flowers of the dioecious herb Silene latifolia
Authors: Martignier Thomas , Labouche Anne-Marie , Pannell John R.
Published: June 2019

More than 85% of plants rely on biotic pollen vectors attracted by olfactory or visual signals. While these signals are beneficial for plant reproduction, they are also costly in terms of resource investment, and may involve additional costs related to herbivore attraction, transmission of diseases, and increased transfer of self-pollen among flowers of an individual plant. Given the potential costs of signalling to pollinators, we hypothesized that plants should cease signalling to pollinators as soon as the costs of being attractive exceed the benefits. Here, we used the herb Silene latifolia Poir., which is pollinated by the nocturnal seed-predator Hadena bicruris, to investigate the possible reduction of scent emission after pollination. We compared the progressive decrease of scent and attractive compound emission between pollinated and unpollinated flowers on an hourly basis, overnight. We found that total scent emission decreased significantly faster over time for pollinated than for non-pollinated flowers. Our findings suggest that the costs of maintaining the attractiveness of pollinated flowers of Silene latifolia exceed the benefits, which could be linked with the risks of parasitism.
Semi-Parametric Cure Rate Proportional Odds Models with Spatial Frailties for Interval-Censored Data
Authors: Bao Yiqi , Cancho Vicente G. , Louzada Francisco , Suzuki Adriano K.
Published: June 2019

In this work, we proposed the semi-parametric cure rate models with independent and dependent spatial frailties. These models extend the proportional odds cure models and allow for spatial correlations by including spatial frailty for the interval censored data setting. Moreover, since these cure models are obtained by considering the occurrence of an event of interest is caused by the presence of any nonobserved risks, we also study the complementary cure model, that is, the cure models are obtained by assuming the occurrence of an event of interest is caused when all of the nonobserved risks are activated. The MCMC method is used in a Bayesian approach for inferential purposes. We conduct an influence diagnostic through the diagnostic measures in order to detect possible influential or extreme observations that can cause distortions on the results of the analysis. Finally, the proposed models are applied to the analysis of a real data set.
Adaptive Test for RF/Analog Circuit Using Higher Order Correlations among Measurements
Authors: Li Yanjun , Yilmaz Ender , Sarson Pete , Ozev Sule
Published: June 2019

As process variations increase and devices get more diverse in their behavior, using the same test list for all devices is increasingly inefficient. Methodologies that adapt the test sequence with respect to lot, wafer, or even a device's own behavior help contain the test cost while maintaining test quality. In adaptive test selection approaches, the initial test list, a set of tests that are applied to all devices to learn information, plays a crucial role in the quality outcome. Most adaptive test approaches select this initial list based on fail probability of each test individually. Such a selection approach does not take into account the correlations that exist among various measurements and potentially will lead to the selection of correlated tests. In this work, we propose a new adaptive test algorithm that includes a mathematical model for initial test ordering that takes correlations among measurements into account. The proposed method can be integrated within an existing test flow running in the background to improve not only the test quality but also the test time. Experimental results using four distinct industry circuits and large amounts of measurement data show that the proposed technique outperforms prior approaches considerably.
Search Result Reranking with Visual and Structure Information Sources
Authors: Liu Yiqun , Zhang Junqi , Mao Jiaxin , Zhang Min , Ma Shaoping , Tian Qi , Lu Yanxiong , Lin Leyu
Published: June 2019

Relevance estimation is among the most important tasks in the ranking of search results. Current methodologies mainly concentrate on text matching, link analysis, and user behavior models. However, users judge the relevance of search results directly from Search Engine Result Pages (SERPs), which provide valuable signals for reranking. In this article, we propose two different approaches to aggregate the visual, structure, as well as textual information sources of search results in relevance estimation. The first one is a late-fusion framework named Joint Relevance Estimation model (JRE). JRE estimates the relevance independently from screenshots, textual contents, and HTML source codes of search results and jointly makes the final decision through an inter-modality attention mechanism. The second one is an early-fusion framework named Tree-based Deep Neural Network (TreeNN), which embeds the texts and images into the HTML parse tree through a recursive process. To evaluate the performance of the proposed models, we construct a large-scale practical Search Result Relevance (SRR) dataset that consists of multiple information sources and relevance labels of over 60,000 search results. Experimental results show that the proposed two models achieve better performance than state-of-the-art ranking solutions as well as the original rankings of commercial search engines.
Microfacet BSDFs Generated from NDFs and Explicit Microgeometry
Authors: Ribardière Mickaël , Bringier Benjamin , Simonot Lionel , Meneveaux Daniel
Published: June 2019

Microfacet distributions are considered nowadays as a reference for physically plausible BSDF representations. Many authors have focused on their physical and mathematical correctness, while introducing means to enlarge the range of possible appearances. This article is dedicated to Normal Distribution Functions (NDFs) and the influence of their shape on the rendered material aspect. We provide a complete framework for studying the impact of NDFs on the observed Bidirectional Scattering Distribution Functions (BSDFs). To explore very general NDFs, manually controlled by the user, and including anisotropic materials, we propose to use a piecewise continuous representation. It is derived with its associated Smith shadowing-masking function and importance sampling formulations for ensuring efficient global illumination computations. A new procedure is also proposed in this article for generating an explicit geometric micro-surface, used to evaluate the validity of analytic models and multiple scattering effects. The results are produced with a computer-generated process using path tracing. They show that this generation procedure is suitable with any NDF model, independently from its shape complexity.
Ghrelin attenuates sepsis-induced acute lung injury by inhibiting the NF-κB, iNOS, and Akt signaling in alveolar macrophages
Authors: Zheng Haichong , Liang Wenjie , He Wanmei , Huang Chunrong , Chen Qingui , Yi Hui , Long Lingli , Deng Yubin , Zeng Mian
Published: June 2019

Ghrelin has proven to be protective against sepsis-induced acute lung injury (ALI) via anti-inflammatory effects. However, its mechanisms remain poorly understood. Alveolar macrophages (AMs) play a key role in mediating inflammatory responses during sepsis-induced ALI by secretion of cytokines and chemokines. This study was undertaken to investigate whether ghrelin suppresses inflammatory effects of AMs and therefore may help to attenuate sepsis-induced ALI. A sepsis model in rats was achieved using cecal ligation and puncture. Ghrelin treatment markedly improved histopathological changes in the lungs and reduced pulmonary inflammation in septic rats. NF-κB translocation and p-Akt and inducible nitric oxide synthase (iNOS) activities in AMs from septic rats were suppressed by ghrelin. In vitro data indicated that ghrelin decreased the levels of LPS-induced IL-1β, TNF-α, and IL-6, NF-κB translocation, and iNOS and Akt activities of AMs. Furthermore, the NF-κB/iNOS pathway or Akt signaling was positively correlated with LPS-induced inflammatory production of AMs in vitro. In conclusion, ghrelin exerts a protective role against sepsis-induced ALI probably by reducing the production of inflammatory cytokines from AMs via inhibition of the NF-κB/iNOS pathway or Akt signaling.
Distinct pathways to the parafacial respiratory group to trigger active expiration in adult rats
Authors: Silva Josiane N. , Oliveira Luiz M. , Souza Felipe C. , Moreira Thiago S. , Takakura Ana C.
Published: June 2019

Active expiration (AE) is part of the breathing phase; it is conditional and occurs when we increase our metabolic demand, such as during hypercapnia, hypoxia, or exercise. The parafacial respiratory group (pFRG) is involved in AE. Data from the literature suggest that excitatory and the absence of inhibitory inputs to the pFRG are necessary to determine AE. However, the source of the inputs to the pFRG that trigger AE remains unclear. We show in adult urethane-anesthetized Wistar rats that the pharmacological inhibition of the medial aspect of the nucleus of the solitary tract (mNTS) or the rostral aspect of the pedunculopontine tegmental nucleus (rPPTg) is able to generate AE. In addition, direct inhibitory projection from the mNTS or indirect cholinergic projection from the rPPTg is able to contact pFRG to trigger AE. The inhibition of the mNTS or the rPPTg under conditions of high metabolic demand, such as hypercapnia (9–10% CO2), did not affect the AE. The present results suggest for the first time that inhibitory sources from the mNTS and a cholinergic pathway from the rPPTg, involving M2/M4 muscarinic receptors, could be important sources to modulate and sustain AE.