bluuebunny/crossref_metadata_2025 huggingface dataset:
Referrals for uncomplicated lower back pain: a cluster parallel randomised trial of patient-centred communication to improve the management of acute back pain in primary care. A study protocol
Authors: Schedlbauer Angela , Burggraf Larissa , Hueber Susann , Terzakis-Snyder Irini-Alexia , Kühlein Thomas , Roos Marco
Published: October 2019

Introduction

Low back pain (LBP) is one of the most frequent encounters in General Practice. Investigation and referral remain common despite the self-limiting character of episodes that are not largely attributable to specific underlying injuries. Identifying patients’ ideas, concerns and expectations (ICE) is a well-established element within consultation skills training and has been shown to improve prescribing. It can be a powerful communication tool setting the base for transferring and adjusting adequate clinical information. This study aims to evaluate whether ICE can decrease unnecessary medicine in the management of acute LBP in primary care.

Methods and analysis

Research question: Does ICE training intervention have an effect on doctors’ referrals of patients suffering from acute LBP?Population: Recruitment to this parallel cluster randomised trial will take place among general practitioners belonging to four independent practice networks in Northern Bavaria/Germany.Intervention: At baseline, 24 out of 48 doctors will be randomly assigned to take part in a 1-day training session covering theoretical background and clinical implementation of patient-centred communication by stimulating ICE. They will also be given access to a web-based supporting tool for reflective practice on their communication skills.Comparison: GPs in the control group will continue consultations as usual.Outcome: Outcome measures are referrals to diagnostic imaging, physiotherapy and specialists obtained from routine practice data, compared between intervention and control group.Time: Referrals of patients consulting their doctors for documented LBP will be monitored up to 3 months after the ICE training intervention.

Ethics and dissemination

Ethical approval for the study was obtained by the Ethics Committee of the University Erlangen-Nuremberg (296_17B). Results will be disseminated by conference presentations and journal publications.

Trial registration number

The trial is registered in clinicaltrials.gov (NCT03711071).
Use of real-world evidence in postmarketing medicines regulation in the European Union: a systematic assessment of European Medicines Agency referrals 2013–2017
Authors: Brown Jeremy Philip , Wing Kevin , Evans Stephen J , Bhaskaran Krishnan , Smeeth Liam , Douglas Ian J
Published: October 2019

Objectives

To assess the use, and evaluate the usefulness, of non-interventional studies and routinely collected healthcare data in postmarketing assessments conducted by the European Medicines Agency (EMA).

Design

We reviewed and systematically assessed all referrals to the EMA made due to safety or efficacy concerns that were evaluated between 1 January 2013 and 30 June 2017. We extracted information from the assessment report and the referral notification. Two reviewers independently assessed the contribution of non-interventional evidence to decision-making.

Results

The preliminary evidence leading to the assessment in 52 eligible referrals was mostly from spontaneous reports (cited in 26 of 52 referrals) and randomised trials (22/52). In contrast, many evidence types were used for the full assessment. Non-interventional studies were frequently used in the full assessment for the evaluation of product safety (31/52) and product efficacy (18/52). In particular, non-interventional studies were relied on for the evaluation of safety and efficacy in subgroups, the evaluation of safety relating to a rare adverse event, understanding product usage and misuse and for evaluation of the effectiveness of risk minimisation measures. The most common recommendations were changes to product information (43/52) and marketing authorisation withdrawal or suspension (12/52). In the majority of referrals, non-interventional evidence was judged to contribute to the decision made (30/52) and in three referrals it was the primary source of evidence.

Conclusions

European regulatory decision-making relies on multiple evidence types, particularly randomised trials, spontaneous reports and non-interventional studies. Non-interventional studies had an important role particularly for the characterisation and quantification of adverse events, the evaluation of product usage and for evaluating the effectiveness of regulatory action to minimise risk.
HPV self-sampling acceptability in rural and indigenous communities in Guatemala: a cross-sectional study
Authors: Murchland Audrey R. , Gottschlich Anna , Bevilacqua Kristin , Pineda Andres , Sandoval-Ramírez Berner Andrée , Alvarez Christian S , Ogilvie Gina S , Carey Thomas E , Prince Mark , Dean Michael , Mendoza Montano Carlos , Rivera-Andrade Alvaro , Meza Rafael
Published: October 2019

Introduction

Cervical cancer disproportionately burdens low-income and middle-income countries (LMICs) such as Guatemala. Self-collection testing for human papillomavirus (HPV) has been suggested as a form of cervical cancer screening to facilitate access in LMICs. This study assessed and compared the acceptability of self-collection HPV testing in two rural, indigenous and ethnically distinct communities in Guatemala: Santiago Atitlán, Sololá and Livingston, Izabal.

Methods

All participants, women between the ages of 18 and 60, completed a questionnaire. Eligible participants were also asked to self-collect a vaginal sample and complete a questionnaire regarding comfort and acceptability. Self-collected samples were tested for high-risk HPV using the real-time PCR Hybribio kit.

Results

In the indigenous community of Santiago Atitlán, of 438 age-eligible participants, 94% completed self-collection. Of those, 81% found it comfortable and 98% were willing to use it as a form of screening. In the multiethnic (Afro-Caribbean, indigenous) community of Livingston, of 322 age-eligible participants, 53% chose to self-collect. Among those who took the test, 83% found it comfortable and 95% were willing to use it as a form of screening. In Livingston, literacy (can read and/or write vs cannot read or write) was higher in women who chose to self-collect (prevalence ratio 2.25; 95% CI 1.38 to 3.68). Ethnicity, history of screening and reproductive history were not associated with willingness to self-collect in Livingston. Women in Santiago reported less prior use of healthcare than women in Livingston. Overall, 19% (106/549) of samples tested positive for high-risk HPV.

Conclusion

Among women willing to self-collect in rural and indigenous communities in Guatemala, self-collection for HPV testing is highly acceptable. However, willingness to try self-collection might vary across communities and settings. Women from a community that used less healthcare were more likely to choose self-collection. Further research is necessary to determine what factors influence a woman’s choice to self-collect.
The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs)
Authors: Johnson Mark I , Jones Gareth , Paley Carole A , Wittkopf Priscilla G
Published: October 2019

Introduction

The aim of this systematic review with meta-analysis is to evaluate the clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for any type of acute and chronic pain in adults.

Methods and analysis

We intend to search electronic databases (Cochrane Library, MEDLINE, Embase, CINAHL, PsycINFO, LILACS, PEDRO, Web of Science, AMED and SPORTDiscus) from inception to the present day to identify all randomised controlled trials (RCT) on the use of TENS in adults for any type of pain including acute pain, chronic pain and cancer-related pain. We will screen the RCTs against eligibility criteria for inclusion in our review. Two reviewers will independently undertake RCT selection, data extraction and risk of bias assessment. Primary outcomes will be: (i) participant-reported pain relief of ≥30% expressed as frequency (dichotomous) data; and (ii) participant-reported pain intensity expressed as mean (continuous) data. We will conduct meta-analyses to determine risk ratio for dichotomous data, and mean difference (MD) or standardised MD for continuous data for TENS versus placebo TENS, no treatment or waiting list control, standard of care, and other treatments. Subgroup analyses will include different pain conditions (eg, acute vs chronic), TENS intensity, during versus after TENS, TENS as a sole treatment versus TENS in combination with other treatments and TENS administered as a single dose versus repetitive dose.

Ethics and dissemination

This systematic review will not use data from individual participants, and the results will be disseminated in a peer-reviewed publication and presented at a conference.

PROSPERO registration number

CRD42019125054.
Are the knowledge of non-malignant asbestos-related diseases and lung function impairment differentially associated with psychological well-being? A cross-sectional study in formerly asbestos-exposed workers in Germany
Authors: Lang Jessica , Felten Michael K , Kraus Thomas
Published: October 2019

Objectives

The knowledge of past asbestos exposure may lead to chronic psychological strain. In addition, the information about an increased cancer risk can place a psychological burden on individuals triggering mental health symptoms of depression or anxiety. This applies in particular to individuals with non-malignant asbestos-related disease (ARD) such as lung fibrosis and pleural thickening with or without lung function impairment. ARDs with or without lung function impairment may develop even years after exposure cessation. Therefore, the aim of the present study was to test for our cohort whether non-malignant ARD and lung function impairment have differential effects on mental health and psychological strain.

Design

Cross-sectional study.

Participants and setting

Overall, 612 male participants (mean age=66.2 years, SD=9.5) attending a surveillance programme for ARDs received routine examinations including lung function testing (24% refused to fill in the psychological questionnaire) at a German university hospital study centre from August 2008 to August 2013.

Outcome measures

Using multiple hierarchical regression analysis, ARD diagnosis and lung function impairment were used to predict psychological health as measured with validated questionnaires for depression and anxiety. Psychological strain was operationalised by intrusive thoughts and specific fear of cancer.

Results

The strongest predictor for mental health was obstructive functional impairment (eg, anxiety: β=0.22, p<0.001). Psychological strain was predicted by the presence of a non-malignant ARD (eg, intrusive thoughts: β=0.17, p=0.003).

Conclusions

The presence of mental health symptoms is associated with ventilation disturbances, whereas the knowledge of an already initiated morphological change—caused by asbestos exposure—is primarily associated with psychological strain. Specifically, the affected individuals are more prone to intrusive thoughts and specific fear of asbestos-related cancer. As an implication, physicians should be sensitised about possible consequences of risk communication and functional impairment to counteract excessive fear or anxiety.
Does socially differentiated cardiac rehabilitation affect the use of healthcare services after myocardial infarction? A 10-year follow-up study
Authors: Hald Kathrine , Meillier Lucette Kirsten , Nielsen Kirsten M. , Breinholt Larsen Finn , Johansen Martin Berg , Larsen Mogens Lytken , Nielsen Claus Vinther , Christensen Bo
Published: October 2019

Objective

To examine the long-term effect of a socially differentiated cardiac rehabilitation (CR) intervention tailored to reduce social inequalities in health regarding use of healthcare services in general practice and hospital among socially vulnerable patients admitted with first-episode myocardial infarction (MI).

Design

A prospective cohort study with 10 years’ follow-up.

Setting

Department of cardiology at a university hospital in Denmark between 2000 and 2004.

Participants

Patients <70 years admitted with first-episode MI categorised as socially vulnerable (n=208) or non-socially vulnerable (n=171) based on educational level and social network.

Intervention

A socially differentiated CR intervention. The intervention consisted of standard CR and expanded CR with focus on cross-sectional collaboration.

Main outcome measures

Participation in annual chronic care consultations in general practice, contacts to general practice, all-cause hospitalisations and cardiovascular readmissions.

Results

At 2-year and 5-year follow-up, socially vulnerable patients receiving expanded CR participated significantly more in annual chronic care consultations (p=0.02 and p<0.01) but at 10-year follow-up, there were no significant differences in annual chronic care consultations (p=0.13). At 10-year follow-up, socially vulnerable patients receiving standard CR had significantly more contacts to general practice (p=0.03). At 10-year follow-up, there were no significant differences in the proportion of socially vulnerable patients receiving expanded CR in the mean number of all-cause hospitalisations and cardiovascular readmissions (p>0.05).

Conclusions

The present study found no persistent association between the socially differentiated CR intervention and use of healthcare services in general practice and hospital in patients admitted with first-episode MI during a 10-year follow-up.
Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study
Authors: Lin Yen-An , Chen Ying-Jen , Tsao Yu-Chung , Yeh Wei-Chung , Li Wen-Cheng , Tzeng I-Shiang , Chen Jau-Yuan
Published: October 2019

Objective

Obesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.

Design

Cross-sectional observational study.

Setting

Community-based investigation in Guishan Township of northern Taiwan.

Participants

A total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).

Outcome measures

Statistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.

Results

Of the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.

Conclusions

WC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.
Study protocol for enhanced CJD surveillance in the 65+ years population group in Scotland: an observational neuropathological screening study of banked brain tissue donations for evidence of prion disease
Authors: Peden Alexander Howard , Kanguru Lovney , Ritchie Diane L , Smith Colin , Molesworth Anna M
Published: October 2019

Introduction

Creutzfeldt-Jakob disease (CJD) is a human prion disease that occurs in sporadic, genetic and acquired forms. Variant CJD (vCJD) is an acquired form first identified in 1996 in the UK. To date, 178 cases of vCJD have been reported in the UK, most of which have been associated with dietary exposure to the bovine spongiform encephalopathy agent. Most vCJD cases have a young age of onset, with a median age at death of 28 years. In the UK, suspected cases of vCJD are reported to the UK National Creutzfeldt-Jakob Disease Research & Surveillance Unit (NCJDRSU). There is, however, a concern that the national surveillance system might be missing some cases of vCJD or other forms of human prion disease, particularly in the older population, perhaps because of atypical clinical presentation. This study aims to establish whether there is unrecognised prion disease in people aged 65 years and above in the Scottish population by screening banked brain tissue donated to the Edinburgh Brain Bank (EBB).

Methods

Neuropathological screening of prospective and retrospective brain tissue samples is performed. This involves histopathological and immunohistochemical analysis and prion protein biochemical analysis. During the study, descriptive statistics are used to describe the study population, including the demographics and clinical, pathological and referral characteristics. Controlling for confounders, univariate and multivariate analyses will be used to compare select characteristics of newly identified suspect cases with previously confirmed cases referred to the NCJDRSU.

Ethics and dissemination

Brain tissue donations to EBB are made voluntarily by the relatives of patients, with consent for use in research. The EBB has ethical approval to provide tissue samples to research projects (REC reference 16/ES/0084). The findings of this study will be disseminated in meetings, conferences, workshops and as peer-reviewed publications.

Trial registration numbers

10/S1402/69 and 10/S1402/70
Reintervention and survival in 1428 patients in the Australian and New Zealand Fontan Registry
Authors: Daley Michael , du Plessis Karin , Zannino Dianna , Hornung Tim , Disney Patrick , Cordina Rachael , Grigg Leeanne , Radford Dorothy J , Bullock Andrew , d'Udekem Yves
Published: October 2019

Objective

Patients undergoing single-ventricle palliation have experienced significant improvement in survival in the recent era. However, a substantial proportion of these patients undergo reoperations. We performed a review of the Australia and New Zealand (ANZ) Fontan Registry to determine the overall reintervention and reoperative burden in these patients.

Methods

A retrospective longitudinal cohort study was performed using data from patients who underwent a Fontan operation between 1975 and 2016 from the ANZ Fontan Registry. The data obtained included Fontan operation, reinterventions and most recent follow-up status. We examined the type and timing of reinterventions and survival.

Results

Of the 1428 patients identified, 435 (30%) underwent at least one reintervention after the Fontan operation: 110 patients underwent early reintervention and 413 underwent late reinterventions. Excluding Fontan conversion and transplantation, 220 patients underwent at least one interventional procedure and 209 patients underwent at least one reoperation. Fenestration closure and pacemaker-related procedures were the most common catheter and surgical interventions, respectively. The cumulative incidence of reintervention following Fontan was 23%, 37% and 55% at 10, 20 and 30 years, respectively. Survival and freedom from failure were worse in patients requiring later reintervention after Fontan surgery (51% vs 83% and 42% vs 69%, respectively at 30 years, p<0.001). This difference persisted after excluding pacemaker-related procedures (p<0.001). Operative mortality for non-pacemaker late reoperations after Fontan was 6%.

Conclusions

A substantial proportion of Fontan patients require further intervention to maintain effective single-ventricle circulation. Patients undergoing reoperation after Fontan have higher rates of mortality and failure, despite intervention.
Just caring: screening needs limits
Authors: Fleck Leonard Michael
Published: October 2019

This personal narrative tugs at the heart strings. However, personal narratives are not sufficient to justify public funding for any screening policy. We have to take seriously the ‘just caring’ problem. We have only limited resources to meet virtually unlimited health care needs. No doubt, screening tests often save lives. The author wants public funding for prostate-specific antigen screening for prostate cancer. However, why only prostate cancer? Numerous cancers at various stages can be screened for. Are all of them equally deserving of public funding? What about screening for a very long list of other life-threatening medical disorders? There is nothing ethically special about cancer. Where does the money come from to pay for all these screening tests? Do we reduce expensive life-prolonging care for patients in late-stage diseases? Ultimately, a balance must be struck between saving statistical lives through screening and saving identifiable lives in the intensive care unit. Achieving a just balance requires rational democratic deliberation as justification for these choices, not personal narratives.
Influence of feedlot manure amendments on runoff hydrology and sediment loss during transition between continuous and legacy phases
Authors: Miller J.J. , Beasley B.W. , Owen M.L. , Drury C.F. , Chanasyk D.S.
Published: October 2019

Little research has been conducted on the effect of beef feedlot manure amendments on runoff hydrology and soil loss during the transition between continuous and legacy application phases. We conducted a 6 yr (2013–2018) study and utilized surface (0–5 cm) soil collected from a long-term (since 1998) field experiment on a clay loam soil in southern Alberta, Canada. The treatments were stockpiled or composted feedlot manure with straw (ST) or wood-chip (WD) bedding applied at 13, 39, and 77 Mg ha−1 (dry weight). There was also an unamended control and inorganic fertilized treatment (IN). Disturbed surface soil was collected from all treatments after 15 (C15), 16 (C16), and 17 (C17) continual annual applications (2013–2015), and then 1 (L1), 2 (L2), and 3 (L3) yr (2016–2018) after manure applications were discontinued in 2015. The soil was packed into runoff trays, and a Guelph rainfall simulator (70 mm h−1) was used to generate 30 min of runoff. The time to runoff, total runoff depth, and flow-weighted mean concentrations (FWMCs) and mass loads of total suspended solids (TSS) were determined. Mean values of runoff variables were significantly greater for ST than WD in certain years for time to runoff (by 28%–127%), runoff depth (44%), TSS FWMCs (58%–137%), and FWMC loads (28%–230%). Mean TSS was generally significantly greater at the two lower than highest manure rates for FWMC (48%–135%) and loads (21%–253%). Overall, choice of bedding material showed the most potential to maximize infiltration and reduce water and sediment loss.
A singular elliptic system involving the p(x)-Laplacian and generalized Lebesgue–Sobolev spaces
Authors: Saoudi Kamel
Published: October 2019

The purpose of this work is to study a class of singular elliptic system involving the [Formula: see text]-Laplace operator of the form [Formula: see text] where [Formula: see text] [Formula: see text] is a bounded domain with [Formula: see text] boundary, [Formula: see text] are two parameters, [Formula: see text] are non-negative weight functions with compact support in [Formula: see text] and [Formula: see text] are assumed to satisfy the assumptions (A0)–(A2) in Sec. 1. We employ the Nehari manifold approach combined with some variational techniques in order to show the existence and the multiplicity of positive solutions.
Exciton binding energy in cubic semiconductor quantum dot
Authors: Moradi Zahra , Saeidi Mohammadreza
Published: October 2019

In this paper, the exciton binding energy in a cubic semiconductor nanostructure quantum dot has been investigated by using variational method. Results show that in cubic quantum dot with a size of 50 Å, will have the most exciton binding energy.
Removing colors 2k, 2k − 1, and k
Authors: Lopes Pedro
Published: October 2019

This article concerns Fox colorings. We prove that if a link admits non-trivial [Formula: see text]-colorings, with prime [Formula: see text], it also admits non-trivial [Formula: see text]-colorings not involving colors [Formula: see text], nor [Formula: see text].
Casimir effect around an Ellis wormhole
Authors: Sorge Francesco
Published: October 2019

We discuss the Casimir effect in a small cavity, moving in a circular orbit around an Ellis wormhole. We show that the interplay between the spacetime geometry and the cavity orbital motion gives rise to a distortion in the Casimir energy density, causing a reduction of its absolute value. Quite interestingly, such effect can be observed also when the cavity moves on a circular geodesic (albeit unstable) orbit at the wormhole throat, where a comoving observer becomes locally inertial (namely, the observer’s reference frame reduces to a geodesic, Fermi-Walker transported one). In that respect, the discussed effect appears as a nonlocal quantum effect by means of which some properties of the underlying spacetime geometry, hidden to local classical measurements, can be captured and unveiled.
Damping the tail of the Woods–Saxon potential
Authors: Baran Á. , Vertse T.
Published: October 2019

Cutting of the tail of the Woods–Saxon (WS) potential influences the distribution of the poles of the [Formula: see text]-matrix considerably. A new attempt is made here to correct the tail of the cut-off WS potential in order to bring the positions of the poles closer to the WS potential without cut. New types of strictly finite range potentials are introduced in which the tail of the WS and the generalized Woods–Saxon (GWS) potentials are modified to damp them at their ends. This damping affects the energies of the bound and narrow resonant states weakly. The resonant pole positions in the new potentials were affected more significantly and the new pole positions became closer to that of the GWS potential without cut. However, the cut-off effect cannot be diminished completely. The new potentials belong to the [Formula: see text] function class.
A self-adaptive regularized alternating least squares method for tensor decomposition problems
Authors: Mao Xianpeng , Yuan Gonglin , Yang Yuning
Published: October 2019

Though the alternating least squares algorithm (ALS), as a classic and easily implemented algorithm, has been widely applied to tensor decomposition and approximation problems, it has some drawbacks: the convergence of ALS is not guaranteed, and the swamp phenomenon appears in some cases, causing the convergence rate to slow down dramatically. To overcome these shortcomings, the regularized-ALS algorithm (RALS) was proposed in the literature. By employing the optimal step-size selection rule, we develop a self-adaptive regularized alternating least squares method (SA-RALS) to accelerate RALS in this paper. Theoretically, we show that the step-size is always larger than unity, and can be larger than [Formula: see text], which is quite different from several optimization algorithms. Furthermore, under mild assumptions, we prove that the whole sequence generated by SA-RALS converges to a stationary point of the objective function. Numerical results verify that the SA-RALS performs better than RALS in terms of the number of iterations and the CPU time.
F-MaMcDm: Sustainable Green-Based Hydrogen Production Technology Roadmap Using Fuzzy Multi-Aspect Multi-Criteria Decision-Making
Authors: Matani Behnoosh , Shirazi Babak , Soltanzadeh Javad
Published: October 2019

In recent years, with increasing demand for fossil fuels, greenhouse gas emissions, acid rains, and air pollution have increased. These issues have encouraged industries to replace the existing fossil fuel system by the hydrogen energy system which is a clean energy carrier. Replacing hydrogen in the future energy systems needs a dynamic and flexible strategic tool for planning and management. Roadmapping tool is a strategic choice for supporting technology management in long-term planning and under the fast-changing environment in manufacturing technologies. This study tackles a novel methodology that considers the uncertainties and linguistic assessments for developing a green-based hydrogen production technology roadmap considering concurrent multi-layered aspects. The aim of this paper is to develop a dynamic and flexible technology roadmap using a combination of the classical roadmapping method with a novel fuzzy multi-aspect multi-criteria decision-making approach (F-MaMcDm). This study represents a quantitative paradigm to roadmapping instead of conventional descriptive “when and how” paradigm. The F-MaMcDm classifies sustainable green-based hydrogen production technologies considering four comprehensive aspects (technical, socio-political, environmental and economic) and criteria relevant to the aspects. The results show that biomass gasification is the first technology to be prioritized followed by other green-based hydrogen production technologies in a long time.
Project Success: Exploring the Value of Backing Up Behaviors and How They Can Be Developed in Project-Based Work
Authors: Aronson Zvi
Published: October 2019

The changing project environment does not allow to detail or estimate all desired employee behaviors. We contend that to increase project outcomes, it is valuable for managers to create a context in which project members willingly help colleagues perform their tasks, beyond what is required. The current study’s objectives are to investigate whether these project members’ backing up behaviors influence success and can be brought about by project culture. We support the model utilizing 219 project members (project participants) in 69 projects, from various industries in the USA. Results imply a plunge in members’ backing up behaviors can indicate project failure. Owed to restrictions facing project managers, in terms of control over compensation and employee availability, results imply that project culture is a useful substitute lever to manage members’ backing up behaviors, which in due course can propel project success. Practical implications for managing backing up behaviors in order to augment project success are provided.
Photodynamic activity of Sn(IV) meso-tetraacenaphthylporphyrin and its methyl-β-cyclodextrin inclusion complexes on MCF-7 breast cancer cells
Authors: Molupe Nthabeleng , Babu Balaji , Prinsloo Earl , Kaassis Abdessamad Y. A. , Edkins Katharina , Mack John , Nyokong Tebello
Published: October 2019

A novel Sn(IV) meso-tetraacenaphthylporphyrin (SnTAcP) has been synthesized and characterized. SnTAcP was complexed with methyl-[Formula: see text]-cyclodextrin (m[Formula: see text]-CD), a nanocarrier that enhances water solubility, and the complexes were evaluated as PDT agents using MCF-7 breast cancer cells. A relatively low singlet oxygen quantum yield value of 0.36 was obtained in DMF, and the lowest energy Q band lies at 608 nm on the edge of the therapeutic window. SnTAcP was found to be non-toxic in the dark and phototoxic towards MCF-7 breast cancer cells with a half-maximal inhibitory concentration (IC[Formula: see text] value of 11 ± 1.1 [Formula: see text]g · mL[Formula: see text] after 30 min of irradiation with a 625 nm Thorlabs LED that provides a dose of 432 J · cm[Formula: see text]. A higher IC[Formula: see text] value of 21 ± 1.1 [Formula: see text]g · mL-1 was obtained for the m[Formula: see text]-CD inclusion complex of SnTAcP.
Projective properties of Lorentzian surfaces
Authors: Mounoud Pierre
Published: October 2019

We investigate projective properties of Lorentzian surfaces. In particular, we prove that if T is a non-flat torus, then the index of its isometry group in its projective group is at most two. We also prove that any topologically finite non-compact surface can be endowed with a metric having a non-isometric projective transformation of infinite order.
Cardiac overexpression of perilipin 2 induces atrial steatosis, connexin 43 remodeling, and atrial fibrillation in aged mice
Authors: Sato Satsuki , Suzuki Jinya , Hirose Masamichi , Yamada Mika , Zenimaru Yasuo , Nakaya Takahiro , Ichikawa Mai , Imagawa Michiko , Takahashi Sadao , Ikuyama Shoichiro , Konoshita Tadashi , Kraemer Fredric B. , Ishizuka Tamotsu
Published: October 2019

Atrial fibrillation (AF) is prevalent in patients with obesity and diabetes, and such patients often exhibit cardiac steatosis. Since the role of cardiac steatosis per se in the induction of AF has not been elucidated, the present study was designed to explore the relation between cardiac steatosis and AF. Transgenic (Tg) mice with cardiac-specific overexpression of perilipin 2 (PLIN2) were housed in the laboratory for more than 12 mo before the study. Electron microscopy of the atria of PLIN2-Tg mice showed accumulation of small lipid droplets around mitochondrial chains, and five- to ninefold greater atrial triacylglycerol (TAG) content compared with wild-type (WT) mice. Electrocardiography showed significantly longer RR intervals in PLIN2-Tg mice than in WT mice. Transesophageal electrical burst pacing resulted in significantly higher prevalence of sustained (>5 min) AF (69%) in PLIN2-Tg mice than in WT mice (24%), although it was comparable in younger (4-mo-old) mice. Connexin 43 (Cx43), a gap junction protein, was localized at the intercalated disks in WT atria but was heterogeneously distributed on the lateral side of cardiomyocytes in PLIN2-Tg atria. Langendorff-perfused hearts using the optical mapping technique showed slower and heterogeneous impulse propagation in PLIN2-Tg atria compared with WT atria. Cardiac overexpression of hormone-sensitive lipase in PLIN2-Tg mice resulted in atrial TAG depletion and amelioration of AF susceptibility. The results suggest that PLIN2-induced steatosis is associated with Cx43 remodeling, impaired conduction propagation, and higher incidence of AF in aged mice. Therapies targeting cardiac steatosis could be potentially beneficial against AF in patients with obesity or diabetes.
Reduction of Soiling on Photovoltaic Modules by a Tracker System with Downward-Facing Standby State
Authors: Ota Yasuyuki , Nagaoka Akira , Nishioka Kensuke
Published: October 2019

The radiation received by solar cells within photovoltaic modules is lower than that arriving at the module surface. One of the causes of this energy loss is soiling of the module surface. Therefore, the influence of dust adhesion on photovoltaic modules must be studied. In this study, we prepared two tracker systems: a new system and a typical system. During the night, the former can switch to a downward-facing standby state, while the latter assumes an upward-facing standby state. The soiling on the polymethylmethacrylate and glass set on the tracker systems with both standby states was evaluated for 20 months in Miyazaki, Japan. By adopting the tracker system with the downward-facing standby state, a direct transmittance that was more-than-5% higher than before was consistently obtained at 500 nm in both cases with polymethylmethacrylate and glass.
PDRCNN: Precise Phishing Detection with Recurrent Convolutional Neural Networks
Authors: Wang Weiping , Zhang Feng , Luo Xi , Zhang Shigeng
Published: October 2019

Through well-designed counterfeit websites, phishing induces online users to visit forged web pages to obtain their private sensitive information, e.g., account number and password. Existing antiphishing approaches are mostly based on page-related features, which require to crawl content of web pages as well as accessing third-party search engines or DNS services. This not only leads to their low efficiency in detecting phishing but also makes them rely on network environment and third-party services heavily. In this paper, we propose a fast phishing website detection approach called PDRCNN that relies only on the URL of the website. PDRCNN neither needs to retrieve content of the target website nor uses any third-party services as previous approaches do. It encodes the information of an URL into a two-dimensional tensor and feeds the tensor into a novelly designed deep learning neural network to classify the original URL. We first use a bidirectional LSTM network to extract global features of the constructed tensor and give all string information to each character in the URL. After that, we use a CNN to automatically judge which characters play key roles in phishing detection, capture the key components of the URL, and compress the extracted features into a fixed length vector space. By combining the two types of networks, PDRCNN achieves better performance than just using either one of them. We built a dataset containing nearly 500,000 URLs which are obtained through Alexa and PhishTank. Experimental results show that PDRCNN achieves a detection accuracy of 97% and an AUC value of 99%, which is much better than state-of-the-art approaches. Furthermore, the recognition process is very fast: on the trained PDRCNN model, the average per URL detection time only cost 0.4 ms.
Finite‐Time Observer‐Based Adaptive Control of Switched System with Unknown Backlash‐Like Hysteresis
Authors: Sun Guofa , Xu Yaming
Published: October 2019

This work investigates a finite‐time observer problem for a class of uncertain switched nonlinear systems in strict‐feedback form, preceded by unknown hysteresis. By using a finite‐time performance function, a finite‐time switched state observer (FTSO) is derived using radial basis function neural networks (RBFNNs) to estimate the unmeasured states. An adaptive feedback neural network tracking control is derived based on the backstepping technique, which guarantees that all the signals of the closed‐loop system are bounded, the output tracking error converges to zero, and the observer error converges to a prescribed arbitrarily small region within a finite‐time interval. In addition, two simulation studies and an experiment test are provided to verify the feasibility and effectiveness of the theoretical finding in this study.
Tongue Tied after Shoulder Surgery: A Case Series and Literature Review
Authors: Kraus Molly B. , Cain Rachel B. , Rosenfeld David M. , Caswell Renee E. , Hinni Michael L. , Molloy Michael J. , Trentman Terrence L.
Published: October 2019

This article presents three cases of cranial nerve palsy following shoulder surgery with general anesthesia in the beach chair position. All patients underwent preoperative ultrasound-guided interscalene nerve block. Two cases of postoperative hypoglossal and one case of combined hypoglossal and recurrent laryngeal nerve palsies (Tapia’s syndrome) were identified. Through this case series, we provide a literature review identifying postoperative cranial nerve palsies in addition to the discussion of possible etiologies. We suggest that intraoperative patient positioning and/or airway instrumentation is most likely causative. We conclude that the beach chair position is a risk factor for postoperative hypoglossal nerve palsy and Tapia’s syndrome.
Disturbance Observer‐Based Robot End Constant Contact Force‐Tracking Control
Authors: Zhang Tie , Liang Xiaohong
Published: October 2019

A disturbance observer‐based hybrid sliding mode impedance control method is proposed in this paper, which is able to achieve robot end constant contact force‐tracking control without force/torque sensors. The method requires only the values of joint torque, joint angle, and joint angular velocity, which are converted by robot servo motor signals, to implement the control. The control scheme consists of two parts: one is a disturbance observer and the other is a hybrid sliding mode impedance controller. The disturbance observer, which takes robot internal signals mentioned above as the inputs to estimate the robot end contact force, is designed based on generalized momentum, thus improving the estimation accuracy. The hybrid sliding mode impedance controller, which uses the values estimated by the disturbance observer and the robot internal signals as the inputs to calculate the corresponding position adjustment, integrates both the impedance control and sliding mode control, thus improving the force‐tracking performance and robustness. Experimental results show that the proposed disturbance observer‐based hybrid sliding mode impedance control method possesses high control precision.
VPN Traffic Detection in SSL-Protected Channel
Authors: Zain ul Abideen Muhammad , Saleem Shahzad , Ejaz Madiha
Published: October 2019

In recent times, secure communication protocols over web such as HTTPS (Hypertext Transfer Protocol Secure) are being widely used instead of plain web communication protocols like HTTP (Hypertext Transfer Protocol). HTTPS provides end-to-end encryption between the user and service. Nowadays, organizations use network firewalls and/or intrusion detection and prevention systems (IDPS) to analyze the network traffic to detect and protect against attacks and vulnerabilities. Depending on the size of organization, these devices may differ in their capabilities. Simple network intrusion detection system (NIDS) and firewalls generally have no feature to inspect HTTPS or encrypted traffic, so they rely on unencrypted traffic to manage the encrypted payload of the network. Recent and powerful next-generation firewalls have Secure Sockets Layer (SSL) inspection feature which are expensive and may not be suitable for every organizations. A virtual private network (VPN) is a service which hides real traffic by creating SSL-protected channel between the user and server. Every Internet activity is then performed under the established SSL tunnel. The user inside the network with malicious intent or to hide his activity from the network security administration of the organization may use VPN services. Any VPN service may be used by users to bypass the filters or signatures applied on network security devices. These services may be the source of new virus or worm injected inside the network or a gateway to facilitate information leakage. In this paper, we have proposed a novel approach to detect VPN activity inside the network. The proposed system analyzes the communication between user and the server to analyze and extract features from network, transport, and application layer which are not encrypted and classify the incoming traffic as malicious, i.e., VPN traffic or standard traffic. Network traffic is analyzed and classified using DNS (Domain Name System) packets and HTTPS- (Hypertext Transfer Protocol Secure-) based traffic. Once traffic is classified, the connection based on the server’s IP, TCP port connected, domain name, and server name inside the HTTPS connection is analyzed. This helps in verifying legitimate connection and flags the VPN-based traffic. We worked on top five freely available VPN services and analyzed their traffic patterns; the results show successful detection of the VPN activity performed by the user. We analyzed the activity of five users, using some sort of VPN service in their Internet activity, inside the network. Out of total 729 connections made by different users, 329 connections were classified as legitimate activity, marking 400 remaining connections as VPN-based connections. The proposed system is lightweight enough to keep minimal overhead, both in network and resource utilization and requires no specialized hardware.
Does Implantation of an Artificial Soft Anal Band Provide an Opportunity for Improvement of Biopsychosocial Function in Patients with Severe Fecal Incontinence?
Authors: Żelazny Dorota , Romaniszyn Michał , Wałęga Piotr
Published: October 2019

Introduction. Severe fecal incontinence describes a condition of complete loss of control over fundamental physiological functions and loss of abilities to fulfil psychosocial functions by the patients. The last-step procedure, that is, to restore hope for improvement of biopsychosocial functioning and quality of life determined by the patient’s health status is implantation of an artificial anal sphincter. Objective. The study was a comparative analysis of the effect of the employed surgical procedure upon the degree of defecation control and quality of life indices in its behavioral, mental, and social aspects prior to and 3, 6, and 12 months postoperatively. The analysis also included the effect of the patient’s individual style of coping with stress and the functional outcome of the procedure. Material and Methods. The study included a group of 12 patients: 6 females and 6 males, aged from 36 to 60 years of life. The tools consisted of scoring systems that measured symptom intensity (FISI and Jorge and Wexner scale). In assessing the psychosocial functioning, the authors employed the Fecal Incontinence Quality of Life Scale (by Rockwood). The individual mode of coping with the disease was evaluated by using the CISS scale by Endler and Parker. Conclusions. The analysis of results demonstrated that the procedure of implanting an artificial anal sphincter affected the “continence” (up to 50–60% postoperatively) and led to improvement in psychosocial functioning in all its assessed aspects, i.e., lifestyle, employment of precautionary measures, depression, anxiety, and embarrassment. It was also noted that due to the specific character of the procedure (the necessity to operate an artificial implant), better mean results in assessment of the procedure functionality were achieved by patients presenting the goal-concentrated mode rather than emotions-concentrated mode of coping with the disease. Thus, it seems justified to state that assessment of biopsychological functioning may be a good criterion of the procedure effectiveness.
Choosing the Best Chemotherapy Agent to Boost Immune Checkpoint Inhibition Activity
Authors: Garassino Marina Chiara , Torri Valter , Colombo Mario Paolo , Sica Antonio
Published: October 2019

Despite the fact that reactivation of specific antitumor immunity through inhibition of immune checkpoints represents a formidable therapeutic weapon against cancer, many patients are poorly reactive to this treatment. To overcome this limitation, efforts are being made to characterize the immunostimulatory properties of chemotherapeutic agents and how they can be best combined with immune checkpoint inhibitors. The work by Wanderley and colleagues indicates that the TLR4 agonist taxol can restore the anticancer activity of tumor-associated macrophages and improve the clinical efficacy of immune checkpoint inhibitors. Cancer Res; 78(20); 5729–30. ©2018 AACR.

See related article by Wanderley et al., p. 5891