bluuebunny/crossref_metadata_2025 huggingface dataset:
Sandwich osteotomy in atrophic mandibles: A retrospective study with a 2‐ to 144‐month follow‐up
Authors: Geng Yuan‐ming , Zhou Miao , Parvini Patricia , Scarlat Sebastian , Naujokat Hendrik , Abraha Sophia Mulugeta , Terheyden Hendrik
Published: July 2019

Objectives

The aim of the present retrospective study was to assess the long‐term clinical outcome of sandwich osteotomy in pre‐implant augmentation of atrophic mandible.

Materials and methods

Sandwich osteotomies were performed in partially and fully edentulous mandibles of 63 consecutive patients in the present study. The vertical bone gain, graft stability, and marginal bone loss were measured radiographically. Implant survival and success rates were estimated in the follow‐up ranged from 2 to 144 months (mean, 58 months).

Results

A total of 75 procedures were reviewed. After an average healing time of 148 days, 220 implants were placed in 74 procedures. Perioperative complications included intraoperative fracture (1/75), transient paresthesia (18/75), wound healing disturbance (18/75), and keratinized tissue deficiency (14/75). The average vertical bone gain was 5.4 mm at the time of implant placement. Significant marginal bone loss occurred during the first 6 months, after which the resorption remained stable. The implant survival rate was estimated as 96.7%, and the success rate was 95.3%. Implant survival and success showed no significant correlation with higher age, anticoagulation therapy, cardiovascular disease, or thyroid disorder. Smoking was correlated with significant lower success rate.

Conclusion

Sandwich osteotomy is a suitable augmentation procedure for atrophic mandible, allowing for implant placement with promising outcome.
Performatively Driven: A Genre for Signifying in Popular Music Exhibitions
Authors: Cortez Alcina
Published: July 2019

This article explores a relatively novel field of practice, or genre, emerging in the context of museums and exhibitions of popular music and what I will refer to as performatively driven, here discussed and illustrated with examples drawn from particular international exhibitions that I have visited. This genre is comprised of a myriad of strategies used by curators to give substance to their exhibiting narratives that tends to cluster into four essential types – (i) exhibiting sound and music; (ii) dramatic strategies (for current purposes, the example of contrast is considered); (iii) enveloping strategies, and (iv) sound epistemologies – and all of which draw on combinations of multifarious exhibits (material and immaterial). In terms of their signifying potential, my analysis points to these strategies, each of them focused on imparting meaning in an experiential rather than a purely rational sense, as achieving the following ends: conveying notions of popular music as object and artifact; eliciting emotional responses and prompting engagement; valuing museumgoers’ individualities, while also locating them as part of a community (e.g., of music fans, of followers of a particular musical artist, of a particular generation); providing re‐enactment (both by reconstructing scenarios from the past or from live concerts and by activating memories offered of popular music); and conveying knowledge. As these signifying strategies dissolve into the aforementioned meanings in an experiential rather than in a more rational sense, I would suggest they are correspondingly rooted in the concept of performance and therefore propose adding this concept to the typology of concepts presented by Baker et al. (2018).
Integrating resistance functions to predict response to induction chemotherapy in de novo acute myeloid leukemia
Authors: Chiu Yu‐Chiao , Hsiao Tzu‐Hung , Tsai Jia‐Rong , Wang Li‐Ju , Ho Tzu‐Chieh , Hsu Shih‐Lan , Teng Chieh‐Lin Jerry
Published: July 2019

Objectives

This study explored resistance functions and their interactions in de novo AML treated with the “7 + 3” induction regimen.

Methods

We analyzed RNA‐sequencing profiles of whole bone marrow samples from 52 de novo AML patients who completed the “7 + 3” regimen and stratified patients into CR (n = 35) and non‐CR (n = 17) groups.

Results

A systematic gene set analysis revealed significant associations between chemoresistance and mTOR (P < .001), myc (P < .001), mitochondrial oxidative phosphorylation (P < .001), and stemness (P = .002). These functions were independent with regard to gene contents and activity scores. An integration of these four functions showed a prediction of chemoresistance (area under the receiver operating characteristic curve = 0.815) superior to that of each function alone. Moreover, our proposed seven‐gene scoring system significantly correlated with the four‐function model (r = .97; P < .001) to predict chemoresistance to the “7 + 3” regimen. On multivariate analysis, a seven‐gene score of ≥−0.027 (hazard ratio: 11.18; 95% confidence interval: 2.06‐60.65; P = .005) was an independent risk factor for induction failure.

Conclusions

Myc, OXPHOS, mTOR, and stemness were responsive for chemoresistance in AML. Treatments other than the “7 + 3” regimen need to be considered for de novo AML patients predicted to be refractory to the “7 + 3” regimen.
Twenty years of research on total quality management in Higher Education: A systematic literature review
Authors: Nasim Kanwal , Sikander Arif , Tian Xiaowen
Published: July 2019

Faced with intensified global education competition, universities and other Higher Education institutions are implementing Total Quality Management (TQM) to keep rivals at bay. Meanwhile, research interest in TQM in Higher Education is growing. This paper reviews the achievements and limitations of extant research on TQM in Higher Education, and discusses directions for future research. The paper finds that extant research focuses on (1) teaching and learning but neglects research and industry engagement; (2) an isolated factor (e.g., teacher) but neglects other factors (e.g., facilities); (3) the Higher Education sector in advanced countries but neglects the Higher Education sector in developing countries; and (4) TQM as a phenomenon but neglects theory development and integration. Future research needs to address these limitations, adopt a more holistic perspective, and take a more inclusive and comprehensive approach to TQM in the Higher Education sector.
Offshoring, the threat effect, and wage inequality
Authors: Jeon Yongsik , Kwon Chul‐Woo
Published: July 2019

The effects of offshoring threats on the domestic skill premium are widely accepted, but theoretically unanalyzed. This study constructs a simple theoretical model based on task‐trading offshoring and collective wage bargaining models to examine the effects of a firm's offshoring threat on the domestic skill premium. Theoretical analysis suggests that under a moderate demand for the final good, the possibility of offshoring could lower the wages of unskilled domestic workers, who are vulnerable to offshoring, more than the wages of skilled domestic workers. Thus, even when there is no actual offshoring, the skill premium between the two types of workers increases.
Cellular therapy: Immune‐related complications
Authors: Oved Joseph H. , Barrett David M. , Teachey David T.
Published: July 2019

The advent of chimeric antigen receptor T (CAR‐T) and the burgeoning field of cellular therapy has revolutionized the treatment of relapsed/refractory leukemia and lymphoma. This personalized “living therapy” is highly effective against a number of malignancies, but this efficacy is tempered by side effects relatively unique to immunotherapies, including CAR‐T. The overwhelming release of cytokines and chemokines by activated CAR‐T and other secondarily activated immune effector cells can lead to cytokine release syndrome (CRS), which can have clinical and pathophysiology similarities to systemic inflammatory response syndrome and macrophage activating syndrome/hemophagocytic lymphohistiocytosis. Tocilizumab, an anti‐IL6 receptor antibody, was recently FDA approved for treatment of CRS after CAR‐T based on its ability to mitigate CRS in many patients. Unfortunately, some patients are refractory and additional therapies are needed. Patients treated with CAR‐T can also develop neurotoxicity and, as the biology is poorly understood, current therapeutic interventions are limited to supportive care. Nevertheless, a number of recent studies have shed new light on the pathophysiology of CAR‐T‐related neurotoxicity, which will hopefully lead to effective treatments. In this review we discuss some of the mechanistic contributions intrinsic to the CAR‐T construct, the tumor being treated, and the individual patient that impact the development and severity of CRS and neurotoxicity. As CAR‐T and cellular therapy have redefined the concept of personalized medicine, so too will personalization be necessary in managing the unique side effects of these therapies.
Outcomes following persistent atrial fibrillation ablation using localized sources identified with Ripple map
Authors: Melby Daniel P. , Gornick Charles , Abdelhadi Raed , Sengupta Jay , Pai Manju , Zakaib John S. , Moore JoEllyn , Benditt David G.
Published: July 2019

Background

Ablation of persistent atrial fibrillation (AF) remains challenging. Identification and ablation of localized AF drivers may offer the possibility for improved outcomes. Ripple map is a novel software algorithm that may allow improved localization of possible AF drivers through the whole chamber graphical display of continuously recorded bipolar electrograms. The objective of this study was to determine whether regions of high‐frequency Ripple activation (HFRA) observed on Ripple map provide useful ablation targets in patients with persistent AF.

Methods and Results

Consecutive patients underwent the first‐time ablation of persistent AF (n = 162) using a standard stepwise (n = 105) or a Ripple map guided approach (n = 57). Ripple map guided patients underwent pulmonary vein antral isolation followed by ablation of HFRA sites. Acute termination of AF was observed in 91.2% of the Ripple‐guided patients vs 52.4% in the stepwise approach, P < .0001. Following a single ablation procedure, after 18 months 98.2% of Ripple map guided patients were free of AF, compared with 81.4% of standard stepwise ablation (P = .005). Freedom from atrial tachycardia (54.4% Ripple map vs 52.4% standard, P = .9) or any atrial arrhythmia (52.6% Ripple map vs 39.0% standard, P = .10) did not differ between the two strategies. In a subset analysis (n = 30 of 56), Ripple map regions corresponded to sites with spatiotemporal dispersion in all atrial locations. No differences were observed in the rate of procedural complications.

Conclusions

Ablation of HFRA sites identified with Ripple map resulted in a higher rate of acute termination and improved freedom from AF compared to a standard stepwise approach.
Determinants of postoperative left atrial structural reverse remodeling in patients undergoing combined catheter ablation of atrial fibrillation and left atrial appendage closure procedure
Authors: Li Yi‐Gang , Gong Chang‐Qi , Zhao Ming‐Zhe , Sun Jian , Wang Qun‐Shan , Zhang Peng‐Pai , Feng Xiang‐Fei , Yu Yi , Yu Yi‐Chi , Liang Bing‐Er ,   and other members of the Xinhua Cardiac EP Study Group
Published: July 2019

Introduction

Catheter ablation of atrial fibrillation (AFCA) and left atrial appendage closure (LAAC) exert opposite effects on left atrial (LA) size. We aim to observe the net impact of combined AFCA and LAAC strategy on LA size and explore those factors which might affect the postprocedure LA structural remodeling.

Methods

A total of 53 patients, who underwent combined AFCA and Watchman LAAC in our center from March to December 2017, were enrolled. Atrial fibrillation (AF) recurrence was monitored after the procedure. Left atrial volume (LAV) and left atrial appendage volume (LAAV) were measured by Mimics based on dual‐source computed tomography images.

Results

At 6 months, sinus rhythm (SR) was maintained in 79.2% patients. LAV was significantly reduced (130.2 ± 36.3 mL to 107.1 ± 30.0 ml; P < .001) in SR maintenance group, but not in AF recurrence group (138.8 ± 39.3 mL to 137.9 ± 36.9 mL; P = .671). In SR group, preoperative LAAV/LAV ratio (B = −0.894; P = .015), NT‐proBNP (B = 0.005; P = .019) and left ventricular ejection fraction (LVEF) (B = −0.778; P < .001) could interactively affect the extent of postoperative LA structural reverse remodeling, among which LAAV/LAV ratio could independently predict the significance of reverse remodeling (≥15% reduction in LAV) (OR, 0.56; 95% CI, 0.34‐0.90; P = .018). A preoperative LAAV/LAV ratio less than 7.1% is indicative of significant LA structural reverse remodeling in this patient cohort.

Conclusions

LA structural reverse remodeling could be evidenced in patients with maintained SR following combined AFCA and LAAC. Smaller LAAV/LAV ratio, higher NT‐proBNP or lower LVEF at baseline are associated with more significant LA structural reverse remodeling, while LAAV/LAV ratio can predict the significance of the process after one‐stop treatment.
Low‐cost healthy extrudates of rice and bhimkol (Musa balbisiana, ABB) formulated through linear programming
Authors: Borah Anjan , Das Deepjyoti K. , Hazarika Manuj K. , Mukhopadhyay Rupak , Mahanta Charu L.
Published: July 2019

Low amylose rice, intermediate amylose rice, and seeded banana were taken for formulation of an extruded product using linear programming (LP) model. The model was designed to develop nutritious low‐cost extrudate products. The optimization for development of extrudates was performed by using central composite rotatable design (CCRD). The formulated extruded product developed at the optimized condition was found to have calorific value of 175 kcal/100 g and protein content of 6.35% with adequate amount of micro‐nutrients like magnesium (15.3 mg/100 g) and potassium (33.2 mg/100 g), respectively. Cytotoxicity assay with various levels of the extrudate showed negligible toxicity against human embryonic kidney (HEK293) cells.

Practical Application

Ready‐to‐eat (RTE) foods are becoming widely popular due to change in lifestyle. However, RTE products are basically cereal‐based and found to have low nutritional value. Thus, there is a need to increase protein and minerals in cereal‐based extruded cereals.
Voluntary Reserve Targets
Authors: BAUGHMAN GARTH , CARAPELLA FRANCESCA
Published: July 2019

We study monetary policy implementation through an operating regime involving voluntary reserve targets (VRTs). Operating regimes based on reserve requirements may lead to a collapse in interbank trade, as they have since the financial crisis. We show that, no matter the abundance of reserves, VRTs encourage market activity and support the central bank's control over interest rates. We consider (i) the impact of anticipated and unanticipated liquidity injections by the central bank on market outcomes and (ii) a comparison with the implementation framework currently adopted by the Federal Reserve. Overall, a VRT framework may provide several advantages over other frameworks.
Clinical factors associated with the recurrence of central giant cell lesions
Authors: Chrcanovic Bruno Ramos , Gomes Carolina Cavaliéri , dos Santos Thiago Rezende , Abreu Mauro Henrique Nogueira Guimarães , Gomez Ricardo Santiago
Published: July 2019

Central giant cell lesion of the jaws (CGCLJ) is a destructive condition that shows a varied and unpredictable biological behaviour. In the present study, we aimed to evaluate factors associated with the recurrence of CGCLJ. Based on the data of a previous systematic review of 2270 cases of CGCLJ, we used the multiple imputation to deal with the missing data. The dependent variable was the recurrence after the first treatment (yes/no). The dichotomic covariates were sex, upper or lower jaw location, size (up to or larger than 4 cm), pain, cortical bone perforation (yes/no), locularity (uni‐/multilocular), tooth displacement (yes/no), treatment type (curettage or enucleation) and root resorption (yes/no). The final logistic model indicated that the tumours associated with tooth displacement, root resorption and treated with curettage had a more significant chance of recurrence. In conclusion, our study suggests that tooth displacement, root resorption and the type of treatment are potentially useful in the future construction of an algorithm for patient's treatment.
Intraosseous xanthoma of the mandible: A multi‐institutional case series with a literature review
Authors: de Arruda José Alcides Almeida , Almeida Tatiana Fernandes Araújo , Abreu Lucas Guimarães , do Amaral Márcio Bruno Figueiredo , Anbinder Ana Lia , Flores René Martínez , Agostini Michelle , Romañach Mário José , Silva Tarcília Aparecida , de Andrade Bruno Augusto Benevenuto , Mesquita Ricardo Alves
Published: July 2019

Background

The aim of the present study was to report the clinicopathologic, radiographic and immunohistochemical features of five South American cases of intraosseous xanthomas of the mandible and to compare them to those detected in a literature review.

Methods

Clinical data were collected from the records of three Oral and Maxillofacial Pathology services in South America and compared with those compiled from a literature review based on a search of three electronic databases (PubMed, Web of Science and Scopus). All cases were evaluated by haematoxylin and eosin staining and immunohistochemistry for CD68 and S‐100.

Results

The series comprised four females (80%) and one male (20%) with a mean age of 23.3 ± 10.9 years (range: 13‐45 years). In four cases, there was involvement of the posterior region of the mandible (80%). The lesions presented radiographically as unilocular (60%) radiolucencies with punched‐out margin (80%). All cases predominantly consisted of CD68‐positive and S‐100‐negative xanthomatous cells. No recurrences were observed after curettage, with a median follow‐up of 27 months.

Conclusion

Intraosseous xanthoma of the jaws is a rare benign disorder. We report here five additional cases affecting the mandible, for a total of 36 cases of the jaws reported in the literature. Overall, this lesion has predilection for posterior sites of the mandible of asymptomatic young adults.
Review: Recent advances in the understanding of the pathophysiology of neuromyelitis optica spectrum disorder
Authors: Chang V. T. W. , Chang H.‐M.
Published: July 2019

Neuromyelitis optica is an autoimmune inflammatory disorder of the central nervous system that preferentially targets the spinal cord and optic nerve. Following the discovery of circulating antibodies against the astrocytic aquaporin 4 (AQP4) water channel protein, recent studies have expanded our knowledge of the unique complexities of the pathogenesis of neuromyelitis optica and its relationship with the immune response. This review describes and summarizes the recent advances in our understanding of the molecular mechanisms underlying neuromyelitis optica disease pathology and examines their potential as therapeutic targets. Additionally, we update the most recent research by proposing major unanswered questions regarding how peripheral AQP4 antibodies are produced and their entry into the central nervous system, the causes of AQP4‐IgG‐seronegative disease, why peripheral AQP4‐expressing organs are spared from damage, and the impact of this disease on pregnancy.
Influence of risk factors in the ESC‐EHRA EORP atrial fibrillation ablation long‐term registry
Authors: Trines Serge A. , Stabile Giuseppe , Arbelo Elena , Dagres Nikolaos , Brugada Josep , Kautzner Josef , Pokushalov Evgeny , Maggioni Aldo P. , Laroche Cécile , Anselmino Matteo , Beinart Roy , Traykov Vassil , Blomström‐Lundqvist Carina ,   on behalf of the ESC‐EHRA Atrial Fibrillation Ablation Long‐Term Registry investigators
Published: July 2019

Background

The influence of risk factors on atrial fibrillation (AF) ablation recurrence is increasingly recognized. We present a sub‐analysis of the European Society of Cardiology‐European Heart Rhythm Association‐European Society of Cardiology AF ablation long‐term registry on the effect of traditional risk factors for AF on postablation recurrence, reablation, and complications using real‐world data.

Methods

Risk factors for AF were defined as body mass index ≥27 kg/m², hypertension, chronic obstructive pulmonary disease, diabetes, alcohol ≥2 units/day, sleep apnea, smoking, no/occasional sports activity, moderate/severe mitral or aortic valve disease, any cardiomyopathy, peripheral vascular disease, chronic kidney disease, heart failure, coronary artery disease/infarction, and previous pacemaker/defibrillator implant. Patients were divided in two groups with ≥1 or without risk factors. Primary outcomes were arrhythmia recurrence after blanking period, reablation, and adverse events or death. Differences between the groups and the influence of individual risk factors were analyzed using multivariate Cox regression.

Results

Three thousand sixty nine patients were included; 217 patients were without risk factors. Risk factor patients were older (58.4 vs 54.1 years), more often female (32% vs 19.8%) and had more often persistent AF (27.2% vs 23.5%). In a multivariate analysis, patients without risk factors had a hazard ratio of 0.70 (95% CI 0.49‐0.99) for recurrence compared to risk factor patients. The multivariate hazard ratios for reablation or adverse events/death were not different between the two groups. Hypertension and body mass index were univariate predictors of recurrence.

Conclusions

Patients with ≥1 risk factor had a 30% higher risk for arrhythmia recurrence after ablation, but no differences in risk for repeat ablations and adverse events or death.
Inheritance and molecular mapping of restorer‐of‐fertility (Rf) gene in A2 hybrid system in pigeonpea (Cajanus cajan)
Authors: Sharma Pankaj , Singh Inderjit , Sirari Asmita , Khosla Gaurav , Singh Gurjeet , Ludhar Navkiran Kaur , Singh Sarvjeet
Published: July 2019

Inheritance of fertility restorer gene in pigeonpea was studied using F2 and BC1F1 populations derived from cross AL103A × IC245273. It was found to be controlled by single dominant gene. Out of 228 SSR primer pairs, 33 primer pairs showed parental polymorphism, while four primers were found polymorphic in bulk segregant analysis (BSA). These four primers viz., CcM 1615, CcM 0710, CcM 0765 and CcM 1522 were used for genotyping of F2 population and were found to be placed at 3.1, 5.1, 28.1 and 45.8 cM, respectively. Two of them, CcM 1615 and CcM 0710, evinced clear and unambiguous bands for fertility restoration in F2 population. The Rf gene was mapped on linkage group 6 between the SSR markers CcM 1615 and CcM 0710 with the distances of 3.1 and 5.1 cM, respectively. The accuracy of the CcM 1615 was validated in 18 restorers and six maintainer lines. The marker CcM 1615 amplified in majority of male restorer lines with a selection accuracy of 91.66%.
Trichinella spiralis muscle larvae release extracellular vesicles with immunomodulatory properties
Authors: Kosanović Maja , Cvetković Jelena , Gruden‐Movsesijan Alisa , Vasilev Saša , Svetlana Milanović , Ilić Nataša , Sofronić‐Milosavljević Ljiljana
Published: July 2019

Aims

Extracellular vesicles (EVs) represent a newly discovered but universal communication tool between cells or organisms. However, few data exist on nematode EVs and none for Trichinella spiralis. Here, we aimed to investigate whether T spiralis muscle larvae produce EVs, whether they carry immunomodulatory proteins and whether they have a role in immunomodulation as a component of excretory‐secretory muscle larvae products (ES L1).

Methods and results

EVs were enriched from conditioned medium of T spiralis muscle larvae. Transmission electron microscopy images showed T spiralis EVs to be 30‐80 nm in size, and Western blot confirmed the presence of two out of three glycoproteins with the immunodominant epitope characteristic for muscle larvae of the genus Trichinella. Using a peripheral blood mononuclear cell (PBMC) stimulation assay, it was shown that these EVs elevated production of IL10 and IL6.

Conclusion

T spiralis muscle larvae produce EVs. Those EVs carry immunomodulatory proteins and have the capacity independently to induce regulatory responses in the same way as the T spiralis excretory‐secretory muscle larvae products from which they were isolated.
Priority Service Pricing with Heterogeneous Customers: Impact of Delay Cost Distribution
Authors: Cao Ping , Wang Yaolei , Xie Jingui
Published: July 2019

This paper studies the priority pricing problem for a single‐server queueing system with two priority classes in which customers have different sensitivities to delay. The system makes a fixed–delay announcement to inform arriving customers of the expected delay for each class, whereupon each customer must decide which class to join. Any customer who joins the priority class is charged a fixed priority price. Our examination of customers’ joining behavior under any given priority prices reveals that there can be multiple equilibrium delays and that the number of those delays depends on the structure of customers’ delay cost distribution. We characterize the stability of these equilibria and show that the system can reach the largest or smallest equilibrium by making a proper initial delay announcement. In addition, we consider two pricing problems to maximize the system’s long‐run average revenue and social welfare, respectively. The results derived here establish that both the revenue‐maximizing price and the social welfare–maximizing price are quite sensitive to the delay cost distribution. Finally, we investigate the influence of the number of priority classes by extending the two–priority‐class model to a multiple–priority‐class model.
A review of the known unknowns in the early stages of septoria tritici blotch disease of wheat
Authors: Brennan C. J. , Benbow H. R. , Mullins E. , Doohan F. M.
Published: July 2019

Septoria tritici blotch (STB) disease of wheat is caused by the fungal pathogen Zymoseptoria tritici. It is the most important foliar disease of wheat in western Europe and affects wheat cultivation worldwide. The combination of intensive fungicide usage, a polycyclic asexual life cycle and an active sexual cycle has led to the emergence of fungal strains resistant/tolerant to all the major classes of fungicides used in its control. The hallmark of this disease is a long, symptomless latent phase that precedes the onset of visible symptoms. Understanding the processes that occur during the symptomless phase of infection is paramount in developing alternative strategies for disease control; however, large gaps in our knowledge of the disease remain. The known unknowns of the latent stage of infection can be summarized in three questions. Does the fungus initiate or manipulate host defences to trigger programmed cell death in order to facilitate nutrient acquisition or is the host acting exclusively? Does the fungus feed during both the latent phase and the necrotrophic phase like a true hemibiotroph? Does the long latent phase serve a beneficial function for the fungus or is it simply an artefact of evolution? This review aims to distil observations made during studies that have directly or indirectly contributed to answering these questions and points towards their most likely answers.
Detailed Model of a Thermoelectric Generator Performance
Authors: Buchalik Ryszard , Nowak Iwona , Rogozinski Krzysztof , Nowak Grzegorz
Published: July 2019

The paper deals with mathematical modeling of heat transfer phenomena occurring in a system containing thermoelectric elements. The main focus was on creating a useful computational tool for designing, validating, testing, controlling, and regulating the energy harvesting system with a thermoelectric cell. The model widely described in the literature, assuming a constant temperature level on both sides of the cell, has been modified to take into account the thermal resistance of heat exchangers that are inseparable parts of nearly every device of this kind. The results and conclusions from the solutions of equations forming a formalized record of the proposed method, the assumed approach to modeling, used physical phenomena and sensitivity analysis of the impact of the tested parameters on the system operation was presented. The calculations were made for the data of a selected thermoelectric generating cell available on the market.
Design, Modeling, and Test: The Hydraulic Vibration Energy Recovery System of Speed Bump
Authors: Guo Yan , He Ren
Published: July 2019

This paper designs a hydraulic vibration energy recovery system of speed bump that can recover vehicle vibration energy while decelerating the vehicle. Using hydraulic fluid as the energy recovery medium for deceleration, according to the speed range of vehicles passing through the speed bump, a design scheme for the hydraulic vibration energy recovery device for speed bump with a combination of split generation and continuous generation is proposed. Based on the coupling characteristics of the vehicle-speed bump-hydraulic transducer at different speeds of the vehicle, a joint simulation model was established to study the speed bump power generation module. Based on the simulation results, the hydraulic system operating parameters and component types were determined. Finally, a simulation test was conducted on an improved test-bed to test the power generation capability of the system.
Multiple-Objective Optimization for Solar Concentrator Layout
Authors: Wang Kung-Jeng , Dao Le Duc
Published: July 2019

Solar energy is critical because it does not only sustain global environment but also produce ample power to use. This study addresses solar concentrator layout to maximize the profit for the firm manufacturing the concentrator, while helping an energy user receives as much sunlight as possible. We consider several key design factors of a solar concentrator layout, such as light transmission loss, to make the model more accurate. As for the economic scale of production, some key constraints are considered, such as concentrator thickness and the number of exits, where a sunbeam is delivered to an optical cable for energy transmission. To obtain a high brightness from a good solar concentrator for the user, the concentrator manufacturer requires to increase the complexity of concentrator layout, but suffers from the high manufacturing cost. In this study, we simultaneously address the issues of the optimal solar concentrator layout and trade-off of conflict objectives between the energy user and the concentrator manufacturer. This study proposes a nondominated sorting genetic algorithm for multiple-objective optimization solution. To summarize, the result from this study presents a promising solution both for the light efficiency to supply users and for the profit of the firm on delivering the solar concentrator layout.
Evaporative Wicking Phenomena on Nanotextured Surfaces
Authors: Le Duong Vy , Pham Quang N. , Lee Jonggyu , Zhang Shiwei , Won Yoonjin
Published: July 2019

As modern electronics become miniaturized with high power, thermal management for electronics devices has become significant. This motivates the implementation of new cooling solutions to dissipate high-heat levels from high-performance electronics. Evaporative cooling is one of the most promising approaches for meeting these future thermal demands. Thin-film evaporation promotes heat dissipation through the phase change process with minimal conduction resistance. In this process, it is important to design surface structures and corresponding surface properties that can minimize meniscus thickness, increase liquid–vapor interfacial area, and enhance evaporation performances. In this study, we investigate thin-film evaporation by employing nanotextured copper substrates for varying thermal conditions. The liquid spreading on the nanotextured surfaces is visualized using a high-speed imaging technique to quantify evaporative heat transfer for various surfaces. The permeability is calculated using an enhanced wicking model to estimate the evaporation effect combined with the mass measurements. Then, infrared (IR) thermography is employed to examine two-dimensional temporal temperature profiles of the samples during the evaporative wicking with a given heat flux. The combination of optical time-lapse images, evaporation rate measurements, and temperature profiles will provide a comprehensive understanding of evaporation performances using textured surfaces.
Atomic H diffusion and C etching in multilayer graphene monitored using a Y based optical sensor
Authors: Mund Baibhav K. , Soroka Olena , Sturm Jacobus M. , van den Beld Wesley T. E. , Lee Chris J. , Bijkerk Fred
Published: July 2019

In this work, the authors expose transferred multilayer graphene on a yttrium based hydrogen sensor. Using spectroscopic ellipsometry, they show that graphene, as well as amorphous carbon reference films, reduce diffusion of hydrogen to the underlying Y layer. Graphene and C are both etched due to exposure to atomic H, eventually leading to hydrogenation of the Y to YH2 and YH3. Multilayer graphene, even with defects originating from manufacturing and transfer, showed a higher resistance against atomic H etching compared to amorphous carbon films of a similar thickness.
Active acoustic cloaking in a convected flow field
Authors: Eggler Daniel , Karimi Mahmoud , Kessissoglou Nicole
Published: July 2019

Acoustic cloaking has mostly been considered within a stationary fluid. The authors herein show that accounting for the effects of convection in the presence of fluid flow is critical for cloaking in the acoustic domain. This work presents active acoustic cloaking in a convected flow field for two different incident fields, corresponding to a plane wave and a single monopole source, impinging on a rigid body. Monopole control sources circumferentially arranged around the rigid body are used to generate a secondary acoustic field to destructively interfere with the primary scattered field arising from the incident excitation cases. The authors show that for sound waves in a moving fluid, active cloaking can only be achieved using a convected cloak, which is dependent on Mach number.
Altered ellipsoid zone reflectivity and deep capillary plexus rarefaction correlate with progression in Best disease
Authors: Romano Francesco , Arrigo Alessandro , Leone Pier Pasquale , Saladino Andrea , Bandello Francesco , Battaglia Parodi Maurizio
Published: July 2019

Aims

To evaluate the effects of neurovascular damage in patients with the typical vitelliform lesion of Best vitelliform macular dystrophy (BVMD) in the attempt to identify different progression patterns.

Methods

Prospective, observational case series. Patients in the vitelliform stage of BVMD and healthy controls underwent complete ophthalmological examination on a yearly basis, including best-corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT) and OCT angiography (OCT-A). 4.5×4.5 mm OCT-A slabs were imported into ImageJ software and their vessel density (VD) was calculated. Similarly, the ellipsoid zone (EZ) was manually outlined and the reflectivity was measured above the vitelliform lesion and in the 500 µm external to it. Retinal pigment epithelium–Bruch’s membrane complex was taken as internal reference.

Results

34 eyes (24 patients) and 34 matched controls were included in the study. Mean follow-up was of 28.4±5.8 months, with 12 eyes showing signs of stage progression at the end follow-up. The EZ overlying the vitelliform lesion and in the peri-lesional area disclosed a significant reduction in reflectivity when compared with the foveal and para-foveal EZ of controls, respectively. VD resulted meaningfully decreased only at the deep capillary plexus. Of notice, more extensive EZ (reflectivity <0.7) and vascular alterations (VD <0.4) at baseline strongly correlated with worse BCVA and were associated with a more rapid progression at follow-up.

Conclusions

Both EZ reflectivity and VD at deep capillary plexus may prove valuable biomarkers to assess BVMD severity and detect progression. In this view, ‘rapid progressors’ might benefit the most from timely genetic therapies in the future.
Hospital volume and outcomes for acute pulmonary embolism: multinational population based cohort study
Authors: Jiménez David , Bikdeli Behnood , Quezada Andrés , Muriel Alfonso , Lobo José Luis , de Miguel-Diez Javier , Jara-Palomares Luis , Ruiz-Artacho Pedro , Yusen Roger D , Monreal Manuel
Published: July 2019

Objectives

To evaluate the association between experience in the management of acute pulmonary embolism, reflected by hospital case volume, and mortality.

Design

Multinational population based cohort study using data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry between 1 January 2001 and 31 August 2018.

Setting

353 hospitals in 16 countries.

Participants

39 257 consecutive patients with confirmed diagnosis of acute symptomatic pulmonary embolism.

Main outcome measure

Pulmonary embolism related mortality within 30 days after diagnosis of the condition.

Results

Patients with acute symptomatic pulmonary embolism admitted to high volume hospitals (>40 pulmonary embolisms per year) had a higher burden of comorbidities. A significant inverse association was seen between annual hospital volume and pulmonary embolism related mortality. Admission to hospitals in the highest quarter (that is, >40 pulmonary embolisms per year) was associated with a 44% reduction in the adjusted odds of pulmonary embolism related mortality at 30 days compared with admission to hospitals in the lowest quarter (<15 pulmonary embolisms per year; adjusted risk 1.3% v 2.3%; adjusted odds ratio 0.56 (95% confidence interval 0.33 to 0.95); P=0.03). Results were consistent in all sensitivity analyses. All cause mortality at 30 days was not significantly reduced between the two quarters (adjusted odds ratio 0.78 (0.50 to 1.22); P=0.28). Survivors showed little change in the odds of recurrent venous thromboembolism (odds ratio 0.76 (0.49 to 1.19)) or major bleeding (1.07 (0.77 to 1.47)) between the low and high volume hospitals.

Conclusions

In patients with acute symptomatic pulmonary embolism, admission to high volume hospitals was associated with significant reductions in adjusted pulmonary embolism related mortality at 30 days. These findings could have implications for management strategies.
Emergency care research ethics in low-income and middle-income countries
Authors: Millum Joseph , Beecroft Blythe , Hardcastle Timothy Craig , Hirshon Jon Mark , Hyder Adnan A. , Newberry Jennifer A. , Saenz Carla
Published: July 2019

A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health.
Advancing research on emergency care systems in low-income and middle-income countries: ensuring high-quality care delivery systems
Authors: Moresky Rachel T , Razzak Junaid , Reynolds Teri , Wallis Lee A , Wachira Benjamin W , Nyirenda Mulinda , Carlo Waldemar A , Lin Janet , Patel Shama , Bhoi Sanjeev , Risko Nicholas , Wendle Lily A , Calvello Hynes Emilie J
Published: July 2019

Emergency care systems (ECS) address a wide range of acute conditions, including emergent conditions from communicable diseases, non-communicable diseases, pregnancy and injury. Together, ECS represent an area of great potential for reducing morbidity and mortality in low-income and middle-income countries (LMICs). It is estimated that up to 54% of annual deaths in LMICs could be addressed by improved prehospital and facility-based emergency care. Research is needed to identify strategies for enhancing ECS to optimise prevention and treatment of conditions presenting in this context, yet significant gaps persist in defining critical research questions for ECS studies in LMICs. The Collaborative on Enhancing Emergency Care Research in LMICs seeks to promote research that improves immediate and long-term outcomes for clients and populations with emergent conditions. The objective of this paper is to describe systems approaches and research strategies for ECS in LMICs, elucidate priority research questions and methodology, and present a selection of studies addressing the operational, implementation, policy and health systems domains of health systems research as an approach to studying ECS. Finally, we briefly discuss limitations and the next steps in developing ECS-oriented interventions and research.
Clinical emergency care research in low-income and middle-income countries: opportunities and challenges
Authors: Aluisio Adam R , Waheed Shahan , Cameron Peter , Hess Jermey , Jacob Shevin T , Kissoon Niranjan , Levine Adam C , Mian Asad , Ramlakhan Shammi , Sawe Hendry R , Razzak Junaid
Published: July 2019

Disease processes that frequently require emergency care constitute approximately 50% of the total disease burden in low-income and middle-income countries (LMICs). Many LMICs continue to deal with emergencies caused by communicable disease states such as pneumonia, diarrhoea, malaria and meningitis, while also experiencing a marked increase in non-communicable diseases, such as cardiovascular diseases, diabetes mellitus and trauma. For many of these states, emergency care interventions have been developed through research in high-income countries (HICs) and advances in care have been achieved. However, in LMICs, clinical research, especially interventional trials, in emergency care are rare. Furthermore, there exists minimal research on the emergency management of diseases, which are rarely encountered in HICs but impact the majority of LMIC populations. This paper explores challenges in conducting clinical research in patients with emergency conditions in LMICs, identifies examples of successful clinical research and highlights the system, individual and study design characteristics that made such research possible in LMICs. Derived from the available literature, a focused list of high impact research considerations are put forth.
Emergency care research as a global health priority: key scientific opportunities and challenges
Authors: Razzak Junaid , Beecroft Blythe , Brown Jeremy , Hargarten Stephen , Anand Nalini
Published: July 2019

Quality emergency medical care is critical to reducing the burden of disease in low-income and middle-income countries (LMICs) and protecting the health of populations during disasters and epidemics. However, conducting research in emergency care settings in LMIC settings entails unique methodological and operational challenges. Therefore, new approaches and strategies that address these challenges need to be developed and will require increased attention from scientists, academic institutions and the global health research funding community. Research priorities to address emergency care in LMICs have also not been well defined, resulting in limited research output from LMICs. This manuscript frames the efforts of four multidisciplinary working groups, which were established under the auspices of the Fogarty International Center as part of the Collaborative on Enhancing Emergency Care Research in LMICs and serves as an introduction to this series, which identifies challenges and solutions in the context of emergency care research in LMICs. The objective of this introductory paper is to articulate the need for emergency care research in LMICs and underscore its future promise. We present public health arguments for greater investment in emergency care research, identify barriers to develop and conduct research, and present a list of research priorities for community organizations, academic institutions and funding agencies. We conclude that advances in emergency care research will be critical to achieve national and global health targets, such as the Sustainable Development Goals (SDGs), and to ensure that evidence informs how such research is best conducted.
Validation of the five-tier Taiwan Triage and Acuity Scale for prehospital use by Emergency Medical Technicians
Authors: Ng Chip-Jin , Chien Cheng-Yu , Seak Julian Chen-June , Tsai Shang-Li , Weng Yi-Ming , Chaou Chung-Hsien , Kuo Chan-Wei , Chen Jih-Chang , Hsu Kuang-Hung
Published: July 2019

Objectives

This study aimed to determine the inter-rater reliability of the five-level Taiwan Triage and Acuity Scale (TTAS) when used by emergency medical technicians (EMTs) and triage registered nurses (TRNs). Furthermore, it sought to validate the prehospital TTAS scores according to ED hospitalisation rates and medical resource consumption.

Methods

This was a prospective observational study. After training in five-level triage, EMTs triaged patients arriving to the ED and agreement with the nurse triage (TRN) was assessed. Subsequently, these trained research EMTs rode along on ambulance calls and assigned TTAS scores for each patient at the scene, while the on-duty EMTs applied their standard two-tier prehospital triage scale and followed standard practice, blinded to the TTAS scores. The accuracy of the TTAS scores in the field for prediction of hospitalisation and medical resource consumption were analysed using logistic regression and a linear model, respectively, and compared with the accuracy of the current two-tier prehospital triage scale.

Results

After EMT’s underwent initial training in five-level TTAS, inter-rater agreement between EMTs and TRNs for triage of ED patients was very good (κw=0.825, CI 0.750 to 0.900). For the outcome of hospitalisation, TTAS five-level system (Akaike’s Information Criteria (AIC)=486, area under the curve (AUC)=0.75) showed better discrimination compared with TPTS two-level system (AIC=508, AUC=0.66). Triage assignments by the EMTs using the the five-level TTAS was linearly associated with hospitalisation and medical resource consumption.

Conclusions

A five-level prehospital triage scale shows good inter-rater reliability and superior discrimination compared with the two-level system for prediction of hospitalisation and medical resource requirements.
BET 1: Green or blue for you? Methoxyflurane (Penthrox) or nitrous oxide/oxygen 50% mixture (Entonox) for the management of acute pain in the ED
Authors: Rahman Shah Mizanur , Quinn Eimhear
Published: July 2019

A short-cut review of the literature was carried out to establish whether inhaled methoxyflurane (Penthrox) is comparable or superior with a standard inhalational analgesia for the management of acute pain. Only two papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that both methods of inhaled analgesia appear to be useful options for acute pain in the ED when compared with placebo. No evidence was found to suggest superiority of methoxypenflurane. International studies directly comparing the use of both drugs for in acute trauma are ongoing and will develop the evidence base.