bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicore bi-layer gold-coated SPR-based sensor for simultaneous measurements of CFC and HCFC
Authors: Asaduzzaman Jabin Md. , Ahmed Kawsar , Juwel Rana Md. , Kumar Paul Bikash , Dhasarathan Vigneswaran , Shahin Uddin Muhammad
Published: November 2019

Global warming is an alarming issue in our daily life. As we know that CFCs and HCFCs have a great impact on ozone depletion and global warming process. So, there must be a cheaper way to detect CFCs and HCFCs from refrigerant products like refrigerator, aerosols, air-conditioner, etc. So, for the very first time, this paper proposes a novel highly sensitive dual-core bi-layer gold-coated surface plasmon resonance (DB-SPR)-based photonic crystal fiber (PCF) for sensing CFCs and HCFCs in the field of chemical and biosensing. The analysis is assumed at 20[Formula: see text]C (293 K) for the concentration level of CFCs and HCFCs ranging between 20% and 80%. The entire numerical evaluation process is done by using finite element method (FEM) with a full vectorial software named COMSOL V-5.1 by examining the number of mesh elements of 228,120 which has better flexibility in the fabrication process. The proposed model can prove itself better than any other models by the justification of the major optical parameters, such as birefringence (B[Formula: see text]), coupling length (L[Formula: see text]), confinement loss ([Formula: see text]), transmittance (T[Formula: see text]), transmittance variance (T[Formula: see text]), power fraction (P[Formula: see text]), amplitude sensitivity (S[Formula: see text]), wavelength sensitivity (S[Formula: see text]), figure of merit (FOM), resolution (Rl[Formula: see text]), resonance (R2), etc. which respectively corresponds to their maximum performance profiles of 0.038, 40 [Formula: see text]m, 1140 dB/cm, −180 dB, 410 dB/RIU, 51%, −3200 RIU[Formula: see text], 30450.43 nm/RIU, 1300, 1.25[Formula: see text]×[Formula: see text]10[Formula: see text], 0.98712. So, it is evident that proposed SPR PCF can be a tough competitor in the field of biosensing and chemical sensing as well as gas sensing.
First-principle study of the structural, mechanical, electronic and thermodynamic properties of intermetallic compounds: Pd3M (M=Sc, Y)
Authors: Boulechfar R. , Trad Khodja A. , Khenioui Y. , Meradji H. , Drablia S. , Chouahda Z. , Ghemid S. , Naqib S. H. , Khenata R. , Wang X. T.
Published: November 2019

The mechanical, electronic and thermodynamic properties of Pd3M (M[Formula: see text]=[Formula: see text]Sc, Y) compounds have been investigated using the Full Potential Linearized Augmented Plane Wave (FP-LAPW) formalism. The generalized gradient approximation (GGA) is used to treat the exchange–correlation terms. The calculated formation enthalpies and the cohesive energies reveal that the L12 structure is more stable than the D0[Formula: see text] one. The obtained lattice parameters and bulk modulus calculations conform well to the available experimental and theoretical results. The elastic and mechanical properties are analyzed and results show that both compounds are ductile in nature. The Debye temperature and melting temperature are also estimated and are in a good agreement with experimental findings. The total and partial densities of states are determined for L12 and D0[Formula: see text] structures. The density of states at the Fermi level, [Formula: see text]([Formula: see text]), indicates electronic stability for both compounds. The presence of the pseudo-gap near the Fermi level is suggestive of formation of directional covalent bonding. The number of bonding electrons per atom [Formula: see text] and the electronic specific heat coefficient [Formula: see text] are also determined. The quasi-harmonic Debye model has been used to explore the temperature and pressure effects on the thermodynamic properties for both compounds.
(V, Ti) co-doping effect on electronic and magnetic properties of zb-AlAs
Authors: Rami R. , Drissi L. B. , Rkhioui N. , Drissi El Bouzaidi M. , Ahl Laamara R.
Published: November 2019

The ab initio study of electronic, magnetic properties and Curie temperature of AlAs doped by single and double impurities is investigated using LDA–KKR–CPA method. It is shown that the Al substituted by V and/or Ti induces a half-metallic character and ferromagnetism in the system for different concentrations except co-doping by x[Formula: see text]=[Formula: see text]y[Formula: see text]=[Formula: see text]0.035. The stability of magnetism between the ferromagnetic and DLM states as well as the mechanism of exchange interaction are discussed. The density of states are plotted in the energy diagram for different concentrations of dopants. The co-doping with (V, Ti) increases Curie temperature in AlAs with respect to single substituant. The finding of this work confirms that the new compounds have a great potential for spintronic devices.
Study of bright–dark solitons of strain wave equation in micro-structured solids and its applications
Authors: Arshad Muhammad , Seadawy Aly R. , Lu Dianchen
Published: November 2019

In this study, several novel solutions of strain wave equation for micro-structured solids are obtained by using the powerful modified extended direct algebraic method. In micro-structured solids, the strain wave dynamical equation is utilized to model the wave propagation in micro-structured materials. We have profitably obtained exact traveling wave solutions, including solitons, solitary waves, kink and anti-kink solitary waves, periodic and rational solutions have been found. This approach can not only produce the same solution, but also find new solutions that we think other researchers have missed. These attained solutions help researchers for knowing the physical phenomena of this dynamical equation. The three-dimensional maps of some solutions obtained in this study are plotted through giving appropriate values of the parameters engaged in the solutions for knowing the physical interpretation. The computational work and obtained results demonstrate that the new extended technique, gives an efficient and direct mathematical tools for resolving the nonlinear models in engineering and mathematical physics.
Chaos versus EMI: Methodologies and Practice
Authors: Song Yuhong , Niu Junying , Li Zhong
Published: November 2019

This paper gives a review on the methodologies of using the continuous power spectrum feature of chaos to suppress electromagnetic interference (EMI), which have been extensively studied in the past 15 years, and their practical applications in power electronic converters of various topologies and powers, which have been widely employed in various electrical and electronic devices in our daily lives and thus form the main sources of EMI. This paper not only points out that chaotic modulation is effective and feasible in improving the electromagnetic compatibility (EMC) of various types of power electronic converters, but also gives the circuit design methodologies for different kinds of converters, especially the design methods of modules and chips. It can serve as a guide for engineering applications.
Global Stability and Hopf Bifurcation in a Delayed Viral Infection Model with Cell-to-Cell Transmission and Humoral Immune Response
Authors: Xu Jinhu , Geng Yan , Zhang Suxia
Published: November 2019

We have developed a class of viral infection model with cell-to-cell transmission and humoral immune response. The model addresses both immune and intracellular delays. We also constructed Lyapunov functionals to establish the global dynamical properties of the equilibria. Theoretical results indicate that considering only two intracellular delays did not affect the dynamical behavior of the model, but incorporating an immune delay greatly affects the dynamics, i.e. an immune delay may destabilize the immunity-activated equilibrium and lead to Hopf bifurcation, oscillations and stability switches. Our results imply that an immune delay dominates the intracellular delays in the model. We also investigated the direction of the Hopf bifurcation and the stability of the periodic solutions by applying normal form and center manifold theory, and investigated the existence of global Hopf bifurcation by regarding the immune delay as a bifurcation parameter. Numerical simulations are carried out to support the analytical conclusions.
Hopf Bifurcation of a Type of Neuron Model with Multiple Time Delays
Authors: Ma Suqi
Published: November 2019

By applying a geometrical scheme developed to tackle the eigenvalue problem of delay differential equations with multiple time delays, Hopf bifurcation of Hopfield neuron model is analyzed in two-parameter space. By the introduction of two new angles, the calculation of imaginary roots is carried out analytically and effectively. By increasing the parameter to cross over the Hopf bifurcation lines, the stability switching direction is confirmed. The method is a useful tool to show the partition of stable and unstable regions in two-parameter space and detect double Hopf bifurcation further. The typified dynamical behaviors based on nearby double Hopf points are analyzed by applying the normal form technique and center manifold method.
Poincaré Maps of “ <”-Shape Planar Piecewise Linear Dynamical Systems with a Saddle
Authors: Zhao Qianqian , Yu Jiang
Published: November 2019

It is important in the study of limit cycles to investigate the properties of Poincaré maps of discontinuous dynamical systems. In this paper, we focus on a class of planar piecewise linear dynamical systems with “[Formula: see text]”-shape regions and prove that the Poincaré map of a subsystem with a saddle has at most one inflection point which can be reached. Furthermore, we show that one class of such systems with a saddle-center has at least three limit cycles; a class of such systems with saddle and center in the normal form has at most one limit cycle which can be reached; and a class of such systems with saddle and center at the origin has at most three limit cycles with a lower bound of two. We try to reveal the reasons for the increase of the number of limit cycles when the discontinuity happens to a system.
On Nearly σ-Embedded Subgroups of Finite Groups
Authors: Hussain Muhammad Tanveer , Cao Chenchen , Zhang Li
Published: November 2019

Let G be a finite group, σ={σi|i∈I} be some partition of the set of all primes and σ(G)={σi|σi∩π(G)≠∅}. We say that a subgroup H of G is nearly σ-embedded in G if there exists a σ-permutable subgroup T of G such that HT is a σ-permutable subgroup of G and H∩T≤HσeG, where HσeG is the subgroup of H generated by all those subgroups of H which are σ-permutably embedded in G. In this paper, we study the structure of G under the condition that some given subgroups of G are nearly σ-embedded in G. Some known results are generalized.
Entanglement HCI The Next Wave?
Authors: Frauenberger Christopher
Published: November 2019

This article argues that our intimate entanglement with digital technologies is challenging the foundations of current HCI research and practice. Our relationships to virtual realities, artificial intelligence, neuro-implants or pervasive, cyberphysical systems generate ontological uncertainties, epistemological diffusion and ethical conundrums that require us to consider evolving the current research paradigm. I look to post-humanism and relational ontologies to sketch what I call Entanglement HCI in response. I review selected theories—Actor-Network Theory, Post-Phenomenology, Object-Oriented Ontology, Agential Realism—and their existing influences on HCI literature. Against this background, I develop Entanglement HCI from the following four perspectives: (a) the performative relationship between humans and technology; (b) the re-framing of knowledge generation processes around phenomena; (c) the tracing of accountabilities, responsibilities and ethical encounters; and (d) the practices of design and mattering that move beyond user-centred design.
Using Butterfly-patterned Partial Sums to Draw from Discrete Distributions
Authors: Jr. Guy L. Steele , Tristan Jean-Baptiste
Published: November 2019

We describe a
simd
technique for drawing values from multiple discrete distributions, such as sampling from the random variables of a mixture model, that avoids computing a complete table of partial sums of the relative probabilities. A table of alternate (“butterfly-patterned”) form is faster to compute, making better use of coalesced memory accesses; from this table, complete partial sums are computed on the fly during a binary search. Measurements using
cuda
7.5 on an
nvidia
Titan Black
gpu
show that this technique makes an entire machine-learning application that uses a Latent Dirichlet Allocation topic model with 1,024 topics about 13% faster (when using single-precision floating-point data) or about 35% faster (when using double-precision floating-point data) than doing a straightforward matrix transposition after using coalesced accesses.
Evaluation of Final-Year Turkish Dental Students’ Knowledge, Attitude, and Self-Perceived Competency towards Preventive Dentistry
Authors: Pınar Erdem Arzu , Peker Kadriye , Kuru Sinem , Sepet Elif
Published: November 2019

Background. Dental education plays an important role in providing students with the opportunity to develop their evidence-based knowledge and clinical skills regarding patient-specific preventive care and caries management strategies. The aims of this study were to examine the knowledge, attitude, and self-perceived competency towards preventive dentistry among final-year dental students and to investigate their preventive practice for high-caries-risk children. Methods. Data were collected from a convenience sample of 126 dental students using a questionnaire. The IBM SPSS Statistics version 21 was used for data analysis.Results. A total of 126 students completed the questionnaire, and 63% of the respondents were female. Significant gender differences were found in the total Professional Preventive Knowledge Scale (PPKS) (p=0.016) and its subscales of the noncariogenic nutrition (p=0.015), dental hygiene/clinical examination (p<0.001), caries-preventive practice (p=0.02), and the Hiroshima University-Dental Behavioral Inventory (HU-DBI) (p=0.028). Significant differences were observed in the total PPKS (p=0.003) and its subscales of the noncariogenic nutrition (p=0.043) and caries risk management (p=0.006) in terms of self-perceived need to receive education and training. Caries-preventive practice was correlated with the self-perceived competency (r = 0.279;p=0.002), the attitudes (r = 0.394;p<0.001), the total PPKS (r = 0.457;p<0.001) and its all subscales of dental hygiene and clinical examination (r = 0.425;p<0.001), noncariogenic nutrition (r = 0.410;p<0.001), and caries risk management (r = 0.184;p=0.039). The self-perceived competency was positively correlated with the total PPKS (r = 0.192;p=0.031) and its subscale of noncariogenic nutrition (r = 0.259;p=0.003). Greater self-perceived competence, more positive attitudes, and good knowledge regarding preventive dentistry were found to be important predictors of the caries-preventive practice of dental students, explaining 31% of the variance (adjustedR2 = 0.312,p<0.001).Conclusion. 40% of dental students reported educational and training needs regarding the diagnosis, caries-preventive agents, and risk-based treatment plan. These results should be taken into account by the stakeholders in developing the national core curriculum for undergraduate Turkish dental education.
Cabazitaxel Induced Thrombotic Microangiopathy in a Patient with Prostate Cancer
Authors: Nlandu Yannick , Pourcine Franck , Vong Ly van phach , Chelly Jonathan , Jochmans Sebastien , Mazerand Sandie , Monchi Mehran
Published: November 2019

Cancer-associated thrombotic microangiopathy (TMA) refers to a group of disorders characterized by microangiopathic haemolytic anemia, thrombocytopenia, and ischemic organ damage. TMA manifestations can be induced by cancer or by chemotherapy. We report the case of a 64-year-old man with metastatic prostate cancer who experienced a Cabazitaxel-induced TMA manifestation. TMA responds to conservative therapy, dialysis without plasmaphoresis, with progressive recovered renal function.
Hepatic Sarcoidosis Complicated with Pancreatic Adenocarcinoma
Authors: Gupta Kamesh , Hassan Tuyyab , Rizwan Shahid , Hans Bandhul , Jawale Rahul , Desilets David
Published: November 2019

Sarcoidosis is a systemic noncaseous granulomatous disease. The liver is a common location but usually asymptomatic. Current literature suggests an association between sarcoidosis and cancers. However, there is a lack of definite evidence. We present a case of a 59-year-old man with jaundice and acutely elevated alkaline phosphatase. The diagnosis was confirmed by obtaining a liver biopsy and was treated with 6 months of steroids. A year later, he had a recurrence of jaundice. MRCP showed biliary dilatation and a mass in the pancreatic head, confirmed by biopsy to be adenocarcinoma. This is the first case to be reported of hepatic sarcoidosis associated with pancreatic cancer.
Clinical Characteristics of Patients with Type 2 Diabetes Mellitus Receiving a Primary Total Knee or Hip Arthroplasty
Authors: Na Annalisa , Jansky Laurie , Gugala Zbigniew
Published: November 2019

Aim. The purpose of this study is to explore clinical characteristics of patients with T2DM receiving a primary knee (TKA) or hip (THA) arthroplasty to patients without T2DM receiving a TKA or THA and patients with T2DM with no history of osteoarthritis (OA). Methods. The study included a retrospective database review of 500 consecutive primary TKA or THA identified with ICD-9 codes and 100 consecutive T2DM patients. Patients who received a TKA or THA were screened for inclusion and exclusion and divided into with or without T2DM groups. A comparison group of patients with T2DM only without arthroplasty was screened to exclude patients with a history of OA or arthroplasty. All groups were compared based on demographic and relevant comorbidity differences. OA characteristics, including OA and previous arthroplasty of the involved and contralateral joints, were compared between patients with and without T2DM receiving a TKA or THA. Finally, patients with T2DM with and without TKA or THA were compared for T2DM differences. Results. Study results found that among those receiving a primary arthroplasty, patients with T2DM were more likely to be obese and older and reported cardiovascular, urinary, dyslipidemia, and peripheral neuropathy than those with T2DM. Among the T2DM individuals, those receiving an arthroplasty surgery were older and obese and more likely to report peripheral neuropathy; however, those with T2DM with no OA were more likely to report atherosclerosis and cardiovascular disease. Within the arthroplasty subgroup of individuals with T2DM, those requiring antidiabetic medication were 4.5 times more likely to have contralateral OA or arthroplasty. Conclusions. The results of this study suggest that patients with T2DM requiring a primary arthroplasty are a unique subgroup that requires careful considerations as they are often older, have obesity, and specific comorbidities predisposing to worse postoperative outcomes than their non-T2DM arthroplasty counterparts. Therefore, clinical practice and future studies must consider strategies that would limit OA and arthroplasty management delays while accounting for comorbidities and patient characteristics.
Grape Seed Polyphenols Ameliorated Dextran Sulfate Sodium-Induced Colitis via Suppression of Inflammation and Apoptosis
Authors: Wang Yunxia , Wang Yunan , Shen Wanli , Wang Yandi , Cao Yini , Nuerbulati Nuerdida , Chen Wen , Lu Guotao , Xiao Weiming , Qi Rong
Published: November 2019

Background: Ulcerative colitis (UC) is an inflammatory bowel disease. Its onset is typically gradual, usually followed by periods of spontaneous remission and subsequent relapses. Grape seed polyphenols (GSP), a natural product extracted from grape seeds, have strong anti-inflammatory functions. Objectives: In this study, we investigated whether GSP has an inhibitory effect on UC and its related mechanism or not. Methods: We induced UC by 2.5% dextran sulfate sodium (DSS) and GSP at different doses (500 and 750 mg/kg body weight per day) was administrated to the mice by gavage. Body weight, diarrhea, and bloody stool were recorded every day to evaluate disease activity index. Hemotoxylin-eosin staining and immunohistochemical staining were used to identify the histological damages and inflammatory infiltration in colon tissues. Real-time polymerase chain reaction was used to evaluate mRNA expression of interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α and the expression of phosphorylated-signal transducer and activator of transcription 3 (STAT3) and STAT3 were assessed by western blot. The immunofluorescent assay was used to evaluate the apoptosis of intestinal epithelial cells (IECs). Results: GSP could alleviate the loss of body weight, diarrhea, bloody stool, the mucosal damage, and inflammatory infiltration. GSP could also downregulate the mRNA expression of inflammatory cytokines IL-6, IL-1β, and TNF-α as well as the phosphorylation of STAT3 and ameliorate the apoptosis of IECs. Conclusions: Our study suggests that GSP has protective effects against DSS-induced UC, which may through suppression of inflammation and apoptosis.
Histopathological Changes and Clinical Outcomes following Intervention for Sub-Internal Limiting Membrane Haemorrhage
Authors: Hussain Rumana N. , Stappler Theodor , Hiscott Paul , Wong David
Published: November 2019

Introduction: Haemorrhage confined to the sub-internal limiting membrane (ILM) space can be associated with good visual recovery. There is controversy as to the best management of purely sub-ILM haemorrhage, which ranges from observation to immediate surgical intervention. Methods: We studied a retrospective case series of patients with sub-ILM haemorrhage who underwent vitrectomy with subsequent histological analysis of the removed ILM. Results: Sixteen patients underwent vitrectomy for sub-ILM haemorrhage. Five patients had underlying Terson syndrome, 6 had ruptured macro-aneurysms, and 5 had Valsalva retinopathy. Seven patients demonstrated cellular proliferation on the retinal surface of the ILM with staining for glial fibrillary acidic protein and cytokeratin 7, as well as CD68pg and Prussian blue. All but 1 of these cases were isolated from patients undergoing surgery >4 weeks following initial symptoms, the other presented at >2 weeks. Serial optical coherence tomography (OCT) was available in 8 patients; serial OCT in patients with delayed intervention demonstrated persistent inner retinal layer hyper-reflectance. Fourteen of 15 patients demonstrated symptomatic recovery and showed visual improvement with acuity ranging from –0.1 to 1.8 (mean 0.43) within 3 months of intervention (1 was lost to follow-up). The post-operative vision was 0.11 logMAR (mean; range –0.1 to 0.4) at 3 months in the group with intervention within 2 weeks of symptoms, and 0.9 logMAR (mean; range 0.0 to HM) in the group with delayed surgery. Conclusions: Early surgical intervention for sub-ILM haemorrhage resulted in good visual outcomes; delayed surgery may lead to proliferative vitreoretinopathy-like changes on the inner retinal surface of the ILM, and untreated cases may demonstrate persistent inner retinal changes potentially limiting visual prognosis despite subsequent surgical intervention.
Fluorescence Lifetime Patterns of Retinal Pigment Epithelium Atrophy in Patients with Stargardt Disease and Age-Related Macular Degeneration
Authors: Solberg Yasmin , Dysli Chantal , Escher Pascal , Berger Lisa , Wolf Sebastian , Zinkernagel Martin S.
Published: November 2019

Purpose: To investigate whether autofluorescence lifetime patterns within retinal pigment epithelium (RPE) atrophy differ between age-related macular degeneration (AMD) and Stargardt disease (STGD). Methods: Mean retinal autofluorescence lifetimes were measured in a short and a long spectral channel (SSC: 498–560 nm; LSC: 560–720 nm). Mean retinal fluorescence lifetimes were analyzed with corresponding clinical features, fundus images, fundus autofluorescence intensity images, and optical coherence tomography. Mean fluorescence lifetime values of atrophic areas were compared between the two cohorts and within the same patient to adjacent nonatrophic regions. Results: Mean fluorescence lifetimes within areas with RPE atrophy of 13 patients with STGD (mean age ± SEM 43.7 ± 5 years) and 30 patients with geographic atrophy (mean age: 78 ± 2 years) were analyzed and compared to age-matched healthy participants. The mean area of RPE atrophy in STGD and AMD was 6.6 ± 2.3 mm2 (range: 0.66–33.17 mm2) and 17.5 ± 3.8 mm2 (range: 0.58–50.02 mm2), respectively. In patients with AMD, atrophic areas revealed significantly longer mean fluorescence lifetime values as compared with patients with STGD (SSC: 997 ± 60 vs. 363 ± 26 ps; LSC: 880 ± 46 vs. 393 ± 23 ps; p < 0.0001). Conclusions: This study established that RPE atrophy in patients secondary to STGD and AMD display distinctive mean fluorescence lifetime characteristics. As retinal fluorescence lifetimes within areas of RPE atrophy were significantly longer in AMD patients, the analysis of specific lifetime patterns may provide additional insight into the disease processes and the pathogenetic mechanisms in the development of atrophic patches in AMD and STGD.
Using Body Composition Assessment to Evaluate the Double Burden of Malnutrition
Authors: Wells Jonathan C.K.
Published: November 2019

Background: Populations in low- and middle-income countries are increasingly experiencing a double burden of malnutrition (DBM), incorporating both persistent levels of child undernutrition and rising prevalence of overweight/obesity at later ages. A growing number of individuals experience both components of the DBM through the life-course, thereby accumulating high susceptibility to noncommunicable disease (NCD). Summary: Measurements of body composition may prove valuable for assessing NCD risk at the level of the individual. The capacity-load model provides a simple conceptual framework for integrating data on different components of body composition to predict NCD risk. Poor growth in early life, indexed by becoming wasted or stunted, constrains the development of lean mass components such as muscle and organ mass, each of which contribute to the metabolic capacity for homeostasis. Catch-up weight gain in early life, or the development of excess weight from childhood onwards, is associated with elevated adiposity, especially abdominal adiposity, which challenges cardio-metabolic homeostasis and elevates NCD risk. Key Messages: A variety of techniques are now available for the measurement of body composition, helping research the association of the DBM with NCD risk. Reference charts allow raw data to be converted to age- and sex-specific z-scores, aiding interpretation.
Strengthened Data Systems to Mitigate the Double Burden of Malnutrition: The Role of Stable Isotope Technique-Derived Nutrition Indicators
Authors: Owino Victor O. , Mouratidou Theodora
Published: November 2019

Indicators reflecting the double burden of malnutrition are rarely measured in nutrition surveys and are needed to strengthen national data systems. Indicators such as body composition reflect both metabolic response to undernutrition and obesity risk and nutrition-related noncommunicable diseases. Stable isotope techniques (SITs) provide accurate data on body composition, exclusive breastfeeding and vitamin A status that are otherwise problematic with routine methods. Integration of SIT-derived nutrition indicators in data systems could improve the design and evaluation of programmes focused on obesity prevention, food fortification and infant and young child feeding practices. The Working Group at the symposium considered “how SIT-derived nutrition indicators may be integrated into surveillance systems to strengthen data availability and capacity at national and regional levels”. Practical considerations for the use of SITs include cost, sample size, rigorous training and logistics. It was concluded that SITs are best suited, at present, for use in sub-samples of population surveys and for validating tools that can be scaled-up more easily in population surveys. In the long term, SITs could be applied to larger surveys following potential innovations in more affordable, hand-held devices for analysis of stable isotope enrichment in the field and simpler specimen collection protocols.
Towards a Multi-Dimensional Index of Child Growth to Combat the Double Burden of Malnutrition
Authors: Haisma Hinke , Pelto Gretel , Venkatapuram Sridhar , Yousefzadeh Sepideh , Kramer Lybrich , Anand Paul ,   members of the Working Group “Towards a multi-dimensional index of child growth”
Published: November 2019

Background: There is growing awareness in the field of public health that combatting the double burden of malnutrition requires approaches that address its multi-dimensional origin, rather than focusing primarily on the biomedical domain. Current frameworks of malnutrition like the UNICEF conceptual framework, and the Lancet Series 2013 framework have been instrumental in understanding the determinants of malnutrition and developing appropriate interventions. However, these frameworks fail to explicitly address issues of agency, that is, about being able to pursue one’s goal. The capability approach as originally developed by Amartya Sen includes agency in the causal chain. Summary and key Messages: In the past 5 years, the International Union of Nutritional Sciences Task Force “Towards a multi-dimensional index for child growth and development” has developed a capability framework for child growth, and conducted empirical research applying this framework. The working group discussed what would be needed to further develop the approach and explained the added value to international organisations and policy makers. We suggest developing an index of advantage that will be a proxy for a child’s agency. We hypothesise that such an index will explain much of the variance in studying inequalities in child nutrition and thus call for action to improve this focal point.
Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: African Region
Authors: Onyango Adelheid W. , Jean-Baptiste Juddy , Samburu Betty , Mahlangu Tshimi Lynn Moeng
Published: November 2019

Sub-Saharan Africa is experiencing the double burden of malnutrition (DBM) with high levels of undernutrition and a growing burden of overweight/obesity and diet-related noncommunicable diseases (NCDs). Undernourishment in sub-Saharan Africa increased between 2010 and 2016. Although the prevalence of chronic undernutrition is decreasing, the number of stunted children under 5 years of age is increasing due to population growth. Meanwhile, overweight/obesity is increasing in all age groups, with girls and women being more affected than boys and men. It is increasingly recognized that the drivers of the DBM originate outside the health sector and operate across national and regional boundaries. Largely unregulated marketing of cheap processed foods and nonalcoholic beverages as well as lifestyle changes are driving consumption of unhealthy diets in the African region. Progress toward the goal of ending hunger and malnutrition by 2030 requires intensified efforts to reduce undernutrition and focused action on the reduction of obesity and diet-related NCDs. The World Health Organization is developing a strategic plan to guide governments and development partners in tackling all forms of malnutrition through strengthened policies, improved service delivery, and better use of data. It is only through coordinated and complementary efforts that strides can be made to reduce the DBM.
Regional Overview on Maternal and Child Nutrition and Examples of Nutrition Governance and Policy Responses: Europe, Central Asia and Eastern Mediterranean Regions
Authors: Yarparvar Amirhossein , Jewell Jo Martin , Al-Jawaldeh Ayoub
Published: November 2019

The Eastern Mediterranean Regions and Europe and Central Asia Regions are facing an epidemiological and nutrition transition, especially among vulnerable groups including mothers, children and adolescents. This has led to a double burden of malnutrition (DBM). Poor infant and young child feeding (IYCF), poor dietary diversity, excessive consumption of energy dense unhealthy foods, a growing obesogenic environment for children, including aggressive marketing of unhealthy foods for children, and reduced physical activity are among the main causes. In addition, several countries in the region lack the nutrition governance capacity to respond effectively to the DBM. This article reviews the context and provides a set of conclusions in which countries are called to reduce the marketing of unhealthy foods for children, enforce the fortification of staple foods with micronutrients to reduce micronutrient deficiencies and improve IYCF, including breastfeeding in the region. Also, the call is strong for cross-border multi-sectoral efforts to address the DBM in these regions.
Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: Latin America and the Caribbean
Authors: Grajeda Ruben , Hassell Trevor , Ashby-Mitchell Kimberly , Uauy Ricardo , Nilson Eduardo
Published: November 2019

Background: Hunger, food insecurity, stunting, anemia, overweight, and noncommunicable diseases (NCDs) may coexist in the same person, household, and community in Latin America and the Caribbean (LAC). The double burden of malnutrition (DBM) is an important cause of disability and premature death, which could be addressed with comprehensive policies such as the Plan of Action for the Prevention of Obesity in Children and Adolescents. This paper summarizes the main policies and actions aimed to prevent undernutrition and obesity. Summary: Several countries are implementing the Plan of Action, Caribbean Public Health Agency is actively supporting Ministries of Health, Education, and Sport to develop school nutrition policies and strategies to create health-promoting environments at school and in their surrounding communities. Chile is implementing the comprehensive child protection system “Chile Crece Contigo” that integrates health, social development, and educational activities to optimize growth and childhood cognitive-motor development. Brazil is implementing policies and plans to commit to international targets regarding food and nutrition security, NCDs and their risk factors. Key Messages: The DBM exists in the Americas and contributes to disability and premature death. The Region is making progress implementing policies and actions addressing the DBM. However, stronger political will and leadership are needed to enact legislation and policies that create and support enabling ­environments.
Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment
Authors: Alicandri-Ciufelli Matteo , Molinari Giulia , Beckmann Sven , Caversaccio Marco , Presutti Livio , Anschuetz Lukas
Published: November 2019

Introduction: The management of bleeding in exclusive endoscopic ear surgery (EES) is largely dependent on epinephrine use. However, to date its suitability and safety have not been assessed. The aim of the present study would be to assess the safety profile of topical application and/or local infiltrationof diluted epinephrine during EES regarding the intra- and postoperative periods. We hypothesize that epinephrine may be safely used during EES. Methods: Retrospective analysis of 90 EES cases performed at the University Hospital of Modena, Italy. Patient’s charts and video recordings of the operations were assessed. Results: Epinephrine was used in all cases for hemostatic purposes as following: (1) diluted epinephrine (1:200,000) injection: mean 1.2 mL (range: 0–3.5) corresponding to 0.006 mg (range 0–0.018), and (2) topical application (1:1,000) directly in the surgical field: mean 7 cottonoids (range: 0–18) corresponding to mean 0.56 mg (range: 0–1.44). No major cardiovascular adverse effects were assessed. Only 2 intraoperative hypertensive events were recorded. One sensorineural hearing loss was observed in a case of cholesteatoma involving the stapes; no facial palsy occurred during the study period. Conclusion: The combined use of local injection and topical epinephrine is a safe and effective strategy to control bleeding in exclusive EES, when used within the dilutions and quantities reported in this study.
Educational Program in Complementary and Alternative Medicine for Cancer Self-Help Groups
Authors: Jablotschkin Martina , Bartsch Hans Helge , Gschwendtner Kathrin , Hauer Johannes , Horneber Markus , Weis Joachim
Published: November 2019

Background: The use of complementary and alternative medicine (CAM) among cancer patients is estimated to be approximately 40%. In self-help groups there is a need for information about CAM. This pilot study aimed to develop and evaluate a CAM educational program for cancer self-help groups. Methods: The educational program was developed in cooperation with health professionals and representatives of cancer self-help organizations. Participants were trained to increase their knowledge about CAM, to reflect their user behavior, and to use evidence-based information. Self-help group leaders were educated along the curriculum and motivated to carry out the course in their groups. Using questionnaires it was evaluated in terms of acceptance, feasibility, and satisfaction by participants. Results: A total of 171 self-help group leaders were educated. In a pilot run 7 implemented the course in their groups, with a total of 70 participants. Most of them (n = 60, 85.7%) appreciated its contents and material and would recommend it. Overall acceptance and satisfaction were high. Conclusions: The educational program was implemented successfully in a small sample and showed positive results for acceptance and feasibility. In addition to consultation by experts, it can be a good option to inform cancer survivors about CAM.
Review of Gait, Cognition, and Fall Risks with Implications for Fall Prevention in Older Adults with Dementia
Authors: Zhang Weihong , Low Lee-Fay , Schwenk Michael , Mills Nicholas , Gwynn Josephine Diana , Clemson Lindy
Published: November 2019

Background: Older people with cognitive impairment are at increased risk of falls; however, fall prevention strategies have limited success in this population. The aim of this paper is to review the literature to inform a theoretical framework for fall prevention in older adults with dementia. Summary: A narrative review was conducted on fall risk factors in people with cognitive impairment, the relationship between cognition and gait, and their joint impact on the risk of falls. This was used to develop a theoretical framework for fall prevention for people with dementia. Executive function and motor function are closely related as they share neuroanatomy. This close relationship has been confirmed by observational studies including neuroimaging and intervention studies. Executive function is the cognitive domain most commonly associated with gait dysfunction. Attention, sensory integration, and motor planning are the sub-domains of executive function associated with risk of falls through gait dysfunction, whereas cognitive flexibility, judgement, and inhibitory control affect risk of falls through risk-taking behaviour. Key Messages: Gait, cognition, and falls are closely related. The comorbidity and interaction between gait abnormality and cognitive impairment may underpin the high prevalence of falls in older adults with dementia. Gait assessment and cognitive assessment, particularly executive function, should be integrated in fall risk screening. Assessment results should be interpreted and utilised using a multidisciplinary approach; specific strategies such as customised gait training and behavioural modulation should be considered as part of falls prevention for people with dementia.
RHEMITT Score: Predicting the Risk of Rebleeding for Patients with Mid-Gastrointestinal Bleeding Submitted to Small Bowel Capsule Endoscopy
Authors: de Sousa Magalhães Rui , Cúrdia Gonçalves Tiago , Rosa Bruno , Moreira Maria João , Sousa-Pinto Bernardo , Cotter José
Published: November 2019

Introduction: Small bowel capsule endoscopy (SBCE) is the gold standard for mid-gastrointestinal bleeding (MGIB). No score has been developed to predict the risk of small bowel rebleeding after SBCE. Objective: Creating a predictive small bowel rebleeding risk score for MGIB, after initial SBCE. Methods: Retrospective, single center study, including SBCEs for MGIB, from June 2006 to October 2016. The minimum follow-up was 12 months. Univariate analysis and a multivariable Cox regression model tested the association with rebleeding. Statistically significant variables were used to compute the score. The score’s accuracy was tested through a receiver operating characteristic (ROC) curve. A classification tree identified risk groups. For internal validation, we performed a 5-fold cross validation. Results: We assessed 357 SBCEs for MGIB, of which 88 (24.6%) presented rebleeding during follow-up. Seven variables were used to compute a risk-predicting score – the RHEMITT score – namely, renal disease; heart failure; endoscopic capsule P1/P2 lesions; major bleeding; incomplete capsule; tobacco consumption; and endoscopic treatment. The score presented good accuracy toward the outcome (area under the curve ROC 0.842, 95% CI 0.757–0.927). We established 3 rebleeding risk groups: low (0–3 points); intermediate (4–10 points); and high (+11 points). Conclusion: A new MGIB score, named RHEMITT, accurately anticipates the individual risk of small bowel rebleeding after initial SBCE.
A New Percutaneous Approach to Treat Combined Right Ventricular and Respiratory Failure: The “Aachen Cannula”
Authors: Hima Flutura , Gümmer Marjolijn , Prescher Andreas , Altarawneh Bader , Zayat Rachad , Hatam Nima , Ernst Lisa , Kalverkamp Sebastian , Spillner Jan , Arias-Pinilla Jessica
Published: November 2019

Introduction: Right ventricular failure (RVF) on its own is a life-threatening condition. Often it manifests as a two-organ failure in the final phase of several lung diseases. Mechanical circulatory support is a proven treatment of RVF but remains challenging. Our objective is to develop a novel, simplified, and minimally invasive cannula approach to treat both RVF and respiratory failure. Methods: We conceptualized a dual lumen cannula approach to allow oxygenated right-to-left shunting at an atrial level to decompress right-sided circulation. A minimally invasive approach through percutaneous, transjugular insertion and transseptal placement should enable patients to be non-sedated and even ambulatory. In an iterative design, pre-prototyping, prototyping, and anatomic fitting process, such a cannula was generated and tested in both cadaveric and fluid dynamic studies. Results: After various modifications and improvements, a 27-Fr 255-mm-long double-lumen cannula with an inner line (oxygenated blood return to patient into the left atrium) of 18 Fr and an inflatable balloon (with a volume of approximately 1 mL) at the outflow tip was produced – one version with a straight head and another one with a curved head. In our anatomic studies, the “Aachen Cannula” allowed an easy transjugular introduction and advancement into the right atrium by Seldinger technique. Transseptal placement was achieved by puncture (Brockenbrough needle) in combination with dilatation and was then secured in place with the stabilizing balloon, even under slight tension. The cannula prototype enabled a flow of up to 3.5 L/min, at which common pressure drops were observed. Conclusion: In conclusion, we successfully conceptualized, designed, and verified a minimally invasive one-cannula approach for the treatment of either isolated right heart failure and even combined RVF and respiratory failure through our transseptal Aachen Cannula. This concept may also be carried out in ambulatory conditions. Moreover, this approach completely avoids recirculation issues and ensures reliable oxygenated coronary as well as cerebral perfusion.
Diaspora of Chinese Intellectuals in the Cold War Era
Authors: Yung (容启聪) Kenneth Kai-chung
Published: November 2019

On the eve of the Communist takeover in 1949, a considerable number of Chinese intellectuals were reluctant to live under Communist rule. They began their self-exile and the search for a new home outside China. Many travelled to places on China’s periphery such as Taiwan and Hong Kong. Others continued their journey and finally settled down in Southeast Asia and North America. Sojourning abroad, most of these self-exiled intellectuals still kept a close eye on Chinese politics and society. They were eager to promote their political ideal for a liberal-democratic China in the overseas Chinese communities. However, they were at the same time facing the challenge of assimilation into local society. This article traces the journey of the self-exiles in the 1950s and 1960s from Hong Kong to Southeast Asia and North America. It examines several representative figures and studies their activities in their new place of settlement. It argues that, although the self-exiles largely maintained a strong commitment to the future of their homeland, they varied in their degree of assimilation into their new homes. Age was not a key factor in their decision to adapt to the local community. Instead, the existence of a politically and economically influential Chinese population played a more important role in such a decision. Intellectuals who lived in Hong Kong or Southeast Asia were more willing to adjust their life to the locality, while those who went to North America were less attached to the local society.
Societal Rationality: Bounded or Embedded?
Authors: DeMoor Michael J.
Published: November 2019

This paper offers a characterization and critique of the idea of bounded rationality and its consequences for public policy. It offers an alternative way of accounting for the crucial features of human rationality that bounded rationality sees, using categories inspired by the Reformational philosophy of Herman Dooyeweerd and others, and then shows how this alternative account of the “bounds” of human rationality points toward an alternative orientation toward public policy-making.
Naticid gastropods from the middle Miocene of western Ukraine
Authors: PEDRIALI LUCA , SOSSO MAURIZIO , DELL’ANGELO BRUNO
Published: November 2019

The paper covers 11 species of naticid gastropods occurring in the lower Serravallian (Upper Badenian) strata of western Ukraine (Central Paratethys). The studied material (over 1,700 naticids) represents six genera and 11 species, of which eight are new: Cochlis odovychenorum, Cochlis ukrainensis, Tectonatica anistratenkorum, Tectonatica pseudoprietoi, Euspira sirenkoi, Payraudeautia ermesi, Payraudeautia sabrinae and Payraudeautia varovtsiana. Additionally, we have also identified Euspira protracta (Eichwald, 1830), Polinices staszici (Friedberg, 1923) and Sinum affinis (Eichwald, 1830). A lectotype of Sinum affinis is designated (ZISP 1/62208). Detailed descriptions of the protoconch and teleoconch morphology of the taxa involved, including SEM images, are presented.