bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental questionnaires provided reliable data on childhood asthma compared with national registers
Authors: Strömberg Celind Frida , Vasileiadou Styliana , Goksör Emma
Published: November 2020

Background

Much of our knowledge of childhood asthma comes from questionnaire‐based studies. Our main aim was to assess the agreement between parental‐reported data at 12 years of age and data from two national Swedish registers.

Methods

Data were obtained from the prospective, longitudinal, population‐based Children of Western Sweden cohort, which focused on children born in 2003. The parents answered questionnaires at six months and one, four, eight and 12 years of age. Personal identity numbers linked 3634 children to the Swedish Prescribed Drug Register (SPDR) and the National Patient Register (NPR).

Results

At 12 years of age, there was substantial overall agreement between the asthma medication reported by the parents in the questionnaire and the SPDR for any asthma medication (94.8%, kappa 0.71) and maintenance treatment (95.3%, kappa 0.68). In contrast, the agreement between the outpatient asthma diagnoses in the NPR and the questionnaire‐based asthma was 30.5% and it was 32.8% between the NPR and the dispensed asthma medication in the SPDR. Hospitalization was rare for obstructive diseases after early childhood, and 38.2% of the 12‐year‐old children only received a short‐acting beta agonist, with no maintenance treatment.

Conclusion

There was good agreement between the questionnaire‐based data on asthma medication and the national drug register, but the National Patient Register provided incomplete information on asthma diagnoses, probably because it did not include primary care diagnoses. The results show that well‐constructed parental questionnaires can provide reliable data on childhood asthma.
Diversity and distribution of pathotypes of the soybean rust fungusPhakopsora pachyrhiziin East Africa
Authors: Murithi Harun M. , Soares Rafael M. , Mahuku George , van Esse H. Peter , Joosten Matthieu H. A. J.
Published: November 2020

Phakopsora pachyrhiziis a biotrophic fungus that causes rust on soybean, leading to devastating yield losses. Development of resistant cultivars for deployment in different geographic regions requires a comprehensive understanding of the prevalentP.pachyrhizipathotypes. To determine the pathotypes existing in four East African countries, 65 isolates were tested on 11 soybean host differentials. In addition, the virulence spectrum of isolates collected from the same region over multiple years was compared. The majority of the isolates (54%) belonged to pathotype 1000, which was found in all countries. The pathotypes with the most complex virulence spectrum, which comprised isolates from Kenya and Malawi, were virulent on four differentials. All pathotypes were virulent on soybean genotypes carrying theRpp1resistance gene toP.pachyrhizi, but they were avirulent on cultivars carrying theRpp1b,Rpp2, orRpp3gene, as well as on cultivar No6‐12‐1 that carriesRpp2,Rpp4, andRpp5. Two of the pathotypes were virulent on cultivar UG 5 that carriesRpp1andRpp3and on Hyuuga that carriesRpp3andRpp5. The isolates collected from different countries differed in their virulence spectrum across the years. Shannon's index (H) and Simpson's index (S) of diversity indicated that the isolates from Malawi were more diverse (H = 1.55,S = 0.90) while those from Uganda had lower diversity (H = 0.78,S = 0.46 ). TheRppgenes that were found to provide resistance to all pathotypes ofP.pachyrhizican be employed for soybean breeding aimed at durable rust resistance.
Motivational orientation mediates the association between depression and cardiovascular reactivity to acute psychological stress
Authors: Keogh Tracey M. , Howard Siobhán , O’Riordan Adam , Gallagher Stephen
Published: November 2020

Recent theoretical developments in cardiovascular reactivity research suggest the association between depression and blunted reactions to stress is linked to motivational factors. Thus, the present study aimed to test whether the association between depressive symptoms and cardiovascular reactivity to acute stress was mediated by motivation; be it intrinsic or extrinsic motivation. One hundred and eighty‐two healthy young adults completed measures of motivation (Global Motivation Scale; GMS), and depression (Hospital Anxiety and Depression Scale; HADS) and had their blood pressure and heart rate monitored throughout a standardised stress testing protocol. Results indicated that depression was negatively associated with both systolic blood pressure (SBP) and heart rate (HR) reactions to the stress task (all ps < .05), such that those who reported higher depressive symptomology displayed a blunted response. Furthermore this relationship was mediated by intrinsic, but not extrinsic motivation; the blunted responses were less pronounced through intrinsic motivation. The present findings add extensively to existing research and confirm that motivation is an underlying mechanism linking depression and cardiovascular reactivity.
Body image perception and its psychological influence on prosthesis satisfaction
Authors: Banu R. Fathima , R. Vaishnavi , Kumar V. Anand , Veeravalli Padmanabhan T.
Published: November 2020

Aim

To identify the body image perception of an individual utilising figure rating scale and assess its psychological influence in altering the prosthetic satisfaction.

Methods

One hundred five of 140 participants were categorised into Groups I, II and III according to their body image satisfaction. Pre‐ and posttreatment denture satisfaction questionnaires, and pretreatment Big Five personality, Life Satisfaction questionnaires were given to the participants in each group. Analysis of variance (ANOVA) and Tukey post hoc tests assessed the significant relation between the groups.

Results

Body image satisfied group (I) was highly contented with the prosthetic treatment (46.90), while body image dissatisfied groups (II and III) had lower denture satisfaction scores (36.80 and 29.70). Neurotic score was significantly different in pairs; Groups I and III, and Groups II and III (P < .001), with high mean for Group III (75.30). The agreeable score was significantly different in Groups I and II (P < .05), with a high mean for Group I (83.60). Life Satisfaction score was significantly different in pairs; Groups I and III, and Groups I and II (P < .001), with a high mean for Group I (30.60).

Conclusion

The individual's perception of body image had an effect on their denture satisfaction level, and figure rating scale would help in identifying the psychological profile of the patient.
The relationship of soluble klotho level with uremic cardiomyopathy and ecocardiographic parameters in hemodialysis patients
Authors: Erkus Edip , Buyukterzı Zafer , Karakose Suleyman , Kurku Huseyın , Kurtgoz Pervın O. , Topal Mustafa , Guney Ibrahim
Published: November 2020

There are studies reporting that soluble kltho (sKlotho) deficiency plays a role in cardiovascular disease in addition to traditional risk factors such as diabetes, hypertension, anemia, smoking, and excessive volume burden. Our aim in this study was to investigate the relationship of sKlotho with uremic cardiomyopathy and echocardiographic parameters in patients receiving hemodialysis treatment. According to the median value, the sKlotho value was divided into two groups as ≥1.24 and <1.24 ng/ml. Ventricular wall thicknesses, ejection fractions, left atrium, M mode aorta systole, and diastole diameter measurements were taken. The left ventricular mass (LVM) was calculated using the Devereux formula. There were significant differences between the two groups in terms of age, number of patients with diabetes mellitus, comorbidity, dialysis time, sKlotho, phosphorus, parathormone, and albumin parameters. No significant difference was found between the two groups that were separated according to the median sKlotho value, when the echocardiographic parameters of interventricular septum thickness, left ventricular posterior wall thickness, left atrial diameter, left ventricular ejection fraction, and LVM index were compared. In conclusion, sKlotho is not a marker for showing and predicting uremic cardiomyopathy in hemodialysis patients.
Seeing the sound of castanets: Acoustic resonances between shells captured by high-speed optical visualization with 1-mm resolution
Authors: Ishikawa Kenji , Yatabe Kohei , Oikawa Yasuhiro
Published: November 2020

Sound fields radiated from the castanet, a Spanish percussive instrument comprising two shells, were optically visualized. A measurement system, which used parallel phase-shifting interferometry and a high-speed polarization camera, enabled the capture of instantaneous sound fields around the castanets, while the castanets were played, with the spatial resolution of 1.1 mm and frame rate of 100 000 fps. By carefully aligning the tilt of the castanets, the sound fields within the 1-mm gaps between both the shells were captured. From the visualization results, two acoustic resonances between the shells were identified. The first mode appeared between 1000 and 2000 Hz and exhibited a frequency chirp of several hundred hertz for several milliseconds after the impact. This can be explained by the Helmholtz resonance with a time-varying resonator shape, which is caused by the movement of the shells after impact. The second mode showed a resonance pattern with a single nodal diameter at the center of the shells, i.e., the standing wave mode caused by the interior volume. These physical phenomena involved in the sound radiation were identified owing to the unique features of the optical imaging method, such as contactless nature and millimeter-resolution imaging of instantaneous pressure fields.
An ultrasound and formant study of manner contrasts at four coronal places of articulation
Authors: Tabain Marija , Kochetov Alexei , Beare Richard
Published: November 2020

This study examines consonant manner of articulation at four coronal places of articulation, using ultrasound and formant analyses of the Australian language Arrernte. Stop, nasal, and lateral articulations are examined at the dental, alveolar, retroflex, and alveo-palatal places of articulation: /t̪ n̪ l̪ / vs /t n l/ vs /ʈɳɭ/ vs /c ɲ ʎ/. Ultrasound data clearly show a more retracted tongue root for the lateral, and a more advanced tongue root for the nasal, as compared to the stop. However, the magnitude of the differences is much greater for the stop∼lateral contrast than for the stop∼nasal contrast. Acoustic results show clear effects on F1 in the adjacent vowels, in particular the preceding vowel, with F1 lower adjacent to nasals and higher adjacent to laterals, as compared to stops. Correlations between the articulatory and acoustic data are particularly strong for this formant. However, the retroflex place of articulation shows effects according to manner for higher formants as well, suggesting that a better understanding of retroflex acoustics for different manners of articulation is required. The study also suggests that articulatory symmetry and gestural economy are affected by the size of the phonemic inventory.
Heat-induced drift reduction of time of flight in fused quartz acoustic waveguides via annealing process
Authors: Hileman Zachary , He Jiaji , Wang Ruixuan , Homa Daniel , Kong Qingzhao , Wang Anbo , Pickrell Gary
Published: November 2020

High temperature structural acoustic sensors play an important role in many applications. Fused quartz waveguide is a popular choice due to its resistance to harsh environments and its convenience of modification. However, time of flight between pulse and echo, which is widely used in these sensors, tends to encounter drifts in fast temperature changing process even after temperature returns to initial value. In this article, different annealing process are performed for a special modified fused quartz waveguide with a sensor node. Annealing treatment is found able to reduce the drift when the waveguide undergoes a sudden temperature spike to 1000 °C at 500 kHz operating acoustic frequency, and the best annealing condition could make the drift one magnitude smaller. A following temperature test up to 1000 °C shows consistent measurement readings.
Symptomatic neurocutaneous melanosis: mild clinical onset in a teenager
Authors: Vanood Aimen , Lee Young Ah , Leleszi Elizabeth , Krishnan Anant
Published: November 2020

Neurocutaneous melanosis (NCM) is a rare disorder characterised by giant or multiple melanocytic nevi and meningeal melanosis or melanoma. Onset of neurological symptoms is typically in children younger than 2 years and can be rapidly fatal. We present the case of a 13-year-old adopted girl presenting with numerous congenital melanocytic nevi and a seizure. She had no significant previous neurological history. Electroencephalogram showed epileptiform discharges over the right frontal region. MRI of the brain showed T1 hyperintensity in the bilateral amygdala and anterior temporal lobes with corresponding hyperintensity on T2 and fluid attenuated inversion recovery. There was no hydrocephalus. Along with the history of nevi, these imaging findings were concerning for NCM. The patient is being managed with levetiracetam and trametinib and shows no further neurological decline at 1-year follow-up, providing prognostic hope in this case of NCM.
Continuous infusion factor replacement in haemophilia B during and after cardiac surgery: the better choice?
Authors: Farid Saira , Sewaralthahab Sarah , Smith Hedy Patricia
Published: November 2020

A 57-year-old man with mild haemophilia B was admitted for coronary artery bypass graft surgery. His factor IX (FIX) activity was 15% on admission. Our goal was to maintain his FIX activity at 80%–100% for post-op days (PODs) 0–3, and at 60%–80% for PODs 4–14. Preoperatively, the patient was given recombinant FIX (rFIX) bolus using the formula:

Dosage needed=%(desired FIX level−current level of FIX)×weight (kg)×1.3.

This increased his activity to 100%. One IU of rFIX increased FIX activity by 0.8%; the half-life of rFIX is 18–24 hours. The rFIX infusion was started intraoperatively and continued after surgery to maintain target FIX activity. He was discharged on POD 9 on rFIX bolus dosing of 5000 IU every 12 hours for an additional 5 days. Using continuous factor infusion, we managed to decrease the amount rFIX used by >60% while maintaining steady state FIX activity level.
Rare case of primary leiomyosarcoma of the breast treated with wide local excision and planned cosmetic breast reduction surgery
Authors: Horton Luke , Wohlfeil Madeline , Al-Kourainy Nabil , Choi Lydia
Published: November 2020

Primary leiomyosarcoma of the breast is an extremely rare neoplasm accounting for less than 0.0006% of all breast malignancies, with fewer than 80 cases reported in the literature to date. Here, we present a case of leiomyosarcoma of the breast in a 61-year-old woman without traditional risk factors. This case was treated with lumpectomy requiring wide margins due to the high rate of local recurrence. A planned breast reduction surgery was deemed adequate postlumpectomy therapy to prevent cancer recurrence, negating the need for chemotherapy or radiation therapy. To our knowledge, this is the first case in which cosmetic breast reduction surgery will be used as postlumpectomy cancer recurrence risk mitigation for primary leiomyosarcoma of the breast. Patients with this malignancy have a relatively poor prognosis compared with other breast cancer types, with a 5-year disease-free survival of 33%–52%. As such, frequent follow-up and monitoring for postresection recurrence is essential.
Monophasic synovial sarcoma of the pyriform fossa
Authors: Ng Chun Tau , Wong Eugene Hung Chih , Prepageran Narayanan
Published: November 2020

Head and neck synovial sarcoma is rare. We report the case of a 71-year-old man who presented with progressive dysphagia, odynophagia, shortness of breath on exertion and hoarseness of voice. Nasendoscopy revealed a smooth, non-fungating, non-ulcerative mass arising from the left lateral pharyngeal wall. CT showed a well-defined, heterogenous enhancing lesion arising from the left pyriform fossa. Initial biopsy taken was inconclusive and patient underwent a transcervical complete excision of the tumour, where histopathological analysis confirmed the diagnosis of monophasic synovial sarcoma of the left pyriform fossa. This patient also received adjuvant radiotherapy postoperatively and remained disease free 1 year after completion of treatment.
IgA nephropathy after pembrolizumab therapy for mesothelioma
Authors: Wang Ryan , Das Tathagata , Takou Anna
Published: November 2020

The use of immune checkpoint inhibitors (CPIs), such as pembrolizumab, for the treatment of cancer, is now prevalent. CPIs are associated with a significant side effect profile, termed immune-related adverse events (irAEs). Renal irAEs, such as interstitial nephritis, are rare, and CPI-related glomerulonephritis even rarer. This is a case report of a 72-year-old man with mesothelioma of the left lung, whose serum creatinine rose during pembrolizumab treatment. Renal biopsy revealed IgA nephropathy. Withdrawal of therapy for 2 months saw no improvement in renal function, and following recommencement, serum creatinine fluctuated at approximately 1.4 times original baseline. This report will highlight the renal irAEs to be the aware of when starting CPIs, and the importance of early renal biopsy in management.
Brain metastasis from gallbladder neuroendocrine carcinoma
Authors: Sasaki Hanako , Goto Takayoshi , Hirao Motohiro , Fujimoto Yasunori
Published: November 2020

A 52-year-old woman was diagnosed with unresectable gallbladder neuroendocrine carcinoma (GB-NEC) exhibiting lymph node and peritoneal metastases, and received eight courses of chemotherapy with irinotecan plus cisplatin. Radiological examinations revealed significant regression of the GB tumour and disappearance of metastatic lesions, so the patient underwent laparoscopic cholecystectomy. However, the patient presented with multiple haemorrhagic brain metastases (BMs) and died 13 months after the initial diagnosis despite neurosurgical interventions. Pathological examination of the resected gallbladder demonstrated an extensive fibrous scar along with tubular adenocarcinoma components, which may indicate that the chemotherapy eliminated a pre-existing neuroendocrine carcinoma (NEC) component. Furthermore, pathological analysis confirmed that the BMs comprised NEC. In patients with advanced GB-NEC, conversion surgery may be a reasonable option if a first-line chemotherapy leads to downstaging of the tumour. Second-line drug therapy and systemic screening might also be considered in cases with BMs.
Twin pathologies: synchronous leiomyosarcoma and squamous cell carcinoma of the larynx
Authors: Crotty Thomas , Keane Emma , Corbett Mel , Moran Tom
Published: November 2020

The synchronous discovery of leiomyosarcoma (LMS) and squamous cell carcinoma (SCC) of the larynx is extremely rare. We describe our experience of managing a patient with this unusual presentation. A 35-year-old man was initially diagnosed with advanced stage (T4bN1M0) laryngeal LMS. Neoadjuvant sarcoma-directed chemotherapy and radiation therapy allowed a successful pharyngolaryngo-oesophagectomy to be performed in an otherwise inoperable cancer. Histological examination of the resection specimen revealed poorly differentiated SCC, indicating the underlying diagnosis was a sarcomatoid carcinoma of the larynx. Considering our limited experience of managing synchronous LMS and SCC of the larynx, it is important to carefully evaluate the natural history, route of spread and pathological characteristics of both tumours, when determining treatment.
Vaping-induced lung injury in a 21-year-old woman
Authors: Perrenoud Abby , Vetos Develyn , Wabwire Godfrey
Published: November 2020

In the last few years, there has been a significant increase in younger generations using vaping devices as an alternative to smoking. Social media and celebrities have played a major role in its increased popularity. Many consumers believe it to be a relatively safer and healthier choice. We present a case of a 21-year-old, female, non-smoker with vaping exposure who developed severe acute lung injury. Her workup was negative for any other cause of acute lung injury.
Metastasis of cutaneous squamous cell carcinoma to the stomach: a rare entity
Authors: Reise-Filteau Marica , Carter Michael , DeCoste Ryan , Kohansal Ali
Published: November 2020

Metastatic spread of cutaneous squamous cell carcinoma (cSCC) to the gastrointestinal tract is a rare entity. A 63-year-old woman with a history of poorly controlled HIV and a recurrent cSCC on the right temple presented with functional decline, ascites and shortness of breath. A CT scan showed widespread metastatic malignancy involving lung, pleura, heart, stomach, liver, retroperitoneum and soft-tissue. In the case presented here, an upper endoscopy revealed a submucosal lesion in the stomach. Biopsies described the lesion as a poorly differentiated SCC. Comprehensive genomic profiling yielded striking molecular similarities between the gastric tumour and the patient’s prior cSCC. It confirmed the origin of the disease and excluded spread from an occult primary. This case adds to the limited literature on gastrointestinal metastases of cSCC and serves as a reminder that non-AIDS-defining cancers are on the rise in the HIV-population.
Cardiovascular risk profiles in German Air Force pilots
Authors: Sammito Stefan , Güttler N
Published: November 2020

Introduction

Cardiovascular disease (CVD) is the leading cause of death in western industrial countries and one of the most frequent causes of sudden incapacitation in flight for pilots. There are limited data available on cardiovascular risk profiles of pilots, and especially military pilots. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) in German military pilots.

Methods

The changing prevalence of CVRF in active military pilots was studied using a cross-sectional survey during two distinct periods, 2007–2009 and 2016–2018. Data collected included sex, body mass index (BMI), smoking status, resting blood pressure, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides and glucose. The use of antihypertensive drugs, diagnosis of diabetes mellitus and positive family history of myocardial infarction were also captured. Based on these data, the PROCAM (Prospective Cardiovascular Münster) score was calculated.

Results

Data from 5353 flight medical examinations were analysed, 3397 from 2007 to 2009, and 1959 from 2016 to 2018. Between the cohorts, age, BMI, total cholesterol, HDL, LDL, glucose and triglycerides increased significantly. The number of pilots on antihypertensive medication decreased significantly. The PROCAM score increased between cohorts from 18 to 23 points predicting a 10-year risk of an acute coronary event of <1% and 1.3%, respectively.

Conclusion

The German military pilot population has become older with increased CVRF. CVD will be a future challenge for the German Armed Forces and probably other military forces. However, there was only a mild increase of the PROCAM score over time.
‘Where have all the doctors gone?’ A protocol for an ethnographic study of the retention problem in emergency medicine in the UK
Authors: Darbyshire Daniel , Brewster Liz , Isba Rachel , Body Richard , Goodwin Dawn
Published: November 2020

Introduction

‘Emergency medicine (EM) in the UK has a medical staffing crisis.’ Inadequate staffing, in EM and across healthcare, is a problem that affects the quality of patient care globally. Retention of doctors in EM is a particularly acute problem in the UK’s National Health Service. Sustainable careers in healthcare are gaining increasing attention at a national and international policy level, but research to understand the factors that facilitate retention is lacking.

This study aims to develop understanding of what drives retention of doctors in EM by focusing on those who remain in these careers, where previous research has targeted those who have left. By addressing the problem of retention in a different way, using innovative methods in this context, we aim to develop a deeper and more nuanced understanding of sustainable careers in EM.

Methods and analysis

This is an ethnographic study combining participant observation in two emergency departments, interviews with doctors from these departments, from organisations with influence or interest at a policy level and with doctors who have left EM. The analyses will integrate detailed workplace observation alongside key academic and policy documents using reflexive thematic analysis.

Ethics and dissemination

Approvals have been obtained from Lancaster University via the Faculty of Health and Medicine Research Ethics Committee (FHMREC18058) and the Health Research Authority (IRAS number 256306). The findings will inform understanding of sustainable careers in EM that may be transferable to other settings, professions, and locations that share key characteristics with EM such as paediatrics, emergency nursing and general practice. Findings will be disseminated through a series of academic publications and presentations, through local and specialty research engagement, and through targeted policy statements.
Safety and efficacy of mycophenolate mofetil in treating neuromyelitis optica spectrum disorders: a protocol for systematic review and meta-analysis
Authors: Han Mengyu , Nong Luqi , Liu Ziqiang , Chen You , Chen Yang , Meng Huan , Qin Yali , Wang Zhijun , Jin Ming
Published: November 2020

Introduction

Neuromyelitis optica spectrum disorders (NMOSD) is an inflammatory and heterogeneous astrocyte disorder of the central nervous system with the characteristic of higher incidence in women and Asian people. Most patients with NMOSD have a course of recurrence and remission that is prone to cause paralysis and blindness. Several studies have confirmed the efficacy and promising prospect of mycophenolate mofetil (MMF) in the treatment of NMOSD. Yet its therapeutic effect and safety are controversial. Although there has been two published literature that is relevant to the topic of this study, both of them have certain defects, and they can only provide answers about the efficacy or safety of MMF in the treatment of NMOSD from partial perspectives or conclusions. This research aims to perform a direct and comprehensive systematic review and meta-analysis to evaluate MMF’s effectiveness and safety in treating NMOSD.

Methods and analysis

This systematic review will cover all comparative researches, from randomised controlled trials to cohort studies, and case–control study. A relevant literature search will be conducted in PubMed, Web of Science, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and Chinese Biomedical Literature Database from their inception to 31 June 2020. We will also search registers of clinical trials, potential grey literature and abstracts from conferences. There are no limits on language and publication status. The reporting quality and risk of bias will be assessed by two researchers independently. Expanded Disability Status Scales and annualised relapse rate will be evaluated as the primary outcome. The secondary outcomes will consist of the frequency and severity of adverse events, best-corrected visual acuity, relapse-free rate and time to the next attack. A meta-analysis will be performed using RevMan V.5.3 software provided by the Cochrane Collaboration and Stata V.12.0.

Ethics and dissemination

Because the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and will be shared on social media platforms.

PROSPERO registration number

CRD42020164179.
Interface management concepts in healthcare for rare diseases in Germany: a study protocol for a mixed-methods study to develop best practice recommendations
Authors: Inhestern Laura , Zybarth David , Otto Ramona , Brandt Maja , Härter Martin , Bergelt Corinna
Published: November 2020

Introduction

Patients and families affected by a rare disease are burdened in multiple ways. Functional interface management can unburden patients or relatives from the need to be solely accountable for the navigation through the healthcare system. This study aims at (1) providing an assessment of approaches and interface management concepts in the care of rare diseases, (2) evaluating selected existing approaches and concepts and (3) developing best practice recommendations for interface management.

Methods and analysis

We will conduct a mixed-methods study with three phases. In phase 1, we will develop a tool to assess existing concepts of interface management for rare diseases based on a literature search and an expert workshop. The tool will be applied in a telephone survey with representatives of centres or clinics of expertise for rare diseases (target: n=100) and cooperating practitioners (target: n=60). Based on the results of phase 1, we will select four to six centres of expertise with interface management concepts, which will be evaluated extensively in phase 2. For the evaluation, we will conduct semistructured interviews with practitioners cooperating with centres or clinics for rare diseases (target: n=50), a paper-based survey including patients or parents/legal guardians (target: n=300) from the selected centres or clinics, and semistructured interviews with patients or parents/legal guardians (target: n=50). The final phase of the study will be an integration of results from phases 1 and 2 to develop best practice recommendations for interface management in healthcare of rare diseases. In a concluding expert workshop, recommendations will be presented and finalised.

Ethics and dissemination

This study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-0062). The findings of our study will be presented on national and international conferences and published in scientific, peer-reviewed journals. To assure that centres for rare diseases get access to the study results, centres are invited to send a representative to a final expert workshop in phase 3. Moreover, an executive summary will be provided and sent to relevant stakeholders.

Trial registration number

German Clinical Trials Registry (DRKS00020488).
Multicentre randomised phase II study of the perioperative administration of flurbiprofen axetil in patients with non-small cell lung cancer: study protocol of the FLAX Study
Authors: Sakamaki Kentaro , Watanabe Katsuya , Woo Tetsukan , Masuda Munetaka
Published: November 2020

Introduction

In patients with non-small cell lung cancer, surgical treatment with postoperative adjuvant chemotherapy is performed. However, the improvement of overall survival achieved by postoperative adjuvant chemotherapy may be insufficient in consideration of the deterioration of quality of life (QOL). Considering the relationships among surgical treatments, inflammation and carcinogenesis, non-steroidal anti-inflammatory drugs (NSAIDs) are a candidate postoperative treatment for preventing recurrence and maintaining QOL. In this study, we investigate the effects of the perioperative administration of flurbiprofen axetil on postoperative recurrence in patients with non-small cell lung cancer.

Methods and analysis

This study is a multicentre, parallel group, open label, randomised controlled trial. Patients clinically suspected of non-small cell lung cancer are randomly assigned to the flurbiprofen axetil group or the no-NSAIDs group. A total of 420 patients (210 per group) will be registered. The primary analysis will evaluate the treatment effect of flurbiprofen axetil on postoperative recurrence.

Ethics and dissemination

The study protocol was approved by the Clinical Research Review Board of Saitama Medical University in September 2019 (No. 192002) and will be approved by each institutional review board of all participating institutions before patient enrolment. This study complies with the latest version of the Declaration of Helsinki, Clinical Trial Act and related notifications. Results will be published in a peer-reviewed journal.

Trial registration number

Japan Registry of Clinical Trials (jRCTs031190167; Pre-results) (https://jrct.niph.go.jp/).
The ‘Walker dip’
Authors: Walker A J
Published: November 2020

Throughout recent history there has been a pattern whereby military medical care improves in wartime and these advances are lost by the time the next conflict occurs. This dip in medical performance potentially represents lives that may be lost and recovery that may be impaired for our young servicemen and women at the start of every new conflict. When reviewing the wars of the last two centuries, three themes emerge. Firstly, post-war military cuts fall disproportionately on medical services, leaving a mismatch between the size of forces that can be deployed and the ability to care for them when injured. Secondly, insufficient medical representation in military operational planning results in the neglect of medical logistics; and finally, technical and procedural lessons are not adequately captured and incorporated into training and doctrine.
Field recognition and management of freezing and non-freezing cold injuries
Authors: Kuht J , Smith B , Brown A
Published: November 2020

Peripheral cold injuries have disabled entire armies in the past and, as recently as the Falklands conflict of 1982, jeopardised the success of an entire military operation. They can be divided into those that involve freezing of the peripheral tissue and those that do not, termed Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI) respectively.

This article focuses on the recognition and management of cold injuries in the field. It draws from the current literature, briefly outlining the pathophysiological basis of the two injuries, then focuses on the challenges of field recognition of cold injuries, especially NFCI, which is characterised by a lack of overt physical signs. A framework for field management of these injuries is then outlined, with an emphasis on the contrasting re-warming strategies for FCI and NFCI, and the pharmacological therapies used in each condition.

The article is pertinent to those who may train or deploy to an area with temperatures lower than 20° Celsius, the generally accepted temperature below which peripheral cold injuries may occur. It is hoped that improved awareness of the risks coupled with better field recognition and management may reduce the incidence of cold injury, especially in light of recent observations that re-exposure to cold in those with NFCI can cause more significant morbidity, highlighting the importance of getting the diagnosis and management right in the field.
Operation LITTEN: a year delivering medical care during the peak of the Mediterranean migrant crisis, 2016-2017
Authors: Sharp W M J , Tanzer W J , Castledine B
Published: November 2020

The increased movement of migrants across the Mediterranean to the European Union intensified in 2015. This paper will focus on the complex experiences and lessons learnt by three Medical Officers (MOs) involved in one year of maritime rescue operations in the Mediterranean (August 2016 to July 2017). During this period a total of 7930 people were rescued by the Royal Navy (RN), with the largest single rescue involving 712 people. The medical teams involved delivered sustained care for periods of up to 80 hours, often with no immediate casualty evacuation available. The scope of clinical practice was wide and challenging, from the birth of infants, to the delivery of care to those with burns, gunshot wounds, sepsis and drowning. The teams were often confronted with mass casualty events, a challenge for any deployed unit.
The involvement of the French military medical service in helicopter rescue missions for Emergency Medical Aid at Sea: the current situation and prospects for the future.
Authors: Guénot P , Leigh-Smith S , Granger-Veyron N , Carfantan C , Dulaurent E
Published: November 2020

French military Search and Rescue (SAR) is primarily for the recovery of downed aircrew in an operational environment but has traditionally also played an important civilian role. Military doctors and nurses with competence in this area frequently form part of civilian teams, their experience being transferable between operational and civilian spheres. A recent re-organisation of French Medical Aid at Sea (MAS) has seen greater involvement of civilian medical services in this sector with consequent potential for negative impact on future military involvement.

The French Military Medical Service / Service de Santé des Armées (SSA) 2020 plan provides opportunities for mutually advantageous, deeper engagement and joint working between the SSA and the French National Health Service / Service Public de Santé (SPS).

This article describes the current structure for MAS and the involvement of SSA therein before considering some of the challenges and potential solutions with respect to deeper civilian-military engagement in this domain in future.
Geochemical tracers in submarine groundwater discharge research: practice and challenges from a view of climate changes
Authors: Jiang Shan , Ibánhez Juan Severino Pino , Wu Ying , Zhang Jing
Published: November 2020

Submarine groundwater discharge (SGD), the flux of porewater from permeable seabed or karst conduits to surface water bodies, delivers a significant quantity of land-borne solutes to coastal oceans. This input of land-derived solutes is frequently linked with eutrophication, harmful algae blooms, and benthic hypoxia, and hence has the potential to trigger great economic losses. Geophysical and geochemical tracers, including salinity, temperature, water stable isotopes, and radioactive elements, have been widely applied in SGD studies for more than 50 years to, amongst others, identify water sources, estimate residence times, and quantify discharge rates. Here we review advantages and shortcomings of these tracers in the study of SGD. Application requirements are outlined based on previous research and combined tracer approaches in karst environments, permeable coasts, and estuaries are illustrated under the view of climate changes. Current challenges with the use of geochemical tracers in SGD studies are highlighted and opportunities to develop these tracers for improved coastal management showcased.
Network Traffic Classification Using Deep Learning
Authors: Chen Lei , Liu Jian , Xian Ming
Published: November 2020

The large amount of network traffic generated by Internet applications brings great challenges to Internet security. In order to facilitate network management and realize automatic classification of network traffic, this paper proposes a network traffic classification model NTCNET based on CNNs. Use open data set to do simulation verification experiment, then compare the test results with a variety of traditional classification methods. The experimental results shows that the constructed traffic classification model NTCNET has better precision, robustness and accuracy, with an accuracy of 99.66%.
Calibration Algorithm for Error Screening Based on Line Structured Light
Authors: Liu Baolong , Wu Ruixia , Liu Yu
Published: November 2020

The 3D measurement system based on line-structured light uses a camera to capture laser stripes due to changing in the shape of an object, and uses the acquired pixel coordinates for 3D reconstruction. System calibration is an important step in 3D measurement. The current camera calibration algorithm research mainly focuses on improving the algorithm itself, and there is less research on the influence of external factors. This paper proposes a coplanar hybrid calibration algorithm based on the error screening model by combining the error screening model, mathematical model and neural network model. It is mainly divided into two steps. The first step is to use the radial array constraint calibration algorithm based on the error screening model to solve the camera’s internal and external parameters. The second step uses the camera internal and external parameters obtained in the first step to convert the pixel coordinates into real three-dimensional coordinates, and compares the calculated three-dimensional coordinates with the actual coordinates. Using machine learning to establish a compensation network, get a compensation function, and use the resulting 3D world coordinates to perform point cloud stitching. Experiments show that compared with the traditional calibration algorithm, the calibration algorithm has a small error and reduces the calibration error by about 6.5%.
Research on Logistics Distribution Route Based on Multi-objective Sorting Genetic Algorithm
Authors: Zhao Jun , Xiang Hui , Li Jinbao , Liu Jie , Guo Luyao
Published: November 2020

With the continuous development of society, the social division of labor is further improved, and social production tends to be highly specialized and industrialized. Moreover, enterprise production is increasingly internationalized, and sales are gradually expanding. Therefore, the multi-objective sequencing in logistics distribution is incorporated into the path optimization of the logistics system, and a multi-objective bi-level programming model of time and cost is established. What is more, considering the limitations of the traditional algorithm in solving multi-objective problems, the low-dimensional multi-objective problem is selected, and according to the actual situation, the inheritance strategy of genetic factors is adopted to solve the more targeted rapid dominating sorting genetic problem. Besides, the specific conditions and characteristics of the model determine the encoding method, which is brought into the operation of the cross-mutation law and the interruption of individual populations, so that the building foundation of the model is improved. Based on the further theoretical research on the distribution efficiency of logistics system, the corresponding mathematical model is constructed by using the planning method, and the single cost target is transformed into the time and cost double objective, and the improved fast non dominated sorting genetic algorithm with elite strategy is used to solve the problem, which has certain theoretical innovation. Through simulation, the optimal or near optimal path of distribution vehicles in a certain area is given, which has certain practicality and reference value for the optimization of actual logistics distribution path.
On multifluid perturbations in scalar–tensor cosmology
Authors: Ntahompagaze Joseph , Sahlu Shambel , Abebe Amare , Mbonye Manasse R.
Published: November 2020

In this paper, the scalar–tensor theory is applied to the study of perturbations in a multifluid universe, using the [Formula: see text] covariant approach. Both scalar and harmonic decompositions are instituted on the perturbation equations. In particular, as an application, we study perturbations on a background Friedmann-Robertson-Walker (FRW) cosmology consisting of both radiation and dust in the presence of a scalar field. We consider both radiation-dominated and dust-dominated epochs, respectively, and study the results. During the analysis, quasi-static approximation is instituted. It is observed that the fluctuations of the energy density decrease with increasing redshift, for different values of [Formula: see text] of a power-law [Formula: see text] model.
‘Mutual complexity’ in hyperscaling violating background
Authors: Ghanbarian N. , Tanhayi M. Reza
Published: November 2020

In this paper, we use complexity equals action proposal and investigate the recently introduced ‘mutual complexity’ [M. Alishahiha, K. Babaei Velni and M. R. Mohammadi Mozaffar, Phys. Rev. D 99 (2019) 126016, https://doi.org/10.1103/PhysRevD.99.126016 , arXiv:1809.06031 [hep-th]], in the hyperscaling violating backgrounds. For two subregions in order to define holographic complexity, we find the finite bulk action inside the subregions which is followed by introducing the proper counter terms. We show that for two subregions, the mutual complexity is subadditive. Moreover, for three subregions, we define holographic ‘tripartite complexity’ and show that this new quantity is superadditive.
Retracted Article: Adaptive Decentralized Tracking Control for Nonlinear Large-Scale Systems
Authors: Chandran Karthik , Zhang Weidong , Murugesan Rajalakshmi , Prasanna S. , Baseera A. , Pandiyan Sanjeevi
Published: November 2020

This article has been retracted at the request of the first and corresponding author, Dr. Karthik Chandran. The author has alerted the Editor-in-Chief of IJUFKS the reasons for the retraction: The proposed system was modelled with the incorrect data set. The system response has become incorrect because of this incorrect data set. Two percent of the information (mathematical assumptions) was taken from one paper without proper citation of the source.
Pattern Mining Approaches Used in Social Media Data
Authors: Chaki Jyotismita , Dey Nilanjan , Panigrahi B. K. , Shi Fuqian , Fong Simon James , Sherratt R. Simon
Published: November 2020

Social media conveys a reachable platform for users to share information. The inescapable practice of social media has produced remarkable volumes of social data. Social media gathers the data in both structured-unstructured and formal-informal ways as users are not concerned with the exact grammatical structure and spelling when interacting with each other by means of various social networking websites (Twitter, Facebook, YouTube, LinkedIn, etc.). People are increasingly involved in and dependent on social media networks for data, news and opinions of other handlers on a variety of topics. The strong dependence on social media network sites contributes to enormous data generation characterized by three issues: scale, noise, and variety. Such problems also hinder social network data to be evaluated manually, resulting in the correct use of statistical analytical methods. Mining social media data can extract significant patterns that can be advantageous for consumers, users, and business. Pattern mining offers a wide variety of methods to detect valuable knowledge from huge datasets, such as patterns, trends, and rules. In this work, data was collected comprised of users’ opinions and sentiments and then processed using a significant number of pattern mining methods. The results were then further analyzed to attain meaningful information. The aim of this paper is to deliver a summary and a set of strategies for utilizing the ubiquitous pattern mining approaches, and to recognize the challenges and future research guidelines of dealing out social media data.
A Novel Piezoelectric System for Thermal Energy Harvesting from Temperature Fluctuations
Authors: Al-Huniti Naser S. , Al-Nimr Moh’d A.
Published: November 2020

This study presents the analytical modeling of a novel, simple, practical, and environmentally-friendly piezoelectric thermal energy harvester which consists of two main components: a substance exposed to a fluctuating heat source (a solid elastic material or a pressurized gas) and a piezoelectric layer to generate electrical power. Thermal variations resulting from the fluctuating heat source within the substance are converted into pressure fluctuations in the piezoelectric layer, which generates useful electric power. Unlike the widely-used thermal energy harvesters that utilize thermoelectric materials, thermal power cycles, and pyroelectric generators, the proposed system utilizes piezoelectric materials that are common for their electromechanical conversion characteristics. Thermoelastic analysis is carried out to illustrate and evaluate the performance of the model. It is found that the generated power is affected by the heat source intensity and frequency, thermal losses, properties of the medium exposed to the thermal fluctuations, and the piezoelectric properties. It is also found that the model that uses a solid elastic material is more efficient than the one that uses a pressurized gas.