bluuebunny/crossref_metadata_2025 huggingface dataset:
Aerodynamic Characteristics of Helicopter with Ducted Fan Tail Rotor in Hover under Low-Speed Crosswind
Authors: Roh Nahyeon , Oh Sejong , Park Donghun
Published: October 2020

The tail rotor of a helicopter operating under low-speed crosswind undergoes highly complex flow due to the interaction between the main rotor, fuselage, and tail rotor system. In this study, numerical simulations have been conducted on the complete configuration of a helicopter with a ducted fan tail rotor system (comprising a main rotor, ducted fan tail rotor, fuselage, and empennage) to analyze the wake interaction in hovering flight under various crosswind directions. The flow characteristics around the tail rotor, the tail rotor thrust, and the yawing moment of the helicopter are investigated and evaluated. The aerodynamic forces are compared with those of a helicopter with an open-type tail rotor. The results indicate that the aerodynamic performance of the ducted fan tail rotor is highly affected by the wakes of both the main rotor and port wing. Nevertheless, the helicopter with a ducted fan tail rotor is observed to be much more directionally stable under various crosswind directions, than that with an open-type tail rotor. This is because the rotor is protected by the fixed part of the tail rotor system in the former case.
Penetration and Perforation of Terminal Ileum Diverticulitis
Authors: Saijo Fumito , Sawada Kentaro , Nomura Ryohei , Mutoh Mitsuhisa , Narushima Yoichi , Iwama Noriyuki , Nakayama Fumie , Tokumura Hiromi
Published: October 2020

Background. Terminal ileum diverticulitis is a rare clinical disease. It can frequently mimic other processes, such as acute appendicitis. Diagnosis and therapeutic decision making (surgical or conservative treatment) can be complex. We report four interesting cases of terminal ileum diverticulitis. Case Presentation. Case 1: a 55-year-old male presented to us with a 3-day history of severe right lower quadrant pain. Computed tomography (CT) showed penetration of terminal ileum diverticulitis. Following a 7-day conservative treatment, he underwent ileocecal resection. Pathology results revealed a false diverticulum and two in five points of perforated terminal ileum diverticulum. Case 2: a 77-year-old male presented to us with severe right lower quadrant pain and unconsciousness. CT showed penetration of terminal ileum diverticulitis and air in the mesentery. Ileocecal resection was performed 2 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 3: a 61-year-old male presented to us with a right lower quadrant pain for 10 days and fever for 6 days. CT showed penetration of terminal ileum diverticulitis and abscess of the psoas muscle. Puncture and drainage of abscess were performed. Laparoscopic ileocecal resection was performed 30 days postadmission. Pathology results revealed a false diverticulum and penetrated terminal ileum diverticulum. Case 4: a 39-year-old female presented to us with right lower quadrant pain for 9 days, suspicious of appendicitis. CT showed abscess of pericecal area. Puncture and drainage were performed. A drainage tube was located into the cecum through the terminal ileum. Conservative therapy was effective, and she was discharged 23 days postadmission. Conclusions. All four cases had right lower quadrant pain. Three cases were diagnosed by CT, whereas one was diagnosed by abscess drainage. Two cases required surgical treatment within 3 days, one within about 1 month, and one case did not require surgery. The decision of whether to manage a patient surgically or conservatively is difficult. It is critical not to delay the decision of performing a surgical treatment until each patient reaches a stable general condition.
Self‐Centering Steel Frame Systems for Seismic‐Resistant Structures
Authors: Zhu Lihua , Zhao Cheng
Published: October 2020

This paper introduces a review of self‐centering steel frame systems for seismic‐resistant structures. The components and basic mechanisms of the developing posttensioned connections and self‐centering braces are briefly introduced. The structural details and seismic behaviors of the self‐centering systems proposed in recent years, including connections, energy dissipating braces, and steel frames, are condensed in categories. The theoretical and experimental results indicated that self‐centering action could minimize residual deformation and structural damage. The energy dissipating capability of the self‐centering systems is greatly enhanced by the application of energy dissipating device. The shape memory alloys (SMAs) and prepressed springs which exhibited great potential in energy dissipation and recentering capability have been studied increasingly in recent years. Abundant numerical models were propounded to investigate the cyclic response of these self‐centering systems. The current research challenges and the critical issues which need further study are discussed at the end of this paper.
Development and Performance Verification of a Motorized Prosthetic Leg for Stair Walking
Authors: Park Kiwon , Ahn Hyoung-Jong , Lee Kwang-Hee , Lee Chul-Hee
Published: October 2020

The present study emphasized on the optimal design of a motorized prosthetic leg and evaluation of its performance for stair walking. Developed prosthetic leg includes two degrees of freedom on the knee and ankle joint designed using a virtual product development process for better stair walking. The DC motor system was introduced to imitate gait motion in the knee joint, and a spring system was applied at the ankle joint to create torque and flexion angle. To design better motorized prosthetic leg, unnecessary mass was eliminated via a topology optimization process under a complex walking condition in a boundary considered condition and aluminum alloy for lower limb and plastic nylon through 3D printing foot which were used. The structural safety of a developed prosthetic leg was validated via finite element analysis under a variety of walking conditions. In conclusion, the motorized prosthetic leg was optimally designed while maintaining structural safety under boundary conditions based on the human walking data, and its knee motions were synchronized with normal human gait via a PD controller. The results from this study about powered transfemoral prosthesis might help amputees in their rehabilitation process. Furthermore, this research can be applied to the area of biped robots that try to mimic human motion.
Design and Realization of the Intelligent Design System for Tunnel Blasting in Mine Based on Database
Authors: Wu Zhengyu , Luo Dayou , Chen Guan
Published: October 2020

With the improvement of informatization and standardization of mine development, it is an inevitable trend to apply computer technology to the intelligent design of tunnel blasting excavation. Seeking to the problems existing in the intelligent design system of blasting excavation, a new intelligent design system of blasting excavation is constructed from the perspective of database technology. The new intelligent design system adopts the design of central database system and subuser rights to meet the data synchronization and sharing among different users. At the same time, the new system also extracts blasting design parameters and actual engineering data and designs a more reasonable and comprehensive database structure, database logic, and data word table. Based on the T-S fuzzy neural network model, the intelligent search rules of excavation blasting data are also constructed in the new system. Finally, based on Oracle and VB.NET as the new system development platform, MFC, and ADO as the new system development technology, the new intelligent design system for tunnel blasting and excavation was completed. The implementation of the new system addresses the needs of blasting data information storage and search and lays a foundation for the informatization and standardization of tunnel excavation blasting.
Kawasaki Disease with an Initial Manifestation Mimicking Bacterial Inguinal Cellulitis
Authors: Tanaka Tsukasa , Shimizu Masaki , Tokuda Oshi , Yamamoto Hiroko , Matsunoshita Natsuki , Takenaka Kanae , Kawasaki Keiichiro
Published: October 2020

Background. Kawasaki disease (KD) is typically characterized by fever, oral cavity erythematous changes, bilateral bulbar conjunctival injection, skin rash, erythema and edema of the hands and feet, and cervical lymphadenopathy. Some atypical patients with KD initially develop cervical and pharyngeal cellulitis; however, an initial presentation with inguinal cellulitis is extremely rare. In addition, to our knowledge, no report has documented the cytokine profile in a KD patient with cellulitis. Case presentation. A previously healthy 8-year-old Japanese girl was hospitalized following a 2-day history of fever and a 5-day history of pain and erythema in the left inguinal region. She was diagnosed with bacterial inguinal cellulitis and was administered antibiotics. The next day, a polymorphous rash emerged on her trunk. After 3 days of antibiotics, however, her fever continued and the cellulitis had spread over the entire lower abdomen. Simultaneously, the bilateral bulbar conjunctival injection without exudate became more prominent and her lips became erythematous. In addition, erythematous changes on her palms appeared a few hours later, which led to the diagnosis of KD. Since she had a high risk score that predicted no response to initial intravenous immunoglobulin (IVIG) at the initiation of treatment, she was treated with IVIG, intravenous prednisolone (PSL), and oral aspirin. The KD symptoms improved the next day, but the cellulitis did not completely resolve until 2 months after discharge. The patient’s serum cytokine profile at admission had an IL-6 dominant pattern which was consistent with that of patients with KD despite her initial lack of KD symptoms, and the pattern observed at admission was sustained until IVIG and PSL administration. Conclusion. KD should be included in the differential diagnosis for patients presenting with inguinal cellulitis who are unresponsive to initial empiric antibiotics.
An Intelligent Forensics Approach for Detecting Patch-Based Image Inpainting
Authors: Wang Xinyi , Wang He , Niu Shaozhang
Published: October 2020

Image inpainting algorithms have a wide range of applications, which can be used for object removal in digital images. With the development of semantic level image inpainting technology, this brings great challenges to blind image forensics. In this case, many conventional methods have been proposed which have disadvantages such as high time complexity and low robustness to postprocessing operations. Therefore, this paper proposes a mask regional convolutional neural network (Mask R-CNN) approach for patch-based inpainting detection. According to the current research, many deep learning methods have shown the capacity for segmentation tasks when labeled datasets are available, so we apply a deep neural network to the domain of inpainting forensics. This deep learning model can distinguish and obtain different features between the inpainted and noninpainted regions. To reduce the missed detection areas and improve detection accuracy, we also adjust the sizes of the anchor scales due to the inpainting images and replace the original nonmaximum suppression single threshold with an improved nonmaximum suppression (NMS). The experimental results demonstrate this intelligent method has better detection performance over recent approaches of image inpainting forensics.
Novel Cubic Trigonometric B-Spline Approach Based on the Hermite Formula for Solving the Convection-Diffusion Equation
Authors: Yousaf Aatika , Abdeljawad Thabet , Yaseen Muhammad , Abbas Muhammad
Published: October 2020

This paper introduces a cubic trigonometric B-spline method (CuTBM) based on the Hermite formula for numerically handling the convection-diffusion equation (CDE). The method utilizes a merger of the CuTBM and the Hermite formula for the approximation of a space derivative, while the time derivative is discretized using a finite difference scheme. This combination has greatly enhanced the accuracy of the scheme. A stability analysis of the scheme is also presented to confirm that the errors do not magnify. The main advantage of the scheme is that the approximate solution is obtained as a smooth piecewise continuous function empowering us to approximate a solution at any location in the domain of interest with high accuracy. Numerical tests are performed, and the outcomes are compared with the ones presented previously to show the superiority of the presented scheme.
A Real-Time Estimation Method of Roll Angle and Angular Rate Based on Geomagnetic Information
Authors: Gao Lizhen , Zhang Yingying , Zhang Xiaoming , Xue Yuyang
Published: October 2020

In the course of the guidance transformation of the rotating projectile, the accurate acquisition of the roll angle and roll angle rate is very important to the attitude determination and guidance control of the rotating projectile. However, due to the impact of high rotation and high overload of projectile, MEMS gyros have problems such as limited range, saturation, overload, and even performance degradation, which make the roll angle rate unable to be output normally. At the same time, because the MEMS gyro estimation of roll angle is in the form of angular rate integral, the roll angle cannot be estimated normally if the roll angle rate cannot be accurately obtained. In order to solve this problem, a real-time estimation of projectile roll angle and roll rate based on geomagnetic information under high dynamic and high overload conditions is presented. Firstly, according to the motion characteristics of the rotating projectile, the motion model of the projectile is established, and the roll angle and roll angle rate of the projectile are estimated by Kalman filtering algorithm under the conditions of high axial rotation and high overload. Considering the high dynamic characteristics of the rotating projectile, based on the Kalman filter, the algorithm of the forgetting filter with the forgetting factor is further adopted to estimate the roll angle and roll angle rate, so as to reduce the error caused by the estimation delay in the process of high-speed dynamic change. Simulation data and semiphysical test results show that the accuracy of roll angle estimated by this method reaches about 2° in semiphysical test, which is one time higher than that calculated by the system. In the semiphysical experiment, the accuracy of the estimated roll rotation rate reaches 5 °/s, which is more than 6 times higher than that obtained by direct derivation. In the high dynamic stage, compared with the pure Kalman filter, the accuracy of roll angle with forgetting factor estimation is improved by an order of magnitude, and the accuracy of roll angle rate is improved by 4 times, which meets the desired accuracy of rotating projectile.
Misannotated Multi-Nucleotide Variants in Public Cancer Genomics Datasets Lead to Inaccurate Mutation Calls with Significant Implications
Authors: Srinivasan Sujaya , Kalinava Natallia , Aldana Rafael , Li Zhipan , van Hagen Sjoerd , Rodenburg Sander Y.A. , Wind-Rotolo Megan , Qian Xiaozhong , Sasson Ariella S. , Tang Hao , Kirov Stefan
Published: October 2020

Although next-generation sequencing is widely used in cancer to profile tumors and detect variants, most somatic variant callers used in these pipelines identify variants at the lowest possible granularity, single-nucleotide variants (SNV). As a result, multiple adjacent SNVs are called individually instead of as a multi-nucleotide variants (MNV). With this approach, the amino acid change from the individual SNV within a codon could be different from the amino acid change based on the MNV that results from combining SNV, leading to incorrect conclusions about the downstream effects of the variants. Here, we analyzed 10,383 variant call files (VCF) from the Cancer Genome Atlas (TCGA) and found 12,141 incorrectly annotated MNVs. Analysis of seven commonly mutated genes from 178 studies in cBioPortal revealed that MNVs were consistently missed in 20 of these studies, whereas they were correctly annotated in 15 more recent studies. At the BRAF V600 locus, the most common example of MNV, several public datasets reported separate BRAF V600E and BRAF V600M variants instead of a single merged V600K variant. VCFs from the TCGA Mutect2 caller were used to develop a solution to merge SNV to MNV. Our custom script used the phasing information from the SNV VCF and determined whether SNVs were at the same codon and needed to be merged into MNV before variant annotation. This study shows that institutions performing NGS sequencing for cancer genomics should incorporate the step of merging MNV as a best practice in their pipelines.

Significance:

Identification of incorrect mutation calls in TCGA, including clinically relevant BRAF V600 and KRAS G12, will influence research and potentially clinical decisions.
A Novel Mutation in Insulin-Like Growth Factor 1 Receptor (c.641-2A>G) Is Associated with Impaired Growth, Hypoglycemia, and Modified Immune Phenotypes
Authors: Shapiro Melanie R. , Foster Timothy P. , Perry Daniel J. , Rosenfeld Ron G. , Dauber Andrew , McNichols James A. , Muir Andrew , Hwa Vivian , Brusko Todd M. , Jacobsen Laura M.
Published: October 2020

Introduction: Insulin-like growth factor 1 receptor (IGF1R) mutations lead to systemic disturbances in growth and glucose homeostasis due to widespread IGF1R expression throughout the body. IGF1R is expressed by innate and adaptive immune cells, facilitating their development and exerting immunomodulatory roles in the periphery. Case Presentation: We report on a family presenting with a novel heterozygous IGF1R mutation with characterization of the mutation, IGF1R expression, and immune phenotyping. Twin probands presented clinically with short stature and hypoglycemia. Variable phenotypic expression was seen in 2 other family members carrying the IGF1R mutation. The probands were treated with exogenous growth hormone therapy and dietary cornstarch, improving linear growth and reducing hypoglycemic events. IGF1R c.641-2A>G caused abnormal mRNA splicing and premature protein termination. Flow cytometric immunophenotyping demonstrated lower IGF1R on peripheral blood mononuclear cells from IGF1R c.641-2A>G subjects. This alteration was associated with reduced levels of T-helper 17 cells and a higher percentage of T-helper 1 cells compared to controls, suggesting decreased IGF1R expression may affect CD4+ Th-cell lineage commitment. Discussion: Collectively, these data suggest a novel loss-of-function mutation (c.641-2A>G) leads to aberrant mRNA splicing and IGF1R expression resulting in hypoglycemia, growth restriction, and altered immune phenotypes.
Biomarkers in Her2- Positive Disease
Authors: Klocker Eva Valentina , Suppan Christoph
Published: October 2020

Background: Breast cancer is a heterogeneous disease with well-known characteristics such as hormone receptor (HR) status and human epidermal growth factor (Her)2 status. Although Her2 represents an established treatment target, the development of resistance mechanisms during treatment, cardiotoxicity, and a worse response to standard therapies lead to worse outcomes. Summary: Therefore, we investigated various biomarkers in breast cancer such as Her2 mutations, Her2 heterogeneity, HR, PIK3CA, PTEN, programmed death receptor ligand 1 (PD-L1), tumor-infiltrating lymphocytes (TIL), micro RNA (miRNA), and BRCA mutations with regard to their clinical impact in Her2-positive disease. HR status and Her2 status, such as the presence of PIK3CA mutations, already play a role in treatment decision-making processes, whereas other biomarkers like PD-L1 status or TIL represent promising future markers. The influence of BRCA mutations in Her2-positive disease, Her2 mutations, and the impact of miRNA is vague to date. Antibody-drug conjugates (ADC) such as T-DM have been established as important treatment strategies, especially in Her2-positive disease. Key Message: However, up-to-date biomarkers appropriate for clinical practice are missing. Further studies are needed.
Erratum: Molecular phylogeny of the tribe Philodryadini Cope, 1886 (Dipsadidae: Xenodontinae): Rediscovering the diversity of the South American Racers
Authors: Arredondo Juan Camilo , Grazziotin Felipe G. , Scrocchi Gustavo J. , Rodrigues Miguel T. , Bonatto Sandro L. , Zaher Hussam El Dine
Published: October 2020

It corrects the article: http://doi.org/10.11606/1807-0205/2020.60.53
grafite e a formação do espaço geográfico urbano
Authors: Blanco Letícia de Souza , Souza Elisabete Gonçalves de
Published: October 2020

A arte grafiteira é uma das expressões estéticas mais acessíveis à sociedade. Exposta nas ruas das grandes metrópoles, ela transmite mensagens sobre o que é vivido na sociedade, consolidando-se como um meio de comunicação em que a arte está a serviço da fruição, da informação e da denúncia. Os objetivos deste trabalho são conhecer as origens e o desenvolvimento dessa arte urbana e compreender de que maneira o grafite pode ressignificar o espaço em que se inscreve. A metodologia usada foi o estudo exploratório por meio de revisão de literatura. Procurou-se analisar de que forma o grafite intervém na paisagem urbana, especificamente seu efeito na compreensão dos sentidos de cidade. Conclui que a arte grafiteira tem os muros e fachadas não só como suporte, mas como plataforma discursiva a expressar a polifonia da cena urbana.
jornalismo literário como subsídio para a compreensão da Geografia do Livro na literatura brasileira
Authors: Carvalho Sheila Regina Alves
Published: October 2020

O presente artigo tem como objetivo defender que a atuação dos literatos brasileiros na imprensa, período este denominado como jornalismo literário, foi fundamental para a consolidação da literatura nacional, buscando compreender os jornais e revistas do século XIX, no âmbito da Geografia do Livro, como precursores e viabilizadores da edição de livros das obras da literatura brasileira. Por fim, almejamos mapear a geografia das crônicas de Machado de Assis, muitas vezes esquecidas ou coadjuvantes em relação aos romances, mediante o trânsito machadiano pelas revistas e jornais cariocas.
Depressed Patients Intelligent Recognition in Smart Home Environment
Authors: Zhang Jie , Zhao Tingting , Liu Yuan
Published: October 2020

Depression is one of the most harmful diseases in society today, and the etiology and pathological mechanism of depression is one of the most complicated mental illnesses. As the population of people with depression grows, the patient's long duration of illness and the harmfulness of
the results make the disease the biggest challenge in the diagnosis of mental illness. How to improve the recognition rate of depression and make diagnosis and treatment as early as possible is the most effective way. According to the clinical medical manifestations of patients with depression,
it is found that there is a very obvious difference between the patients with depression and the normal group in terms of speech characteristics, such as lower tones and slower speech speed. Therefore, this paper proposes a method for intelligent recognition of depression based on speech signals
in combination with the contemporary smart home environment. A novel ensemble support vector machine (ESVM) algorithm is proposed in this article, which is applied to several classic depression speech data sets. The organic combination of depression recognition and smart home environment can
adapt to the development of future technology.
Construction of Perioperative Preoperative Evaluation Platform Based on Privacy Protection
Authors: Wei Dashun , Zhang Delin , Dong Ruiguo
Published: October 2020

The perioperative preoperative evaluation occupies an important guiding position in the perioperative process, but the data to be evaluated has the characteristics of clutter, inefficiency, and high redundancy, and the manual evaluation effect is difficult to guarantee. This article
proposes the concept of constructing a regional perioperative pre-operative evaluation platform, collecting medical data in a certain spatial area, and using data mining technology to mine hidden associations in medical data to provide a reference for pre-operative evaluation. We propose a
verification mining method based on the original frequent item mining technology, which greatly improves the mining speed. At the same time, to protect privacy, when publishing data in the FP-tree mode, we count the support of decision attributes and the order of item set. The experimental
results show that while satisfying the privacy protection, it has high mining accuracy and has certain clinical feasibility.
The Relationship Between CT Signs of Computed Tomography and Risk Classification of Gastric Stromal Tumors
Authors: Chen Wang , Guo Rong , Sun WeiGao , Lu DingYou
Published: October 2020

Objective: The study aims to explore the role of computed tomography (CT) in clinical diagnosis, thus having a preliminary understanding of the relationship between CT signs and the risk of gastric stromal tumors (GSTs). Methods: In this study, 213 patients with GST with
complete preoperative CT and postoperative pathological results in Yancheng No. 1 People's Hospital from January 2016 to August 2019 are selected as research objects. The patient's basic information is collected. CT machine (Toshiba 320 row CT and Siemens dualsource CT (Somatom Definition
Flash)) is used to examine all patients. The obtained image data are evaluated. Patients are divided into low-risk group, medium risk group and high-risk group according to the risk classification standard of GST. The data collected are analyzed statistically. Results: After risk classification
of all patients, 87 patients in low-risk group, 74 in medium-risk group and 52 in high-risk group are found. After further analysis of the risk classification, it is found that there is no significant difference in GST risk classification between the tumor sites (P > 0.05). In the
GST risk classification, the smaller the tumor, the more the low-risk group, the larger the tumor, the more the high-risk group, the difference is statistically significant (P < 0.05). In the observation of the relationship between tumor growth pattern and risk classification, it
is found that the number of intraluminal growth is the most, while mixed growth is the least (P < 0.05). Further analysis of tumor density, solid part enhancement, distant metastasis and risk grade show that there are significant differences (P < 0.05). Conclusion:
As an auxiliary diagnostic method in clinic, CT signs can be used to analyze the relationship with risk grade from tumor location, tumor size, tumor growth mode, tumor density, solid part enhancement degree and tumor distant metastasis, so as to have a more accurate understanding of patients'
situation, and provide experimental basis for the later application of CT signs in tumor and auxiliary diagnosis.
The Protective Effects of Social Support on Hypertension Among African American Adolescents Exposed to Violence
Authors: Hsieh Hsing-Fang , Heinze Justin E. , Caruso Elise , Scott Briana A. , West Brady T. , Mistry Ritesh , Eisman Andria B. , Assari Shervin , Buu Anne , Zimmerman Marc A.
Published: October 2020

African Americans develop hypertension earlier in life than Whites and the racial/ethnic disparities in blood pressure level can appear as early as adolescence. Violence victimization, a prevalent environmental stressor among inner-city youth, may play a role in such disparities. In a sample of inner-city youth in the United States, the current study examines the relationship between violence victimization and hypertension while investigating the role of social support in moderating that relationship. We analyzed eight waves of data from a longitudinal study of African American youth ( n = 353, 56.7% female) from mid-adolescence (9th grade, mean age = 14.9 years old) to emerging adulthood (mean age = 23.1 years old) using probit regression. Higher levels of self-reported violence victimization during ages 14–18 was associated with more reports of hypertension during ages 20–23, after adjusting for sex, socioeconomic status, substance use, and mental distress. The relationship of violence victimization with hypertension was moderated by friends’ support, but not parental support. The association between victimization and hypertension was weaker and non-significant among individuals with more peer support compared to those with less support. Researchers have reported many instances of associations of early violence exposure to later risk for hypertension; however, most have focused on childhood maltreatment or intimate partner violence. We extend these findings to violence victimization in an African American sample of youth from adolescence to early adulthood, while examining social support modifiers. The disparity in African American hypertension rates relative to Whites may partly be explained by differential exposure to violence. Our findings also suggest that having supportive friends when faced with violence can be beneficial for young adulthood health outcomes.
A Triple Helix systems perspective of UK drug discovery and development: A systematic review of REF impact case studies
Authors: Kelleher Leonard , Zecharia Anna
Published: October 2020

UK drug discovery and development is increasingly being shaped through a complex interaction of research, policy and practice. However, our understanding of this innovation system is partially due to the dearth of systems-level empirical studies and to simplistic conceptual approaches. This study uses a Triple Helix systems approach to illustrate how a novel database of Research Excellence Framework 2014 impact case studies may be used both to advance empirical understanding of UK drug discovery and development and for theory development. The authors refine the Triple Helix system by identifying relationships between its three components (academia, government and industry) and various social actors. The paper also make two contributions to practice, concerning the relative unimportance for impact generation of geographical clusters relative to strategic alliances, network linkages and knowledge spillovers, and the strong bias towards national and Anglo-American academic–practitioner linkages with few or no links to emerging knowledge economies.
Successful Treatment of Urticarial Vasculitis in a Patient With Systemic Lupus Erythematosus With Rituximab
Authors: Alharbi Samar , Sanchez-Guerrero Jorge
Published: October 2020

Urticarial vasculitis is an eruption of erythematous wheals that clinically resemble urticaria but histologically show changes of leukocytoklastic vasculitis. In association with connective tissue disease it is most commonly seen complicating Systemic lupus erythematous (SLE) and, less often, Sjogren’s syndrome. Here, we report a 25-year-old woman who developed SLE in 1998. In May 2013 she presented with urticarial vasculitis; her skin biopsy was consistent with leukocytoclastic vasculitis. She also developed bilateral uveitis. She had most of the clinical and laboratory characteristics of hypocomplementic urticarial vasculitis syndrome (HUVS) which is difficult to be differentiated from SLE. She was treated with high-dose prednisone, Mycophenolate Mofetil (MMF), colchicine, and Dapsone but failed. We decided to give her Rituximab (RTX), her urticarial vasculitis and uveitis symptoms improved significantly. Unfortunately, later on she presented with severe discoid lupus. We started her on thalidomide and responded well. Our case highlights that Rituximab is a good option for severe refractory urticarial vasculitis and thalidomide is effective in treatment of discoid lupus erythematosus (DLE), and can be used safely in specialist rheumatological practice.
Associations between pornography exposure, body image and sexual body image: A systematic review
Authors: Paslakis Georgios , Chiclana Actis Carlos , Mestre-Bach Gemma
Published: October 2020

There is evidence for associations between pornography exposure and sexual behaviors of adults and adolescents. Here, we review associations between pornography exposure and body image/sexual body image. Using a systematic search, we found 26 studies meeting inclusion criteria. Compelling evidence shows that frequency of pornography exposure is associated with negatively perceived body image and sexual body image; both heterosexual men and women appear to be affected. Due to scarcity of studies in adolescents and non-heterosexual samples, findings cannot be generalized to adolescents or individuals who identify as sexual minorities. Implications and future directions are discussed.
Variability in Medicaid Reimbursement in Hand Surgery May Lead to Inequality in Access to Patient Care
Authors: Baker William , Rivlin Michael , Sodha Samir , Nakashian Michael , Katt Brian , Fletcher Daniel , Lutsky Kevin , Beredjiklian Pedro
Published: October 2020

Background:

Medicare (MCR) and Medicaid (MCD) remain the dominant providers of government-funded health insurance in the United States. The purpose of this study was to evaluate the variability between MCR and MCD reimbursements for common hand and wrist surgical procedures. We hypothesized that MCD reimbursement rates would have substantial variation between states, whereas MCR rates would remain relatively constant.

Methods:

Using the Medicare Physician Fee Schedule Database, the 2019 reimbursements for 7 common hand and wrist procedures were recorded via the respective Current Procedural Terminology codes. The MCD reimbursement rates were then obtained from each state’s physician fee schedule database. Comparisons of reimbursement for these procedures were then calculated between states and between MCD and MCR while adjusting for cost of living using the Medicare Wage Index. Finally, the coefficients of variation were computed to compare the extent of variability between the insurance types.

Results:

Across all procedures, reimbursement rates for MCD ranged from 30.6% to 240% of the average MCR reimbursement, with the mean reimbursement for MCD valued at 78.3% of MCR. Endoscopic carpal tunnel release (CTR) is valued similarly by MCD compared with open CTR with an average of 77.7% and 78.2% reimbursement of MCR, respectively. The coefficients of variation for MCD reimbursements ranged from 0.25 to 0.45, whereas the value was 0.06 for all MCR procedures.

Conclusions:

These findings demonstrate a wide variation in MCD payments between states. When compared with MCR, the lower average state MCD reimbursement questions the sustainability for hand surgeons to accept these patients in practice.
The speed-locking effect of particles on a graphene layer with travelling surface wave
Authors: Wang Dan , Wang Lifeng , Hu Zhili
Published: October 2020

Fast diffusion induced by thermal fluctuation and vibration has been detected at nanoscales. In this paper, the movement of particle on a graphene layer with travelling surface wave is studied by molecular dynamics simulation and theoretical model. It is proved that the particle will keep moving at the wave speed with certain prerequisite conditions, namely speed-locking effect. By expressing van der Waals (vdW) potential between particle and wavy surface as a function of curvatures, the mechanism is clarified based on the puddle of potential in a relative wave-frame coordinate. Two prerequisite conditions are proposed: the initial position of particle should locate in the potential puddle, and the initial kinetic energy cannot drive particle to jump out of the potential puddle. The parametric analysis indicates that the speed-locking region will be affected by wavelength, amplitude and pair potential between particle and wave. With smaller wavelength, larger amplitude and stronger vdW potential, the speed-locking region is larger. This work reveals a new kind of coherent movement for particles on layered material based on the puddle potential theory, which can be an explanation for fast diffusion phenomena at nano scales.
Acute cholestasis as uncommon onset of Kawasaki disease: a case report
Authors: Gallerani Massimo , Pala Marco , Fabbian Fabio , De Giorgi Alfredo
Published: October 2020

Background

Kawasaki disease (KD) or mucocutaneous lymph node syndrome is a vasculitis that mostly occurs in young children. Adult-onset KD (AKD) is rare and often misdiagnosed. Here we report a rare case of KD with cholestasis as principal symptom.

Case presentation

A 43-year-old caucasian man was admitted to our hospital for high fever, lack of appetite related to nausea and vomiting, headache and significant malaise. Physical examination highlighted fever, increasing jaundice, bilateral laterocervical lymph nodes, erythema of the palms, and strikingly red lips and conjunctiva. The clinical course was complicated by arterial hypotension, tachycardia, decreasing haemoglobin, increasing acute phase reactants tests, and multiorgan failure. Due to cardiovascular instability the patient was admitted to the local Intensive Care Unit. Chest X-ray, abdominal ultrasound, chest and abdominal CT and Colangio Magnetic Resonance were normal. Jaundice was investigated and infections, autoimmune diseases or drugs adverse reactions, were excluded. Also coronary artery computed tomography was carried out excluding coronary artery aneurysms. Broad-spectrum antibiotics were not effective. After exclusion other possible conditions, diagnosis of KD was set. He was treated with high doses of corticosteroids and acetylsalicylic acid and clinical conditions as well as laboratory exams improved.

Conclusions

This report dealing with an adult onset of atypical KD may be of benefit to physicians of various specialties, including primary care doctors, hospital internists, intensivists and gastroenterologists due to its peculiarities. It demonstrates that a case of prolonged fever unresponsive to antibiotics and related to cholestatic jaundice, oedema or erythema of the extremity associated with desquamation of feet and hands, and red eyes, may suggest atypical form of KD.
Malaria vector species composition and entomological indices following indoor residual spraying in regions bordering Lake Victoria, Tanzania
Authors: Kakilla Charles , Manjurano Alphaxard , Nelwin Karen , Martin Jackline , Mashauri Fabian , Kinung’hi Safari M. , Lyimo Eric , Mangalu Doris , Bernard Lucy , Iwuchukwu Nduka , Mwalimu Dismasi , Serbantez Naomi , Greer George , George Kristen , Oxborough Richard M. , Magesa Stephen M.
Published: October 2020

Background

Vector control through long-lasting insecticidal nets (LLINs) and focal indoor residual spraying (IRS) is a major component of the Tanzania national malaria control strategy. In mainland Tanzania, IRS has been conducted annually around Lake Victoria basin since 2007. Due to pyrethroid resistance in malaria vectors, use of pyrethroids for IRS was phased out and from 2014 to 2017 pirimiphos-methyl (Actellic® 300CS) was sprayed in regions of Kagera, Geita, Mwanza, and Mara. Entomological surveillance was conducted in 10 sprayed and 4 unsprayed sites to determine the impact of IRS on entomological indices related to malaria transmission risk.

Methods

WHO cone bioassays were conducted monthly on interior house walls to determine residual efficacy of pirimiphos-methyl CS. Indoor CDC light traps with or without bottle rotator were hung next to protected sleepers indoors and also set outdoors (unbaited) as a proxy measure for indoor and outdoor biting rate and time of biting. Prokopack aspirators were used indoors to capture resting malaria vectors. A sub-sample of Anopheles was tested by PCR to determine species identity and ELISA for sporozoite rate.

Results

Annual IRS with Actellic® 300CS from 2015 to 2017 was effective on sprayed walls for a mean of 7 months in cone bioassay. PCR of 2016 and 2017 samples showed vector populations were predominantly Anopheles arabiensis (58.1%, n = 4,403 IRS sites, 58%, n = 2,441 unsprayed sites). There was a greater proportion of Anopheles funestus sensu stricto in unsprayed sites (20.4%, n = 858) than in sprayed sites (7.9%, n = 595) and fewer Anopheles parensis (2%, n = 85 unsprayed, 7.8%, n = 591 sprayed). Biting peaks of Anopheles gambiae sensu lato (s.l.) followed periods of rainfall occurring between October and April, but were generally lower in sprayed sites than unsprayed. In most sprayed sites, An. gambiae s.l. indoor densities increased between January and February, i.e., 10–12 months after IRS. The predominant species An. arabiensis had a sporozoite rate in 2017 of 2.0% (95% CI 1.4–2.9) in unsprayed sites compared to 0.8% (95% CI 0.5–1.3) in sprayed sites (p = 0.003). Sporozoite rates were also lower for An. funestus collected in sprayed sites.

Conclusion

This study contributes to the understanding of malaria vector species composition, behaviour and transmission risk following IRS around Lake Victoria and can be used to guide malaria vector control strategies in Tanzania.
The experiences of female surgeons around the world: a scoping review
Authors: Xepoleas Meredith D. , Munabi Naikhoba C. O. , Auslander Allyn , Magee William P. , Yao Caroline A.
Published: October 2020

Introduction

The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons’ experiences globally to identify strategies to increase surgical capacity through women.

Methods

Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI).

Results

Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans.

Conclusion

The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons’ experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons’ experiences and promote gender equity in increasing the number of surgical providers.
Evaluation of an exercise-enabling control interface for powered wheelchair users: a feasibility study with Duchenne muscular dystrophy
Authors: Lobo-Prat Joan , Enkaoua Aure , Rodríguez-Fernández Antonio , Sharifrazi Nariman , Medina-Cantillo Julita , Font-Llagunes Josep M. , Torras Carme , Reinkensmeyer David J.
Published: October 2020

Background

Powered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.

Methods

In this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.

Results

We found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.

Conclusions

These results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.
Occupational exposure to organophosphorus and carbamates in farmers in La Cienega, Jalisco, Mexico: oxidative stress and membrane fluidity markers
Authors: Salazar-Flores Joel , Pacheco-Moisés Fermín P. , Ortiz Genaro G. , Torres-Jasso Juan H. , Romero-Rentería Odette , Briones-Torres Ana L. , Torres-Sánchez Erandis D.
Published: October 2020

Background

The region of La Cienega in Jalisco Mexico, is an important agricultural reference for the production of corn, sorghum and wheat, among other grains, so the use of pesticides for pest control is high. However, in this rural area there are no toxicological studies that assess the occupational risk of pesticide use. Therefore, this study is the first to determine the oxidative stress levels markers (GSH, GSSG, carbonyl groups, nitric oxide metabolites and lipid peroxides) as well as alteration of the mitochondrial membrane fluidity caused by occupational exposure to organophosphorus and carbamates in farmers of this region. This occupational risk can increase cellular oxidation, which explains the high prevalence of neurodegenerative diseases and cancer in Cienega settlers to be analyzed in future studies.

Methods

Comparative cross-sectional study was performed using two groups: one not exposed group (n = 93) and another one with occupational exposure (n = 113). The latter group was sub-divided into 4 groups based on duration of use/exposure to pesticides. Oxidative stress levels and membrane fluidity were assessed using spectrophotometric methods. Statistical analyses were performed using SPSS software ver. 19.0 for windows.

Results

The most commonly used pesticides were organophosphorus, carbamates, herbicide-type glyphosate and paraquat, with an average occupational exposure time of 35.3 years. There were statistically significant differences in markers of oxidative stress between exposed farmers and not exposed group (p = 0.000). However, in most cases, no significant differences were found in markers of oxidative stress among the 4 exposure sub-groups (p > 0.05).

Conclusion

In the Cienega region, despite the indiscriminate use of organophosphorus and carbamates, there are no previous studies of levels oxidative stress. The results show increased levels of oxidative stress in occupationally exposed farmers, particularly membrane fluidity levels increased three times in contrast to not exposed group.