bluuebunny/crossref_metadata_2025 huggingface dataset:
GHD Diagnostics in Europe and the US: An Audit of National Guidelines and Practice
Authors: Binder Gerhard , Reinehr Thomas , Ibáñez Lourdes , Thiele Susanne , Linglart Agnès , Woelfle Joachim , Saenger Paul , Bettendorf Markus , Zachurzok Agnieszka , Gohlke Bettina , Randell Tabitha , Hauffa Berthold P. , Claahsen van der Grinten Hedi L. , Holterhus Paul-Martin , Juul Anders , Pfäffle Roland , Cianfarani Stefano
Published: November 2019

Introduction: Almost 20 years after the first international guidelines on the diagnosis and treatment of GHD have been published, clinical practice varies significantly. The low accuracy of endocrine tests for GHD and the burden caused by ineffective treatment of individual patients were strong motives for national endocrine societies to set up national guidelines regarding how to diagnose GHD in childhood. This audit aims to review the current state and identify common changes, which may improve the diagnostic procedure. Methods: A group of eight German pediatric endocrinologists contacted eight pediatric endocrinologists from Spain, France, Poland, the UK, the Netherlands, Denmark, Italy, and the US. Each colleague responded as a representative for the own country to a detailed questionnaire containing 22 open questions about national rules, guidelines, and practice with respect to GHD diagnostics and GH prescription. The results were presented and discussed in a workshop and then documented in this study which was reviewed by all participants. Results: National guidelines are available in 7 of 9 countries. GH is prescribed by pediatric endocrinologists in most countries. Some countries have established boards that review and monitor prescriptions. Preferred GH stimulation tests and chosen cutoffs vary substantially. Overall, a trend to lowering the GH cutoff was identified. Priming is becoming more popular and now recommended in 5 out of 9 countries; however, with different protocols. The definition of pretest-conditions that qualify the patient to undergo GH testing varies substantially in content and strictness. The most frequently used clinical sign is low height velocity, but definition varies. Height, IGF-1, and bone age are additional parameters recommended in some countries. Conclusions: GHD diagnostics varies substantially in eight European countries and in the US. It seems appropriate to undertake further efforts to harmonize endocrine diagnostics in Europe and the US based on available scientific evidence.
Clinical Characteristics of Polypoidal Choroidal Vasculopathy and Anti-Vascular Endothelial Growth Factor Treatment Response in Caucasians
Authors: Kokame Gregg T. , Liu Keke , Kokame Kelli A. , Kaneko Kyle N. , Omizo Jase N.
Published: November 2019

Background/Aims: To identify the clinical characteristics of polypoidal choroidal vasculopathy (PCV) in Caucasian patients and assess the prevalence of anti-vascular endothelial growth factor (anti-VEGF) resistance. Methods: This involved a retrospective chart review of Caucasian patients diagnosed with PCV and utilizing indocyanine green angiography with the scanning laser ophthalmoscope. Data collected included patients’ demographics, disease characteristics, and treatment response. Results: There were 54 eyes of 49 patients with PCV; 51.0% were male and 49.0% were female with a mean age of 72.9 years. Forty-four patients (89.8%) had PCV unilaterally and 10.2% (5 patients) had PCV bilaterally. PCV was located in the macula in 79.6%, in the peripapillary region in 16.7%, and in both regions in 3.7%. PCV commonly presents with serous detachment (66.7%), retinal pigment epithelial detachment (RPED) (51.9%) and subretinal hemorrhage (37.0%). Twenty-nine eyes were included in the treatment response analysis, with 18 eyes (62.1%) showing persistent disease activity after 3 initial injections of anti-VEGF treatment. Conclusion: PCV in Caucasian patients is more often unilateral and presents more commonly in the macular region than the peripapillary region. Serous detachment and RPED are the 2 most common findings. Resistance to current anti-VEGF treatment was noted frequently; it is thus extremely important to identify this subtype of type I subretinal neovascularization.
Neurological Improvement with Medical Cannabis in a Progressive Supranuclear Palsy Patient: A Case Report
Authors: Hounie Ana Gabriela , Almeida Vasques Marco Agassiz
Published: November 2019

Progressive supranuclear palsy (PSP) is a severe, debilitating, and often fatal disease resembling other neurodegenerative disorders, namely Alzheimer’s (AD) and Parkinson’s (PD) diseases, which have been successfully treated with cannabinoids. We herein report the case of a 71-year-old woman diagnosed with PSP, displaying severe impairment of motor and language functions which progressively improved after treatment with medical cannabis. Before treatment, the patient was unable to move her limbs, was fed soft food, and was unable to speak or move her eyes. The patient has regained horizontal eye movement, is able to walk with assistance, has returned to physiotherapy, started to eat solid food, and has had a remarkable improvement in her speech. The possible mechanisms of this improvement are discussed.
First-in-Human Use of a Hybrid Real-Time Ultrasound-Guided Fine-Needle Acquisition System for Peripheral Pulmonary Lesions: A Multicenter Pilot Study
Authors: Yarmus Lonny B. , Mallow Christopher , Pastis Nicholas , Thiboutot Jeffrey , Lee Hans , Feller-Kopman David , Lerner Andrew D. , Tanner Nicole , Silvestri Gerard , Chen Alexander ,   on behalf of the Interventional Pulmonary Outcomes Group (IPOG)
Published: November 2019

Background: The ability to successfully perform a biopsy on pulmonary lesions by means of bronchoscopy varies widely due to anatomic and technological limitations. One major limitation is the lack of the ability to utilize real-time guidance during tissue sampling in the periphery. A novel system has been developed that enables real-time visualization and sampling of peripheral lesions by displaying an ultrasound image of the lesion and needle simultaneously. Methods: We performed a multicenter, prospective pilot in patients with peripheral pulmonary lesions undergoing a clinically indicated bronchoscopy. The purpose of this study was to demonstrate the feasibility of visualizing, accessing, and obtaining specimens adequate for the cytology of lung lesions when using a novel hybrid real-time ultrasound-guided fine-needle aspiration system for peripheral pulmonary lesions. Results: Twenty-three patients underwent bronchoscopic sampling of a peripheral pulmonary lesion with the study device. Mean lesion size was 3.6 (range 1.7–5.7) cm. Targeted lesions were located in all lobes of the lung. All lesions were successfully visualized and sampled under real-time visualization with specimens adequate for cytological evaluation. The needle was visualized in all lesions throughout targeting and sampling. There were no incidents of pneumothorax or moderate-to-severe bleeding. Conclusion: In this feasibility study, we report the first-in-human use of a continuous real-time endobronchial ultrasound guidance system to sample peripheral pulmonary lesions. Future generations of this device may improve usability and further studies are needed to determine the true diagnostic capabilities of this novel technique.
Insight Into the Mechanism of Macroreentrant Atrial Tachycardia With Cycle Length Alternans Using Ultrahigh Density Mapping System
Authors: Zhang Jinlin , Zheng Liangrong , Zhou Dongchen , Zhao Anquan , Tang Cheng , Zhang Yonghua , Su Xi
Published: November 2019

Background:

Atrial tachycardia (AT) with cycle length (CL) alternans is a rare phenomenon. We aimed to identify the characteristics and precise mechanism of this special category of ATs by using an ultrahigh density mapping system.

Methods:

We identified 7 ATs with alternating CL in a total of 478 ATs from 2 institutions mapped with an ultrahigh density mapping system. Activation maps were performed for long CL (289±35 ms; mapping points, 21 520±11 103) and short CL (251±18 ms; mapping points,17 594±8059) separately.

Results:

We classified ATs with CL alternans into 2 types. Type 1: There existed 2 potential loops with different routes. CL alternans resulted from an intermittently 2:1 conducting block within the channel of the smaller loop. Type 2: CL alternans resulted from different conduction velocity through 2 closely spaced gaps within preexisting linear lesions. Catheter ablation successfully terminated all the 7 ATs.

Conclusions:

Ultrahigh density mapping provides an opportunity to delineate the precise mechanism of AT with CL alternans. Intermittent conduction block or slowing of a channel was essential for the maintenance of AT.
Determinants of Patient and Surrogate Experiences With Acute Care Research Consent: A Key Informant Interview Study
Authors: Scicluna Victoria M. , Goldkind Sara F. , Mitchell Andrea R. , Pentz Rebecca D. , Speight Candace D. , Silbergleit Robert , Dickert Neal W.
Published: November 2019

Background

Informed consent for acute myocardial infarction and stroke research is challenging. Time for enrollment decisions is limited, patients and family are usually stressed, and being asked to participate in research is often unexpected. Despite these barriers, patients and surrogates have reported a preference for prospective involvement in research decisions and generally positive views of the consent process. It is unknown what drives positive or negative consent experiences. These data are crucial to making consent processes more context appropriate.

Methods and Results

We conducted a qualitative interview study with 27 patients and surrogates enrolled in acute myocardial infarction and stroke trials in the past 5 years. Purposive sampling from the P‐CARE (Patient‐Centered Approaches to Research Enrollment) study was based on participant characteristics and responses to initial patient‐centered interviews. In‐depth interviews used open‐ended questions to explore factors influencing consent experiences. Qualitative descriptive analysis was performed utilizing a multilevel coding strategy. Participants identified specific researcher behaviors as important, including expressions of respect, professionalism, and nonpressuring communication. Participants preferred consent conversations focused on risks/benefits and the trial protocol. They had varying views of consent forms and communicated several reasons the form was valuable unrelated to informational content. Participants also valued postenrollment interactions as opportunities to ask questions and learn about the study.

Conclusions

Barriers to consent in acute myocardial infarction and stroke trials are unavoidable, but participants identified productive ways to demonstrate respect for patients during enrollment conversations. These include key researcher behaviors, concentrating consent discussions on what participants find most important, and structured postenrollment follow‐up.
Global Burden of Small Vessel Disease–Related Brain Changes on MRI Predicts Cognitive and Functional Decline
Authors: Jokinen Hanna , Koikkalainen Juha , Laakso Hanna M. , Melkas Susanna , Nieminen Tuomas , Brander Antti , Korvenoja Antti , Rueckert Daniel , Barkhof Frederik , Scheltens Philip , Schmidt Reinhold , Fazekas Franz , Madureira Sofia , Verdelho Ana , Wallin Anders , Wahlund Lars-Olof , Waldemar Gunhild , Chabriat Hugues , Hennerici Michael , O’Brien John , Inzitari Domenico , Lötjönen Jyrki , Pantoni Leonardo , Erkinjuntti Timo
Published: November 2019

Background and Purpose—

Cerebral small vessel disease is characterized by a wide range of focal and global brain changes. We used a magnetic resonance imaging segmentation tool to quantify multiple types of small vessel disease–related brain changes and examined their individual and combined predictive value on cognitive and functional abilities.

Methods—

Magnetic resonance imaging scans of 560 older individuals from LADIS (Leukoaraiosis and Disability Study) were analyzed using automated atlas- and convolutional neural network–based segmentation methods yielding volumetric measures of white matter hyperintensities, lacunes, enlarged perivascular spaces, chronic cortical infarcts, and global and regional brain atrophy. The subjects were followed up with annual neuropsychological examinations for 3 years and evaluation of instrumental activities of daily living for 7 years.

Results—

The strongest predictors of cognitive performance and functional outcome over time were the total volumes of white matter hyperintensities, gray matter, and hippocampi (
P
<0.001 for global cognitive function, processing speed, executive functions, and memory and
P
<0.001 for poor functional outcome). Volumes of lacunes, enlarged perivascular spaces, and cortical infarcts were significantly associated with part of the outcome measures, but their contribution was weaker. In a multivariable linear mixed model, volumes of white matter hyperintensities, lacunes, gray matter, and hippocampi remained as independent predictors of cognitive impairment. A combined measure of these markers based on
Z
scores strongly predicted cognitive and functional outcomes (
P
<0.001) even above the contribution of the individual brain changes.

Conclusions—

Global burden of small vessel disease–related brain changes as quantified by an image segmentation tool is a powerful predictor of long-term cognitive decline and functional disability. A combined measure of white matter hyperintensities, lacunar, gray matter, and hippocampal volumes could be used as an imaging marker associated with vascular cognitive impairment.
Air and Friction in the Celestial Region: Some medieval solutions to the difficulties of the Aristotelian theory concerning the production of celestial heat
Authors: Panzica Aurora
Published: November 2019

This paper explores the medieval debates concerning problems with the Aristotelian theory of the production and transmission of solar heat as presented in De Caelo II, 7 and Meteorologica I, 3. In these passages, Aristotle states that celestial heat is generated by the friction set up in the air by the motion of celestial bodies. This statement is difficult to reconcile with Aristotle’s cosmology, which presupposes that the heavenly bodies are not surrounded by air, but by aether, and that the celestial spheres are perfectly smooth, and therefore cannot cause any friction. In their commentaries on De Caelo and on Meteorologica, the Latin commentators elaborated a model that solves these difficulties. In this attempt, they invoke a non-mechanical principle, namely celestial influence.
The Role of Circulation and Its Changes in Present and Future Atmospheric Rivers over Western North America
Authors: Tan Yaheng , Zwiers Francis , Yang Song , Li Chao , Deng Kaiqiang
Published: November 2019

Performance in simulating atmospheric rivers (ARs) over western North America based on AR frequency and landfall latitude is evaluated for 10 models from phase 5 of the Coupled Model Intercomparison Project among which the CanESM2 model performs well. ARs are classified into southern, northern, and middle types using self-organizing maps in the ERA-Interim reanalysis and CanESM2. The southern type is associated with the development and eastward movement of anomalous lower pressure over the subtropical eastern Pacific, while the northern type is linked with the eastward movement of anomalous cyclonic circulation stimulated by warm sea surface temperatures over the subtropical western Pacific. The middle type is connected with the negative phase of North Pacific Oscillation–west Pacific teleconnection pattern. CanESM2 is further used to investigate projected AR changes at the end of the twenty-first century under the representative concentration pathway 8.5 scenario. AR definitions usually reference fixed integrated water vapor or integrated water vapor transport thresholds. AR changes under such definitions reflect both thermodynamic and dynamic influences. We therefore also use a modified AR definition that isolates change from dynamic influences only. The total AR frequency doubles compared to the historical period, with the middle AR type contributing the largest increases along the coasts of Vancouver Island and California. Atmospheric circulation (dynamic) changes decrease northern AR type frequency while increasing middle AR type frequency, indicating that future changes of circulation patterns modify the direct effect of warming on AR frequency, which would increase ARs (relative to fixed thresholds) almost everywhere along the North American coastline.
Linked Lives, Linked Trajectories: Intergenerational Association of Intragenerational Income Mobility
Authors: Cheng Siwei , Song Xi
Published: November 2019

Most intergenerational mobility studies rely on either snapshot or time-averaged measures of earnings, but have yet to examine resemblance of earnings trajectories over the life course of successive generations. We propose a linked trajectory mobility approach that decomposes the progression of economic status over two generations into associations in four life-cycle dimensions: initial position, growth rate, growth deceleration, and volatility. Using father-son dyad data from the Panel Study of Income Dynamics, we show that men resemble their fathers not only in the overall level of earnings but also in the pattern by which their earnings develop over time. The intergenerational persistence of earnings varies substantially across life stages of both generations; it is strongest for fathers’ early-career and sons’ mid-career, with an intergenerational elasticity (IGE) as high as .6. This result can be explained by the concurrence of the parent’s early career and the offspring’s early childhood. Our findings suggest the intergenerational economic association between parents and offspring is not age-constant but is contingent on the respective life stages of both generations and, most importantly, the period during which they overlap.
The Moral Limits of Predictive Practices: The Case of Credit-Based Insurance Scores
Authors: Kiviat Barbara
Published: November 2019

Corporations gather massive amounts of personal data to predict how individuals will behave so that they can profitably price goods and allocate resources. This article investigates the moral foundations of such increasingly prevalent market practices. I leverage the case of credit scores in car insurance pricing—an early and controversial use of algorithmic prediction in the U.S. consumer economy—to unpack the premise that predictive data are fair to use and to understand the conditions under which people are likely to challenge that moral logic. Policymaker resistance to credit-based insurance scores reveals that contention arises when predictions depend on mathematical distinctions that do not align with broader understandings of good and bad behavior, and when theories about why predictions work point to the market holding people accountable for actions that are not really their fault. Via a de-commensuration process, policymakers realign the market with their own notions of moral deservingness. This article thus demonstrates the importance of causal understanding and moral categorization for people accepting markets as fair. As data and analytics permeate markets of all sorts, as well as other domains of social life, these findings have implications for how social scientists understand the novel forms of stratification that result.
Five-year Survival Data on the Role of Endoscopic Endonasal Nasopharyngectomy in Advanced Recurrent rT3 and rT4 Nasopharyngeal Carcinoma
Authors: Wong Eugene Hung Chih , Liew Yew Toong , Loong Siow Ping , Prepageran Narayanan
Published: November 2019

Aim:

Endoscopic endonasal nasopharyngectomy (EEN) for recurrent nasopharyngeal carcinoma (rNPC) is being increasingly used due to the added high magnification, reduced morbidities associated with open procedures and good survival outcomes. Most studies looked at usage of EEN in patients with lower recurrent staging (rT1 and rT2) although more and more surgeons are studying the outcome of EEN in advanced rNPC (rT3 and rT4). The aims of this study were to report the long-term 5-year survival outcome of EEN performed in patients with advanced rNPC, and to determine any prognostic factors for patients’ survival.

Methods:

All patients who underwent EEN for advanced rNPC between January 2003 and December 2015 inclusive were analyzed. All surgeries were performed in University Malaya Medical Centre in Kuala Lumpur and Queen Elizabeth Hospital in Sabah. We reported the 5-year overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and any related complications and significant prognostic factors.

Results:

Twelve patients with rNPC (2 rT3 and 10 rT4) were followed-up over a mean duration of 44.8 months (range, 40-440 weeks). The 5-year OS was 50.0% (mean 44.75 months), DFS was 25.0% (mean 35.25 months) and the DSS was 58.3% (mean 43.33 months). No severe operative complications were encountered and no independent prognostic factors for survival outcome were identified.

Conclusion:

This is the first report in English that exclusively described the long-term 5-year survival data in patients with both rT3 and rT4 recurrent NPC after EEN. The data suggest that EEN is a feasible treatment to improve survival with minimal morbidities in patients with rT3 and rT4 recurrent NPC. However, more studies with larger patient size is recommended.
How Much Brandeis Do the Neo-Brandeisians Want?
Authors: Crane Daniel A.
Published: November 2019

The neo-Brandeis school of antitrust has suddenly emerged as a viable challenger to the reigning consumer welfare establishment. Assuming the mantle of Brandeis gives the neo-Brandeisians a historically grounded brand but also comes with some baggage. Among other things, the neo-Brandeisians need to be prepared to answer the following questions: (1) Will they follow Brandeis in seeing bigness as a curse not only in business but also in government? (2) Will they break cleanly with welfarism and adhere to a moral, social, and political theory of anti-bigness, even at the cost of efficiency? and (3) Will they commit themselves genuinely to Brandeis’s empiricism—that facts on the ground trump theories, wherever the facts may lead?
Using Integrative Data Analysis to Investigate School Climate Across Multiple Informants
Authors: McGrath Kathleen V. , Leighton Elizabeth A. , Ene Mihaela , DiStefano Christine , Monrad Diane M.
Published: November 2019

Survey research frequently involves the collection of data from multiple informants. Results, however, are usually analyzed by informant group, potentially ignoring important relationships across groups. When the same construct(s) are measured, integrative data analysis (IDA) allows pooling of data from multiple sources into one data set to examine information from multiple perspectives within the same analysis. Here, the IDA procedure is demonstrated via the examination of pooled data from student and teacher school climate surveys. This study contributes to the sparse literature regarding IDA applications in the social sciences, specifically in education. It also lays the groundwork for future educational researchers interested in the practical applications of the IDA framework to empirical data sets with complex model structures.
Low Residential Mobility and Novelty-Seeking Consumption
Authors: Ito Kenichi , Su-May Tan Terri , Lee Albert , Li Liman Man Wai
Published: November 2019

Cultural research using a socioecological perspective has shown that residential mobility fosters familiarity-seeking behavior. In particular, residentially mobile individuals tend to purchase from national chain stores, which offer the same products across different locations. Positing this process as a reaction to a rapidly changing high mobility environment, we investigated whether a low mobility environment—characterized by a more familiar, less stimulating environment—results in novelty-seeking consumptive behaviors. In testing our hypothesis, Study 1 used archival data to explore novelty-seeking consumption based on the sales of consumable brands in the United States, Japan, and Singapore. Study 2 primed participants with either a high or a low mobility mind-set to explore the effect of mobility on novelty-seeking consumption. The results supported our hypothesis that consumers in a relatively low mobility country (Japan) tend to purchase from newer and, thus, novel brands more than consumers in mobile countries (the United States or Singapore). Furthermore, compared with high mobility, priming participants with a low mobility mind-set led them to select novel over traditional products.
Playing with history and tradition: television educational programs in contemporary China
Authors: Lin Xiaoqing Diana
Published: November 2019

TV educational programs mushroomed in China in the 1990s and beyond. They combined education and entertainment, and for the first time in Communist Chinese history, used TV ratings to determine the continued existence of these programs. This article addresses the predominant focus on history and traditional learning in the lectures at the most famous of these programs, China Central Television’s Lecture Room (baijiajiangtan) since its inception in 2001. Borrowing Pierre Bourdieu’s concept of habitus, it studies how a confluence of state policies, TV station decisions, market imperatives, and educators who presided over the programs created, through storytelling, a modern, open yet culturally conservative world, to keep the audience oriented to modern ideas and practices while deterring excessive individualism or freedom, and a vibrant social milieu favorable to these ideas and practices through audience input via TV program ratings.
Om toleran Om: four Indonesian reflections on digital heterosexism
Authors: Boellstorff Tom
Published: November 2019

Beginning in January 2016, an unprecedented series of anti-LGBT events took place in Indonesia, the fourth most populous nation (after China, India, and the United States) and home to more Muslims than any other country. These events were notable for the pivotal role of digital media in their articulation and dissemination. In this article, I develop the notions of ‘digital heterosexism’ and ‘digital exclusionary populism’ to reflect on how these anti-LGBT events relate to earlier dynamics of oppression in the archipelago, and their possible consequences for Indonesia’s future. I focus on the shifting implications of media for subjectivity, community, and inequality – in the country that was a model for the notion of ‘imagined community’. Through these reflections, I seek to illuminate continuity and discontinuity with regard to media and culture change.
Heliotropes
Authors: Marasco Robyn
Published: November 2019

A reflection on Seyla Benhabib’s Exile, Statelessness, and Migration, with a particular focus on her reconstruction of early critical theory and the ‘Benjaminian moment’ that links Hannah Arendt to Theodor Adorno.
Non-pooled Human Platelet Lysate: A Potential Serum Alternative for In Vitro Cell Culture
Authors: Hesler Michelle , Kohl Yvonne , Wagner Sylvia , von Briesen Hagen
Published: November 2019

Serum supplementation is crucial in in vitro cell culture to provide all the essential nutrients needed for cellular processes. Fetal bovine serum (FBS) is considered the ‘gold standard’, but its production raises serious ethical concerns. Human-derived alternatives to FBS exist in the form of human platelet lysates (hPLs) or human AB serum (ABS). However, these serum products are usually pooled from several donors, in order to have a standardised product without patient-specific deviations. Nevertheless, the use of patient-specific serum in cell culture might be the key to successful transplantation of the cultured cells in medical applications, particularly as it avoids the transmission of infectious components or xenogenic proteins. In addition, the production of non-pooled hPL from single donors is likely to be a cost-effective and time-saving method. The current study used hPL units isolated from single donors and tested their performance as medium supplements for cell culture in comparison with FBS or ABS. This proof-of-concept study aimed to assess the potential of non-pooled hPL for personalised serum supplementation, and thus optimise in vitro models by making them more relevant to human physiology. We showed that A549, HepG2 and Caco-2 human cell lines were generally able to adapt to the new culture conditions and maintain viability, morphology and certain cell-specific characteristics. These results indicate that non-pooled, single patient-derived hPL could be a suitable alternative for in vitro serum supplementation.
Violations of basic deliberative norms: The systemic turn and problems of inclusion
Authors: Holdo Markus
Published: November 2019

What is the appropriate way to respond to actions that break basic norms of respectfulness, sincerity, and public-mindedness? At the same time as this question has become a central concern for democratic societies, a ‘systemic’ turn has unsettled established solutions for democratic theorists. From the systemic perspective, it is more important how actions contribute to public discourse than whether they meet standards of deliberation individually. This article challenges theorists to consider three additional propositions: (1) to be inclusive and deliberative, the system and its parts must be mutually supportive; (2) well-performing systems have sufficient reflective capacity to examine their own deficiencies when violations of basic norms occur; and (3) the performance of a deliberative system needs to take into account both the frequency of violations and the reflective qualities of the system’s response. For a well-performing system, violations of basic norms are opportunities to learn and strengthen the support for spaces of deliberation.
Evaluation of diagnostic accuracy of intracranial aneurysm detection using medical-grade versus commercial consumer-grade displays and different image reconstructions against the background of process optimization for telemedicine
Authors: Auer Timo Alexander , Münzfeld Hanna , Posch Helena , Stöckel Juliane , Tietze Anna , Bohner Georg , Böning Georg
Published: November 2019

Background

Process optimization in computed tomography (CT) and telemedicine.

Purpose

To compare image quality and objective diagnostic accuracy of medical-grade and consumer-grade digital displays/computer terminals for detection of intracranial aneurysms.

Material and Methods

Four radiologists with different levels of experience retrospectively read a total of 60 patients including 30 cases of proven therapy-naïve intracranial aneurysm detectable on a medical-grade grayscale calibrated display. They had 5 min per case reading the first 20 datasets using only axial slices, the next 20 patients using axial slices and multiplanar reconstructions (MPRs), and the last 20 patients using axial slices, MPRs, and maximum intensity projections (MIPs). Three months after the first reading session on a medical-grade display, they read all datasets again under the same standardized conditions but on a consumer-grade display. Diagnostic performance, subjective diagnostic confidence, and reading speed were analyzed and compared. Readers rated image quality on a five-point Likert scale.

Results

Diagnostic accuracy did not differ significantly with areas under the curve of 0.717–0.809 for all readers on both display devices. Sensitivity and specificity did not increase significantly when adding MPRs and/or MIPs. Reading speed was similar with both devices. There were no significant differences in subjective image quality scores, and overall inter-reader variability of all subjective parameters correlated positively between the two devices ( P <0.001–0.011).

Conclusion

Diagnostic accuracy and readers’ diagnostic confidence in detecting and ruling out intracranial aneurysm were similar on commercial-grade and medical-grade displays. Additional reconstructions did not increase sensitivity/specificity or reduce the time needed for diagnosis.
Knowledge management in practice in academic libraries
Authors: Shropshire Sandra , Semenza Jenny Lynne , Koury Regina
Published: November 2019

Developments in higher education present disruptions in the normal operations of an academic library. Shrinking budgets, technological innovations, and changes in staffing each cause organizations to question traditional mores and can motivate managers to utilize new ways of thinking to manage workflow and to address evolving institutional initiatives. Knowledge management has emerged as one such way of thinking about management challenges. The authors present basic knowledge management principles, and identify and analyse knowledge management practices at two academic libraries.
The Influence of Psychological Factors on the Incidence and Severity of Sports-Related Concussions: A Systematic Review
Authors: Trinh Lily N. , Brown Symone M. , Mulcahey Mary K.
Published: November 2019

Background:

An athlete’s preexisting psychological factors may influence the incidence and/or severity of sports-related concussions (SRCs).

Purpose:

To determine if emotional states, personality traits, temperament, life stressors, and explanatory styles (optimism vs pessimism) influence the incidence and severity of SRCs in athletes.

Study Design:

Systematic review.

Methods:

A systematic literature search of multiple major medical reference databases was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included that evaluated the effect of preexisting psychological factors on the incidence and severity of SRCs in male and female athletes participating in all sports.

Results:

The initial search identified 1195 articles. Ten studies met our inclusion criteria and were included in our analysis. Factors such as meanness, aggression, and psychoticism were associated with an increased incidence of SRCs. Baseline traits of irritability, sadness, nervousness, and depressive symptoms were associated with worse symptomatology after SRCs. In young athletes, preexisting psychiatric illnesses, family history of psychiatric illness, and significant life stressors were associated with an increased risk of developing postconcussion syndrome after SRCs.

Conclusion:

This systematic review demonstrated a potential relationship between an athlete’s preexisting psychological factors and the incidence and severity of SRCs. These associations are not entirely clear owing to the heterogeneity across included studies and the low-to-moderate certainty of evidence. Future studies should attempt to evaluate men and women independently, use well-validated psychological questionnaires, and limit the usage of self-reported SRCs, when possible. Furthermore, the potential efficacy of baseline psychological factor and/or symptom reports on the prevention and management of SRCs should be explored.
Endoscopic Brow Lift Without Muscle Resection: Objective and Subjective Changes in Intereyebrow Width
Authors: Hollabaugh Brian A. , Perenack Jon , Christensen Brian J.
Published: November 2019

The purpose of this study is to evaluate the objective and subjective changes in medial intereyebrow distance following endoscopic brow lift without corrugator resection. The authors designed a retrospective cohort study. The eligible patients included those receiving endoscopic brow lifts at Williamson Cosmetic Center in Baton Rouge, LA between June 1, 2014 and March 31, 2018. The primary outcome variable was the distance between the left and right medial brow. The secondary outcome variables were nonsurgeon evaluator’s perception of the change in intereyebrow distance and the aesthetics of the intereyebrow region. The relationship of the outcome variables to the primary predictor (time point—preoperative and postoperative) was analyzed using paired sample t-tests. The relationship of the outcome variables to the other predictors was analyzed using Pearson correlations. A P-value of less than .05 was considered significant. A total of 41 patients were included in the study. The average age was 55.3 ± 8.5 years and all patients were women. The average time from surgery to postoperative photos was 6.2 ± 3.2 (range: 3-15) months. The average preoperative intereyebrow width was 31.5 mm, and the average postoperative width was 33.1 mm ( P < .0001). Correct perception of the intereyebrow change was found to be positively correlated with increasing patient age ( P = .047) and increasing change in intereyebrow width ( P = .008). The intereyebrow distance was perceived as aesthetic for 73.4% ± 31.0% of preoperative patients and 76.1% ± 27.6% of postoperative patients ( P = .346). Patients with a preoperative intereyebrow distance perceived as aesthetic are very likely to be perceived as aesthetic postoperatively (correlation coefficient 0.817, P-value < .0001). Following endoscopic brow lift without corrugator muscle resection, there is a small, but statistically significant increase in the intereyebrow distance. However, this change was not associated with negative perception of the aesthetic appearance of the intereyebrow region.
Rethinking pandemic preparedness in the Anthropocene
Authors: Stephen Craig
Published: November 2019

The social and ecological changes accompanying the Anthropocene require changes in how pandemics are anticipated, conceived, and managed. Pandemics need to be reframed from infections we can predict to inevitable infectious and non-communicable surprises with which we need to cope. A hazard-by-hazard approach to planning and response is insufficient when the next pandemic cannot be predicted. Decision-making will benefit from scoping the problem broadly to generate deeper insights into potential threats. The origins of pandemics come from our relationships with the world around us. Health leaders, therefore, need to be aware of primordial determinants of risk arising from these changing relationships. Cross-sectoral co-learning to anticipate surprise will require bridging agents embedded within a health agency to facilitate transdisciplinary intelligence gathering. A unified set of guidelines is needed to promote pandemic resilience by collaboratively tending to the determinants of health for each other, our communities, and the natural environment.
Sustained Long-Term Effectiveness of an Energy Management Training Course on Employee Vitality and Purpose in Life
Authors: Das Sai Krupa , Mason Shawn T. , Vail Taylor A. , Blanchard Caroline M. , Chin Meghan K. , Rogers Gail T. , Livingston Kara A. , Turgiss Jennifer L.
Published: November 2019

Purpose:

Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting.

Design:

A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months.

Setting:

Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8).

Participants:

One hundred sixty-three employees with a mean age of 47 (11) years (57% female).

Intervention:

A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL).

Measures:

Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months.

Analysis:

General linear models with repeated measures for mean values at baseline and follow-up.

Results:

At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL ( P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months ( P < .05 for all measures).

Conclusions:

An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.
Poly(ethylene terephthalate)/titanium phosphate nanocomposites: Effect of fillers on thermal, crystallographic diffraction, molecular mobility, and UV-Vis absorption
Authors: Valencia Albitres Gerson Alberto , Cestari Sibele Piedade , Malafaia Macedo Katharina Rodrigues , Mendes Luis Claudio , Cruz Mateus Oliveira , Filho Marcus Ferreira , Araújo André Souza
Published: November 2019

There are several chemicals for using as ultraviolet (UV) absorbers. Considering that titanium phosphate (TiP) not yet studied for this purpose, we intended to investigate its effect on poly(ethylene terephthalate) (PET). TiP was synthesized and intercalated with two types of long-chain amine, octadecylamine (OETiP) and ether-amine-O-(2-aminopropyl)-O′-(2-methoxyethyl)polypropylene glycol) (JETiP) being the intercalation assisted by ethylamine. Nanocomposites of PET/TiP (filled with 5 wt%) (PET-TiP, PET-OETiP, and PET-JETiP) were prepared by melting extrusion. Thermogravimetric analysis, differential scanning calorimetry, wide-angle X-ray diffraction (WAXD), Fourier transform infrared spectroscopy, hydrogen low-field nuclear magnetic resonance (1H LFNMR), and UV-visible (Vis) absorption were used for characterizations. OETiP and JETiP induced the decrease of PET glass transition temperature ( Tg) and heat crystallization temperature ( Tch) while PET crystallinity degree ( Xc), cold crystallization temperature ( Tcc), and crystallization rate increased. WAXD suggested the intercalation of PET chains inside of fillers lamellae. According to 1H LFNMR, all fillers increased the PET molecular mobility. Diffuse reflectance revealed increase of the absorption at UV light region. The sample might be thought as a UV absorber.
Mechanical design and modelling of lightweight additively manufactured lattice structures evolved from regular three-dimensional tessellations
Authors: Dragoni Eugenio , Ciace Valerio A
Published: November 2019

To lower costs and improve efficiency, most additively manufactured parts are printed as thin shells filled with a lightweight cellular material, which reacts to secondary stresses and provides distributed support to the load-carrying outer casing. This paper proposes a two-step method to design filling metamaterials that are intrinsically strong, stiff and lightweight. First, the space is divided into repetitive volumes according to available three-dimensional tessellation schemes. The tessellation is then transformed into a trabecular wireframe by converting each unit volume into a kinematically-rigid open cell with edge beams and bracings. Dimensional analysis allows the lattice structures to be characterized mechanically and elastically with a finite number of simple computational analyses. The paper shows that the properties of metamaterials with triangular, square and hexagonal prismatic cells compare favourably with state-of-the art porous materials like foams and honeycombs.
A pseudo-modal structural damage index based on orthogonal empirical mode decomposition
Authors: Lofrano Egidio , Romeo Francesco , Paolone Achille
Published: November 2019

A structural damage identification technique hinged on the combination of orthogonal empirical mode decomposition and modal analysis is proposed. The output-only technique is based on the comparison between pre- and post-damage free structural vibrations signals. The latter are either kinematic (displacements, velocities or accelerations) or deformation measures (strains or curvatures). The response data are decomposed by means of the orthogonal empirical mode decomposition to derive a finite set of orthogonal intrinsic mode functions; the latter are used as a multi-frequency and data-driven basis to build pseudo-modal shapes. A new damage index, the so-called pseudo-mode index, is introduced to compare the response obtained for the two states of the structural system and detect potential damages. The performance of the devised index in detecting a localised damage is shown through numerical and experimental tests on two structural models, namely a 4-degrees-of-freedom system and a two-hinged parabolic arch.
Effect of angular misalignment on the stiffness of the double-row self-aligning ball bearing
Authors: Geng Keke , Lin Shengye
Published: November 2019

The double-row self-aligning ball bearing commonly runs with angular misalignment between the inner and outer rings, and the angular misalignment significantly affects the bearing performance. However, the effect of angular misalignment on the dynamic characteristics of the double-row self-aligning ball bearing has not been studied thoroughly. This paper investigates the effect of angular misalignment on the stiffness of the double-row self-aligning ball bearing. The quasi-static model for the double-row self-aligning ball bearing is established with five degrees of freedom, namely, three translational displacements along x, y, and z directions and two tilting angles around x-axis and y-axis. The internal clearance between balls and raceways is included in the presented model. The formulation of the three-dimensional stiffness matrix for the double-row self-aligning ball bearing is analytically derived, and is verified by comparing with the available dada in published literature. Finally, the stiffness of the double-row self-aligning ball bearing under various angular misalignment conditions is analyzed systematically. The results show that the tilting angles vary the contact angles and contact forces of the compressed balls in the double-row self-aligning ball bearing, thus affect the bearing stiffness; the bearing stiffness decreases with the internal clearance; the angular misalignment significantly impacts the stiffness of the bearing running at a low speed.
Effect of turbulent inlet conditions on the prediction of flow field and hemolysis in the FDA ideal medical device
Authors: Wu Peng , Zhang Liudi , Gao Qi , Dai Weifeng
Published: November 2019

Hemolysis is one of the most important issues of blood contacting artificial organs. Computational fluid dynamics, in conjunction with hemolysis models, has been widely used to predict the flow field and hemolysis during the development phase of these devices. It is widely accepted that hemolysis is related to flow field parameters, such as stress and energy dissipation. It is known that inlet boundary conditions such as turbulent intensity have important effects on flow fields. Nonetheless, the influence of inlet turbulent intensity on hemolysis is not yet clear. This study investigates the influence of turbulent intensity on the prediction of flow field and hemolysis in the FDA benchmark nozzle model. Three configurations are investigated: first is the original nozzle model (with a gradual contraction, throat, and sudden expansion); the second is composed only of the throat and sudden expansion; the third one is similar with the second, but with a shorter throat. Four turbulent intensities are considered, ranging from 1% to 20%. For the first configuration, the influence of turbulent intensity on both flow field and hemolysis is very small and limited prior to the gradual contraction, while for the other two configurations, the influence is considerable. The jet breaks down sooner with increased turbulent intensity. Both turbulence dissipation rate and Reynolds stress increase in the throat with increased turbulent intensity, but decrease after the jet breaks down. The influence of turbulent intensity is more considerable for the configuration with a shorter inlet. The influence of turbulent intensity on the prediction of hemolysis is up to 38.5%. This study shows that turbulent intensity can have considerable influence on the prediction of flow field and hemolysis in blood-contacting devices, thus should be taken in account when conducting blood compatibility design.