bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on dual-wheel-independent-drive control of electric forklift based on optimal slip ratio
Authors: Zhang Zhilu , Xiao Benxian 
Published: August 2020

Introduction: As an important transportation, the research on the control strategy of forklift has not been widely carried out. Objectives: This article proposes a turning slip regulation control strategy, which includes the improved electronic differential velocity control and turning slip regulation control, to track the optimal slip ratio. Methods: First, combined with the basic structure and characteristics of dual-wheel-independent-drive electric forklift, the vehicle model, Ackermann–Jeantand steering model, tire-ground model, and tire model of the driving wheel are established respectively. Second, according to these models, an improved electronic differential control strategy considering the influence of vertical load on tire force is proposed and it can reasonably allocate the driving torque of the two driving wheels of electric forklift. Moreover, the optimal slip ratio is given out and the turning slip regulation control strategy, which can track the optimal slip ratio of electric forklift under the conditions of different road surfaces is designed. Results: The simulation result and vehicle test show that the control strategy can optimize the slip ratio of electric forklift and greatly improve the stability of electric forklift. Conclusion: The turning slip regulation control strategy can be implemented on the TFC35 forklift to improve the safety and stability.
Working Toward an mHealth Platform for Adolescents with Type 1 Diabetes: Focus Groups With Teens, Parents, and Providers
Authors: Sinisterra Manuela , Kelly Katherine Patterson , Shneider Caitlin , El-Zein Ashley , Swartwout Ellen , Deyo Patricia , Streisand Randi 
Published: August 2020

Purpose The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. Methods Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. Results Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. Conclusion Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.
Pleural and serum markers for diagnosis of malignant pleural effusion
Authors: Allama Amr M , Abou-Elela Dalia H , Ibrahim Islam M 
Published: August 2020

Background Differentiation between benign and malignant exudative pleural effusion remains a clinical challenge. Recently, several markers have been reported to increase the diagnostic accuracy of malignant pleural effusion, with controversial results. Methods Patients with exudative pleural effusion were divided into 2 groups: a malignant pleural effusion group (39 patients) diagnosed by malignant cells in pleural fluid cytology or by malignant infiltration of the pleura on pleural biopsy, and a benign pleural effusion group (51 patients) with neither malignant cells in pleural fluid cytology nor malignant infiltration of the pleura on pleural biopsy. Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were determined in both serum and pleural fluid samples, using commercially available enzyme-linked immunosorbent assay kits. Results The etiology of malignant pleural effusion in the malignant group was breast cancer in 43.6% and bronchogenic carcinoma in 25.6%. There was a statistically significant difference between the 2 groups regarding sex, with more males in the benign group. There was no significant difference between groups regarding age. The median levels of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were higher in the malignant group than in the benign group, and the differences were highly significant in both pleural fluid ( p < 0.001) and serum ( p < 0.001). Conclusion Matrix metaloproteinase-9 and tissue inhibitor of metalloproteinase-1 in serum and pleural fluid samples might be valuable markers for differentiating benign from malignant pleural effusions.
Comparative efficacy and life quality effects of surgical stripping, radiofrequency ablation, and cyanoacrylate embolization in patients undergoing treatment for great saphenous vein insufficiency
Authors: Ay Yasin , Gunes Esra , Turkkolu Sevket Tuna , Selcuk Emre , Calim Muhittin , Akal Ramazan , Aydin Cemalettin , Inan Bekir , Koksal Cengiz , Kahraman Ay Nuray 
Published: August 2020

Objectives To compare traditional surgery with two minimally invasive endo-venous procedures in terms of their long-term effect on the quality of life in great saphenous vein insufficiency (GSV). Method This prospective observational study included 217 patients that underwent surgical stripping (n = 62), radiofrequency ablation (n = 70), or cyanoacrylate embolization (n = 85) for the treatment of GSV insufficiency. Venous Clinical Severity Score (VCSS) assessments were made, 36-item Short-Form Health Survey (SF-36) questionnaire and Chronic Venous Insufficiency quality of life Questionnaire (CIVIQ-14) were administered, before and 1 year after the treatments. Results Surgical stripping group had significantly higher closure rates than the other groups (p < 0.05). At 12 months, decrease in VCSS scores was less pronounced in the cyanoacrylate embolization group when compared to the other two groups (p < 0.05). Improvement in CIVIQ-14 scores was better in the radiofrequency ablation group when compared to the cyanoacrylate embolization group (p < 0.05). Surgical stripping or radiofrequency ablation groups performed better on several domains of SF-36, when compared to the cyanoacrylate embolization group. Conclusions Surgical stripping and radiofrequency ablation seem to provide a better quality of life results at one year in patients undergoing treatment for GSV insufficiency.
Diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging for malignant ovarian tumors: a systematic review and meta-analysis
Authors: Wei Mingxiang , Bo Fan , Cao Hui , Zhou Wei , Shan Wenli , Bai Genji 
Published: August 2020

Background Accurate preoperative diagnosis of malignant ovarian tumors (MOTs) is particularly important for selecting the optimal treatment strategy and avoiding overtreatment. Purpose To evaluate the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for MOTs. Material and Methods A systematic search was performed in PubMed, Embase, the Cochrane Library, and Web of Science databases to find relevant original articles up to October 2019. The included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Studies on the diagnosis of MOTs with quantitative or semi-quantitative DCE-MRI were analyzed separately. The bivariate random-effects model was used to assess the diagnostic authenticity. Meta-regression analyses were performed to analyze the potential heterogeneity. Results For semi-quantitative DCE-MRI, the pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic curves (AUC) were 85% (95% confidence interval [CI] 0.75–0.92), 85% (95% CI 0.77–0.91), 5.8 (95% CI 3.8–8.8), 0.17 (95% CI 0.10–0.30), 33 (95% CI 18–61), and 0.92 (95% CI 0.89–0.94), respectively. For quantitative DCE-MRI, the pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 88% (95% CI 0.65–0.96), 93% (95% CI 0.78–0.98), 12.3 (95% CI 3.4–43.9), 0.13 (95% CI 0.04–0.45), 91 (95% CI 10–857), and 0.96 (95% CI 0.94–0.98), respectively. Conclusion DCE-MRI has great diagnostic value for MOTs. Semi-quantitative DCE-MRI may be a relatively mature approach; however, quantitative DCE-MRI appears to be more promising than semi-quantitative DCE-MRI.
The feasibility and effects of eye movement training for visual field loss after stroke: a mixed methods study
Authors: Hazelton Christine , Pollock Alex , Dixon Diane , Taylor Anne , Davis Bridget , Walsh Glyn , Brady Marian C 
Published: August 2020

Introduction Visual field loss affects around 20% of stroke survivors, reducing quality of life. Eye movement training is a promising rehabilitation method, and several different interventions are used by occupational therapists. This study aimed to explore the feasibility and effects of four eye movement training interventions for stroke survivors with visual field loss. Method A mixed methods study – quantitative n-of-1 with qualitative interviews. The participants were 11 home-dwelling stroke survivors with visual field loss. The interventions used were MyHappyNeuron, NVT, Rainbow Readers and VISIOcoach, delivered in a randomised order. Visual search, reading speed, activities of daily living and quality of life were assessed three times before intervention use, then immediately after each intervention; these were analysed visually. A final semi-structured interview was then analysed using framework methods. Results Evidence of effect was divergent. Quantitatively there was no measured effect, but qualitatively participants reported benefits in visual skills, daily life skills and emotions, which varied by intervention. Median training time was 3–4 hours (range 0.5–6.5) for NVT, Rainbow Readers and MyHappyNeuron, and 9.5 hours (range 2.3–16.8) for VISIOcoach. Conclusion Eye movement training interventions were feasible for stroke survivors at home. Qualitative evidence suggests that variations in the eye movements trained and delivery modality underlie variations in perceived effect.
Measurement of older adults’ performance in digital technology-mediated occupations and management of digital technology
Authors: Fischl Caroline , Malinowsky Camilla , Nilsson Ingeborg 
Published: August 2020

Introduction Supporting older adults’ digital engagement requires an understanding of how occupational performance and technology use are related, as well as having a range of methods that can assist occupational therapists while observing occupational performance and management of technology. The study objectives were to investigate how older adults’ ability to perform digital technology-mediated occupations and ability to manage digital technology could be measured and to examine the association between these two abilities. Method Twenty-five older adults were observed performing digital technology-mediated occupations and managing digital technologies, and were scored on two instruments: the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. FACETS was used to generate respective multifaceted Rasch measurement models for scores on the instruments. The Spearman correlation test was used to investigate correlation between person ability measures from respective Rasch models of the instruments. Results The results include item, occupation, and technology difficulty estimates, as well as person ability measures that could illustrate older adults’ ability to perform occupations and to manage technology. There is also a strong positive correlation between these abilities. Conclusion Insight into an older person’s ability to manage technology can provide information about his or her ability to perform digital technology-mediated occupations and vice versa.
Morphing wings review: aims, challenges, and current open issues of a technology
Authors: Ameduri S , Concilio A 
Published: August 2020

The scope of this work is to provide a critical review on the expectations about the morphing wing technology against the current open issues and showstoppers. In synergy to other emerging and promising technologies, morphing is asked for bridging the evident gap between the current growth trend of the aerospace compartment and its impact onto the environment. The potential of morphing, in particular, its primary impact on the aerodynamic efficiency of the aircraft, primed the investigation of different technologies, achieving interesting results but often highlighting limitations and showstoppers against the airworthiness regulations. The authors focus their attention on some specific aspects that characterize the morphing wing attachments and that may represent weakness points for the maturation of the technology: the load transmission of the movable parts to the supporting wing box, the way the flexibility–rigidity paradox is addressed by specific critical components (the skin), the scalability dependence of the morphing architectures, and the specific aeroelastic behavior of the nonconventional architectures.
Maternal and fetal outcomes of lupus pregnancies: A collective effort by Karnataka Rheumatologists
Authors: Janardana Ramya , Haridas Vikram , Priya Vishnu , Bhat Vasudha , Singh Yogesh , Rao Vijay K , Jois Ramesh , Srikantiah Chandrashekara , Pinto Benzeeta , Shobha Vineeta 
Published: August 2020

Introduction Identifying factors predicting adverse pregnancy outcomes involving systemic lupus erythematosus (SLE) is a research priority. The aims of this study were to investigate (a) the maternal and fetal outcomes of pregnant lupus patients and the factors associated with adverse pregnancy outcomes, and (b) the effect of pregnancy on lupus disease activity of these patients. Methods This was an ambi-directional study collecting information from five multi-specialist referral centres across the state of Karnataka, India over 5 years (2013–2018). Clinical details of pregnancies and outcomes that were temporally associated with lupus disease were recorded using a structured pro forma. The Safety of Estrogen in SLE National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) was used to assess lupus activity during the 6 months prior to pregnancy and the intra- and post-partum periods. Modifications suggested in the SLE Pregnancy Disease Activity Index were considered while scoring. Results A total of 121 pregnancies in 80 SLE patients with a mean age of 27.1 (±4.5) years and with a mean disease duration of 4.6 (±4.1) years were reviewed. Largely patients were in clinical remission (109/121; 90.1%). Antiphospholipid antibody positivity was seen in 45/121 (37.2%) patients. A history of lupus nephritis was noted in 29/121 (24%) patients. Maternal complications (32%) were mainly due to hypertensive disorders of pregnancy (HDP; 19/121; 15.7%). Adverse fetal outcomes (58%) were mainly in the form of spontaneous first-trimester abortions (21/121; 16%), stillbirth (14/121; 11.6%) and prematurity (24/121; 20%). HDP is strongly associated with stillbirth and prematurity and is independent of active lupus. Disease activity was associated with a three-fold increased risk of adverse fetal outcome in univariate analysis. The risk of major flare during pregnancy is low (4.1%) when conception occurs during stable disease. Hydroxychloroquine (HCQ) use was associated with reduced risk of flare ( p = 0.001) in patients in remission at the time of conception. Conclusions The risk of major flare during pregnancy is low when conception happens during stable disease. HCQ use was associated with reduced risk of flare in patients in remission at the time of conception. HDP was strongly associated with stillbirth and prematurity and are independent of active lupus in our cohort.
Identifying co-morbid fibromyalgia in patients with systemic lupus erythematosus using the Multi-Dimensional Health Assessment Questionnaire
Authors: Huang Frank F , Fang Ray , Nguyen Matthew H , Bryant Katherine , Gibson Kathryn A , O’Neill Sean G 
Published: August 2020

Objective Fibromyalgia (FM) is prevalent but often under-recognized in patients with systemic lupus erythematosus (SLE). Patient-reported outcomes (PROs) from the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) can identify co-morbid FM in patients with rheumatic diseases. The present study examined the utility of the MDHAQ in recognizing FM in patients with SLE during routine consultations. Methods Patients with SLE completed an MDHAQ. FM status was determined by the validated 2016 revision of the ACR 2010/2011 preliminary FM criteria. Individual PROs from the MDHAQ and composite Fibromyalgia Assessment Tool (FAST) indices of the discriminatory PROs were compared between patients with and without FM using Student’s unpaired t-test and receiver operating characteristic curve analysis to determine the area under the curve (AUC). The physician’s clinical impression of FM was recorded, and the SLE Disease Activity Index was used to assess disease activity. Results Of 88 patients with SLE, 23 (26%) satisfied the 2016 FM criteria. The FAST3 composite measure of two out of three of pain (≥6/10), joint count (≥16/48) and symptom checklist (≥16/60) correctly classified 89% of patients (AUC=0.90, kappa=0.71). Physician diagnosis demonstrated moderate agreement with the 2016 FM criteria (kappa=0.43) but missed 43% of patients with FM. In the presence of active disease, the FAST3 correctly classified 91% of patients. Conclusions Co-morbid FM is prevalent in SLE yet often underdiagnosed by physicians. The simple FAST3 index of the MDHAQ provides an easy-to-use self-reported tool to improve identification of FM in patients with SLE.
Characteristics of lupus nephritis in Saudi lupus patients: A retrospective observational study
Authors: Albirdisi Majed R , Al-Homood Ibrahim A 
Published: August 2020

Objectives Systemic lupus erythematosus (SLE) is a chronic autoimmune multi-systemic disorder of the connective tissue, characterized mainly by involvement of the skin, joints, kidneys, and serosal membranes. It affects females particularly at childbearing age more commonly than males. Lupus nephritis affects around half of patients with SLE. Data about SLE and lupus nephritis in Saudi Arabia are still scarce. In this study, we aimed to evaluate the prevalence, clinical and laboratory findings of SLE and different histological types of lupus nephritis among Saudi patients at King Fahad Medical City. Methods This is a retrospective study for adult patients who have been evaluated at king Fahad medical city between 2014 and 2019 and fulfilled the Systemic Lupus International Collaborating Clinics classification criteria (SLICC). Results 112 patients, 103 (92%) females and 9 (8%) males, with confirmed diagnoses of SLE were reviewed. Skin rash (69.6%), photosensitivity (61.6%), mucosal ulcerations (45.9%), arthralgia and/or arthritis (44.6%) are the most common clinical features. Ninety seven (86.6%) out of 112 patients had a recorded first visit 24 hour urine protein level, out of those only 26 (23.2) patients presented with significant proteinuria of more than 0.5grams per day. Forty four (39.2%) have undergone kidney biopsy. Class IV and III lupus nephritis are the most common reported biopsy results (43.18% and 27.28% respectively). During the study period, three patients (2.7%) developed end-stage kidney disease requiring dialysis and five (4.5%) had renal transplant. Conclusion Our study provided insight on the demographics, characteristics and presentation of SLE patients and the outcome of lupus nephritis in Saudi Arabia.
Age at diagnosis and health-related quality of life are associated with fatigue in systemic lupus erythematosus patients: Data from the Almenara Lupus Cohort
Authors: Elera-Fitzcarrald Claudia , Reátegui-Sokolova Cristina , Gamboa-Cárdenas Rocío V , Medina Mariela , Zevallos Francisco , Pimentel-Quiroz Victor R , Zeña-Huancas Paola A , Pastor-Asurza César A , Perich-Campos Risto A , Rodríguez-Bellido Zoila J , Alarcón Graciela S , Ugarte-Gil Manuel F 
Published: August 2020

Objective To define the factors associated with fatigue in Mestizo patients with Systemic Lupus Erythematosus (SLE). Methods This is a cross-sectional study of SLE patients from a single center cohort. Visits were performed every six months. For these analyses, the first visit between October 2017 and December 2018 was included. Demographic and clinical characteristics as well as treatment were recorded at every visit. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FT), Health-Related Quality of Life (HRQoL) with the LupusQoL, disease activity with the Systemic Lupus Erythematosus Disease Activity Index –2 K (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology damage index (SDI). Prednisone use was recorded as current daily dose. Immunosuppressive drugs and antimalarial use were recorded as current, past or never. Univariable and multivariable analyses were performed using linear regression models. For the multivariable analyses, model selection followed a backward elimination procedure. Results Two hundred and twenty-six patients were evaluated. The mean (SD) age at diagnosis was 35.6 (13.1) years, 211 (93.4%) were female; and disease duration was 11.0 (7.3) years. The mean SLEDAI and SDI were 2.4 (3.5) and 1.3 (1.5), respectively. The mean FACIT-FT was 33.1 (10.8). On the multivariable analysis, age at diagnosis and some domains of HRQoL (physical health, emotional health and fatigue) remained associated. Conclusions Age at diagnosis is negatively associated with fatigue whereas HRQoL domains like physical health, emotional health and fatigue are positively associated with fatigue.
Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation?
Authors: Moghli Maram Abu , Farha Rana Abu , Hammour Khawla Abu 
Published: August 2020

Objective This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital. Method This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients’ Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients’ BPMH and their current medications was conducted where discrepancies were recognized. Results Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants ( n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions ( n = 71, 65.1%,) and the second most common type being additions ( n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified. Conclusion This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.