bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of manpower and medical facility reduction on surgical practice during the Gulf Conflict 1991
Authors: Howell G. E. D. , Dale R. F. 
Published: October 2021

AbstractThe General Surgical admissions to Royal Naval Hospital, Stonehouse from 1 April 1990—31 March 1991 were audited. This period included the Gulf War. There remained throughout the build-up to Operation Desert Storm, and during the actual conflict, a requirement to treat Service personnel as well as maintaining surgical training. This paper shows that both criteria were met despite reduced medical manpower and facilities.
Passive smoking in the Royal Navy
Authors: Cannon L. B. 
Published: October 2021

AbstractPassive smoking is an emotive issue and one which has received considerable coverage in the past few years from both the scientific community and the media. The arguments for and against links between passive smoking and disease are as fiercely contested among members of the Royal Navy as among civilians.This article aims to present the current evidence in favour of such a link and also the views on the matter as expressed by the ship’s company of a Type 22 frigate. Their views will be compared to the result of a similar survey carried out among civilian workforces. Finally, based on the evidence and results presented, strategies for tackling this problem will be discussed.
Comparative female to male consultation rates in NHS Primary Care: Extrapolation to the Royal Navy
Authors: Scott-Moncrieff N. F. J. 
Published: October 2021

SummaryPrevailing wisdom accepts that women consult their GP more often than men. Those with a modicum of interest will know that across the NHS, all ages and all social classes for all grades of consultation, the approximate ratio is two female consultations for one male consultation. However, if the figures are carefully sifted to identify that group most clearly akin to Royal Naval personnel, the gap widens.The following figures and discussion describe how in Naval personnel’s age, class and illness matched groups, extrapolating from NHS experience, the ‘typical’ Royal Naval ‘Wren’ might be expected to present as a fresh case (including family planning and pregnancy) three times more commonly and consult an RN GP four times more frequently than her male counterpart.In addition, a comparison of various pathology groups are compared and pronounced differences discussed.
Colorectal Cancer in the Royal Navy – an opportunity to intervene?
Authors: Cripps N. P. J. , Cannon L. B. 
Published: October 2021

AbstractColorectal cancer is uncommon in Royal Naval personnel; an average of two cases are diagnosed annually, often with disease advanced at presentation. During the next five years, 10 serving individuals are likely to present with colorectal cancer and many, if not all of these, already harbour premalignant adenomas or asymptomatic colonic malignancy. Currently over 2,000 servicemen are estimated to carry undiagnosed colorectal adenomas.Requests for hospital appointments for those reporting a family history of colorectal cancer and who request screening are increasing in frequency. An understanding of the personal implications of a family history of colorectal cancer and a basis for the management of these individuals will be provided.This paper considers ways in which the impact of colorectal cancer on the Royal Navy and its pensioners could be altered. Evidence derived from population based and family history based colorectal cancer screening studies are organised into a protocol by which the Royal Navy might be examined. The effect of a family history of colorectal cancer on disease incidence and the percentage of positives resulting from faecal occult blood testing are applied to the age profile of the Royal Navy. These show that a maximum of 56 flexible sigmoidoscopies and 90 colonoscopies would be needed in the first year of a programme to attempt the early detection of colorectal neoplasia.This paper is aimed at gaining feedback from primary and secondary care practitioners so that the possibility of introducing a programme for the early detection of colorectal cancer in the Royal Navy can be considered.
Care of World War II convoy casualties in the Kola area of North Russia. Part 1 – Initial arrangements
Authors: McMillan G. H. G. 
Published: October 2021

AbstractDuring much of World War II, the Allied Arctic Convoy Route to North Russia was a vital lifeline to sustain the Russian contribution to the defeat of Germany. Initial convoys were unopposed by enemy forces but it was not long before these joined the fearful elemental forces of the northern seas to reap a rich harvest of war material and human life. Survivors who reached North Russia frequently required skilled hospital care but, sadly, this was not available to any in the initial year or so of the operation. Conditions in host country hospitals are described in this part of the paper. The contribution of the Royal Naval Auxiliary Hospital which was eventually established in the autumn of 1942 under the charge of Temporary Surgeon Lieutenant Commander James Murray McEwan RNVR will be described in Part 2 of this paper which is to be published in the Spring 1996 issue.
The early morbidity of varicose vein surgery
Authors: Mackay D. C. , Summerton D. J. , Walker A. J. 
Published: October 2021

AbstractThe early outcome and morbidity associated with varicose vein surgery were assessed at six months post operation by postal questionnaire. Most cases underwent sapheno-femoral ligation, above-knee stripping of the long saphenous vein and multiple stab avulsions. A 73.8% response rate resulted in 155 replies, and revealed a high incidence (65.8%) of perceived complications within the first two weeks after surgery. The commonest of these were bruising, pain and numbness. Over a third of patients consulted their general practitioner (GP) postoperatively. Half of these required further management or treatment and the rest, reassurance alone. At six months 79.4% were satisfied with the outcome of their surgery, although some still claimed problems with residual veins, skin discoloration, numbness, and ankle or foot discoloration. Eleven percent were referred to hospital for further opinion, mostly because of perceived residual varicose veins. The difference between residual and recurrent varicose veins is discussed. No patient felt that the standard 2.5 day admission was too long, and 12.9% thought it too short. Day case surgery is not a popular option in this population group.Despite high satisfaction rates, there is a considerable morbidity attached to varicose vein surgery. We believe that good pre- and perioperative communication, augmented by a comprehensive information sheet, is important to prepare patients for those postoperative problems and thus reduces their perceived importance.
Learning in the clinical area: The Portsmouth Partnership experience
Authors: Smith S. 
Published: October 2021

AbstractThis paper outlines a new, innovative method of obtaining a degree pertinent to one’s job description. The Partnership Programme implemented from the University of Portsmouth had its first intake of students in October 1992. The course is primarily aimed for students in full-time employment. Following submission of a portfolio, students can obtain a degree in two years. Students undertake part-time university modules and learning projects at the workplace, the latter forming up to 60% of their total credits. Presently there are only two similar course frameworks in the United Kingdom.
Problem drinking in the Naval Service: A study of personnel identified as alcohol abusers
Authors: Micklewright S 
Published: October 2021

AbstractA group of naval personnel referred for alcohol problems was studied for a number of characteristics
including sex, service status, age group, Branch, presenting factors, where serving, referral source,
marital status, length of service and family history of alcohol abuse. They were compared with a control group of othernaval personnel.The alcohol referral group displayed a number of statistically significant differences from the control group. Junior rates, those aged below 20, communications branch personnel and those serving at sea were over represented. The alcohol referrals group were also more likely to be unmarried or divorced, and have a family history of alcohol abuse. Officers, Senior Rates and engineering branch personnel were under represented. With regard to male:female ratio, age group distribution over age 20 and length of service, there were no significant differences between the alcohol referral and control groups. The majority of alcohol referrals were made by Medical and Divisional Officers, the overwhelming reason being disciplinary action related to alcohol abuse.
Evaluating the Tactical Combat Casualty Care principles in civilian and military settings: systematic review, knowledge gap analysis and recommendations for future research
Authors: Strauss Rachel , Menchetti Isabella , Perrier Laure , Blondal Erik , Peng Henry , Sullivan-Kwantes Wendy , Tien Homer , Nathens Avery , Beckett Andrew , Callum Jeannie , da Luz Luis Teodoro 
Published: October 2021

ObjectivesThe Tactical Combat Casualty Care (TCCC) guidelines detail resuscitation practices in prehospital and austere environments. We sought to review the content and quality of the current TCCC and civilian prehospital literature and characterize knowledge gaps to offer recommendations for future research.MethodsMEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were searched for studies assessing intervention techniques and devices used in civilian and military prehospital settings that could be applied to TCCC guidelines. Screening and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal was conducted using appropriate tools.ResultsNinety-two percent (n=57) of studies were observational. Most randomized trials had low risk of bias, whereas observational studies had higher risk of bias. Interventions of massive hemorrhage control (n=17) were wound dressings and tourniquets, suggesting effective hemodynamic control. Airway management interventions (n=7) had high success rates with improved outcomes. Interventions of respiratory management (n=12) reported low success with needle decompression. Studies assessing circulation (n=18) had higher quality of evidence and suggested improved outcomes with component hemostatic therapy. Hypothermia prevention interventions (n=2) were generally effective. Other studies identified assessed the use of extended focused assessment with sonography in trauma (n=3) and mixed interventions (n=2).ConclusionsThe evidence was largely non-randomized with heterogeneous populations, interventions, and outcomes, precluding robust conclusions in most subjects addressed in the review. Knowledge gaps identified included the use of blood products and concentrate of clotting factors in the prehospital setting.Level of evidenceSystematic review, level III.
Chirality detected in Hartley’s electronic oscillator
Authors: Gallas Jason A. C. 
Published: October 2021

AbstractChirality is an elusive asymmetry important in science and technology and confined mainly to the quantum realm. This paper reports the observation of chirality in a classical (that is, not quantum) scenario, namely in stability diagrams of an autonomous electronic oscillator with a junction-gate field-effect transistor (JFET) and a tapped coil. As the number of spikes (local maxima) of stable oscillations changes along closed parameter paths, they generate two types of intricate structures. Surprisingly, such pair of structures are artful images of each other when reflected on a mirror. They are dual chiral pairs interconnecting families of stable oscillations in closed loops. Chiral pairs should not be difficult to detect experimentally. This chirality is conjectured to be a generic property of nonlinear oscillators governed by classical (that is, not quantum) equations.
Quantum-Inspired Recommendation System with Threshold Proportion Interception
Authors: Qiao Meng , Shan Zheng , Wang Junchao , Sun Huihui , Liu Fudong 
Published: October 2021

Modern recommendation systems leverage historical behavior information to generate precise recommendation results for users. However, when the data scale of users and items is large, it is difficult to generate recommendation results in time. Tang proposed a quantum-inspired recommendation algorithm, which could solve the recommendation problem in constant time complexity. However, Tang’s approach is based on a set of assumptions which rely heavily on some empirical parameters. The time complexity for calculating parameters is high. Thus, this approach cannot be directly applied in industrial applications. In this paper, we propose a method, namely, Quantum-inspired Recommendation system with threshold Proportion Interception (QRPI), which is based on the quantum-inspired recommendation system and more suitable for industrial environments. Compared with the existing widely used recommendation algorithms, we show through numerical experiments that our solution can achieve almost the same performance with better efficiency.
Mapping Surgeons Hand/Finger Movements to Surgical Tool Motion During Conventional Microsurgery Using Machine Learning
Authors: Fattahi Sani Mohammad , Ascione Raimondo , Dogramadzi Sanja 
Published: October 2021

Purpose: Recent developments in robotics and artificial intelligence (AI) have led to significant advances in healthcare technologies enhancing robot-assisted minimally invasive surgery (RAMIS) in some surgical specialties. However, current human–robot interfaces lack intuitive teleoperation and cannot mimic surgeon’s hand/finger sensing required for fine motion micro-surgeries. These limitations make teleoperated robotic surgery not less suitable for, e.g. cardiac surgery and it can be difficult to learn for established surgeons. We report a pilot study showing an intuitive way of recording and mapping surgeon’s gross hand motion and the fine synergic motion during cardiac micro-surgery as a way to enhance future intuitive teleoperation. Methods: We set to develop a prototype system able to train a Deep Neural Network (DNN) by mapping wrist, hand and surgical tool real-time data acquisition (RTDA) inputs during mock-up heart micro-surgery procedures. The trained network was used to estimate the tools poses from refined hand joint angles. Outputs of the network were surgical tool orientation and jaw angle acquired by an optical motion capture system. Results: Based on surgeon’s feedback during mock micro-surgery, the developed wearable system with light-weight sensors for motion tracking did not interfere with the surgery and instrument handling. The wearable motion tracking system used 12 finger/thumb/wrist joint angle sensors to generate meaningful datasets representing inputs of the DNN network with new hand joint angles added as necessary based on comparing the estimated tool poses against measured tool pose. The DNN architecture was optimized for the highest estimation accuracy and the ability to determine the tool pose with the least mean squared error. This novel approach showed that the surgical instrument’s pose, an essential requirement for teleoperation, can be accurately estimated from recorded surgeon’s hand/finger movements with a mean squared error (MSE) less than 0.3%. Conclusion: We have developed a system to capture fine movements of the surgeon’s hand during micro-surgery that could enhance future remote teleoperation of similar surgical tools during micro-surgery. More work is needed to refine this approach and confirm its potential role in teleoperation.
Worst-case Execution Time Calculation for Query-based Monitors by Witness Generation
Authors: Búr Márton , Marussy Kristóf , Meyer Brett H. , Varró Dániel 
Published: October 2021

Runtime monitoring plays a key role in the assurance of modern intelligent cyber-physical systems, which are frequently data-intensive and safety-critical. While graph queries can serve as an expressive yet formally precise specification language to capture the safety properties of interest, there are no timeliness guarantees for such auto-generated runtime monitoring programs, which prevents their use in a real-time setting. While worst-case execution time (WCET) bounds derived by existing static WCET estimation techniques are safe, they may not be tight as they are unable to exploit domain-specific (semantic) information about the input models. This article presents a semantic-aware WCET analysis method for data-driven monitoring programs derived from graph queries. The method incorporates results obtained from low-level timing analysis into the objective function of a modern graph solver. This allows the systematic generation of input graph models up to a specified size (referred to as
witness models
) for which the monitor is expected to take the most time to complete. Hence, the estimated execution time of the monitors on these graphs can be considered as safe and tight WCET. Additionally, we perform a set of experiments with query-based programs running on a real-time platform over a set of generated models to investigate the relationship between execution times and their estimates, and we compare WCET estimates produced by our approach with results from two well-known timing analyzers, aiT and OTAWA.
Adaptive Computation Reuse for Energy-Efficient Training of Deep Neural Networks
Authors: Servais Jason , Atoofian Ehsan 
Published: October 2021

In recent years, Deep Neural Networks (DNNs) have been deployed into a diverse set of applications from voice recognition to scene generation mostly due to their high-accuracy. DNNs are known to be computationally intensive applications, requiring a significant power budget. There have been a large number of investigations into energy-efficiency of DNNs. However, most of them primarily focused on inference while training of DNNs has received little attention.
This work proposes an adaptive technique to identify and avoid redundant computations during the training of DNNs. Elements of activations exhibit a high degree of similarity, causing inputs and outputs of layers of neural networks to perform redundant computations. Based on this observation, we propose Adaptive Computation Reuse for Tensor Cores (ACRTC) where results of previous arithmetic operations are used to avoid redundant computations. ACRTC is an architectural technique, which enables accelerators to take advantage of similarity in input operands and speedup the training process while also increasing energy-efficiency. ACRTC dynamically adjusts the strength of computation reuse based on the tolerance of precision relaxation in different training phases. Over a wide range of neural network topologies, ACRTC accelerates training by 33% and saves energy by 32% with negligible impact on accuracy.
The Efficacy of Hydroxychloroquine Combined with Huangqi Tablets in the Treatment of Diabetic Nephropathy
Authors: Chen Xiaorong , Sheng Danhong , Kong Xiangdong 
Published: October 2021

Objective. This study aimed to analyze the effect of hydroxychloroquine combined with Huangqi tablets in the treatment of diabetic nephropathy (DN). Methods. Eighty patients with DN were enrolled and divided into two groups by a random number table. 27 patients received routine treatment + hydroxychloroquine (group A), while 27 patients received routine treatment + hydroxychloroquine + Huangqi tablets (group B) and 26 patients received routine treatment (group C). Results. FPG, 2h PG, and HbA1c levels as well as TC and TG levels were lower in group B than in groups A and C at the end of 3 months of treatment and were lower in group A than in group C (

P

< 0.05). SCR, BUN, and 24-hour urine protein were reduced in group B after therapy, whereas eGFR was increased and the difference between groups A and C was significant (

P
=
0.05

). After treatment, VEGF, IGF-1, and TGF-1 levels were lower in group B than in groups A and C and in group A than in group C (

P
=
0.05

). Total symptom scores at 2, 4, and 6 months after treatment was lower in group B than in groups A and C, and they were lower in group A than in group C at all time points (

P

< 0.05). The total effective rates of treatment in groups A, B, and C were 66.67%, 88.89%, and 38.46% (

P

< 0.05). The incidence of adverse reactions in groups A, B, and C was 37.04%, 25.93%, and 11.54% (

P

> 0.05). Conclusion. Hydroxychloroquine combined with Huangqi tablets in the treatment of DN showed the best efficacy, with better control of blood glucose and lipids, which can more effectively delay the progression of renal lesions and effectively inhibit the expression of VEGF, IGF, and TGF-β1 in tethered cells with high safety.
Analysis of Continuous Nursing Intervention on Aplastic Anemia Patients Based on the “Information-Motivation-Behavioral Skills Model”
Authors: Shen Wei , Liu Xiaorong , Zhou Aiping 
Published: October 2021

Objective. To explore the effect of continuous nursing care based on the “information-motivation-behavioral skills model” (IMB) in the intervention of patients with aplastic anemia. Methods. A total of 90 patients with aplastic anemia who were admitted to our hospital from June 2019 to January 2021 were included in the study. The patients were divided into an observation group and a control group according to the random number table, with 45 patients in each group. The control group received routine nursing care, while the observation group received continuous nursing care based on IMB on the basis of the control group. Patients were followed up for 3 months, and their health knowledge was assessed with our self-made health knowledge rating scale. Patients’ medication compliance was assessed using the Morisky medication compliance questionnaire. The self-care ability was assessed with the self-made self-care ability scale in our hospital. The comprehensive quality of life assessment questionnaire (GQOLI-74) was used to assess the quality of life of patients. A self-prepared nursing satisfaction questionnaire was used to score patients’ nursing satisfaction. The total effective rate of nursing was evaluated. Results. The awareness scores of basic disease knowledge, medication knowledge, and daily self-care knowledge in the observation group were higher than those in the control group (

P

< 0.05). The scores of medication compliance in the observation group were higher than those in the control group (

P

< 0.05). The self-care abilities such as healthy diet, psychological adjustment, self-care skills, oral care, and perianal care in the observation group were higher than those in the control group (

P

< 0.05). The quality of life scores of patients in the two groups in the 3 months of nursing were higher than those when they were discharged from hospital (

P

< 0.05). The GQOLI-74 score of 3 months’ nursing care in the observation group was higher than that in the control group (

P

< 0.05). The nursing satisfaction degree of the observation group (97.78%) was higher than that of the control group (82.23%) (

P

< 0.05). The total effective rate of nursing care in the observation group (97.78%) was higher than that in the control group (77.78%) (

P

< 0.05). Conclusion. IMB-based continuous nursing care can significantly increase the awareness of health knowledge in patients with aplastic anemia, effectively improve medication compliance, significantly enhance self-care ability, and thus, improve the quality of life.