bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speed control of hydraulic turbines for grid synchronization using simple adaptive add-ons
Authors: Gezer Dogan , Taşcıoğlu Yiğit , Çelebioğlu Kutay 
Published: July 2018

Background: Parameters of the hydroelectric power plant controllers are typically tuned at the nominal operating conditions such as nominal head and single unit operation. Water level variations in reservoir and/or tailwater, and the presence of other active units sharing the penstock are common disturbances to the nominal assumption. Methods: This article proposes two adaptive add-ons, namely gain scheduling and model reference adaptive control, to the existing speed controllers to improve grid synchronization performance when the site conditions are not nominal. The add-ons were designed and tested on a validated dynamic model of a power plant unit by using a software-in-the-loop simulation setup. An off-season scenario is simulated, in which the original controller of the unit cannot bring the turbine to synchronize with the grid due to low gross head. Then, the add-ons were implemented on-site and experiments were performed under similar conditions. The parameter sets used in gain scheduling for different operation bands are determined off-line with the help of operational experience. The model reference adaptive control add-on requires a reference model and a learning rate. A description of the turbine speed-up profile at nominal operating conditions is sufficient to be used as the reference model. The proposed piecewise linear reference model favors stability over speed in settling to the nominal speed. Results: It is experimentally shown that the proposed add-ons compensate the negative effect of head loss in grid synchronization, and perform similar to the ideal performance at the nominal head. Conclusion: Both add-ons can be implemented on the available off-the-shelf speed governor controllers. They are suitable for use in all hydroelectric power plants, especially in unmanned ones, for automatic synchronization with less waste water.
Media reporting of suicide and adherence to media guidelines
Authors: McTernan Niall , Spillane Ailbhe , Cully Grace , Cusack Eimear , O’Reilly Theresa , Arensman Ella 
Published: July 2018

Background: International research consistently shows evidence for an association between sensationalised and detailed media reporting, and suicidal behaviour. Aim: This study examined the quality of media reporting of suicide and adherence to media guidelines in Ireland. Methods: In accordance with the criteria outlined in the media guidelines for reporting suicide, 243 media articles were screened and analysed for quality of reporting of two high-profile cases of suicide and two cases of suicide that became high profile following a period of intense media coverage that occurred between September 2009 and December 2012. Results: A minority of articles breached the media guidelines in relation to sensationalised language (11.8%), placement of reports on the front page of the newspaper (9.5%), publishing of inappropriate photographs (4.2%) and mention of location of suicide (2.4%), while no articles disclosed the contents of a suicide note. However, in the majority of articles analysed, journalists did not refer to appropriate support services for people vulnerable to, and at risk of suicide (75.8%) or mention wider issues that are related to suicidal behaviour (53.8%). Overemphasis of community grief (48.3%) was also common. Nearly all articles (99.2%) breached at least one guideline and 58.9% of articles breached three or more guidelines. Conclusion: Overall, adherence to media guidelines on reporting suicide in Ireland improved in certain key areas from September 2009 until December 2012. Nonetheless, important challenges remain. Increased monitoring by media monitoring agencies, regulators and government departments is required. Implementation should be conducted using a pro-active approach and form part of the curriculum of journalists and editors. The inclusion of guidelines for the reporting of suicidal behaviour in press codes of conduct for journalists warrants consideration.
Patient Engagement in Type 2 Diabetes: A Collaborative Community Health Initiative
Authors: Freeman Kimberly , Hanlon Michael , Denslow Sheri , Hooper Vallire 
Published: July 2018

Purpose The purpose of this study was to describe the effects of an innovative rural community-based, diabetes self-management education and support (DSMES) program on patient behaviors and outcomes. Methods A 12-month pre-post study design with physiological data collection at program initiation, 16 weeks, and 6 and 12 months postenrollment was used for program assessment. The program consisted of an American Diabetes Association–accredited curriculum provided by the hospital and interfaced with a YMCA curriculum promoting lifestyle change. The 28-session program was delivered over a 1-year period. Results The sample size was 115. Participants were primarily white and female, with a mean age of 57 years. Mean body mass index (BMI) at program initiation was 37; mean A1C was 8.5 (69.4 mmol/mol). Significant reductions were obtained in weight, BMI (at 16 weeks), and A1C (at 6 months); these reductions were sustained at 12 months. Medication intake was significantly reduced, and diabetes-related emergency department visits were below national averages. Conclusions Results support the positive impact of a year-long, community-based, healthy behavior, DSMES program on health outcomes and overall costs of care delivery in the rural setting.
A simplified 10-step Tai-chi programme to enable people with dementia to improve their motor performance: a feasibility study
Authors: Liu Justina Yat Wa , Kwan Rick Yiu Cho , Lai Claudia KY , Hill Keith D 
Published: July 2018

Objective: To evaluate the feasibility and preliminary effects of a simplified 10-step Tai-chi programme to improve the motor performance of people with dementia. Design: A two-arm, single-blinded cluster randomized controlled trial, registered with ClinicalTrials.gov (NCT03341091). Setting: Community health centres. Participants: Twenty-six dyads of people with dementia and their family caregivers were recruited, with mean (SD) ages of 82.2 (7.43) and 51.3 (18.97), respectively. Interventions: The experimental group underwent a 16 week 10-step simplified Tai-chi training programme, with additional measures to enhance engagement. The control group joined recreational activities organized by the centres. Main outcome measure(s): The feasibility assessment included recruitment, attrition, adherence to, and engagement in the Tai-chi programme. The preliminary effects were assessed by the participants’ performance in mobility tests. Results: Preliminary feasibility was established, with an acceptable recruitment rate of 58% (26 out of 45 assessed dyads) and a high attendance rate of 81% (25.88 out of 32 Tai-chi sessions). There was positive engagement in the training sessions, and no adverse incidents. However, five participants withdrew from the Tai-chi group, for a high attrition rate of 38%, and the mean home practice time decreased between weeks 8 and 16. In most of the motor performance tests, a slight but insignificant improvement was observed in the Tai-chi group compared to the control group. Conclusion: A tailored Tai-chi programme for people with dementia using a dyadic approach has been found to be feasible. However, stronger support must be provided to family caregivers to improve the participants’ sustained participation.
The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries
Authors: Smets Tinne , Pivodic Lara , Piers Ruth , Pasman H Roeline W , Engels Yvonne , Szczerbińska Katarzyna , Kylänen Marika , Gambassi Giovanni , Payne Sheila , Deliens Luc , Van den Block Lieve 
Published: July 2018

Background: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. Aim: This study assesses the palliative care knowledge of staff in NHs in Europe. Design: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy. Palliative care knowledge is measured with the Palliative Care Survey. Scores on the scales range between 0 and 1; higher scores indicate more knowledge. Results: A total of 3392 NH-staff were given a questionnaire, and 2275 responded (67%). Knowledge of basic palliative care issues ranged between 0.20 in Poland (95% confidence interval (CI) 0.19; 0.24) and 0.61 in Belgium (95% CI 0.59; 0.63), knowledge of physical aspects that can contribute to pain ranged between 0.81 in Poland (95% CI 0.79; 0.84) and 0.91 in the Netherlands (95% CI 0.89; 0.93), and knowledge of psychological reasons that can contribute to pain ranged between 0.56 in England (95% CI 0.50; 0.62) and 0.87 in Finland (95% CI 0.83; 0.90). Factors associated with knowledge were country, professional role and having undertaken formal training in palliative care. Conclusions: Knowledge of nurses and care assistants concerning basic palliative care issues appears to be suboptimal in all participating countries, although there is substantial heterogeneity. Education of nursing staff needs to be improved across, but each country may require its own strategy to address the unique and specific knowledge gaps.
Kentucky’s Smoking Cessation Quitline: Annual Estimated Return on Investment to Employers
Authors: Pauly Nathan , Talbert Jeffrey , Parsley Shannon , Gray Bobbye , Hahn Ellen J. 
Published: July 2018

Purpose: State-based smoking cessation telephone quitlines offer a cost-effective method of providing tobacco treatment at no cost to participants. The study objective was to assess the annual return on investment (ROI) to employers if they were to bear the entire responsibility from the Kentucky quitline. Design: A retrospective design was used to estimate the annual ROI to employers from the Kentucky quitline. Setting: The telephone quitline (1-800-QUIT-NOW) provided intake and follow-up data for all Kentucky participants who enrolled in the program from 2012 to 2014. Participants: All individuals aged 18+ who enrolled in the Kentucky quitline from 2012 to 2014. Measures: Successful tobacco cessation was assessed from follow-up surveys that took place after individuals completed the program. Cost savings to employers associated with tobacco cessation were gleaned from a published meta-analysis. The Kentucky quitline provided estimates for annual program expenses. Analysis: The annual ROI was calculated as the difference between estimated annual cost savings due to smoking cessation and annual program expenses. Results: From 2012 to 2014, 5425 individuals were enrolled in the quitline. The annual ROI to employers was estimated to be $998 680, with an ROI ratio of 6.2:1. Conclusions: Employers may receive a substantial ROI if they were to fund the Kentucky quitline. Study results may be used as evidence to support cost-sharing partnerships between public health agencies and employers to sustain funding for telephone quitlines.
Effect of Postoperative Ketorolac Administration on Bone Healing in Ankle Fracture Surgery
Authors: McDonald Elizabeth , Winters Brian , Nicholson Kristen , Shakked Rachel , Raikin Steven , Pedowitz David I. , Daniel Joseph N. 
Published: July 2018

Background: In an effort to minimize narcotic analgesia and its potential side effects, anti-inflammatory agents offer great potential provided they do not interfere with bone healing. The safety of ketorolac administration after foot and ankle surgery has not been well defined in the current literature. The purpose of this study was to report clinical healing and radiographic outcomes for patients treated with a perioperative ketorolac regimen after open reduction and internal fixation (ORIF) of ankle fractures. Methods: A retrospective review was performed on all patients that received perioperative ketorolac at the time of lateral malleolar, bimalleolar, and trimalleolar ankle ORIF by a single surgeon between 2010 and 2016 with minimum 4 months follow-up. Patients received 20 tablets of 10 mg ketorolac Q6 hours. Radiographs were evaluated independently by 2 blinded fellowship-trained orthopedic foot and ankle surgeons to assess for radiographic healing. A total of 281 patients were included, with a median age of 51 years and 138 males (47%). Statistical analysis consisted of a linear mixed-effects regression. Results: In all, 265/281 (94%) were clinically healed within 12 weeks and 261/281 (92%) were radiographically healed within 12 weeks. Within the group of patients that did not heal within 12 weeks, mean time to clinical healing was 16.9 weeks (range = 14-25 weeks), and mean time to radiographic healing was 17.1 weeks (range = 14-25 weeks). In patients taking ketorolac, there were no cases of nonunion in our series (n = 281) and no significant difference found between fracture patterns and healing or complications ( P = .500). Conclusions: Perioperative ketorolac use was associated with a high rate of fracture union by 12 weeks. This is the first study to examine the effect of ketorolac on radiographic time to union of ankle fractures. Additional studies are necessary to determine whether ketorolac helps reduce opioid consumption and improve pain following ORIF of ankle fractures. Level of Evidence: Level IV, case series.
Bioengineered surgical repair of a chronic oronasal fistula in a cat using autologous platelet-rich fibrin and bone marrow with a tailored 3D printed implant
Authors: Soares Carla S , Barros Luís C , Saraiva Virgínia , Gomez-Florit Manuel , Babo Pedro S , Dias Isabel R , Reis Rui L , Carvalho Pedro P , Gomes Manuela E 
Published: July 2018

Clinical summary: A tissue engineering approach was used to aid the surgical repair of a chronic oronasal fistula (ONF) in a 13-year-old cat. A three-dimensional (3D) printed mesh, tailored to the size and shape of the ONF, was created to support a soft tissue flap used to close the defect; and also to provide a matrix for mesenchymal stromal cells present in bone marrow aspirate and bioactive cytokines and growth factors present in platelet-rich fibrin harvested from the patient. A CT scan at day 75 after surgery revealed the formation of new tissue in the defect and the healing process was complete at follow-up 6 months after surgery. Relevance and novel information: Complications are frequently reported following surgical repair of ONFs and include dehiscence of the palatal suture line, flap necrosis due to damage to the greater palatine artery and maxillary osteomyelitis, mainly due to chronic infection and bone lysis. The case described here demonstrates how input from a multidisciplinary team and the use of a biomaterial, processed by sophisticated technologies, can create a precision regenerative medicine strategy adapted to the patient’s clinical needs; this provided a novel therapeutic solution for an otherwise hard to treat clinical problem.
Interleukin-18 and the NLR family pyrin domain containing-3 inflammasome in adipose tissue are strongly associated with glucometabolic variables in a cohort of middle-aged men
Authors: Åkra Sissel , Aksnes Tonje A , Flaa Arnljot , Eggesbø Heidi B , Opstad Trine Baur , Njerve Ida U , Seljeflot Ingebjørg 
Published: July 2018

Background: Previous studies have indicated an association between interleukin-18 and glucose. Interleukin-18 becomes active when cleaved by caspase-1, activated by the NLR family pyrin domain containing-3 inflammasome. Aim: To investigate associations between glucometabolic variables and serum levels of interleukin-18 and genetic expression of interleukin-18, caspase-1 and NLR family pyrin domain containing-3 in adipose tissue and circulating leukocytes, and whether these mediators are related to the amount of abdominal adipose tissue . Materials and Methods: Fasting blood samples and subcutaneous adipose tissue were collected in a cohort of 103 middle-aged men. Serum levels of interleukin-18 were determined by enzyme-linked immunosorbent assay, gene expression by real-time polymerase chain reaction and insulin sensitivity by glucose clamp. The distribution of abdominal adipose tissue, separated into superficial- and deep subcutaneous, and visceral adipose tissue, was assessed by computed tomography scan. Results: Glucometabolic variables correlated significantly to serum levels of interleukin-18, and to the expression of interleukin-18 and NLR family pyrin domain containing-3 in subcutaneous adipose tissue ( p < 0.05). Significant correlations were further observed between the amount of fat in the different compartments of abdominal adipose tissue and both serum levels of interleukin-18 and genetic expression of interleukin-18 and NLR family pyrin domain containing-3 in adipose tissue. Conclusion: The results implicate that the glucometabolic state is of importance for the inflammasome-related inflammation expressed both circulatory and genetically in subcutaneous adipose tissue, the latter highly reflected in the amount of abdominal adipose tissue.
The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia
Authors: Sencan Savas , Cuce Isa , Karabiyik Ozgur , Demir Fatmagul U , Ercalik Tulay , Gunduz Osman H 
Published: July 2018

Objective Ganglion impar block (GIB) can be performed in patients with chronic coccygodynia who do not respond to conservative treatments. We investigated the effect of coccygeal dynamic patterns on the treatment outcome in patients with chronic coccygodynia treated with GIB. Materials and methods We retrospectively analyzed the data for patients diagnosed with chronic coccygodynia who underwent GIB only once by a transsacrococcygeal method under fluoroscopy guidance in our Pain Medicine Clinic. Patients were assessed with standard and dynamic coccyx radiographs and classified according to coccygeal mobility. Pain scores were assessed with a numerical rating scale (NRS) before and after the intervention (at 1 hour and 4, 12 and 24 weeks). A 50% or more reduction in the NRS score was accepted as significant pain relief. Results Of the 37 patients included in the study, 14 had normal coccyx (Group I) and 23 had immobile coccyx (Group II) based on the radiological evaluation. The NRS scores were significantly reduced in both groups on each follow-up visit but there was no significant difference between the two groups in terms of pre- and post-intervention NRS scores. Significant pain relief was achieved in 42.9% and 61.9% of patients in Group I and II at the last examination, respectively. Conclusion GIB administered by transsacrococcygeal method in patients with chronic coccygodynia is a safe and alternative treatment approach with reduced pain scores and low complication rates. In patients with chronic coccygodynia, having a normal or immobile coccyx does not appear to affect treatment outcomes.
Duplication of the vertebral artery: A series of four cases
Authors: Kritikos Michael , Sharma Nikhil , Sedora-Roman Neda , Choudhri Omar , Pukenas Bryan , Hurst Robert , Kung David 
Published: July 2018

Introduction Duplication of the vertebral artery (VA) is a rare vascular variant, with less than 50 reported cases in the literature. Case series We present four cases of VA duplication and discuss the imaging findings, which highlight the rarely seen VA duplication. Discussion VA duplication is generally considered to be an incidental finding. The VA is formed from the fusion of the longitudinal anastomoses that link the cervical intersegmental arteries, during the 32–40-day stage. The duplication of the VA is a clinically relevant finding for planning of head and neck surgery and neuro-interventional procedures.
Successful recanalization using the Embolus Retriever with Interlinked Cage for acute stroke due to calcified cerebral emboli
Authors: Kwak Hyo S , Park Jung S 
Published: July 2018

Mechanical thrombectomy is a safe and effective treatment in patients with acute ischemic stroke caused by large vessel occlusions. However, in rare cases, the procedure may be challenging due to the composition of the embolus. We describe a case of a mechanical thrombectomy with the Embolus Retriever with Interlinked Cage (ERIC) device in a patient with an acute ischemic stroke due to calcified cerebral emboli in the middle cerebral artery. The procedure was done after a failed recanalization attempt with manual aspiration thrombectomy. An 82-year-old woman presented to the emergency department with a sudden onset of right-sided weakness. A computed tomographic angiography showed left middle cerebral (M1 branch) calcified emboli. After the administration of an intravenous thrombolytic agent, the patient was transferred to the angiographic suite for a mechanical thrombectomy. After failure to recanalize the vessel with manual aspiration thrombectomy, successful recanalization was achieved via mechanical thrombectomy using the ERIC device. Mechanical thrombectomy with an ERIC device can be a useful option in cases of acute ischemic stroke caused by calcified cerebral emboli.
A Pilot Randomized Clinical Trial Comparing Three Brief Group Interventions for Individuals With Tinnitus
Authors: Martz Erin , Chesney Margaret A , Livneh Hanoch , Jelleberg Chennettee , Fuller Bret , Henry James A 
Published: July 2018

Background Tinnitus (ie, ear or head noises not caused by external sounds) is common among the general population and is the most prevalent service-connected disability in the United States’ Department of Veterans Affairs system. While numerous clinical interventions have been created to systematically address the range of issues caused by tinnitus, only a few tinnitus interventions have focused on both teaching and assessing coping strategies. The present pilot study involved a randomized clinical trial comparing 3 brief group interventions to a usual-care (UC) group (ie, a wait-list control group): the first intervention based on acceptance and commitment therapy (ACT), a second based on cognitive-behavioral therapy (CBT), and a third based on coping effectiveness training (CET). Each intervention group also received tinnitus-related audiological education. Participants Forty individuals met the eligibility requirements and were randomized into 1 of the 4 groups (ACT, CBT, CET, or UC). An intent-to-treat analysis was used in this study. Measures The Brief COPE scale was used to assess coping. Coping was assessed at 3 time points (pre-intervention, post-intervention, and at 4-week follow-up). The outcomes were 3 coping factors (engagement coping, disengagement coping, and social support coping). Results When examining differences among the groups on mean coping scores over time, significant group differences were found on social support coping, with the CET group scores significantly higher than the UC group. Discussion While all 3 brief interventions teach stress-reduction techniques, ACT and CBT focus primarily on managing one’s unwanted thoughts and emotions. CET teaches participants both a range of coping strategies (eg, stress-management approaches) to more effectively manage stressors that cannot be changed, as well as coping strategies (eg, such as problem-solving) that can be used to eliminate stressors that can be changed. CET also teaches communication skills for telling others about one’s tinnitus-related issues. CET instructs individuals on how to select coping strategies that are appropriate for different kinds of stressors and how to seek social support, which is a skill not explicitly taught by ACT or CBT. Results of this study were derived from a small sample size, and thus, future research should focus on replicating the results among a larger sample. In addition, future research could focus on adapting the CET intervention to a different delivery format.