bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Medicine Palliative Care Access (EMPallA): protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness
Authors: Grudzen Corita R , Shim Deborah J , Schmucker Abigail M , Cho Jeanne , Goldfeld Keith S 
Published: January 2019

IntroductionEmergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.Methods and analysisThis is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate <15 mL/min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life.Ethics and disseminationInstitutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03325985; Pre-results.
Pathways of antibiotic use in Bangladesh: qualitative protocol for the PAUSE study
Authors: Rousham Emily K , Islam Mohammad Aminul , Nahar Papreen , Lucas Patricia Jane , Naher Nahitun , Ahmed Syed Masud , Nizame Fosiul Alam , Unicomb Leanne 
Published: January 2019

IntroductionGlobal actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires a greater understanding of the drivers of antibiotic use from the perspective of providers and consumers. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers.The aim of this study is to conduct integrated research on household decision-making for healthcare and antibiotic use, as well as the awareness, behaviours and priorities of healthcare providers and sellers of antibiotics to translate into policy development and implementation.Methods and analysisIn-depth interviews will be conducted with (1) household members responsible for decision-making about illness and antibiotic use for family and livestock; (2) qualified and unqualified private and government healthcare providers in human and animal medicine and (3) stakeholders and policy-makers as key informants on the development and implementation of policy around AMR. Participant observation within retail drug shops will also be carried out. Qualitative methods will include a thematic framework analysis.A holistic approach to understanding who makes decisions on the sale and use of antibiotics, and what drives healthcare seeking in Bangladesh will enable identification of routes to behavioural change and the development of effective interventions to reduce the health risks of AMR.Ethics and disseminationApproval for the study has been obtained from the Institutional Review Board at the International Centre for Diarrhoeal Disease Research, Bangladesh following review by the Research and Ethics Committees (PR-16100) and from Loughborough University (R17-P081). Information about the study will be provided in a participant information letter in Bangla (to be read verbally and given in writing to participants). A written informed consent form in Bangla will be obtained and participants will be informed of their right to withdraw from the study. Dissemination will take place through a 1 day dissemination workshop with key stakeholders in public health and policy, practitioners and scientists in Bangladesh, and through international conference presentations and peer-review publications. Anonymised transcripts of interviews will be made available through open access via institutional data repositories after an embargo period.
Comparison of tetradecyl sulfate versus polidocanol injections for stabilisation of joints that regularly dislocate in an Ehlers-Danlos population
Authors: Burling Fraser 
Published: January 2019

ObjectivesTo determine whether there is similarity between tetradecyl sulfate and polidocanol in stabilising a joint from dislocating in patients with Ehlers-Danlos syndrome (EDS).MethodA retrospective analysis of patients with EDS in a sole-practice clinic in New Zealand. Patients must have had the diagnosis of EDS, had easily dislocatable joints, had treatment and at least 3 months’ follow-up. 0.11% tetradecyl sulfate solution, or 0.25% polidocanol solution, was injected to ligament attachments (enthesis) on the side of the joints where they dislocated. Patients were deemed successfully treated if their affected joints were no longer dislocated over a minimum of 3 months’ follow-up (out to 3 years).ResultsOf 250 patients at the time of the study, 46 fitted the criteria. There were 37 treated with tetradecyl sulfate and nine with polidocanol. For the tetradecyl group there were a total of 305 injections around 97 joints: mean 3.1, range 1–22, median 2. For the polidocanol group there were 36 injections around 19 joints: mean 1.9, range 1–8, median 2. The difference of means between group 1 (tetradecyl) and group 2 (polidocanol) is 1.2, CIs 0.34 to 2.98. All patients had no further dislocations of treated joints unless they had a major new injury (two patients).ConclusionThere was no difference between the two groups for stabilising joints from dislocating. These two agents appear promising for treating patients with recurrent joint dislocations in the setting of EDS. Prospective multicentre randomised controlled trials are needed to confirm these data.
An Obturator Nerve Block does not Alleviate Postoperative Pain after Total Hip Arthroplasty: a Randomized Clinical Trial
Authors: Nielsen Niels Dalsgaard , Runge Charlotte , Clemmesen Louise , Børglum Jens , Mikkelsen Lone Ramer , Larsen Jens Rolighed , Nielsen Thomas Dahl , Søballe Kjeld , Bendtsen Thomas Fichtner 
Published: January 2019

Background and objectivesA substantial group of patients suffer from moderate to severe pain following elective total hip arthroplasty (THA). Due to the complex innervation of the hip, peripheral nerve block techniques can be challenging and are not widely used. Since the obturator nerve innervates both the anteromedial part of the joint capsule as well as intra-articular nociceptors, we hypothesized that an obturator nerve block (ONB) would decrease the opioid consumption after THA.MethodsSixty-two patients were randomized to receive ONB or placebo (PCB) after primary THA in spinal anesthesia. Primary outcome measure was opioid consumption during the first 12 postoperative hours. Secondary outcome measures included postoperative pain score, nausea score and ability to ambulate.ResultsSixty patients were included in the analysis. Mean (SD) opioid consumption during the first 12 postoperative hours was 39.9 (22.3) mg peroral morphine equivalents (PME) in the ONB group and 40.5 (30.5) mg PME in the PCB group (p=0.93). No difference in level of pain or nausea was found between the groups. Paralysis of the hip adductor muscles in the ONB group reduced the control of the operated lower extremity compared with the PCB group (p=0.026). This did, however, not affect the subjects’ ability to ambulate.ConclusionsA significant reduction in postoperative opioid consumption was not found for active versus PCB ONB after THA.Trial registration numberNCT03064165and 2017-000068-14.
Prevalence of human papillomavirus-related diseases in the Republic of Korea: a cross-sectional study
Authors: Oh Jin-Kyoung , Choi Hwa Young , Han Minji , Lee Jae-Kwan , Min Kyung-Jin , Ki Moran 
Published: January 2019

ObjectiveWe aimed to evaluate trends in the prevalence of human papillomavirus (HPV)-related diseases in the era before the introduction of organised HPV vaccination programmes in the Republic of Korea.MethodsThis cross-sectional study used National Health Insurance Service data from 2002 to 2015 and included participants who were diagnosed with the following HPV-related diseases (codes from the International Classification of Diseases, 10th Revision): genital warts (A63.0); cancer in the head and neck (C00–C10), anus (C21), vulva (C51), vagina (C52), cervix uteri (C53) and penis (C60); carcinoma in situ (CIS) of the lip/oral cavity/pharynx (D00.0), anus (D01.3), cervix (D06), vulva (D07.1), vagina (D07.2) and penis (D07.4); benign neoplasms of the larynx (D14.1); and dysplasia of the cervix (N87), vagina (N89) and vulva (N90). For each diagnosis, the fraction of cases attributable to HPV in Korea was assessed based on the percentages of diseases attributable to HPV reported in some international studies. The age-standardised prevalence was estimated using the direct population-based method.ResultsThe overall age-standardised prevalence of HPV-related diseases increased from 2002 to 2015, mainly due to increased prevalence of genital warts in men and cervical dysplasia and CIS in women. In women, genital wart prevalence increased from 2002 (24.4 per 100 000) to 2011 (57.1) and then decreased until 2015 (53.5); in men, the prevalence increased steadily from 2002 (22.9) to 2015 (109.4). The prevalence of cervical dysplasia and CIS increased (from 86.5 in 2002 to 484.5 in 2015, and from 60.3 in 2002 to 114.9 in 2015, respectively), but that of cervical cancer decreased (from 120.0 in 2002 to 106.9 in 2015).ConclusionsNon-organised HPV vaccination and organised cervical cancer screening may have contributed to the downward trend in genital wart prevalence and the upward trend in cervical abnormalities among women.
Effect of prehospital tourniquets on resuscitation in extremity arterial trauma
Authors: McNickle Allison G , Fraser Douglas R , Chestovich Paul J , Kuhls Deborah A , Fildes John J 
Published: January 2019

BackgroundTimely tourniquet placement may limit ongoing hemorrhage and reduce the need for blood products. This study evaluates if prehospital tourniquet application altered the initial transfusion needs in arterial injuries when compared with a non-tourniquet control group.MethodsExtremity arterial injuries were queried from our level I trauma center registry from 2013 to 2017. The characteristics of the cohort with prehospital tourniquet placement (TQ+) were described in terms of tourniquet use, duration, and frequency over time. These cases were matched 1:1 by the artery injured, demographics, Injury Severity Score, and mechanism of injury to patients arriving without a tourniquet (TQ−). The primary outcome was transfusion within the first 24 hours, with secondary outcomes of morbidity (rhabdomyolysis, renal failure, compartment syndrome), amputation (initial vs. delayed), and length of stay. Statistical tests included t-test and χ2for continuous and categorical variables, respectively, with p<0.05 considered as significant.ResultsExtremity arterial injuries occurred in 192 patients, with 69 (36%) having prehospital tourniquet placement for an average of 78 minutes. Tourniquet use increased over time from 9% (2013) to 62% (2017). TQ+ patients were predominantly male (81%), with a mean age of 35.0 years. Forty-six (67%) received blood transfusion within the first 24 hours. In the matched comparison (n=69 pairs), TQ+ patients had higher initial heart rate (110 vs. 100, p=0.02), frequency of transfusion (67% vs. 48%, p<0.01), and initial amputations (23% vs. 6%, p<0.01). TQ+ patients had increased frequency of initial amputation regardless of upper (n=43 pairs) versus lower (n=26 pairs) extremity involvement; however, only upper extremity TQ+ patients had increased transfusion frequency and volume. No difference was observed in morbidity, length of stay, and mortality with tourniquet use.DiscussionTourniquet use has increased over time in patients with extremity arterial injuries. Patients having prehospital tourniquets required a higher frequency of transfusion and initial amputation, without an increase in complications.Level of evidenceTherapeutic study, level IV.
MICROSTRUCTURE AND ELECTROCHEMICAL PROPERTIES OF Ni–B/GO ULTRASONIC-ASSISTED COMPOSITE COATINGS
Authors: JIANG JIBO , CHEN HAOTIAN , ZHU LIYING , SUN YAOXIN , QIAN WEI , LIN HUALIN , HAN SHENG 
Published: January 2019

Graphene oxide (GO) sheet and ultrasonic field (UF) were successfully employed to produce Ni–B/GO and UF–Ni–B/GO composite coatings on Q235 mild steel by electroless plating. The composite coatings’ structure and surface morphology were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), Raman spectroscopy and X-ray photoelectron spectroscopy (XPS). Results showed that GO was successfully co-deposited in the Ni–B alloy. Moreover, UF–Ni–B/GO composite coatings have smoother surface and thicker cross-section than others. The microhardness and corrosion resistance of the sample coatings were determined using Vickers hardness tests, Tafel electrochemical tests and electrochemical impedance measurements (EIS) in 3.5[Formula: see text]wt.% NaCl solution to receive the effect of GO and ultrasonic. The findings indicated that UF–Ni–B/GO exhibited optimum hardness (856[Formula: see text]HV) and enhanced corrosion resistance (6.38 [Formula: see text][Formula: see text] over the Ni–B and Ni–B/GO coatings. Due to these interesting properties of the coating, it could be used as a protective material in the automotive and aerospace industries for parts of machines that were manipulated in high temperature and corrosive environments.
A New Damage Index for Isolated Structures
Authors: Elyasi Niloofar , Khoshnoudian Faramarz , Khoshnoudian Yasaman 
Published: January 2019

Damage indices based on structural dynamic characteristics are often used to detect damage in the structures. In this study, a new index for identifying damages in base-isolated structures is proposed using the frequency response function (FRF). Since calculation of the FRF data is time- and memory-consuming for problems of large size, the two-dimensional principal component analysis technique is employed to decrease the data size. The damage indices calculated, representing the health state of the structure, are stored in a database, which are then used to detect the damage location and severity by utilizing the lookup table method. The proposed damage detection method is applied to four concrete frame models, one of which is fixed at the base and the others are isolated by elastomeric bearings. The FRF data are polluted with three different noise values (5%, 10% and 15%) in order to evaluate the uncertainty of measurements. The accuracy of the proposed indices is compared with each other for various parameters such as noise values, bearings characteristics, base conditions and different damage scenarios. The results show the precision of the proposed method.
The Path Selection of the Chinese Judges’ Disciplinary System Reform
Authors: LI Dejia 
Published: January 2019

The reform of the judicial disciplinary system is an important part of China’s judicial reform. The purpose of the Disciplinary Committee for Judges and Prosecutors is to re-establish the judicial disciplinary system, including specific procedures, such as producing evidence, making arguments and statements, to protect the professional rights of judicial personnel. This article examines the main models of the extraterritorial judicial disciplinary system, and analyses the trend and characteristics of current judges’ disciplinary system reform. The reform’s largest problem lies in the positioning of the judges’ disciplinary committee and the distribution of judge’s disciplinary power which need to be clearly defined.
Piezoelectric and ferroelectric properties of Na0.5Bi4.5Ti4O15–BaTiO3 composite ceramics with Mg doping
Authors: Jiang Chaobin , Ma Chao , Luo Qian , Liu Kanghui , Qin Lu , Wu Zhentao , Cao Wanqiang , Chen Yong 
Published: January 2019

As one of the representatives of lead-free NBT ceramics, Na[Formula: see text]Bi[Formula: see text]Ti4O[Formula: see text] has still attracted much attention due to its excellent dielectric properties and has become the focus of research. However, its piezoelectric properties are far from satisfactory. In order to improve the piezoelectric properties of Na[Formula: see text]Bi[Formula: see text]Ti4O[Formula: see text], Na[Formula: see text]Bi[Formula: see text]Ti[Formula: see text]MgxOy–BaTiO3 (NBTM–BT) composite ceramics were synthesized by a conventional mixed oxide route and sintered at 1040∘C through two-step method. We optimized the electrical properties of NBTM–BT by changing the stoichiometric ratio of Mg content and studied its microscopic mechanism. The piezoelectric coefficient ([Formula: see text]) is stable at about 20 pC/N. Moreover, the maximum remanent polarization (2[Formula: see text]) of the ceramic is 3.08[Formula: see text][Formula: see text]C/cm2 with the coercive field of 18.01[Formula: see text]kV/cm. The dielectric constant and dielectric loss for Na[Formula: see text]Bi[Formula: see text]Ti[Formula: see text]Mg[Formula: see text]–BT composite ceramic were found to be 486 and 0.17 at 10[Formula: see text]kHz, respectively. The characteristic peaks of BT and Na[Formula: see text]Bi[Formula: see text]Ti4O[Formula: see text] can be observed clearly from the X-ray diffraction analysis. SEM analysis showed that all samples were well crystallized. Consequently, the piezoelectric and ferroelectric properties of Na[Formula: see text]Bi[Formula: see text]Ti4O[Formula: see text]–BT composite ceramic will be enhanced much by Mg doping, which means it has a wider range of applications in electronic devices such as piezoelectric devices.
Insights into the mechanism of paradoxical low-flow, low-pressure gradient severe aortic stenosis: association with reduced O2 consumption by the whole body
Authors: Onoue Takeshi , Iwataki Mai , Araki Masaru , Itoh Hideaki , Isotani Akihiro , Umeda Hiromi , Fukuda Shota , Nagata Yasufumi , Tsuda Yuki , Fujino Yoshihisa , Hanyu Michiya , Ando Kenji , Shirai Shinichi , Takeuchi Masaaki , Saeki Satoru , Levine Robert A. , Otsuji Yutaka 
Published: January 2019

The mechanism of reduced stroke volume index (SVi) in paradoxical low-flow, low-pressure gradient (PLFLPG) aortic stenosis (AS) remains unclarified. Guyton et al. ( 21 ) demonstrated that SVi is determined by whole body O2 consumption (V̇o2) in many subjects, including patients with heart disease. We hypothesized that reduced SVi in PLFLPG AS is associated with reduced V̇o2 by the whole body. This study investigated the relationship between V̇o2, SVi, and AS severity in patients with AS to examine the association between reduced V̇o2 and PLFLPG AS. In 59 patients (24 men and 35 women, mean age: 78 ± 7 yr old) with severe AS, SVi, AS severity, and type were evaluated by echocardiography, and V̇o2 was measured by the fraction of O2 in expired gases. SVi and V̇o2 were significantly decreased in 20 patients with PLFLPG AS compared with 39 patients with non-PLFLPG AS (30 ± 4 vs. 41 ± 7 ml/m2 and 2.4 ± 0.5 vs. 3.0 ± 0.5 ml·min−1·kg−1, respectively, P < 0.01). The SVi-to-V̇o2 ratio was not different between the two groups (13.1 ± 2.6 vs. 13.6 ± 2.1, not significant). SVi was independently correlated with V̇o2 ( r = 0.74, P < 0.01) but not with the aortic valve area index. Categorized PLFLPG AS was also significantly associated with reduced V̇o2 ( P < 0.001). PLFLPG AS is associated with reduced V̇o2 by the whole body, which may offer insights into the mechanism of PLFLPG AS. NEW & NOTEWORTHY Paradoxical low-flow, low-pressure gradient severe aortic stenosis (PLFLPG AS) is an important and problematic subtype, and its central pathophysiology with reduced stroke volume is yet to be clarified. We hypothesized and subsequently clarified that reduced stroke volume in PLFLPG AS is associated with reduced O2 consumption by the whole body. This study suggests important insights into the mechanism of PLFLPG AS and may further promote studies to investigate further mechanisms and novel treatment.
Mixed Linearity Improvement Techniques for Ultra-wideband Low Noise Amplifier
Authors: Abbas Mohammed Nadhim , Khaleel Farooq Abdulghafoor 
Published: January 2019

<span>We present the linearization of an ultra-wideband low noise amplifier (UWB-LNA) operating from 2GHz to 11GHz through combining two linearization methods. The used linearization techniques are the combination of post-distortion cancellation and derivative-superposition linearization methods. The linearized UWB-LNA shows an improved linearity (IIP3) of +12dBm, a minimum noise figure (NF<sub>min.</sub>) of 3.6dB, input and output insertion losses (S<sub>11</sub> and S<sub>22</sub>) below -9dB over the entire working bandwidth, midband gain of 6dB at 5.8GHz, and overall circuit power consumption of 24mW supplied from a 1.5V voltage source. Both UWB-LNA and linearized UWB-LNA designs are verified and simulated with ADS2016.01 software using BSIM3v3 TSMC 180nm CMOS model files. In addition, the linearized UWB-LNA performance is compared with other recent state-of-the-art LNAs.</span>
Spectral Clustering and Vantage Point Indexing for Efficient Data Retrieval
Authors: R. Pushpalatha , Sundaram K. Meenakshi 
Published: January 2019

<p>Data mining is an essential process for identifying the patterns in large datasets through machine learning techniques and database systems. Clustering of high dimensional data is becoming very challenging process due to curse of dimensionality. In addition, space complexity and data retrieval performance was not improved. In order to overcome the limitation, Spectral Clustering Based VP Tree Indexing Technique is introduced. The technique clusters and indexes the densely populated high dimensional data points for effective data retrieval based on user query. A Normalized Spectral Clustering Algorithm is used to group similar high dimensional data points. After that, Vantage Point Tree is constructed for indexing the clustered data points with minimum space complexity. At last, indexed data gets retrieved based on user query using Vantage Point Tree based Data Retrieval Algorithm. This in turn helps to improve true positive rate with minimum retrieval time. The performance is measured in terms of space complexity, true positive rate and data retrieval time with El Nino weather data sets from UCI Machine Learning Repository. An experimental result shows that the proposed technique is able to reduce the space complexity by 33% and also reduces the data retrieval time by 24% when compared to state-of-the-art-works.</p>