bluuebunny/crossref_metadata_2025_split huggingface dataset:
Injury profile suffered by targets of antipersonnel improvised explosive devices: prospective cohort study
Authors: Smith Shane , Devine Melissa , Taddeo Joseph , McAlister Vivian Charles 
Published: August 2017

ObjectiveTo describe pattern 1 injuries caused by the antipersonnel improvised explosive device (AP-IED) in comparison to those previously described for antipersonnel mines (APM).DesignProspective cohort study of 100 consecutive pedestrian victims of an AP-IED, with traumatic amputation without regard for gender, nationality or military status.SettingMultinational Medical Unit at Kandahar Air Field, Afghanistan.ParticipantsOne hundred consecutive patients, all male, 6–44 years old.Main outcome measuresThe details of injuries were recorded to describe the pattern and characterise the injuries suffered by the target of AP-IEDs. The level of amputation, the level of soft tissue injury, the fracture pattern (including pelvic fractures) as well as perineal, gluteal, genital and other injuries were recorded.ResultsVictims of AP-IED were more likely, compared with APM victims, to have multiple amputations (70.0% vs 10.4%; p<0.001) or genital injury (26% vs 13%; p=0.007). Multiple amputations occurred in 70 patients: 5 quadruple amputations, 27 triple amputations and 38 double amputations. Pelvic fracture occurred in 21 victims, all but one of whom had multiple amputations. Severe perineal, gluteal or genital injuries were present in 46 patients. Severe soft tissue injury was universal, with injection of contaminated soil along tissue planes well above entry sites. There were 13 facial injuries, 9 skull fractures and 3 traumatic brain injuries. Eleven eye injuries were seen; none of the victims with eye injuries were wearing eye protection. The casualty fatality rate was at least 19%. The presence of more than one amputation was associated with a higher rate of pelvic fracture (28.6% vs 3.3%; p=0.005) and perineal–gluteal injury (32.6% vs 11.1%; p=0.009).ConclusionThe injury pattern suffered by the target of the AP-IED is markedly worse than that of conventional APM. Pelvic binders and tourniquets should be applied at the point of injury to patients with multiple amputations or perineal injuries.
Developing design principles for a Virtual Hospice: improving access to care
Authors: Taylor Andrea , French Tara , Raman Sneha 
Published: August 2017

ObjectivesProviding access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK.MethodsThe study was structured as a series of Experience Labs with Highland Hospice staff, healthcare professionals and patients. Experience Labs employ a participatory design approach where participants are placed at the centre of the design process, helping to ensure that the resultant service meets their needs. Data from the Experience Labs were analysed using qualitative thematic analysis and design analysis.ResultsA number of themes and barriers to accessing Highland Hospice services were identified. In response, an initial set of seven design principles was developed. Design principles are high-level guidelines that are used to improve prioritisation and decision making during the design process by ensuring alignment with research insights. The design principles were piloted with a group of stakeholders and gained positive feedback.ConclusionsThe design principles are intended to guide the ongoing development of the Highland Hospice Virtual Hospice. However, the challenges faced by Highland Hospice in delivering services in a largely remote and rural setting are not unique. The design principles, encompassing digital and non-digital guidelines, or the design approach could be applied by other hospices in the UK or overseas.
Geometric Reconstruction of Implicitly Defined Surfaces and Domains with Topological Guarantees
Authors: Engwer Christian , Nüßing Andreas 
Published: August 2017

Implicitly described domains are a well-established tool in the simulation of time-dependent problems, for example, using level-set methods. To solve partial differential equations on such domains, a range of numerical methods was developed, for example, the Immersed Boundary method, the Unfitted Finite Element or Unfitted Discontinuous Galerkin methods, and the eXtended or Generalised Finite Element methods, just to name a few. Many of these methods involve integration over cut-cells or their boundaries, as they are described by sub-domains of the original level-set mesh.
We present a new algorithm to geometrically evaluate the integrals over domains described by a first-order, conforming level-set function. The integration is based on a polyhedral reconstruction of the implicit geometry, following the concepts of the marching cubes algorithm. The algorithm preserves various topological properties of the implicit geometry in its polyhedral reconstruction, making it suitable for Finite Element computations. Numerical experiments show second-order accuracy of the integration.
An implementation of the algorithm is available as free software, which allows for an easy incorporation into other projects. The software is in productive use within the DUNE framework (Bastian et al. 2008a).
Age-related external anal sphincter muscle dysfunction and fibrosis: possible role of Wnt/β-catenin signaling pathways
Authors: Rajasekaran M. Raj , Kanoo Sadhana , Fu Johnny , Nguyen My-Uyen (Lilly) , Bhargava Valmik , Mittal Ravinder K. 
Published: August 2017

Studies show an age-related increase in the prevalence of anal incontinence and sphincter muscle atrophy. The Wnt/β-catenin signaling pathway has been recently recognized as the major molecular pathway involved in age-related skeletal muscle atrophy and fibrosis. The goals of our study were to 1) evaluate the impact of normal aging on external anal sphincter (EAS) muscle length-tension (L-T) function and morphology and 2) specifically examine the role of Wnt signaling pathways in anal sphincter muscle fibrosis. New Zealand White female rabbits [6 young (6 mo of age) and 6 old (36 mo of age)] were anesthetized, and anal canal pressure was measured to determine the L-T function of EAS. Animals were killed at the end of the study, and the anal canal was harvested and processed for histochemical studies (Masson trichrome stain for muscle/connective tissue) as well as for molecular markers for fibrosis and atrophy [collagen I, β-catenin, transforming growth factor-β (TGF-β), atrogin-1, and muscle-specific RING finger protein-1 (MuRF-1)]. The L-T was significantly impaired in older animals compared with young animals. Anal canal sections stained with trichrome showed a significant decrease in the muscle content (52% in old compared with 70% in young) and an increase in the connective tissue/collagen content in the old animals. An increased protein and mRNA expression of all the fibrosis markers was seen in the older animals. Aging EAS muscle exhibits impairment of function and increase in connective tissue. Upregulation of atrophy and profibrogenic proteins with aging may be the reason for the age-related decrease in anal sphincter muscle thickness and function. NEW & NOTEWORTHY Our studies using a female rabbit model show age-related alterations in the structure and function of the external anal sphincter (EAS) muscle. We used endoluminal ultrasound to measure age-related changes in EAS muscle thickness. We employed Western blot and quantitative PCR to demonstrate age-related changes in the levels of important fibrogenic as well as atrophy markers. Our findings may have significant clinical implications, i.e., use of specific antagonists to prevent age-related EAS muscle dysfunction.
Sequential, Multiple Assignment, Randomized Trial Designs in Immuno-oncology Research
Authors: Kidwell Kelley M. , Postow Michael A. , Panageas Katherine S. 
Published: August 2017

Abstract
Clinical trials investigating immune checkpoint inhibitors have led to the approval of anti–CTLA-4 (cytotoxic T-lymphocyte antigen-4), anti–PD-1 (programmed death-1), and anti–PD-L1 (PD-ligand 1) drugs by the FDA for numerous tumor types. In the treatment of metastatic melanoma, combinations of checkpoint inhibitors are more effective than single-agent inhibitors, but combination immunotherapy is associated with increased frequency and severity of toxicity. There are questions about the use of combination immunotherapy or single-agent anti–PD-1 as initial therapy and the number of doses of either approach required to sustain a response. In this article, we describe a novel use of sequential, multiple assignment, randomized trial (SMART) design to evaluate immune checkpoint inhibitors to find treatment regimens that adapt within an individual based on intermediate response and lead to the longest overall survival. We provide a hypothetical example SMART design for BRAF wild-type metastatic melanoma as a framework for investigating immunotherapy treatment regimens. We compare implementing a SMART design to implementing multiple traditional randomized clinical trials. We illustrate the benefits of a SMART over traditional trial designs and acknowledge the complexity of a SMART. SMART designs may be an optimal way to find treatment strategies that yield durable response, longer survival, and lower toxicity. Clin Cancer Res; 24(4); 730–6. ©2017 AACR.
Antithrombotic potency of ticagrelor versus clopidogrel in type-2 diabetic patients with cardiovascular disease
Authors: Zafar M. , Baber Usman , Smith Donald , Sartori Samantha , Contreras Johanna , Rey-Mendoza Juan , Linares-Koloffon Carlos , Escolar Gines , Mehran Roxana , Fuster Valentin , Badimon Juan 
Published: August 2017

SummaryType-2 Diabetes Mellitus [T2DM] is associated with increased platelet reactivity and hypo-response to antiplatelet drugs. Ticagrelor, with its faster and more potent antiplatelet effects, was shown to reduce adverse events more than clopidogrel in the overall CAD patient population of PLATO trial, but the benefits did not reach statistical significance in the T2DM subgroup. To better understand these findings, we compared the antithrombotic effects of ticagrelor versus with clopidogrel in T2DM patients with cardiovascular disease. In a randomized, 2 treatment-sequence, crossover-design, T2DM patients (n=20, 57±8 years, 60% male) received a loading-dose [LD] plus one week of daily-therapy [DT] of clopidogrel or ticagrelor. Treatment effects were assessed by measuring thrombus formation (Badimon Chamber) and platelet aggregation (Multiple Electrode Aggregometry (MEA) Analyzer and VerifyNow®) at 2- and 6-hour post-LD and on Day-7 of DT, in comparison with pre-treatment baseline. After 2 weeks of washout, patients switched to the second treatment under identical testing conditions. Ticagrelor significantly reduced thrombus formation versus baseline at 2- and 6-hour post-LD and Day-7 of DT (33%, 40% and 31%, respectively, p<0.01 for all) whereas thrombus reductions with clopidogrel were much lower and significant only at 6-hour post-LD (16%, 20% and 17%, respectively). Antithrombotic effect of ticagrelor at 6-hour was significantly stronger than clopidogrel (p<0.05). Platelet aggregation (MEA and VerifyNow®) was inhibited by both treatments but effects of ticagrelor were significantly stronger at each time-point. Ticagrelor exhibits a faster and more potent antithrombotic effect than clopidogrel in T2DM patients with cardiovascular disease, supporting its use in this population.Clinical Trial Registration: Unique Identifier: NCT01823510.Supplementary Material to this article is available online at www.thrombosis-online.com.
Near-Surface Temperature Inversion Growth Rate during the Onset of the Stable Boundary Layer
Authors: van Hooijdonk Ivo G. S. , Clercx Herman J. H. , Abraham Carsten , Holdsworth Amber M. , Monahan Adam H. , Vignon Etienne , Moene Arnold F. , Baas Peter , van de Wiel Bas J. H. 
Published: August 2017

Abstract
This study aims to find the typical growth rate of the temperature inversion during the onset of the stable boundary layer around sunset. The sunset transition is a very challenging period for numerical weather prediction, since neither accepted theories for the convective boundary layer nor those for the stable boundary layer appear to be applicable. To gain more insight in this period, a systematic investigation of the temperature inversion growth rate is conducted. A statistical procedure is used to analyze almost 16 years of observations from the Cabauw observational tower, supported by observations from two additional sites (Dome C and Karlsruhe). The results show that, on average, the growth rate of the temperature inversion (normalized by the maximum inversion during the night) weakly declines with increasing wind speed. The observed growth rate is quantitatively consistent among the sites, and it appears insensitive to various other parameters. The results were also insensitive to the afternoon decay rate of the net radiation except when this decay rate was very weak. These observations are compared to numerical solutions of three models with increasing complexity: a bulk model, an idealized single-column model (SCM), and an operational-level SCM. It appears only the latter could reproduce qualitative features of the observations using a first-order closure. Moreover, replacing this closure with a prognostic TKE scheme substantially improved the quantitative performance. This suggests that idealized models assuming instantaneous equilibrium flux-profile relations may not aid in understanding this period, since history effects may qualitatively affect the dynamics.
Benzodiazepines and risk for hepatic encephalopathy in patients with cirrhosis and ascites
Authors: Grønbæk Lisbet , Watson Hugh , Vilstrup Hendrik , Jepsen Peter 
Published: August 2017

BackgroundThere is limited evidence to support the belief that benzodiazepines increase cirrhosis patients’ risk of hepatic encephalopathy (HE).ObjectiveWe aimed to examine the association between benzodiazepine use and HE development in cirrhosis patients.MethodsWe used data on 865 cirrhosis patients with ascites from three trials to study the effect of benzodiazepine use on development of first-time HE. For each patient, we classified periods of benzodiazepine use by the number of days since initiation. We used Cox regression to compare the risk of HE in current benzodiazepine users vs. non-users adjusting for confounders.ResultsCirrhosis patients were not at increased risk of HE for the first two days of benzodiazepine use, but then faced a five-fold increased risk of HE during days 3 to 10 of benzodiazepine use. The risk of HE was not increased for those who had been using benzodiazepines for more than 28 days.ConclusionCirrhosis patients who had begun using benzodiazepines between 3 and 10 days previously had a markedly increased risk of developing first-time HE. Cirrhosis patients who had been using benzodiazepines for just one or two days or continued use for more than 28 days did not have such an excess risk.
Minerals of the rhönite-kuratite series in paralavas from a new combustion metamorphic complex in the Choir–Nyalga basin (Central Mongolia): composition, mineral assemblages and formation conditions
Authors: Peretyazhko Igor S. , Savina Elena A. , Khromova Elena A. 
Published: August 2017

AbstractThis is the first description of rare minerals found in paralavas from a recently discovered combustion metamorphic complex in the Choir–Nyalga basin, Central Mongolia. The identified minerals contain strongly variable concentrations of Si, Ti, Mg, Fe2+and Fe3+and most commonly have compositions intermediate in a series from kuratite Ca4Fe102+Ti2O4[Si8Al4O36] and rhönite Ca4(Mg, Fe2+)8Fe23+Ti2O4[Si6Al6O36] to low-Ti kuratite and unnamed Ti-free Fe2+-analogue of rhönite Ca4Fe82+Fe43+O4[Si8Al4O36]. The minerals crystallized in residual Si-Al-K and Si-Al-Ca-Fe immiscible melts after spinel, anorthite–bytownite, melilite, Al-clinopyroxene ± Mg-Fe olivine, together with Fe3+-bearing hercynite, Ca-rich fayalite, kirschsteinite, pyrrhotite ± native iron, wüstite, magnetite, celsian, hyalophane, Ba-orthoclase and fresnoite, but before nepheline± kalsilite, and later sulfates, carbonates, an unidentified 'X-mineral' close to Al- and Fe-rich tobermorite and goethite. Micro-Raman spectroscopy of kuratite shows five bands near 133–155 (strong), 399–401, 545–566, 684–693 (strongest) and 828–839 cm–1.The kuratite-bearing Nyalga paralavas have bulk compositions with MgO/(MgO+FeO+Fe2O3), mol.% ∼0.5 and a CIPW normative ratio of Ne/(Ne+Lc) = 0.23–0.76. Minerals of the rhönite–kuratite series formed during paralava crystallization at ∼1100°C.The diversity of the paralava mineral assemblages might result from local composition variations of Ca-rich silica-undersaturated melts derived from Fe-bearing carbonate-silicate sediments which were affected by nearby coal combustion sources at reducing conditions (IW-WM-QFM buffers) and at a nearly atmospheric pressure.
Biomass Logistics Network Design Under Price-Based Supply and Yield Uncertainty
Authors: Üster Halit , Memişoğlu Gökhan 
Published: August 2017

We consider an integrated supply pricing and biomass logistics network design problem in which yield rates are uncertain. The base supply amount is modeled via a farmers’ decision model that estimates the amount of land dedicated to biomass production under a given biomass wholesale price. We develop a two-stage stochastic integer program for integrated design of a network as well as biomass pricing decisions under yield uncertainty. To efficiently solve our model, we suggest a Benders decomposition–based algorithm in which the Benders cuts, one for each scenario, are aggregated by utilizing a scheme that takes into account yield rates as well as the geographical nature of the underlying problem. With further strengthening of the cuts, we present a significantly improved approach for solving relatively large instances and illustrate its performance via a computational study. We further present an extensive case study in Texas using realistic data to test our model’s capabilities and to demonstrate its effectiveness in capturing the relationships between total cost, biomass wholesale price, network structure, and various input parameters. Finally, we examine the relationship between farmers’ decision model parameters, which dictate the risk profile of farmers, and the expected total system cost, as well as the biomass wholesale price. The online appendix is available at https://doi.org/10.1287/trsc.2017.0766 .
Pembentukan Karakter Peserta Didik Melalui Pembelajaran Matematika
Authors: Suparni Suparni 
Published: August 2017

Character building not only as an issue of education development, but also as a process of citizen moral building. Character building as an education focus in all of education level from elementary school into university spend a high attention. Mathematics education can’t release from mathematics. So, If we want to build the student character, we must be use the philosophies values of mathematics education by expression the characteristic of mathematics as the object is abstract, the symbol is no meaning, agreement reached and deductive axiomatic thinking, and non contradiction. There are many character value in the mathematics instruction that related with the characteristic of mathematics that can be integrated with Al Qur’an that we hope can support national education purposes, as agreement reached, consistent, deduction and whole. The student character can be build by mathematics instruction as religious, truth, tolerance, discipline, creative, democratic, sense to know, nationality, and communicative.
Rumus Indeks Ketidaknyamanan Suatu Wilayah
Authors: Sugiasih Sugiasih 
Published: August 2017

Index of discomfort can be determined, this value is to accommodate everyone at level how humans are considered to be comfortable on a place. There are three who wrote formulas i.e., Discomfort Index (DI), temperature Humidity Index (THI) and Comfort Index (CI). In addition to air temperature, air humidity, wind speed there that affect the comfort of a place, such as the density of buildings, distance to the center of the industry, the distance to the center of the trade, the distance to the main street, the coverage of vegetation in the area of the settlements.
Penyelesaian Persamaan Telegraph Dan Simulasinya
Authors: Surur Agus Miftakus , Adi Yudi Ari , Sugiyanto Sugiyanto 
Published: August 2017

Equation Telegraph is one of type from wave equation. Solving of the wave equation obtainable by using Green's function with the method of boundary condition problem. This research aim to to show the process obtain;get the mathematical formula from wave equation and also know the form of solution of wave equation by using Green's function. Result of analysis indicate that the process get the mathematical formula from wave equation from applicable Green's function in equation which deal with the wave equation, that is applied in equation Telegraph. Solution started with searching public form from Green's function, hereinafter look for the solving of wave equation in Green's function. Application from the wave equation used to look for the solving of equation Telegraph. Result from equation Telegraph which have been obtained will be shown in the form of picture (knowable to simulasi) so that form of the the equation Telegraph.
Pemodelan Matematika Anarkisme Demo Mahasiswa UIN Sunan Kalijaga Yogyakarta dan Solusinya Dari Tinjauan Matematika
Authors: Abrori Muchammad 
Published: August 2017

Demo anarkisme sudah menjadi hal yang umum yang sering dilihat oleh kalangan akademisi di UIN Sunan Kalijaga. Seringkali demo anarkisme ini menjadi tidak terkendali karena emosional mahasiswa yang tinggi dan emosional penjaga keamanan serta adanya ketidakpuasan mahasiswa terhadap peraturan kampus.Metode yang digunakan dalam penelitian ini dengan membuat model penyebab demo anrkisme menggunakan ordinary differential equation dan membuat simulasi dengan MATLAB. Dari pemodelan dicari titik ekuilibrium, eksistensi titik ekuilibrium dan kestabilannya.Hasil dari penelitian ini adalah pemodelan, titik ekuilibrium, kestabilannya dan simulasinya. Pemodelan yang terbentuk adalah dan dimana merupakan demontrasi damai, merupakan demontrasi anarkisme, merupakan itikad baik mahasiswa, merupakan emosional mahasiswa, merupakan itikad baik kampus, merupakan emosional petugas keamanan, merupakan koefisien keletihan demontrasi damai, merupakan koefisien keletihan demontrasi anarkisme. Simulasi disajikan dalam dua kasus, yaitu tidak terjadi demonstrasi anarkisme dan terjadi demonstrasi anarkisme. Simulasi yang tidak terjadi anarkisme dipengaruhi oleh itikad baik mahasiswa yang tidak mau demonstrasi anarkisme sebesar 2 dan nilai emosional mahasiswa 3. Sedangkan kasus kedua demonstrasi anarkis dipengaruhi oleh parameter itikad baik mahasiswa 0 dan nilai parameter emosional mahasiswa 4. Parameter itikad baik mahasiswa sangat menentukan terjadi atau tidak demonstrasi anarkisme mahasiswa.