bluuebunny/crossref_metadata_2025 huggingface dataset:
Partly deepithelialised palatal graft for the treatment of deep-wide palatal recession defect: simplified protocol with 18-month follow-up
Authors: Parashar Amit , Roy Indranil Deb , Gupta Arpit
Published: November 2020

Advances in periodontal plastic surgical procedures have led to achieve predictable root coverage outcomes for the recession defects. However, little has been reported and emphasised over management of palatal recession defects. The root coverage surgical procedures used for coverage of palatal recession defect are technically challenging in terms of accessibility and graft coverage. The purpose of this report is to describe a surgical technique used to manage deep-wide palatal recession defect. The technique usespartly deepithelialised palatal graftthat is designed to approximately fit the defect site. This is employed for prolonged protection of the underlying healing process. This case report is unique in terms of treatment of deep (9.0 mm), wide (6.0 mm) palatal recession defect and its long-term follow-up for 18 months.
Simultaneous bilateral revision total knee arthroplasty followingAbiotrophia defectivainfection
Authors: Wan Joseph , Larsen Matthew P , Panwalkar Parag , Mofidi Ali
Published: November 2020

A 65-year old man presented with 6-week history of bilateral knee pain and swelling, with difficulty mobilising. He had bilateral total knee arthroplasties in situ performed 5 years prior complicated by postoperative wound infection. Bilateral synovial fluid cultures were positive forAbiotrophia defectiva, and extensive investigations had not identified an extra-articular source of infection. Failing debridement antibiotic and implant retention procedure, the patient underwent a simultaneous bilateral 2-stage revision with articulated cement spacers impregnated with vancomycin and gentamycin. The patient received 6 weeks of intravenous antibiotics after each stage.A. defectivais a nutritiously fastidious organism, posing a challenge for clinical laboratories to isolate and perform antimicrobial susceptibility testing, yet prosthetic joint infections caused byA. defectivaare scarce in literature and present atypically with subacute signs of chronic infection. This poses a diagnostic and therapeutic challenge, and two-stage revision is the only documented treatment that successfully eradicates the infection.
Bilateral pleural masses in an immunocompromised patient
Authors: Patel Sachin R , Foroughi Maryam , Nasser Wael , Khan Rumi
Published: November 2020

We present a case of persistent pleural masses with mediastinal adenopathy in an immunocompromised patient initially biopsied, diagnosed and treated forPneumocystis jirovecipneumonia, ultimately requiring surgical thoracoscopy to diagnose pulmonary histoplasmosis. We discuss the diagnostic approach for pleural masses in immunocompromised patients, the limitations of tissue sampling, interpretation and methodology, and pitfalls of testing in making a pathogen-specific diagnosis.
Murine typhus mistaken for COVID-19 in a young man
Authors: Patel Hemesh Mahesh
Published: November 2020

Fever is a widely recognised presenting symptom of COVID-19. Consequently, other febrile illnesses may be difficult to distinguish from COVID-19—leading to delays in diagnosis and treatment. One such illness is murine typhus, a fleaborne illness with worldwide distribution caused byRickettsia typhi. It often presents with fever, headache and myalgia, all of which have been commonly reported with COVID-19. Although the disease is usually mild with a good prognosis, there have been reports of severe illness and death. I present a case of murine typhus in a young male who had 2 weeks of headaches and daily fevers during the COVID-19 pandemic. He was ultimately tested for murine typhus when his occupation as a dog trainer was queried, and he experienced resolution of symptoms after treatment with doxycycline. During this pandemic, clinicians must be vigilant of other febrile illnesses whose symptoms overlap with COVID-19.
Burnout and work-related stressors in gastroenterology: a protocol for a multinational observational study in the ASEAN region
Authors: Ong John , Ong Andrew Ming Liang , Ong Sharon , Xin Xiaohui , Lee Yeong Yeh , Pausawasdi Nonthalee , De Lusong Mark Anthony , Makmun Dadang , Chong Vui Heng , Ho Shiaw Hooi , Lim Wan Yen , Koh Calvin Jianyi , Ong David , Khor Christopher , Dan Yock Young
Published: November 2020

Background

Clinician burnout is an important occupational hazard that may be exacerbated by the novel COVID-19 pandemic. Within Southeast Asia, burnout in gastroenterology is understudied. The primary objective of this study is to estimate the prevalence of burnout symptoms within gastroenterology, in member states of the Associations of Southeast Asian Nations (ASEAN), during and after the COVID-19 pandemic. The secondary objective is to identify work-related stressors that contribute to burnout in ASEAN gastroenterologists.

Methods and analysis

This is an observational study that will use anonymised online surveys to estimate the prevalence of burnout symptoms at two time points: during the COVID-19 pandemic in 2020 and in 2022 (assumed to be after the pandemic). Gastroenterologists from Singapore, Malaysia, Thailand, Indonesia, Philippines and Brunei will be invited to participate in the online survey through their national gastroenterology and endoscopy societies. Burnout will be assessed using the Maslach Burnout Inventory-Human Services Survey tool. Supplementary questions will collect demographic and qualitative data. Associations between demographic characteristics and burnout will be tested by multiple regression.

Results

The prevalence of burnout symptoms in gastroenterology during the COVID-19 pandemic, and the baseline prevalence after COVID-19, will be established in the above-mentioned countries. Work-related stressors commonly associated with burnout will be identified, allowing the introduction of preventative measures to reduce burnout in the future.

Ethics and dissemination

Ethical approval was granted by the Singhealth Centralised Institutional Review Board (2020/2709). Results will be submitted for publication.
Are you really doing ‘codesign’? Critical reflections when working with vulnerable populations
Authors: Moll Sandra , Wyndham-West Michelle , Mulvale Gillian , Park Sean , Buettgen Alexis , Phoenix Michelle , Fleisig Robert , Bruce Emma
Published: November 2020

‘Codesign’ and associated terms such as ‘coproduction’ or ‘patient engagement’, are increasingly common in the health research literature, due to an increased emphasis on the importance of ensuring that research related to service/systems development is meaningful to end-users.  However, there continues to be a lack of clarity regarding the key principles and practices of codesign, and wide variation in the extent to which service users are meaningfully engaged in the process. These issues are particularly acute when end-users include populations who have significant health and healthcare disparities that are linked to a range of intersecting vulnerabilities (eg, poverty, language barriers, age, disability, minority status, stigmatised conditions).  The purpose of this paper is to prompt critical reflection on the nature of codesign research with vulnerable populations, including key issues to consider in the initial planning phases, the implementation process, and final outputs.  Risks and tensions will be identified in each phase of the process, followed by a tool to foster reflexivity in codesign processes to address these issues.
Prevalence and factors associated with overweight and obesity among patients with type 2 diabetes mellitus in Uganda—a descriptive retrospective study
Authors: Tino Salome , Mayanja Billy N , Mubiru Michael Charles , Eling Emmanuel , Ddumba Edward , Kaleebu Pontiano , Nyirenda Moffat
Published: November 2020

Objectives

To assess the prevalence and risk factors of overweight and obesity among type 2 diabetes mellitus (T2DM) patients in Uganda.

Design

Retrospective chart review.

Setting

This study was conducted in the outpatient’s T2DM clinic in St. Francis Hospital—Nsambya, Uganda between March and May 2017.

Participants

Type 2 diabetes patients registered in the diabetes clinic between July 2003 and September 2016.

Outcome measures

Overweight and obesity defined as body mass index (kg/m2) of 25.0–29.9 and obesity as 30.0 or higher.

Results

Of 1275 T2DM patients, the median age was 54 (IQR: 44–65) years, 770 (60.40%) were females, 887 (69.6%) had hypertension, 385 (28%) had controlled glycaemia, 349 (27%) were obese, while 455 (36%) were overweight. Overweight/obesity were lower among men (OR: 0.45, 95% CI: 0.340 to 0.593, p≤0.001) and among patients aged ≥65 years (OR: 0.52, 95% CI: 0.350 to 0.770, p=0.001); patients who rarely ate fruits and vegetables (OR: 0.66, 95% CI: 0.475 to 0.921, p=0.014) but higher among patients of middle (OR: 1.83, 95% CI: 1.320 to 2.550, p≤0.001) and upper (OR: 2.10, 95% CI: 1.450 to 2.990, p≤0.001) socioeconomic status; on dual therapy (OR: 2.17, 95% CI: 1.024 to 4.604, p=0.043); with peripheral neuropathy (OR: 1.40, 95% CI: 1.039 to 1.834, p=0.026) and hypertension (OR: 1.70, 95% CI: 1.264 to 2.293, p≤0.001).

Conclusions

Overweight and obesity are high among T2DM patients in this population and may contribute significantly to poor outcomes of T2DM. Therefore, strategies to address this problem are urgently needed.
Exercise for people living with frailty and receiving haemodialysis: a mixed-methods randomised controlled feasibility study
Authors: Young Hannah M L , March Daniel S , Highton Patrick J , Graham-Brown Matthew P M , Churchward Darren C , Grantham Charlotte , Goodliffe Samantha , Jones William , Cheung Mei-Mei , Greenwood Sharlene A , Eborall Helen C , Conroy Simon , Singh Sally J , Smith Alice C , Burton James O
Published: November 2020

Objectives

Frailty is highly prevalent in haemodialysis (HD) patients, leading to poor outcomes. This study aimed to determine whether a randomised controlled trial (RCT) of intradialytic exercise is feasible for frail HD patients, and explore how the intervention may be tailored to their needs.

Design

Mixed-methods feasibility.

Setting and participants

Prevalent adult HD patients of the CYCLE-HD trial with a Clinical Frailty Scale Score of 4–7 (vulnerable to severely frail) were eligible for the feasibility study.

Interventions

Participants in the exercise group undertook 6 months of three times per week, progressive, moderate intensity intradialytic cycling (IDC).

Outcomes

Primary outcomes were related to feasibility. Secondary outcomes were falls incidence measured from baseline to 1 year following intervention completion, and exercise capacity, physical function, physical activity and patient-reported outcomes measured at baseline and 6 months. Acceptability of trial procedures and the intervention were explored via diaries and interviews with n=25 frail HD patients who both participated in (n=13, 52%), and declined (n=12, 48%), the trial.

Results

124 (30%) patients were eligible, and of these 64 (52%) consented with 51 (80%) subsequently completing a baseline assessment. n=24 (71% male; 59±13 years) dialysed during shifts randomly assigned to exercise and n=27 (81% male; 65±11 years) shifts assigned to usual care. n=6 (12%) were lost to follow-up. The exercise group completed 74% of sessions. 27%–89% of secondary outcome data were missing. Frail HD patients outlined several ways to enhance trial procedures. Maintaining ability to undertake activities of daily living and social participation were outcomes of primary importance. Participants desired a varied exercise programme.

Conclusions

A definitive RCT is feasible, however a comprehensive exercise programme may be more efficacious than IDC in this population.

Trial registration numbers

ISRCTN11299707; ISRCTN12840463.
Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey
Authors: Pedersen Courtney J , Uddin Mohammad J , Saha Samir K , Darmstadt Gary L
Published: November 2020

Objective

Describe the pattern of atopic disease prevalence from infancy to adulthood.

Design

Cross-sectional household survey.

Setting

Community-based demographic surveillance site, Mirzapur, Bangladesh.

Participants

7275 individuals in randomly selected clusters within 156 villages.

Primary and secondary outcome measures

The 12-month prevalence of atopic dermatitis (by UK Working Party Criteria (UK criteria) and International Study of Asthma and Allergies in Childhood (ISAAC)), asthma and rhinitis (by ISAAC); disease severity (by ISAAC); history of ever receiving a medical diagnosis.

Results

Children aged 2 years had the highest prevalence of atopic dermatitis—18.8% (95% CI 15.2% to 22.4%) by UK criteria and 14.9% (95% CI 11.6% to 18.1%) by ISAAC— and asthma (20.1%, 95% CI 16.4% to 23.8%). Prevalence of rhinitis was highest among 25–29 year olds (6.0%, (95% CI% 4.5 to 7.4%). History of a medical diagnosis was lowest for atopic dermatitis (4.0%) and highest for rhinitis (27.3%) and was significantly associated with severe disease compared with those without severe disease for all three conditions (atopic dermatitis: 30.0% vs 11.7%, p=0.015; asthma; 85.0% vs 60.4%, p<0.001; rhinitis: 34.2% vs 7.3%, p<0.001) and having a higher asset-based wealth score for asthma (29.7% (highest quintile) vs 7.5% (lowest quintile), p<0.001) and rhinitis (39.8% vs 12.5%, p=0.003). Prevalence of having>1 condition was highest (36.2%) at 2 years and decreased with age. Having atopic dermatitis (ISAAC) was associated with significantly increased odds ratios (OR) for comorbid asthma (OR 5.56 (95% CI 4.26 to 7.26)] and rhinitis (3.68 (95% CI 2.73 to 4.96)). Asthma and rhinitis were also strongly associated with each other (OR 8.39 (95% CI 6.48 to 10.86)).

Conclusions

Atopic disease burden was high in this rural Bangladeshi population. Having one atopic condition was significantly associated with the presence of another. Low incidence of ever obtaining a medical diagnosis highlights an important opportunity to increase availability of affordable diagnosis and treatment options for all age groups.
Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study
Authors: Vishnubala Dane , Marino Katherine Rose , Pratten Margaret Kathryn , Pringle Andy , Griffin Steffan Arthur , Finn Gabrielle , Bazira Peter , Edwards Kimberley
Published: November 2020

Objectives

To explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.

Methods

Semi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.

Results

N=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.

Conclusion

The management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.
Use of immunostimulants in the successful treatment of a clinical EEHV1A infection in an Asian elephant (Elephas maximus)
Authors: Drake Gabby J , Haycock Jonathan , Dastjerdi Akbar , Davies Hannah , Lopez F Javier
Published: November 2020

Elephant endotheliotropic herpesvirus haemorrhagic disease (EEHV‐HD) poses a significant threat to the captive population of juvenile Asian elephants (Elephas maximus) and also affects elephants in the wild. In human and veterinary medicine, increasing attention is returning to the interferon system, a crucial mediator in the immune response for control of infection. We describe the first reported use of the Zelnate DNA immunostimulant and recombinant human interferon alpha (rhIFNα) as additional medications in the successful treatment of a case of EEHV1A‐HD in a juvenile Asian elephant at a UK zoo. Despite an exponential rise in viraemia to a peak of 2.82×106 viral genomic equivalents/ml, only mild clinical signs developed and the calf survived with no adverse effects attributed to the novel treatments. This case is compared with a previous fatal case within the same herd where Zelnate and rhIFNα were not given.
Effect of Electrolyte Cations on Organic Electrosynthesis: The Case of Adiponitrile Electrochemical Production
Authors: Blanco Daniela E. , Atwi Rasha , Sethuraman Sandhya , Lasri Anne , Morales Julian , Rajput Nav Nidhi , Modestino Miguel A.
Published: November 2020

Electrolyte ions have a profound impact on the reaction environment of electrochemical systems and can be key drivers in determining the reaction rate and selectivity of electro-organic reactions. We combine experimental and computational approaches to understand the individual effect of the size and concentration of supporting alkali cations, as well as their synergies with other electrolyte ions on the electrosynthesis of adiponitrile (ADN). The size of supporting alkali cations influences the surface charge density, availability of water molecules, and stability of reaction intermediates. Larger alkali cations can help limit hydrogen evolution and the early protonation of intermediates by lowering the availability of water molecules in the near electrode region. A selectivity of 93% towards ADN was achieved at −20 mA cm−2 in electrolytes containing cesium phosphate salts, ethylenediaminetetraacetic acid, and tetraalkylammonium ions (TAA ions). Electrolytes containing only supporting phosphate salts promote the early hydrogenation of intermediate species leading to low ADN selectivities (i.e., <10%). However, the combined effect of alkali cations and selectivity-directing ions (i.e., TAA ions) is essential in the enhancement of ADN synthesis. The insights gained in this study provide guidelines for the design of aqueous electrolytes that improve selectivity and limit hydrogen evolution in organic electrosynthesis.
The Dissolution Dilemma for Low Pt Loading Polymer Electrolyte Membrane Fuel Cell Catalysts
Authors: Sandbeck Daniel J. S. , Secher Niklas Mørch , Inaba Masanori , Quinson Jonathan , Sørensen Jakob Ejler , Kibsgaard Jakob , Zana Alessandro , Bizzotto Francesco , Speck Florian D. , Paul Michael T. Y. , Dworzak Alexandra , Dosche Carsten , Oezaslan Mehtap , Chorkendorff Ib , Arenz Matthias , Cherevko Serhiy
Published: November 2020

Cost and lifetime currently hinder widespread commercialization of polymer electrolyte membrane fuel cells (PEMFCs). Reduced electrode Pt loadings lower costs; however, the impact of metal loading (on the support) and its relation to degradation (lifetime) remain unclear. The limited research on these parameters stems from synthetic difficulties and lack of in situ analytics. This study addresses these challenges by synthesizing 2D and 3D Pt/C model catalyst systems via two precise routes and systematically varying the loading. Pt dissolution was monitored using on-line inductively coupled plasma mass spectrometry (on-line-ICP-MS), while X-ray spectroscopy techniques were applied to establish the oxidation states of Pt in correlation with metal loading. Dissolution trends emerge which can be explained by three particle proximity dependent mechanisms: (1) shifts in the Nernst dissolution potential, (2) redeposition, and (3) alteration of Pt oxidation states. These results identify engineering limitations, which should be considered by researchers in fuel cell development and related fields.
Blockage of protease-activated receptor 2 exacerbates inflammation in high-fat environment partly through autophagy inhibition
Authors: Her Ji Yun , Lee Yunna , Kim Su Jin , Heo Gwangbeom , Choo Jieun , Kim Yuju , Howe Cody , Rhee Sang Hoon , Yu Hak Sun , Chung Hae Young , Pothoulakis Charalabos , Im Eunok
Published: November 2020

Deletion of PAR2 with high-fat diet feeding exacerbates colitis in a murine colitis model. Proinflammatory effects of PAR2 blockage in a high-fat environment were associated with an altered balance between autophagy and apoptosis. Increased colonic levels of PAR2 represent as a therapeutic strategy for IBD co-occurring with metabolic syndrome.
Perceived effort affects choice of limb and reaction time of movements
Authors: Wang Jing , Lum Peter S. , Shadmehr Reza , Lee Sang Wook
Published: November 2020

We report that visual amplification may serve as an effective means to alter the perceived effort associated with use of a limb. This method may provide an effective tool with which use of the affected limb can be encouraged noninvasively after neurological injury.
Fatty Amidine as Copper Corrosion Inhibitor
Authors: Mas’ud Zainal Alim , Darmawan Noviyan , Dawolo Januari , Apriliyanto Yusuf Bramastya
Published: November 2020

The development of green and sustainable corrosion inhibitors for copper in a corrosive marine environment is highly desired. Herein, we studied the fatty acid-based amidine as the new type of renewable corrosion inhibitor. Stearamidine salt was used as a model inhibitor, and it was synthesized through stearonitrile intermediate with an excellent isolated yield of 88%. We used electrochemical (potentiodynamic polarization) and morphological (scanning electron microscopy) measurements to assess the corrosion inhibition efficiency of stearamidine in 3.0 wt.% NaCl at 300 K. We show that, in such a condition, the optimum inhibition efficiency of 96% was achieved using only 0.2 mM stearamidine. The results suggested the fatty amidine is a promising corrosion inhibitor for copper that is suitable in the saltwater ecosystem. The thermodynamic parameters of the interaction between the stearamidine and the copper surface were determined, and the result suggests that the adsorption process occurred accordingly with the Langmuir adsorption isotherm and involved both physisorption and chemisorption.
Fault-Tolerant Metric Dimension of Generalized Wheels and Convex Polytopes
Authors: Zheng Zhi-Bo , Ahmad Ashfaq , Hussain Zaffar , Munir Mobeen , Qureshi Muhammad Imran , Ali Imtiaz , Liu Jia-Bao
Published: November 2020

For a graph

G

, an ordered set

S
⊆
V

G

is called the resolving set of

G

, if the vector of distances to the vertices in

S

is distinct for every

v
∈
V

G

. The minimum cardinality of

S

is termed as the metric dimension of

G

.

S

is called a fault-tolerant resolving set (FTRS) for

G

, if

S
\

v

is still the resolving set

∀
v
∈
V

G

. The minimum cardinality of such a set is the fault-tolerant metric dimension (FTMD) of

G

. Due to enormous application in science such as mathematics and computer, the notion of the resolving set is being widely studied. In the present article, we focus on determining the FTMD of a generalized wheel graph. Moreover, a formula is developed for FTMD of a wheel and generalized wheels. Recently, some bounds of the FTMD of some of the convex polytopes have been computed, but here we come up with the exact values of the FTMD of two families of convex polytopes denoted as

D

k

for

k
≥
4

and

Q

k

for

k
≥
6

. We prove that these families of convex polytopes have constant FTMD. This brings us to pose a natural open problem about the existence of a polytope having nonconstant FTMD.
Unilateral Toxic Anterior Segment Syndrome Resulting in Cataract and Urrets-Zavalia Syndrome after Sequential Uneventful Implantation of a Posterior Chamber Phakic Toric Intraocular Lens at Two Different Surgical Facilities: A Series of Unfortunate Events
Authors: Balparda Kepa , Vanegas-Ramirez Claudia Marcela , Márquez-Tróchez Johny , Herrera-Chalarca Tatiana
Published: November 2020

Background. Phakic Intraocular Lens (P-IOL) implantation is a safe, easy, predictable intervention designed to manage moderate to high refractive errors. Complications are relatively uncommon and include mainly cataract and intraocular pressure spikes. Toxic Anterior Segment Syndrome (TASS) is a rather unusual sterile anterior segment inflammation after uneventful intraocular surgery, extremely rarely reported after P-IOL implantation. Urrets-Zavalia Syndrome (UZS) is also very rarely described after P-IOL. To date, to the best of the authors’ knowledge, no article has ever described the simultaneous occurrence of TASS and UZS in a patient after P-IOL implantation. Objective. In this article, the authors present the case of a female patient with moderate myopic astigmatism, who underwent sequential P-IOL implantation at two different facilities. The postoperative course of the first eye was uneventful, but she developed complications associated to the intervention in the second eye. Materials. The article describes the case of a young patient who underwent a sequential Phakic Intraocular Lens (P-IOL) implantation at two different institutions. The postoperative course of the first eye (left eye) was uneventful; however, the second eye (right eye) initially developed Toxic Anterior Segment Syndrome (TASS). Although timely and correct management was instituted, upon resolution of TASS, the patient developed Urrets-Zavalia Syndrome, anterior subcapsular cataract, and significant endothelial damage in the same eye. Results. The patient was followed closely and managed accordingly; corneal edema and anterior segment inflammation of the right eye eventually resolved. Nevertheless, an anterior subcapsular cataract and a fixed dilated pupil remained; with normal intraocular pressure (IOP). Specular microscopy confirmed an endothelial cell loss in the TASS eye (right eye). Pupil size showed no reaction to repeated doses of Pilocarpine 2%. A month after surgery, refraction on her right eye was

+
0.25
+
0.75
×
93

, which resulted in a 20/50 vision. Conclusions. TASS and UZS are both extremely rare complications after uneventful P-IOL implantation, with only a handful of cases having been reported of each of them. To date, this is the very first case where UZS ensued after and potentially as a consequence of TASS in a patient who had undergone P-IOL implantation. Although a direct causative element could not be pinpointed, the fact that the complication ensued after being operated in one surgical institution and not the other, could suggest some role of different sterilization and handling procedures, but no direct conclusion can be made on this case.
Modeling of Marine Asynchronous Shaft Generator and Simulation of Subsynchronization State
Authors: Langtao Yan , Jiawan Tan , Yusheng Liu , Hui Yang
Published: November 2020

The new type of marine asynchronous shaft generator has the advantages of adjustable excitation and power factor, compared to the traditional synchronous shaft generator, and has been widely used. However, the traditional synchronous shaft generator simulation system is still used in domestic ship power station simulators, which seriously restricts the renewal of crew training. In order to overcome the shortage of the simulation system of doubly fed shaft generator for ship power plant simulator, in this paper, the mathematical model of marine doubly fed shaft system is established for the first time, according to the characteristics of doubly fed machine and marine shaft generator. This paper realizes power decoupling by stator flux orientation and simulates and analyses the asynchronous shaft generator under subsynchronous working conditions. The changing trend of each physical quantity in the simulation waveform meets the mathematical relationships of the actual physical quantity, which proves the correctness of the mathematical model and lays a theoretical foundation for the development of the simulation system of asynchronous shaft generator.
Effects of Blade Parameters on the Flow Field and Classification Performance of the Vertical Roller Mill via Numerical Investigations
Authors: Liu Chang , Chen Zuobing , Zhang Weili , Yang Chenggang , Mao Ya , Yu Yongjie , Xie Qiang
Published: November 2020

The vertical roller mill is an important crushing and grading screening device widely used in many industries. Its classification efficiency and the pressure difference determine the entire producing capacity and power consumption, respectively, which makes them the two key indicators describing the mill performance. Based on the DPM (Discrete Phase Model) and continuous phase coupling model, the flow field characteristics in the vertical roller mill including the velocity and pressure fields and the discrete phase distributions had been analyzed. The influence of blade parameters like the shape, number, and rotating speed on the flow field and classification performance had also been comprehensively explored. The numerical simulations showed that there are vortices in many zones in the mill and the blades are of great significance to the mill performance. The blade IV not only results in high classification efficiency but also reduces effectively the pressure difference in the separator and also the whole machine. The conclusions of the flow field analysis and the blade effects on the classification efficiency and the pressure difference could guide designing and optimizing the equipment structure and the milling process, which is of great importance to obtain better overall performance of the vertical roller mill.
Optimal Control Strategy of Companies: Inheriting Period and Carbon Emission Reduction
Authors: Liang Jin , Huang Wenlin
Published: November 2020

In this paper, we develop an optimal control model of companies for the inheriting period, during which interphase banking and borrowing of allowances are allowable. By considering the emission reduction policy and the initial auction amount, we optimize the problem in two steps. The model is then converted into a two-dimensional Hamilton–Jacobi–Bellman equation. The numerical results, analysis, and comparisons are presented. Finally, we highlight several policy implications from the perspectives of companies and governments.
Impact Behavior of a Rotating Rigid Body with Impact and Viscous Friction
Authors: Cojocaru Dorian , Marghitu Dan B.
Published: November 2020

The impact between a rotating link and a solid flat surface is considered. For the impact, we consider three distinct periods: elastic period, elastoplastic period, and restitution period. A Hertzian contact force is considered for the elastic period. Nonlinear contact forces developed from finite element analysis are used for the remaining two phases. The tangential effect is taken into account considering a friction force that combines the Coulomb dry friction model and a viscous friction function of velocity. Simulations results are obtained for different friction parameters. An experimental setup was designed to measure the contact time during impact. The experimental and simulation results are compared for different lengths of the link.
Flow Structures of the Air-Water Layer in the Free Surface Region of High-Speed Open Channel Flows
Authors: Jiang Feng , Xu Weilin , Deng Jun , Wei Wangru
Published: November 2020

In hydraulic engineering, intense free surface breakups have been observed to develop in high-speed open channel flows, resulting in a mixed air-water layer near the free surface that grows with the development of self-aeration. This region is characterized by a substantial number of droplets coexisting with an induced air layer above. Little information about this droplet layer is currently available and no practicable approach has been proposed for predicting the parameters of the induced air layer based on the related flow structures in the droplet layer. In this research, laboratory experiments were accordingly conducted to observe the detailed droplet layer development in terms of layer thickness, droplet size, and frequency distributions under comparative flow conditions. Based on the simplified droplet layer roughness determined using the experimentally measured mean droplet size, the classical power-law of boundary layer theory was applied to provide an analytical solution for the air velocity profile inside the air layer. The relationship of air layer growth to droplet layer thickness, which is a key factor when determining the air velocity distribution, was also established, and the analytical results were proven to be in reasonable agreement with air velocity profiles presented in the literature. By determining the relationship between droplet layer properties and air velocity profiles, the study establishes a basis for the improved modeling of high-speed open channel flows.
Antifungal Activity of Thai Cajuput Oil and Its Effect on Efflux-Pump Gene Expression in Fluconazole-Resistant Candida albicans Clinical Isolates
Authors: Keereedach Pitchayaphong , Hrimpeng Karnjana , Boonbumrung Khaemaporn
Published: November 2020

Candidiasis caused by the fluconazole-resistant opportunistic pathogen Candida albicans is an intractable clinical problem that threatens immunocompromised or normal individuals. The most common mechanism of fluconazole resistance in C. albicans is the failure of cells to accumulate the drug due to increased expression of the efflux proteins encoded by the CDR1, CDR2, and MDR1 genes. Because the number of current antifungal drugs is limited, it is necessary to develop new therapeutic strategies. This study aimed to evaluate the antifungal activity of Thai Cajuput oil, its synergism with fluconazole, and its effect on efflux-pump gene expression in fluconazole-resistant C. albicans clinical isolates. Thus, we first detected the efflux-pump genes in fourteen resistant strains by PCR. The frequencies of the CDR1, CDR2, and MDR1 genes were 68.75%, 62.5%, and 87.5%, respectively, and these efflux-pump genes were distributed in three distinct patterns. Subsequently, the antifungal activity of Thai Cajuput oil was assessed by broth macrodilution and its synergism with fluconazole was evaluated by the checkerboard assay. The changes in the expression levels of CDR1, CDR2, and MDR1 after treatment with Thai Cajuput oil were analyzed by qRT-PCR. The MICs and MFCs of Thai Cajuput oil ranged from 0.31 to 1.25 μl/ml and 0.63 to 1.25 μl/ml, respectively, and its activity was defined as fungicidal activity. The MICs of the combination of Thai Cajuput oil and fluconazole were much lower than the MICs of the individual drugs. Interestingly, sub-MICs of Thai Cajuput oil significantly reduced the MDR1 expression level in resistant strainsP<0.05. Our study suggests that Thai Cajuput oil can be used to create new potential combination therapies to combat the antifungal resistance of C. albicans.
A New Precursor Integral Method for Solving Space-Dependent Kinetic Equations in Neutronic and Thermal-Hydraulic Coupling System
Authors: Wu Yingjie , Liu Baokun , Zhang Han , Guo Jiong , Li Fu , Niu Jinlin , Wang Yizhen , Cui Menglei
Published: November 2020

The accurate prediction of the neutronic and thermal-hydraulic coupling system transient behavior is important in nuclear reactor safety analysis, where a large-scale nonlinear coupling system with strong stiffness should be solved efficiently. In order to reduce the stiffness and huge computational cost in the coupling system, the high-performance numerical techniques for solving delayed neutron precursor equation are a key issue. In this work, a new precursor integral method with an exponential approximation is proposed and compared with widely used Taylor approximation-based precursor integral methods. The truncation errors of exponential approximation and Taylor approximation are analyzed and compared. Moreover, a time control technique is put forward which is based on flux exponential approximation. The procedure is tested in a 2D neutron kinetic benchmark and a simplified high-temperature gas-cooled reactor-pebble bed module (HTR-PM) multiphysics problem utilizing the efficient Jacobian-free Newton–Krylov method. Results show that selecting appropriate flux approximation in the precursor integral method can improve the efficiency and precision compared with the traditional method. The computation time is reduced to one-ninth in the HTR-PM model under the same accuracy when applying the exponential integral method with the time adaptive technique.
Analytical Method for Solving the Fractional Order Generalized KdV Equation by a Beta-Fractional Derivative
Authors: Bagheri Majid , Khani Ali
Published: November 2020

The present work is related to solving the fractional generalized Korteweg-de Vries (gKdV) equation in fractional time derivative form of order

α

. Some exact solutions of the fractional-order gKdV equation are attained by employing the new powerful expansion approach by using the beta-fractional derivative which is used to get many solitary wave solutions by changing various parameters. The obtained solutions include three classes of soliton wave solutions in terms of hyperbolic function, trigonometric function, and rational function solutions. The obtained solutions and the exact solutions are shown graphically, highlighting the effects of nonlinearity. Some of the nonlinear equations arise in fluid dynamics and nonlinear phenomena.
Fuzzy Conformable Fractional Semigroups of Operators
Authors: Harir Atimad , Melliani Said , Chadli Lalla Saadia
Published: November 2020

In this paper, we introduce a fuzzy fractional semigroup of operators whose generator will be the fuzzy fractional derivative of the fuzzy semigroup at

t
=
0

. We establish some of their proprieties and some results about the solution of fuzzy fractional Cauchy problem.
Near-Infrared Spectroscopy as a Process Analytical Technology Tool for Monitoring the Steaming Process of Gastrodiae rhizoma with Multiparameters and Chemometrics
Authors: Zuo Yamin , Yang Jing , Li Chen , Deng Xuehua , Zhang Shengsheng , Wu Qing
Published: November 2020

Steaming is a vital unit operation in traditional Chinese medicine (TCM), which greatly affects the active ingredients and the pharmacological efficacy of the products. Near-infrared (NIR) spectroscopy has already been widely used as a strong process analytical technology (PAT) tool. In this study, the potential usage of NIR spectroscopy to monitor the steaming process of Gastrodiae rhizoma was explored. About 10 lab scale batches were employed to construct quantitative models to determine four chemical ingredients and moisture change during the steaming process. Gastrodin, p-hydroxybenzyl alcohol, parishin B, and parishin A were modeled by different multivariate calibration models (SMLR and PLS), while the content of the moisture was modeled by principal component regression (PCR). In the optimized models, the root mean square errors of prediction (RMSEP) for gastrodin, p-hydroxybenzyl alcohol, parishin B, parishin A, and moisture were 0.0181, 0.0143, 0.0132, 0.0244, and 2.15, respectively, and correlation coefficients (

R
p
2

) were 0.9591, 0.9307, 0.9309, 0.9277, and 0.9201, respectively. Three other batches’ results revealed that the accuracy of the model was acceptable and that was specific for next drying step. In addition, the results demonstrated the method was reliable in process performance and robustness. This method holds a great promise to replace current subjective color judgment and time-consuming HPLC or UV/Vis methods and is suitable for rapid online monitoring and quality control in the TCM industrial steaming process.
Toward Respiratory Support of Critically Ill COVID-19 Patients Using Repurposed Kidney Hollow Fiber Membrane Dialysers to Oxygenate the Blood
Authors: Rubin David M. , Stacey Neil T. , Matambo Tonderayi , Vale Claudia Do , Sussman Martin J. , Snyman Tracy , Mer Mervyn , Hildebrandt Diane
Published: November 2020

The COVID-19 pandemic has highlighted resource constraints in respiratory support. The oxygen transfer characteristics of a specific hollow fiber membrane dialyser was investigated with a view to repurposing the device as a low-cost, readily available blood oxygenator. Oxygen transfer in a low-flux hollow fiber dialyser with a polysulfone membrane was studied by passing first water and then blood through the dialyser in countercurrent to high-purity oxygen. Oxygen transfer rates of about 15% of the nominal 250 ml (STP)/min of a typical adult oxygen consumption rate were achieved for blood flow rates of 500 ml/min. Using two such dialysis devices in parallel could provide up to 30% of the nominal oxygen consumption. Specific hollow fiber dialysis devices operating with suitable pumps in a veno-venous access configuration could provide a cost-effective and readily available supplementation of respiratory support in the face of severe resource constraints.
Assessment of Lifetime Attributable Risk for Public Health Sustainability from the Fukushima Accident
Authors: Rukundo Faith , Kim Juyoul
Published: November 2020

The study aimed at reassessing the radiological risk from exposure to ionizing radiation from Fukushima Daiichi nuclear power plant accident. The estimated risks from the study were compared with World Health Organization (WHO) risk assessment estimates for validity and verification. A Radiation Risk Assessment Tool (RadRAT) was used to estimate Lifetime Attributable Risks (LAR) of cancer upon exposure. All solid cancers, leukemia, and thyroid cancer risks for ages of 1, 10, and 20 years (infants, children, and adults) in 100,000 persons at exposure were estimated. For solid cancers, LAR (10−2) was estimated in a range of 0.223∼0.668 and 0.345∼1.24 for males and females, respectively, whereas the LAR (10−2) for leukemia was estimated at 0.0155∼0.055 and 0.0118∼0.0375 for males and females, respectively. LAR (10−2) for thyroid cancer ranged from 0.0722∼0.545 and 0.0369∼0.265, respectively.
A New Visual Cryptography-Based QR Code System for Medication Administration
Authors: Ti Yen-Wu , Chen Shang-Kuan , Wu Wen-Chieh
Published: November 2020

In health care, medication errors can result in serious health risks to patients, and hospitals require a secure medication administration system to prevent such errors. This paper therefore proposes a secure medication administration method based on threshold sharing technology. When a patient visits a doctor and the doctor prescribes n medications, a photo and the personal information of the patient are encoded into n QR code transparencies that can be decoded by common QR code scanners available for smartphones. The prescription and n QR code transparencies are then stored in a hospital’s medication administration system. When the patient receives their medicine, they can scan these n QR code transparencies using a smartphone to ensure that they have all the medicines prescribed by the doctor; this function is accessible even if the patient’s phone does not have Internet access. The main purpose of the proposed system is to prevent hospitals from giving medicine to the wrong patient, or giving less than the prescribed dosage of medicine to the patient. The focus is not on the internal medicine packaging process in hospitals but on reducing the probability of counter staff giving medicine to the wrong patient. This function is of considerable importance to non-English-speaking people who are not used to reading medicine names in English.
Buccolingual Inclination of Canine and First and Second Molar Teeth and the Curve of Wilson in Different Sagittal Skeletal Patterns of Adults Using Cone-Beam Computed Tomography
Authors: Golshah Amin , Rezaei Navid , Heshmati Sara
Published: November 2020

Objectives. This study aimed to assess the buccolingual inclination of canine and first and second molar teeth and the curve of Wilson in different sagittal skeletal patterns in untreated adults using cone-beam computed tomography (CBCT). Materials and Methods. Sixty-six CBCT scans of adults (mean age: 28.74 ± 5.25 years) were evaluated in this cross-sectional study. The images were standardized using the Frankfurt horizontal plane and the interorbital line. The sagittal skeletal pattern was determined using the ANB angle and Wits appraisal. Inclination angles were measured by NNT Viewer and Mimics software. The curve of Wilson was measured by connecting the tips of mesiobuccal and mesiolingual cusps of maxillary first and second molars along the buccal groove and measuring the formed angle. Data were analyzed using ANOVA. Results. The intraobserver agreement was 0.969. The mean inclination of maxillary first and second molars in class I and III patients was significantly higher than that in class II patients

P
<
0.05

. The mean inclination of mandibular first and second molars in class II patients was significantly higher than that in class I and III patients

P
<
0.05

. The difference in inclination of maxillary and mandibular canine teeth was not significant

P
>
0.05

. The mean curve of Wilson in second molars of class II patients was significantly higher than that in class I patients

P

<

0.05

. Conclusion. In different sagittal skeletal patterns, a compensatory relationship exists between the opposing teeth, which, along with the standards of crowns, can be used to determine the appropriate position of teeth in dental arch.
Radiomic Detection of EGFR Mutations in NSCLC
Authors: Rossi Giovanni , Barabino Emanuele , Fedeli Alessandro , Ficarra Gianluca , Coco Simona , Russo Alessandro , Adamo Vincenzo , Buemi Francesco , Zullo Lodovica , Dono Mariella , De Luca Giuseppa , Longo Luca , Dal Bello Maria Giovanna , Tagliamento Marco , Alama Angela , Cittadini Giuseppe , Pronzato Paolo , Genova Carlo
Published: November 2020

Radiomics is defined as the use of automated or semi-automated post-processing and analysis of multiple features derived from imaging exams. Extracted features might generate models able to predict the molecular profile of solid tumors. The aim of this study was to develop a predictive algorithm to define the mutational status of EGFR in treatment-naïve patients with advanced non–small cell lung cancer (NSCLC). CT scans from 109 treatment-naïve patients with NSCLC (21 EGFR-mutant and 88 EGFR-wild type) underwent radiomics analysis to develop a machine learning model able to recognize EGFR-mutant from EGFR-WT patients via CT scans. A “test–retest” approach was used to identify stable radiomics features. The accuracy of the model was tested on an external validation set from another institution and on a dataset from the Cancer Imaging Archive (TCIA). The machine learning model that considered both radiomic and clinical features (gender and smoking status) reached a diagnostic accuracy of 88.1% in our dataset with an AUC at the ROC curve of 0.85, whereas the accuracy values in the datasets from TCIA and the external institution were 76.6% and 83.3%, respectively. Furthermore, 17 distinct radiomics features detected at baseline CT scan were associated with subsequent development of T790M during treatment with an EGFR inhibitor. In conclusion, our machine learning model was able to identify EGFR-mutant patients in multiple validation sets with globally good accuracy, especially after data optimization. More comprehensive training sets might result in further improvement of radiomics-based algorithms.

Significance:

These findings demonstrate that data normalization and “test–retest” methods might improve the performance of machine learning models on radiomics images and increase their reliability when used on external validation datasets.