bluuebunny/crossref_metadata_2025 huggingface dataset:
Geospatial identification of high youth suicide risk areas via electronic health records: Avenues for research and prevention efforts
Authors: Hill Ryan M. , Gushanas Kimberly L. , Alvis Lauren , Dodd Cody G. , Kurian Sherin , Saxena Johanna , Saxena Kirti , Kaplow Julie B. , Rufino Katrina , Williams Laurel
Published: April 2021

Objective

As suicide risk screening becomes more common in healthcare settings, geospatial coding of behavioral health data may offer a means for identifying areas of elevated suicide risk for use in public health prevention efforts. The present study demonstrates an analytic approach for using universal suicide risk screening data to identify areas of elevated suicide risk.

Method

Data were drawn from standard suicide risk screens recorded in electronic health records of a large pediatric emergency department. A total of 12,400 suicide risk screening responses were recorded, among youth aged 11–19 years (mean = 14.60, SD = 2.16; 57.2% girls, 47.8% Hispanic/Latinx, 72.1% White). A total of 86 unique ZIP codes had at least 50 completed screens, representing 9139 respondents.

Results

Rates of positive screens ranged from 6.17% to 31.03% (mean = 18.33, SD = 5.14) for any suicide‐related behavior and from 0.0% to 19.61% (mean = 9.14, SD = 3.43) for suicide attempt. Rates of positive screens approximated a normal distribution.

Conclusions

Results demonstrated several areas with elevated rates of positive suicide risk screens, within the hospital catchment area. The proposed method capitalizes on large‐scale screening data, provides an estimate of areas of relative increased risk, and may be used to inform public health responses to suicide prevention.
Evaluation of a suicide loss support training program for organ procurement personnel
Authors: Tucker Raymond P. , Drapeau Christopher W. , Schwab Nila , Campbell Frank R.
Published: April 2021

Objective

To evaluate the impact of a 6‐h traumatic loss training program on organ procurement personnel attitudes, confidence, and knowledge about suicide loss and best practices in supporting survivors. Organ procurement personnel may be uniquely positioned to deliver supportive programming as they have early access to suicide loss survivors (i.e., within hours or days of a loss) and are trained in a variety of backgrounds that include skills in supportive service delivery (i.e., nursing and social work).

Method

Sixty‐four personnel participated in the 6‐h Traumatic Loss Support Program (TLSP) training and completed measures of attitudes, confidence, and knowledge about supporting suicide loss survivors prior to and following the training.

Results

Ratings of the usefulness of the training were high and mean scores on all measures of attitudes, confidence, and knowledge increased with moderate to large effect sizes.

Conclusions

Results of the current study demonstrate that the TLSP training may be an effective way of increasing suicide loss supportive services provided by organ procurement personnel; however, further research is needed to determine the extent to which these interactions influence the bereavement of those who have lost loved ones to suicide and the fidelity in which the TLSP is implemented.
Three department of defense‐funded public health approaches to reduce military suicide
Authors: LaCroix Jessica M. , Walsh Adam , Baggett Mark A. , Madison Carter K. ,   the Suicide Care, Prevention, and Research Initiative (Suicide CPR Initiative) Team, Ghahramanlou‐Holloway Marjan
Published: April 2021

Background

Suicide is a serious and growing public health concern, both for the United States (U.S.) and for the Department of Defense (DoD).

Methods

Using the social–ecological framework, we provide examples of how three newly developed, DoD‐funded pilots/programs have incorporated a public health approach to help prevent military suicide.

Key Results

The first two programs demonstrate how non‐clinical, community‐based approaches can be tailored to specific military subgroups at the individual, relational, and community levels. These programs include a universal suicide prevention program developed for Special Operations service members, spouses, and mental health providers, and a selective suicide prevention program pilot developed for military chaplains to support them in their role as a “gateway” to care for distressed service members, improve mental health and chaplaincy collaboration, and prevent burnout. The third program illustrates how the creation of and policy of a methodology/infrastructure to conduct standardized, theory‐driven suicide death reviews across the DoD may inform the DoD public health approach to surveillance, review, and synthesis of suicide data, informed by the social–ecological model. Potential program limitations and evaluation efforts are discussed.

Conclusion

Future prevention approaches should enhance coordination and communication between DoD, VA, and community organizations to enhance multi‐level suicide prevention programming for military personnel, veterans, and civilians.
Veteran peer suicide prevention: A community‐based peer prevention model
Authors: Beehler Sarah , LoFaro Carl , Kreisel Carlee , Dorsey Holliman Brooke , Mohatt Nathaniel V.
Published: April 2021

Objective

The purpose of this study was to develop a conceptual model of community‐based veteran peer suicide prevention.

Method

We conducted a qualitative study in which semi‐structured interviews were followed by three focus groups. Participants (n = 17) were chosen from community‐based organizations who had peers working on veteran suicide prevention; the sample included veteran peers, non‐peers, program managers, and community stakeholders. Interview data were analyzed thematically and inductively to identify key components and subcomponents of veteran peer suicide prevention. A draft model was shared with each focus group to elicit feedback and refine key concepts.

Results

A conceptual model containing nine components and twenty‐six subcomponents was developed. Participants emphasized key organizational, relational, and practical elements needed to achieve positive outcomes. In addition, they described critical contextual and cultural factors that impacted veteran peers’ ability to prevent suicide and promote overall wellness.

Conclusions

Community‐based veteran peer efforts are a promising public health approach to preventing veteran suicide. Provided veteran peers are supported and fully allowed to contribute, these efforts can complement existing clinic‐based efforts. Future research on community‐based veteran peer suicide prevention should document a range of outcomes (e.g., clinical, wellness, financial) and allow for considerable flexibility in peer approaches.
Ultraconserved elements reconstruct the evolution of Chagas disease‐vectoring kissing bugs (Reduviidae: Triatominae)
Authors: Kieran Troy J. , Gordon Eric R.L. , Zaldívar‐Riverón Alejandro , Ibarra‐Cerdeña Carlos N. , Glenn Travis C. , Weirauch Christiane
Published: April 2021

Triatominae are the largest radiation of haematophagous species within the true bugs (Hemiptera) and the sole vectors of Trypanosoma cruzi Chagas, the causative agent of Chagas disease, a neglected human disease that affects millions. We used a combined ultraconserved element (UCE) and ribosomal dataset from ethanol‐preserved and pinned specimens in a museomics approach to elucidate the phylogenetic relationships among triatomines, including taxa of four of the five tribes with substantial representation of the Old World fauna. We conclude that: (i) Triatominae are monophyletic and Opisthacidius Berg is their predatory sister taxon; (ii) the three large genera (Rhodnius Stål, Triatoma Laporte and Panstrongylus Berg) are not monophyletic; (iii) Triatomini fall into nine well‐supported clades, only two of which are identical in composition to previously recognized groups; and (iv) the Old World clade is deeply nested within Triatomini. Ancestral character state reconstructions of specific character traits provide insights into the evolutionary history of Triatominae.
Disseminated blastomycosis in a kidney transplant recipient
Authors: Chesdachai Supavit , Friedman Daniel Z. P. , Boire Nicholas A. , Abu Saleh Omar
Published: April 2021

Disseminated blastomycosis in solid organ transplant is uncommon. The diagnosis is usually challenging due to vague clinical presentations, which could lead to a devastating outcome. We reported a unique case of disseminated blastomycosis with laryngeal involvement in a kidney transplant recipient who presented with hoarseness. The diagnosis was made by histopathology and culture of laryngeal mass.
Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs
Authors: Grimes Janet A. , Reed Rachel A. , Beale Chelsea , Secrest Scott A.
Published: April 2021

Sentinel lymph node (SLN) evaluation is important for accurate cancer staging. Computed tomography (CT) lymphangiography with aqueous contrast is a feasible technique for SLN identification in dogs. Although most studies report success rates around 90%, success rates as low as 60% have been reported. One reason for low success rates may be the difference in viscosity of the various agents used in comparison to normal lymph viscosity. The objective of this study was to evaluate contrast agents of differing viscosities for use in CT lymphangiography for SLN identification and to determine the influence of massage on contrast flow rates. The hypothesis was that lower viscosity agents would have a higher success rate and faster time to identification of the SLN than higher viscosity agents and that massage would increase contrast flow rates. Dogs were anaesthetised and CT lymphangiography was performed with four contrast agents of differing viscosities in a randomized crossover design. Injections were made on the dorsal pes bilaterally on two study days and the popliteal lymph nodes were evaluated for contrast uptake. There was no significant difference in success of SLN identification or time to SLN identification among the four agents. Massage of the injection site increased rate of contrast flow through the lymphatics. No specific recommendation for one contrast agent over another can be made with these results. Massage is recommended to improve lymphatic flow when performing CT lymphangiography with aqueous contrast in dogs.
A deep analysis of the proteomic and phosphoproteomic alterations that occur in skeletal muscle after the onset of immobilization
Authors: Lin Kuan‐Hung , Wilson Gary M. , Blanco Rocky , Steinert Nathaniel D. , Zhu Wenyuan G. , Coon Joshua J. , Hornberger Troy A.
Published: April 2021

Key points

A decrease in protein synthesis plays a major role in the loss of muscle mass that occurs in response to immobilization.

In mice, immobilization leads to a rapid (within 6 h) and progressive decrease in the rate of protein synthesis and this effect is mediated by a decrease in translational efficiency.

Deep proteomic and phosphoproteomic analyses of mouse skeletal muscles revealed that the rapid immobilization‐induced decrease in protein synthesis cannot be explained by changes in the abundance or phosphorylation state of proteins that have been implicated in the regulation of translation.

The disuse of skeletal muscle, such as that which occurs during immobilization, can lead to the rapid loss of muscle mass, and a decrease in the rate of protein synthesis plays a major role in this process. Indeed, current dogma contends that the decrease in protein synthesis is mediated by changes in the activity of protein kinases (e.g. mTOR); however, the validity of this model has not been established. Therefore, to address this, we first subjected mice to 6, 24 or 72 h of unilateral immobilization and then used the SUnSET technique to measure changes in the relative rate of protein synthesis. The result of our initial experiments revealed that immobilization leads to a rapid (within 6 h) and progressive decrease in the rate of protein synthesis and that this effect is mediated by a decrease in translational efficiency. We then performed a deep mass spectrometry‐based analysis to determine whether this effect could be explained by changes in the expression and/or phosphorylation state of proteins that regulate translation. From this analysis, we were able to quantify 4320 proteins and 15,020 unique phosphorylation sites, and surprisingly, the outcomes revealed that the rapid immobilization‐induced decrease in protein synthesis could not be explained by changes in either the abundance, or phosphorylation state, of proteins. The results of our work not only challenge the current dogma in the field, but also provide an expansive resource of information for future studies that are aimed at defining how disuse leads to loss of muscle mass.
Explicit Algebraic Reynolds-Stress Modeling of Pressure-Induced Separating Flows in the Presence of Sidewalls
Authors: Mohammed-Taifour Abdelouahab , Weiss Julien , Dufresne Louis
Published: April 2021

Reynolds-averaged Navier–Stokes (RANS) approach is used to simulate the steady-state of a family of pressure-induced turbulent separation bubbles in the presence of sidewalls. Different turbulence models are employed with a specific emphasis on the baseline explicit algebraic Reynolds stress model (BSL-EARSM) and the simulations are compared with experimental data. The separation and reattachment of a flat-plate turbulent boundary layer are generated through a combination of adverse and favorable pressure gradients (APG-FPG) by numerically reproducing the geometry of the wind-tunnel test section used for the experiments. Three cases are considered a large (LB) and a medium (MB) bubble presenting mean backflow, and a small bubble (SB) without mean-flow reversal. This is achieved by varying the streamwise position of the APG/FPG transition. Good agreement between the BSL-EARSM-computed solutions and the experimental results are obtained for wall-pressure and skin-friction distributions on the centerline plane of the test section as well as for the overall three-dimensional flow topology. However, both detachment and reattachment are predicted too early and the bubble length is slightly overestimated for cases LB and MB. For case LB, the streamwise Reynolds stress is estimated fairly well but its production is somewhat delayed. Normal and shear stresses are in good agreement with the experiments in the upstream part of the bubble but are significantly over-estimated in the reattachment region. The k−ω shear-stress transport (SST) model with the so-called reattachment modification performs better than the other tested linear-eddy-viscosity models but it is still unable to reproduce accurately the three-dimensional flow topology even for the “simplest” case SB. Overall, the results suggest that BSL-EARSM is the most suitable turbulence model for this flow configuration.
Layer-Specific Residual Deformations and Their Variation Along the Human Aorta
Authors: Sokolis Dimitrios P. , Gouskou Nausicaa , Papadodima Stavroula A. , Kourkoulis Stavros K.
Published: April 2021

This study described the regional distribution of layer-specific residual deformations in fifteen human aortas collected during autopsy. Circumferentially and axially cut strips of standardized dimensions from the anterior quadrant of nine consecutive aortic levels were photographed to obtain the zero-stress state for the intact wall. The strips were then dissected into layers that were also photographed to obtain their zero-stress state. Changes in layer-specific opening angle, residual stretches, and thickness at each aortic level and direction were determined via image analysis. The circumferential and axial opening angles of the intima were ∼240 deg and ∼30 deg, respectively, throughout the aorta; those of the adventitia were ∼150 deg and –20 deg to 70 deg. The opening angles of the intact wall and media were similar in either direction. The circumferential residual stretches of the intima and the axial residual stretches of the media showed high values in the aortic arch, decreasing in the descending thoracic aorta and increasing toward the iliac artery bifurcation, while the axial residual stretches of the adventitia increased distally. The remaining residual stretches did not vary significantly with aortic level, suggesting an intimal role in determining circumferential, as well as medial and adventitial roles in determining axial residual stretches. We conclude that the tensile residual stretches released in the intima and media upon separation, and the compressive residual stretches released in the adventitia may moderate the inverse transmural stress gradients under physiologic loads, resulting from the >180 deg circumferential opening angle of the intact wall.
Implementation of Rectangular Vortex Generator Pairs to Improve Film Cooling Effectiveness on Transonic Rotor Blade Endwall
Authors: Li Jinjin , Yan Xin , He Kun , Goldstein Richard J.
Published: April 2021

The rectangular vortex generator pairs (RVGPs) are arranged upstream of the film cooling holes to achieve better coolant coverage on the endwall near the pressure-side corner area. The endwall film cooling effectiveness distributions under transonic flow conditions are numerically calculated for the single RVGP and double rows of RVGPs cases. At first, the effects of three geometrical parameters (i.e., the distance between RVGP and cooling hole, height of RVGP and attack angle of RVGP) on endwall film cooling effectiveness are studied with a single hole and RVGP at different mainstream inlet Reynolds numbers and blowing ratios. Then, the double rows of RVGPs are applied to further enhance the overall film cooling effectiveness on the blade endwall. The results show that the implementation of RVGPs significantly enhances the film cooling effect on transonic blade endwall at a pressure-side corner area. With the increase of RVGP height, the lateral coolant coverage on the endwall corner area is improved. However, by decreasing the distance between the vortex generator pair and cooling hole, the film cooling effectiveness downstream of the cooling holes is increased. The attack angle of RVGP mainly affects the shape of coolant spreading on endwall surface. The RVGP with optimum dimensions and arrangement is able to suppress the coolant from lifting off the endwall and increase the coolant diffusion near the endwall. Compared with no vortex generator case, the area-averaged film cooling effectiveness on endwall with double rows of RVGPs is improved by 13.16%.
Reynolds, Mach, and Freestream Turbulence Effects on the Flow in a Low-Pressure Turbine
Authors: Fiore Maxime , Gourdain Nicolas
Published: April 2021

This article presents the large-eddy simulation (LES) of a low-pressure turbine (LPT) nozzle guide vane (NGV) for different Reynolds (Re) and Mach (Ma) numbers with or without inlet turbulence prescribed. The analysis is based on a slice of an LPT blading representative of a midspan flow, where secondary flows, hub, and shroud effects are lower. The characteristic Re of the LPT can vary by a factor of four between take-off and cruise conditions. In addition, the LPT operates at different Ma values, and the incident flow can have significant levels of turbulence due to upstream blade wakes. This article investigates numerically using LES the flow around an LPT blading with three different Reynolds number Re = 175,000 (cruise), 280,000 (mid-level altitude), and 500,000 (take-off) keeping the same characteristic Mach number Ma = 0.2 and three different Mach number Ma = 0.2, 0.5, and 0.8 keeping the same Reynolds number Re = 280,000. These different simulations are performed with 0% freestream turbulence (FST) followed by inlet turbulence (6% FST). The study focuses on the influence of these three parameters (Re, Ma, and upstream turbulence) on different flow characteristics: pressure distribution around the blade, near-wall flow behavior, loss generation, and turbulent kinetic energy (TKE) budget. The results show an earlier boundary layer separation on the aft region of the blade suction side when the Re is increased, while the increase of the Ma delays separation, similar to freestream turbulence. The TKE budget led on the different cases shows the predominant effect of the turbulent production and diffusion in the wake, the axial evolution of these different terms being relatively insensitive to Re and Ma.
Thermal Post-Buckling Strength Prediction and Improvement of Shape Memory Alloy Bonded Carbon Nanotube-Reinforced Shallow Shell Panel: A Nonlinear Finite Element Micromechanical Approach
Authors: Mehar Kulmani , Mishra Pradeep Kumar , Panda Subrata Kumar
Published: April 2021

This article reported first-time the post-buckling temperature load parameter values of nanotube-reinforced polymeric composite panel and their improvement by introducing the functional material (shape memory alloy, SMA) fiber. The temperature load values of nanotube composite and SMA activation are modeled using the single-layer type higher-order kinematic model in association with isoparametric finite element technique. To ensure the effective properties of SMA bonded nanotube composite under the elevated temperature, a hybrid micromechanical material modeling approach is adopted (Mori–Tanaka scheme and rule of mixture). The present structural geometry distortion under elevated temperature is modeled through the nonlinear strain kinematics (Green–Lagrange), whereas the strain reversal achieved with the help of marching technique (inclusion of material nonlinearity). Owing to the importance of geometrical distortion of the polymeric structure, the current model includes all of the nonlinear strain terms to accomplish the exact deformation. Further, to compute the post-buckling responses, the governing nonlinear eigenvalue equations are derived by Hamilton's principle. The numerical solution accuracy is verified with adequate confirmation of model consistency. The material model applicability for different structural configurations including important individual/combined parameter tested through a series of examples. Moreover, the final understanding relevant to the post-buckling characteristics of the polymeric structure and SMA influences is highlighted in details considering the prestrain, recovery stress, and their volume fractions.
The independent contribution of voice onset time to perceptual metrics of convergence
Authors: Schertz Jessamyn , Johnson Elizabeth K. , Paquette-Smith Melissa
Published: April 2021

This work explores the relationship between phonetic and perceptual metrics for convergence in shadowed productions by adults and 6-year-old children by isolating the role of voice onset time (VOT) in listeners' similarity judgments. Results show a small but independent role for VOT: listeners were less likely to identify shadowed tokens as more similar to the model when natural VOT convergence present in the stimulus set had been artificially removed (experiments 1 and 2). However, VOT equivalence alone, when accompanied by naturally occurring variation along other dimensions, was not sufficient to drive listeners' judgments of similarity (experiment 3).
New Perspectives on Antimicrobial Agents: Ceftolozane-Tazobactam
Authors: Lizza Bryan D. , Betthauser Kevin D. , Ritchie David J. , Micek Scott T. , Kollef Marin H.
Published: April 2021

Ceftolozane-tazobactam (C/T) is a new fifth-generation cephalosporin/beta-lactamase inhibitor combination approved by the Food and Drug Administration and the European Medicines Agency for treatment of complicated intraabdominal infections, complicated urinary tract infections, and hospital-acquired pneumonia in adult patients. This review will briefly describe the pharmacology of C/T and focus on the emerging clinical trial and real-world data supporting its current utilization.
Preclinical Characterization of Immunogenicity and Efficacy against Diarrhea from MecVax, a Multivalent Enterotoxigenic E. coli Vaccine Candidate
Authors: Seo Hyesuk , Garcia Carolina , Ruan Xiaosai , Duan Qiangde , Sack David A. , Zhang Weiping
Published: April 2021

Enterotoxigenic
Escherichia coli
(ETEC) bacteria are a top cause of children’s diarrhea and travelers’ diarrhea and are responsible for over 220 million diarrheal cases and more than 100,000 deaths annually. A safe and effective ETEC vaccine can significantly improve public health, particularly in developing countries.
Switching Sides: How Endogenous Retroviruses Protect Us from Viral Infections
Authors: Srinivasachar Badarinarayan Smitha , Sauter Daniel
Published: April 2021

Long disregarded as junk DNA or genomic dark matter, endogenous retroviruses (ERVs) have turned out to represent important components of the antiviral immune response. These remnants of once-infectious retroviruses not only regulate cellular immune activation, but may even directly target invading viral pathogens.
Single-Dilution COVID-19 Antibody Test with Qualitative and Quantitative Readouts
Authors: Bortz Robert H. , Florez Catalina , Laudermilch Ethan , Wirchnianski Ariel S. , Lasso Gorka , Malonis Ryan J. , Georgiev George I. , Vergnolle Olivia , Herrera Natalia G. , Morano Nicholas C. , Campbell Sean T. , Orner Erika P. , Mengotto Amanda , Dieterle M. Eugenia , Fels J. Maximilian , Haslwanter Denise , Jangra Rohit K. , Celikgil Alev , Kimmel Duncan , Lee James H. , Mariano Margarette C. , Nakouzi Antonio , Quiroz Jose , Rivera Johanna , Szymczak Wendy A. , Tong Karen , Barnhill Jason , Forsell Mattias N. E. , Ahlm Clas , Stein Daniel T. , Pirofski Liise-anne , Goldstein D. Yitzchak , Garforth Scott J. , Almo Steven C. , Daily Johanna P. , Prystowsky Michael B. , Faix James D. , Fox Amy S. , Weiss Louis M. , Lai Jonathan R. , Chandran Kartik
Published: April 2021

Serological surveillance has become an important public health tool during the COVID-19 pandemic. Detection of protective antibodies and seroconversion after SARS-CoV-2 infection or vaccination can help guide patient care plans and public health policies.
Poor postnatal weight growth is a late finding after sepsis in very preterm infants
Authors: Flannery Dustin D , Jensen Erik A , Tomlinson Lauren A , Yu Yinxi , Ying Gui-Shuang , Binenbaum Gil
Published: April 2021

Objective

To characterise the association between sepsis and postnatal weight growth when accounting for the degree of growth restriction present at birth.

Design

Retrospective matched cohort study using data from the Postnatal Growth and Retinopathy of Prematurity study. Participants were born with birth weights of <1500 g or gestational ages of <32 weeks between 2006 and 2011 at 29 neonatal centres in the USA and Canada. Sepsis was defined as a culture-confirmed bacterial or fungal infection of the blood or cerebrospinal fluid before 36 weeks’ postmenstrual age (PMA). Growth was assessed as the change in weight z-score between birth and 36 weeks’ PMA.

Results

Of 4785 eligible infants, 813 (17%) developed sepsis and 693 (85%) were matched 1:1 to controls. Sepsis was associated with a greater decline in weight z-score (mean difference −0.09, 95% CI −0.14 to −0.03). Postnatal weight growth failure (decline in weight z- score>1) was present in 237 (34%) infants with sepsis and 179 (26%) controls (adjusted OR 1.49, 95% CI 1.12 to 1.97). Longitudinal growth trajectories showed similar initial changes in weight z-scores between infants with and without sepsis. By 3 weeks after sepsis onset, there was a greater decline in weight z-scores relative to birth values in those with sepsis than without sepsis (delta z-score −0.89 vs −0.77; mean difference −0.12, 95% CI −0.18 to −0.05). This significant difference persisted until 36 weeks or discharge.

Conclusion

Infants with sepsis had similar early weight growth trajectories as infants without sepsis but developed significant deficits in weight that were not apparent until several weeks after the onset of sepsis.
Lifestyle interventions for type 2 diabetes management among migrants and ethnic minorities living in industrialized countries: a systematic review and meta-analyses
Authors: Rawal Lal , Sahle Berhe W , Smith Ben J , Kanda Kie , Owusu-Addo Ebenezer , Renzaho Andre M N
Published: April 2021

The objective of this systematic review was to determine the effectiveness of lifestyle interventions to improve the management of type 2 diabetes mellitus (T2DM) among migrants and ethnic minorities. Major searched databases included MEDLINE (via PubMed), EMBASE (via Ovid) and CINAHL. The selection of studies and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In the meta-analysis, significant heterogeneity was detected among the studies (I2>50%), and hence a random effects model was used. Subgroup analyses were performed to compare the effect of lifestyle interventions according to intervention approaches (peer-led vs community health workers (CHWs)-led). A total of 17 studies were included in this review which used interventions delivered by CHWs or peer supporters or combination of both. The majority of the studies assessed effectiveness of key primary (hemoglobin (HbA1c), lipids, fasting plasma glucose) and secondary outcomes (weight, body mass index, blood pressure, physical activity, alcohol consumption, tobacco smoking, food habits and healthcare utilization). Meta-analyses showed lifestyle interventions were associated with a small but statistically significant reduction in HbA1c level (−0.18%; 95% CI −0.32% to −0.04%, p=0.031). In subgroup analyses, the peer-led interventions showed relatively better HbA1c improvement than CHW-led interventions, but the difference was not statistically significant (p=0.379). Seven studies presented intervention costs, which ranged from US$131 to US$461 per participant per year. We conclude that lifestyle interventions using either CHWs or peer supporters or a combination of both have shown modest effectiveness for T2DM management among migrants of different background and origin and ethnic minorities. The evidence base is promising in terms of developing culturally appropriate, clinically sound and cost-effective intervention approaches to respond to the growing and diverse migrants and ethnic minorities affected by diabetes worldwide.
Revolutionising rapid recovery: a quality improvement project in hip and knee replacement
Authors: Parkes Rebekah J , Ayeko Olusegun , Brunton Luke , Griffiths-Jones William , Ungvari Zsolt , Goss Henry
Published: April 2021

With increasing bed pressures and an ageing population, there is a need to increase throughput and reduce the bed burden of joint replacements. These issues were recognised in North Devon and an enhanced recovery pathway was established. Enhanced recovery, which aims to optimise the patient journey and shorten the inpatient admission, was first adopted for hip and knee replacements in North Devon District hospital in 2011. The Rapid Recovery Group, comprised a multidisciplinary team involved in the perioperative patient pathway, formed in the third financial quarter of 2018/2019 (Q3). The group was tasked with the optimisation of the pathway for patients requiring hip and knee replacement from referral to 12 months postoperation. Representatives from the group visited a similar sized hospital with successful outcomes from their pathway in order to compare and then construct a new pathway based on observed practices. Multiple interventions were instigated, alongside continuous data collection, forming a combination of simultaneous and sequential Plan Do Study Act cycles. Interventions involved intraoperative local anaesthetic injection protocols, use of Taurus frames together with nurse-led mobilisation and trials of simplified drug charts. Information collected included type of surgery, length of stay, who mobilised patients and when. Mean length of stay in total hip and knee replacement has dropped from 3.6 to 2.4 days and 3.6 to 2.0 days respectively, comparing mean for the fiscal year 2018/2019 to 2019/2020, putting the hospital in the top 10 trusts in the country. With multiple changes occurring simultaneously, the impact of individual elements is difficult to isolate but the overall impact of the interventions is evident. A drastic improvement in the length of stay has been seen and the collaborative multidisciplinary approach has been pivotal to success.
Rationales and uncertainties for aspirin use in COVID-19: a narrative review
Authors: Sayed Ahmed Hazem A , Merrell Eric , Ismail Mansoura , Joudeh Anwar I , Riley Jeffrey B , Shawkat Ahmed , Habeb Hanan , Darling Edward , Goweda Reda A , Shehata Mohamed H , Amin Hossam , Nieman Gary F , Aiash Hani
Published: April 2021

Objectives

To review the pathophysiology of COVID-19 disease, potential aspirin targets on this pathogenesis and the potential role of aspirin in patients with COVID-19.

Design

Narrative review.

Setting

The online databases PubMed, OVID Medline and Cochrane Library were searched using relevant headlines from 1 January 2016 to 1 January 2021. International guidelines from relevant societies, journals and forums were also assessed for relevance.

Participants

Not applicable.

Results

A review of the selected literature revealed that clinical deterioration in COVID-19 is attributed to the interplay between endothelial dysfunction, coagulopathy and dysregulated inflammation. Aspirin has anti-inflammatory effects, antiplatelet aggregation, anticoagulant properties as well as pleiotropic effects on endothelial function. During the COVID-19 pandemic, low-dose aspirin is used effectively in secondary prevention of atherosclerotic cardiovascular disease, prevention of venous thromboembolism after total hip or knee replacement, prevention of pre-eclampsia and postdischarge treatment for multisystem inflammatory syndrome in children. Prehospital low-dose aspirin therapy may reduce the risk of intensive care unit admission and mechanical ventilation in hospitalised patients with COVID-19, whereas aspirin association with mortality is still debatable.

Conclusion

The authors recommend a low-dose aspirin regimen for primary prevention of arterial thromboembolism in patients aged 40–70 years who are at high atherosclerotic cardiovascular disease risk, or an intermediate risk with a risk-enhancer and have a low risk of bleeding. Aspirin’s protective roles in COVID-19 associated with acute lung injury, vascular thrombosis without previous cardiovascular disease and mortality need further randomised controlled trials to establish causal conclusions.
Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience
Authors: Hamshere Stephen , Comer Katrina , Choudhry Fizzah , Rathod Krishna , Mills Gordon , Ferguson Gordon , Lambourne Jonathan , Akhtar Majid , Wragg Andrew , Ozkor Mick , Guttmann Oliver , Mullen Michael , Baumbach Andreas , Smith Elliot , Mathur Anthony , Jones Dan
Published: April 2021

Background

The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway.

Methods

This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used.

Results

143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms.

Conclusion

We demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.
Climate-based allometric biomass equations for five major Canadian timber species
Authors: Xu Kun , Jiang Jinghe , He Fangliang
Published: April 2021

Accurate estimation of forest biomass is essential to quantify the role forests play in balancing terrestrial carbon. Allometric equations based on tree size have been used for this purpose worldwide. There is little quantitative understanding on how environmental variation may affect tree allometries. Even less known is how to incorporate environmental factors into such equations to improve estimation. Here we tested the effects of climate on tree allometric equations and proposed to model forest biomass by explicitly incorporating climatic factors. For the five major Canadian timber species tested, the incorporation of climate was not found to improve the allometric models. For trembling aspen (Populus tremuloides Michx.) and tamarack (Larix laricina (Du Roi) K.Koch), the residuals of their conventional allometric models were found strongly related to frost-free period and mean annual temperature, respectively. The predictions of the two best climate-based models were significantly improved, which indicates that trembling aspen and tamarack store more aboveground biomass when growing in warmer than in colder regions. We showed that, under the RCP4.5 modest climate change scenario, there would be a 10% underestimation of aboveground biomass for these two species if the conventional non-climate models would still be in use in 2030. This study suggests the necessity to proactively develop climate-based allometric equations for more accurate and reliable forest biomass estimation.
ANALYSES OF BRAIN CORTICAL CHANGES OF ALZHEIMER’S DISEASE
Authors: LV YUTING , ZHAO WENSHUO , YAO XUFENG , XU SONG , TANG ZHIXIAN , FAN YIFENG , HUANG GANG
Published: April 2021

Alzheimer’s disease (AD) produces complicated cortical changes in gray matter (GM) of the human brain. However, alterations in the brain cortex have not been clearly addressed. In our study, a cohort of 236 cases MR data enrolled from the ADNI database was categorized into three groups of normal controls (NCs), mild cognitive impairment (MCI) and AD. The GM morphological differences were investigated among the three groups using the magnetic resonance (MR) GM characteristics of gray matter volume (GMV), cortical thickness (CT), cortical surface area (CSA) and local gyrification index (LGI) at the three levels of whole brain, bilateral hemispheres and critical brain regions. Totally, there were six critical brain regions for GMV, 11 for CT, 2 for CSA and 59 for LGI among the three groups for the no-division groups. Also, there were 11 critical brain regions for GMV, 15 for CT, 8 for CSA, 3 for LGI for female sub-groups and 4 critical brain regions for GMV, 11 for CT, 1 for CSA, 3 for LGI for male sub-groups. The four measured cortical characteristics showed reliable capability in the morphological description of GM changes of AD. In conclusion, the cortical characteristics of GMV, CT, CSA and LGI of critical brain regions showed valuable indications for GM changes of AD, and those characteristics could be used as imaging markers for AD prediction.
Review of Human Decision-making during Computer Security Incident Analysis
Authors: Spring Jonathan M. , Illari Phyllis
Published: April 2021

We review practical advice on decision-making during computer security incident response. Scope includes standards from the IETF, ISO, FIRST, and the US intelligence community. To focus on human decision-making, the scope is the evidence collection, analysis, and reporting phases of response, which includes human decision-making within and connecting these phases. The results indicate both strengths and gaps. A strength is available advice on how to accomplish many specific tasks. However, there is little guidance on how to prioritize tasks in limited time or how to interpret, generalize, and convincingly report results. Future work should focus on these gaps in explication and specification of decision-making during incident analysis.
Perceptions of Human and Machine-Generated Articles
Authors: Tewari Shubhra , Zabounidis Renos , Kothari Ammina , Bailey Reynold , Alm Cecilia Ovesdotter
Published: April 2021

Automated journalism technology is transforming news production and changing how audiences perceive the news. As automated text-generation models advance, it is important to understand how readers perceive human-written and machine-generated content. This study used OpenAI’s GPT-2 text-generation model (May 2019 release) and articles from news organizations across the political spectrum to study participants’ reactions to human- and machine-generated articles. As participants read the articles, we collected their facial expression and galvanic skin response (GSR) data together with self-reported perceptions of article source and content credibility. We also asked participants to identify their political affinity and assess the articles’ political tone to gain insight into the relationship between political leaning and article perception. Our results indicate that the May 2019 release of OpenAI’s GPT-2 model generated articles that were misidentified as written by a human close to half the time, while human-written articles were identified correctly as written by a human about 70 percent of the time.
fenicsR13
Authors: Theisen Lambert , Torrilhon Manuel
Published: April 2021

We present a mixed finite element solver for the linearized regularized 13-moment equations of non-equilibrium gas dynamics. The Python implementation builds upon the software tools provided by the FEniCS computing platform. We describe a new tensorial approach utilizing the extension capabilities of FEniCS’ Unified Form Language to define required differential operators for tensors above second degree. The presented solver serves as an example for implementing tensorial variational formulations in FEniCS, for which the documentation and literature seem to be very sparse. Using the software abstraction levels provided by the Unified Form Language allows an almost one-to-one correspondence between the underlying mathematics and the resulting source code. Test cases support the correctness of the proposed method using validation with exact solutions. To justify the usage of extended gas flow models, we discuss typical application cases involving rarefaction effects. We provide the documented and validated solver publicly.
Privacy-preserving Dynamic Symmetric Searchable Encryption with Controllable Leakage
Authors: Cui Shujie , Song Xiangfu , Asghar Muhammad Rizwan , Galbraith Steven D. , Russello Giovanni
Published: April 2021

Searchable Encryption (SE) is a technique that allows Cloud Service Providers to search over encrypted datasets without learning the content of queries and records. In recent years, many SE schemes have been proposed to protect outsourced data. However, most of them leak sensitive information, from which attackers could still infer the content of queries and records by mounting leakage-based inference attacks, such as the
count attack
and
file-injection attack
.

In this work, first we define the leakage in searchable encrypted databases and analyse how the leakage is leveraged in existing leakage-based attacks. Second, we propose a Privacy-preserving Multi-cloud based dynamic symmetric SE scheme for relational Database (
P-McDb
).
P-McDb
has minimal leakage, which not only ensures confidentiality of queries and records but also protects the search, intersection, and size patterns. Moreover,
P-McDb
ensures both forward and backward privacy of the database. Thus,
P-McDb
could resist existing leakage-based attacks, e.g., active file/record-injection attacks. We give security definition and analysis to show how
P-McDb
hides the aforementioned patterns. Finally, we implemented a prototype of
P-McDb
and tested it using the TPC-H benchmark dataset. Our evaluation results show that users can get the required records in 2.16 s when searching over 4.1 million records.
Algorithm 1016
Authors: Hahne Jens , Friedhoff Stephanie , Bolten Matthias
Published: April 2021

In this article, we introduce the Python framework PyMGRIT, which implements the multigrid-reduction-in-time (MGRIT) algorithm for solving (non-)linear systems arising from the discretization of time-dependent problems. The MGRIT algorithm is a reduction-based iterative method that allows parallel-in-time simulations, i.e., calculating multiple time steps simultaneously in a simulation, using a time-grid hierarchy. The PyMGRIT framework includes many different variants of the MGRIT algorithm, ranging from different multigrid cycle types and relaxation schemes, various coarsening strategies, including time-only and space-time coarsening, and the ability to utilize different time integrators on different levels in the multigrid hierachy. The comprehensive documentation with tutorials and many examples and the fully documented code allow an easy start into the work with the package. The functionality of the code is ensured by automated serial and parallel tests using continuous integration. PyMGRIT supports serial runs suitable for prototyping and testing of new approaches, as well as parallel runs using the Message Passing Interface (MPI). In this manuscript, we describe the implementation of the MGRIT algorithm in PyMGRIT and present the usage from both a user and a developer point of view. Three examples illustrate different aspects of the package itself, especially running tests with pure time parallelism, as well as space-time parallelism through the coupling of PyMGRIT with PETSc or Firedrake.
Finding a Shortest Odd Hole
Authors: Chudnovsky Maria , Scott Alex , Seymour Paul
Published: April 2021

An odd hole in a graph is an induced cycle with odd length greater than 3. In an earlier paper (with Sophie Spirkl), solving a longstanding open problem, we gave a polynomial-time algorithm to test if a graph has an odd hole. We subsequently showed that, for every
t
, there is a polynomial-time algorithm to test whether a graph contains an odd hole of length at least
t
. In this article, we give an algorithm that finds a shortest odd hole, if one exists.
Dynamic Analysis and FPGA Implementation of New Chaotic Neural Network and Optimization of Traveling Salesman Problem
Authors: Cui Li , Chen Chaoyang , Jin Jie , Yu Fei
Published: April 2021

A neural network is a model of the brain’s cognitive process, with a highly interconnected multiprocessor architecture. The neural network has incredible potential, in the view of these artificial neural networks inherently having good learning capabilities and the ability to learn different input features. Based on this, this paper proposes a new chaotic neuron model and a new chaotic neural network (CNN) model. It includes a linear matrix, a sine function, and a chaotic neural network composed of three chaotic neurons. One of the chaotic neurons is affected by the sine function. The network has rich chaotic dynamics and can produce multiscroll hidden chaotic attractors. This paper studied its dynamic behaviors, including bifurcation behavior, Lyapunov exponent, Poincaré surface of section, and basins of attraction. In the process of analyzing the bifurcation and the basins of attraction, it was found that the network demonstrated hidden bifurcation phenomena, and the relevant properties of the basins of attraction were obtained. Thereafter, a chaotic neural network was implemented by using FPGA, and the experiment proved that the theoretical analysis results and FPGA implementation were consistent with each other. Finally, an energy function was constructed to optimize the calculation based on the CNN in order to provide a new approach to solve the TSP problem.