bluuebunny/crossref_metadata_2025 huggingface dataset:
The prognostic effect of smoking status on intensively treated acute myeloid leukaemia – A Danish nationwide cohort study
Authors: Kristensen Daniel , Nielsen Lars B. , Roug Anne S. , Kristensen Tove‐Christina C. , El‐Galaly Tarec C. , Nørgaard Jan M. , Marcher Claus W. , Schöllkopf Claudia , Theilgaard‐Mönch Kim , Severinsen Marianne T.
Published: April 2020

With rising life expectancy, the importance of patient‐related prognostic factors and how to integrate such data into clinical decision‐making becomes increasingly important. The aim of this study was to evaluate the prognostic impact of smoking status in patients with acute myeloid leukaemia (AML) treated with intensive chemotherapy. We conducted a nationwide cohort study based on data obtained from the Danish National Leukaemia Registry (DNLR). The study comprised Danish patients aged 18–75 years, diagnosed with AML between 1 January 2000 and 31 December 2012. Medical records were reviewed and data on smoking status were collected. A total of 1040 patients (median age 59 years) were included, and 602 patients (58·9%) were categorised as ever‐smokers and the remaining as never‐smokers. Kaplan–Meier survival estimates revealed that ever‐smokers had a significant shorter median overall survival (OS) at 17·2 months [95% CI (14·9;19·1)] compared to never‐smokers at 24·5 months (95% CI [19·2;30·7]). Multivariate analysis revealed smoking status as a significant prognostic factor for inferior OS with a hazard ratio (HR) of 1·22 [95% CI (1·04;1·44)]. In conclusion, smoking status was found to be associated with inferior OS in intensively treated AML patients.
Interactive effects of social network centrality and social identification on stress
Authors: Mojzisch Andreas , Frisch Johanna Ute , Doehne Malte , Reder Maren , Häusser Jan Alexander
Published: April 2020

The present study aimed to integrate the social identity approach to health and well‐being with social network analysis. Previous research on the effects of social network centrality on stress has yielded mixed results. Building on the social identity approach, we argued that these mixed results can be explained, in part, by taking into account the degree to which individuals identify with the social network. We hence hypothesized that the effects of social network centrality on stress are moderated by social identification. Using a full roster method, we assessed the social network of first‐year psychology students right after the start of their study programme and three months later. The effects of network centrality (betweenness, closeness, eigenvector centrality) and social identification on stress were examined using structural equation models. As predicted, our results revealed a significant interaction between network centrality and social identification on stress: For weakly or moderately identified students, network centrality was positively related to stress. By contrast, for strongly identified students, network centrality was unrelated to stress. In conclusion, our results point to the perils of being well‐connected yet not feeling like one belongs to a group.
Squalene epoxidase‐induced cholesteryl ester accumulation promotes nasopharyngeal carcinoma development by activating PI3K/AKT signaling
Authors: Li Liming , Zhang Qingfeng , Wang Xin , Li Yan , Xie Huifen , Chen Xiangdong
Published: April 2020

Nasopharyngeal carcinoma (NPC) is a common malignant tumor and a major cause of mortality and morbidity in southern China. However, the mechanism is still elusive. Here, we focused on studying the role of squalene epoxidase (SQLE), a key enzyme of cholesterol biosynthesis, in the progression of NPC. Clinical study revealed that SQLE expression was significantly upregulated in NPC tissues compared to normal tissues from mRNA level and patients with high expression of SQLE showed a poor prognosis. In vitro experiments showed that SQLE overexpression led to a significant proliferation of cells whereas SQLE knockdown showed an opposite result. In vivo studies also showed that SQLE promoted tumor growth in nude mice. Further study revealed that SQLE promoted NPC proliferation by cholesteryl ester accumulation instead of cholesterol. Mechanism studies indicated that cholesteryl ester promoted NPC cell proliferation by activating the PI3K/AKT pathway and inhibition of this pathway in SQLE‐overexpressed or cholesteryl ester‐treated cells resulted in a significant reduction of NPC cell proliferation. These results indicate that the oncogenic effect of SQLE in NPC mainly resulted from cholesteryl ester accumulation and PI3K/AKT is a promising target for NPC with SQLE overexpression.
Downregulation of α‐l‐fucosidase 1 suppresses glioma progression by enhancing autophagy and inhibiting macrophage infiltration
Authors: Xu Lixia , Li Zhenwei , Song Sirong , Chen Qian , Mo Lidong , Wang Chen , Fan Weijia , Yan Yan , Tong Xiaoguang , Yan Hua
Published: April 2020

α‐l‐Fucosidase 1 (FUCA1), a lysosomal enzyme that catalyses the hydrolytic cleavage of the terminal fucose residue, has been reported to be involved in tumorigenesis. However, the clinical significance and biological roles of FUCA1 in glioma remain largely unknown. We analyzed FUCA1 expression according to data in Oncomine, The Cancer Genome Atlas, and Chinese Glioma Genome Atlas databases and further verified FUCA1 expression with immunohistochemistry and real‐time PCR analysis in glioma tissues. The results showed that FUCA1 overexpression was significantly associated with high‐grade glioma as well as high mortality rates in the survival analysis. Data analyzed in cBioPortal showed that alterations in FUCA1 (1.4%) were correlated with worse survival in glioblastoma multiforme patients. Functional experiments showed that downregulation of FUCA1 suppressed glioma growth in vitro and in vivo. Conversely, overexpression of FUCA1 had the opposite effects on glioma. Mechanistically, transient inhibition of FUCA1 promoted the formation of large acidic vacuoles, as revealed by staining with acridine orange, increased the ratio of LC3‐B/LC3‐A, and modified the expression of Beclin‐1 and Atg12, which are autophagic markers. Upregulation of FUCA1 attenuated starvation‐induced autophagy in glioma. In addition, lower levels of tumor‐infiltrating macrophages, including CD68+ (−30%), F4/80+ (−50%), and CD11c+ macrophages (−50%), were identified in FUCA1‐downregulated glioma tissues, and CCL2/CCL5 neutralizing Abs blocked this effect. These results show that FUCA1 could serve as a potential therapeutic target for the treatment of patients with glioma by enhancing autophagy and inhibiting macrophage infiltration.
Refractive outcomes, corneal haze and endothelial cell loss after myopic photorefractive keratectomy in an Asian population: The Singapore Armed Forces' experience
Authors: Ang Bryan Chin Hou , Yap Sae Cheong , Toh Zhi Hong , Lim Edmund Wei Long , Tan Mellisa Mei Hui , Nah Gerard Kwang Ming , Zhao Paul Song Bo , Tan Marcus Chiang Lee
Published: April 2020

Importance

This study reports outcomes of myopic photorefractive keratectomy (PRK) in a mainly ethnic Chinese population in Singapore.

Background

To assess the incidence and associations of corneal haze and endothelial cell count (ECC) loss up to 12 months after PRK.

Design

This was a retrospective case series conducted in a tertiary eye centre.

Participants

A total of 158 patients (309 eyes) with a mean age of 22.1 ± 3.4 years were included. The majority was Chinese (97.4%) and male (97.4%). Mean preoperative spherical equivalent was −3.33 ± 1.15 D.

Methods

Eyes were categorized based on postoperative haze severity. A multivariate analysis adjusting for age and use of intraoperative mitomycin‐C (MMC), preoperative sphere and cylinder was performed.

Main outcome measures

Refractive outcomes and corneal haze 3 and 12 months after PRK were assessed. ECC measurements were obtained before PRK and at variable periods postoperatively.

Results

At 12 months, overall efficacy index was 0.98, and safety index was 1.09. Eight (2.5%) eyes underwent enhancement surgery. An analysis was performed on 295 eyes that did not undergo enhancement and had complete clinical data, which demonstrated a decrease in the incidence of haze from 38.2% at 3 months to 9.3% at 12 months. Higher myopia was associated with increased haze severity at 3 months (OR, 1.36; P = .005). Higher astigmatism was associated with increased haze severity at 3 (OR, 1.65; P = .018) and 12 months (OR, 2.32; P = .015). Intraoperative MMC was not associated with haze severity or ECC loss.

Conclusions and relevance

Myopia and astigmatism were associated with increased corneal haze severity. Intraoperative MMC did not accelerate ECC loss. Overall, PRK is effective, predictable and safe in Asian eyes.
Loneliness among people with substance use problems: A narrative systematic review
Authors: Ingram Isabella , Kelly Peter J. , Deane Frank P. , Baker Amanda L. , Goh Melvin C. W. , Raftery Dayle K. , Dingle Genevieve A.
Published: April 2020

Issues

Despite the serious implications of loneliness on health and wellbeing, little is understood about this experience across people with substance use problems. This systematic review aimed to examine: (i) correlates and predictors of loneliness; (ii) theories underpinning loneliness; (iii) methods employed to measure loneliness; and (iv) loneliness interventions for people with substance use problems.

Approach

Empirical sources were identified from key databases for all publications preceding February 2019. Overall, 41 studies met the eligibility criteria and were included in the review.

Key Findings

Findings from this review suggest that loneliness is related to poor physical and mental health, substance use, the quality of relationships, stigma and perception of ill treatment by others. Although cognitive theories have proposed cognitive patterns underlying the onset and maintenance of loneliness, they had not been investigated in relation to measurement or intervention efforts. Just one loneliness measure (UCLA Loneliness Scale) is valid for use with this population. Finally, only a single loneliness intervention had been trialled and was not found to be efficacious in reducing loneliness for people with substance use problems.

Implications

Understanding possible links between loneliness and substance use and how to alleviate loneliness is important for this population in terms of their wellbeing and recovery.

Conclusion

Loneliness is prevalent and experienced as problematic among people with substance use problems. Future research should focus on employing longitudinal designs, using validated, multidimensional measures of loneliness and on developing and trialling loneliness interventions that meet the specific needs of people with substance use problems.
Psychosocial and behavioural prognostic factors for diabetic foot ulcer development and healing: a systematic review
Authors: Westby M. , Norman G. , Vedhara K. , Game F. , Cullum N.
Published: April 2020

Aim

To investigate whether ulceration, amputation and healing of foot ulcers in people living with diabetes are associated with psychosocial and behavioural factors.

Methods

We searched MEDLINE, Embase, PsychINFO, CINAHL and The Cochrane Library to March 2019 for longitudinal studies with multivariable analyses investigating independent associations. Two reviewers extracted data and assessed risk of bias.

Results

We identified 15 eligible studies involving over 12 000 participants. Clinical and methodological heterogeneity precluded meta‐analysis, so we summarize narratively. Risk of bias was moderate or high. For ulceration, we found significantly different results for people with and without an ulcer history. For those with no ulcer history, moderate quality evidence suggests depression increases ulcer risk [three studies; e.g. hazard ratio (HR) 1.68 (1.20, 2.35) per Hospital Anxiety and Depression Scale (HADS) standard unit]. Better foot self‐care behaviour reduces ulcer risk [HR 0.61 (0.40, 0.93) per Summary of Diabetes Self‐Care Activities scale standard unit; one study]. For people with diabetes and previous ulcers, low‐ or very low‐quality evidence suggests little discernible association between ulcer recurrence and depression [e.g. HR 0.88 (0.61, 1.27) per HADS standard unit], foot self‐care, footwear adherence or exercise.

Low‐quality evidence suggests incomplete clinic attendance is strongly associated with amputation [odds ratio (OR) 3.84 (1.54, 9.52); one study]. Evidence for the effects of other psychosocial or behavioural factors on ulcer healing and amputation is very low quality and inconclusive.

Conclusions

Psychosocial and behavioural factors may influence the development of first ulcers. More high quality research is needed on ulcer recurrence and healing. (Open Science Framework Registration: https://osf.io/ej689)
Six‐year history of intermittent symptomatic bilateral vertebral artery stenosis: Imaging and therapeutic intervention
Authors: Kerut Christian K. , Sheahan Claudie , Sheahan Malachi
Published: April 2020

A 66‐year‐old man was evaluated for a 6‐year history of disabling symptoms of typical intermittent vertebrobasilar (VB) insufficiency. Duplex scanning was “normal,” but computed tomographic angiography (CTA) revealed significant bilateral proximal vertebral artery (VA) disease. Angiography with stent placement with the proximal right VA resulted in resolution of symptoms. Symptoms of VB insufficiency may occur from bilateral VA disease, most often involving both proximal segments. Duplex ultrasound has high specificity but relatively low sensitivity for finding hemodynamically significant VA disease. Further imaging with CTA or magnetic resonance angiography (MRA) will help in identification of disease. As with this patient, invasive angiography with percutaneous stenting of the most significantly stenosed VA often results in resolution of symptoms of VB insufficiency.
Independence of coronary artery disease to subclinical left ventricular dysfunction
Authors: Venkataraman Prasanna , Wright Leah , Huynh Quan , Marwick Thomas H.
Published: April 2020

Objective

Epicardial atherosclerosis and heart failure while distinct clinical entities share common pathophysiological features including endothelial dysfunction and inflammation. Presence of subclinical disease could lead to early diagnosis and intervention in the other. The aim of our study was to assess the association between coronary calcium score (CCS), conventional cardiovascular risk factors, and echocardiographic markers of subclinical left ventricular dysfunction (S‐LVD).

Methods

One hundred and fifty‐nine participants aged 40–70 years with intermediate risk of coronary artery disease (5‐year risk of 2%–15%) were identified. Computed tomography (CT) CCS and 2‐D transthoracic echocardiography were performed. Main outcomes included presence of subclinical left ventricular dysfunction defined by reduced average global longitudinal strain, left atrial volume enlargement, and elevated E/e’.

Results

Fifteen participants had evidence of subclinical LV dysfunction (8 with systolic dysfunction and 7 with diastolic dysfunction) and 85 participants had CCS > 0. CCS > 0 was present in 10 participants with S‐LVD compared to 75 participants without S‐LVD (67% vs 53%, P = .47). There was no significant difference between in mean GLS (19.2 vs 19.5, P = .14), E/e’ (7.2 vs 7.5 P = .33) in those without or with coronary artery calcium. Elevated CCS was also not associated with a higher tertiles of indexed LV mass (OR 1.15, P = .49) or index left atrial volume (OR 1.15, P = .49).

Conclusions

In an asymptomatic, low‐intermediate‐risk group, mechanistic processes that lead to atherosclerosis are not directly associated with subclinical LV dysfunction.
Evolution and genetics of bighead and silver carps: Native population conservation versus invasive species control
Authors: Lu Guoqing , Wang Chenghui , Zhao Jinliang , Liao Xiaolin , Wang Jun , Luo Mingkun , Zhu Lifeng , Bernatzhez Louis , Li Sifa
Published: April 2020

Bighead carp (Hypophthalmichthys nobilis) and silver carp (H. molitrix), collectively called bigheaded carps, are cyprinids native mainly to China and have been introduced to over 70 countries. Paleontological and molecular phylogenetic analyses demonstrate bighead and silver carps originated from the Yangtze‐Huanghe River basins and modern populations may have derived from the secondary contact of geographically isolated fish during the last glacial events. Significant genetic differences are found among populations of native rivers (Yangtze, Pearl, and Amur) as well as introduced/invasive environments (Mississippi R., USA and Danube R., Hungary), suggesting genetic backgrounds and ecological selection may play a role in population differentiation. Population divergence of bighead carp or silver carp has occurred within their native rivers, whereas, within the Mississippi River Basin (MRB)—an introduced region, such genetic differentiation is likely taking place at least in silver carp. Interspecific hybridization between silver and bighead carps is rare within their native regions; however, extensive hybridization is observed in the MRB, which could be contributed by a shift to a more homogenous environment that lacks reproductive isolation barriers for the restriction of gene flow between species. The wild populations of native bighead and silver carps have experienced dramatic declines; in contrast, the introduced bigheaded carps overpopulate the MRB and are considered two invasive species, which strongly suggests fishing capacity (overfishing and underfishing) be a decisive factor for fishery resource exploitation and management. This review provides not only a global perspective of evolutionary history and population divergence of bigheaded carps but also a forum that calls for international research collaborations to deal with critical issues related to native population conservation and invasive species control.
Non‐bismuth and bismuth quadruple therapies based on previous clarithromycin exposure are as effective and safe in an area of high clarithromycin resistance: A real‐life study
Authors: Romano Marco , Gravina Antonietta Gerarda , Nardone Gerardo , Federico Alessandro , Dallio Marcello , Martorano Marco , Mucherino Caterina , Romiti Alessandra , Avallone Luciana , Granata Lucia , Priadko Katerina , Compare Debora , Tuccillo Concetta , Romito Maria Raffaella , Sgambato Dolores , Miranda Agnese , Romano Lorenzo , Loguercio Carmelina , Bazzoli Franco , Zagari Rocco Maurizio
Published: April 2020

Background

Bismuth quadruple (BQT) and non‐bismuth quadruple (N‐BQT) therapies are the recommended first‐line treatments for Helicobacter (H.) pylori infection.

Objective

To compare the efficacy of BQT and N‐BQT in clinical practice in an area with high clarithromycin resistance, choosing the regimen on the basis of previous exposure to clarithromycin.

Methods

A total of 404 consecutive H pylori‐positive, naïve patients were enrolled. A total of 203 patients without previous exposure to clarithromycin received N‐BQT, 100 patients for 10 days and 103 for 14 days, whereas 201 with previous exposure to clarithromycin received 10‐day BQT. Efficacy and treatment‐related adverse events were assessed.

Results and Conclusions

Eradication rates by intention‐to‐treat analysis were 88.2% for N‐BQT and 91.5% for BQT (P = .26); per‐protocol analysis eradication rates were 91.2% and 95.8% for N‐BQT and BQT, respectively (P = .07). Eradication rates were significantly higher with 14‐day than 10‐day CT (P < .003). Almost all patients had a good compliance with both N‐BQT (95.6%) and BQT (95%). Adverse events occurred in 24.1% and 26.9% (P = .53) of patients in the N‐BQT and BQT group, respectively. In conclusion, clarithromycin‐containing non‐bismuth or bismuth quadruple therapy, based on the knowledge of previous clarithromycin exposure, is effective and safe even in an area of high prevalence of clarithromycin‐resistant H pylori strains.
Association of AMY1A/AMY2A copy numbers and AMY1/AMY2 serum enzymatic activity with obesity in Mexican children
Authors: Vázquez‐Moreno Miguel , Mejía‐Benítez Aurora , Sharma Tanmay , Peralta‐Romero Jesús , Locia‐Morales Daniel , Klünder‐Klünder Miguel ,   National Obesity Network Mexico, Cruz Miguel , Meyre David
Published: April 2020

Background

Mexican children are characterized by a high‐starch intake diet and high prevalence of obesity.

Objectives

To investigate the association of AMY1A/AMY2A copy numbers (CNs) and AMY1/AMY2 serum enzymatic activity with childhood obesity in up to 427 and 337 Mexican cases and controls.

Methods

Anthropometric and dietary starch intake data were collected. CN of AMY1A/AMY2A and AMY1/AMY2 serum enzymatic activity were determined using droplet digital PCR (ddPCR) and enzymatic colorimetry, respectively. An individual participant level data meta‐analysis of association between AMY1A CNVs and obesity was also performed.

Results

A positive association between AMY1A/AMY2A CNs and their corresponding AMY1/AMY2 serum enzyme activity was observed in children with normal weight and obesity. The serum enzyme activity of AMY1 and AMY2 was negatively associated with childhood obesity risk, and the association was restricted to kids eating medium/high amount of starch (Pinteraction = .004). While no association between AMY1A and AMY2A CNs and childhood obesity was observed in our sample, we confirmed a significant association between AMY1A CN and obesity in a meta‐analysis of 3100 Mexican children.

Conclusions

Our data suggest that genetically determined salivary and pancreatic amylase activity can increase/decrease the risk of obesity in Mexican children, this effect being blunted by a low‐starch diet.
Privacy, confidentiality, security and patient safety concerns about electronic health records
Authors: Bani Issa W. , Al Akour I. , Ibrahim A. , Almarzouqi A. , Abbas S. , Hisham F. , Griffiths J.
Published: April 2020

Aims

This study explored concerns among nurses working in the United Arab Emirates associated with the use of electronic health records, including privacy, confidentiality, security and patient safety.

Background

Given the widespread implementation of electronic health records, there are concerns about data integrity that could jeopardize healthcare quality. Addressing nurses’ concerns about data integrity and safety is critical to inform health policies and promote public trust.

Methods

Nurses working in healthcare settings in the United Arab Emirates (N = 562) were invited to share their concerns about data integrity and patient safety using a mixed‐method approach. Data were collected between January and June 2018 via questionnaires and focus group interviews. Following a survey of nurses’ concerns about privacy, confidentiality, security and patient safety in electronic health records, six focus groups were held to gain deeper insights about their concerns. Major themes that emerged from the focus groups were extracted to align with the main sections of the questionnaire.

Results

Nurses expressed concern over the security of electronic health records (n = 270, 48%). Administrative‐related security, inadequate training and access by unauthorized users were the most frequently reported concerns. The main patient safety concerns were associated with non‐technological factors, including lack of audit by staff, poor communication with technology vendors and length of time required for documentation. The focus group results reflected similar issues, with an additional theme being inconsistency in data integrity policies.

Conclusions and implications for nursing/health policy

Frontline nurse managers need to integrate pragmatic policies to support staff compliance with the code of ethics when using online data. Nurses must follow workplace policies that foster reporting of risks to online incident systems to ensure data integrity. A unified health policy based on multidisciplinary partnership is critical to safeguard online data and promote public trust.
Real‐world data on the incidence, mortality, and cost of ischaemic stroke and major bleeding events among non‐valvular atrial fibrillation patients in England
Authors: Bakhai Ameet , Petri Hans , Vahidnia Farnaz , Wolf Cyrill , Ding Yingjie , Foskett Nadia , Sculpher Mark
Published: April 2020

Rationale, Aims, and Objectives

Several novel oral anticoagulants (NOACs) are licensed for atrial fibrillation (AF) treatment in the United Kingdom. We describe the incidence and mortality from ischaemic stroke and major bleeding in non‐valvular atrial fibrillation (NVAF) patients in England, including treatment patterns before/following introduction of NOACs, healthcare resource utilization (HRU), and costs post‐onset of these events.

Method

Data were extracted from the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics secondary care and Office for National Statistics mortality data.

Results

Of 42 966 patients with a first AF record between 2011 and 2016, 9143 patients (21.3%) remained without AF (antiplatelets/antithrombotics) treatment post‐index diagnosis. The proportion of patients receiving aspirin for ≥3 months post‐index declined during the study (50.6%‐5.5%), irrespective of CHA2DS2‐VASc score, while the proportion prescribed NOACs increased (2.0%‐70.1%). Rates of ischaemic stroke per 1000 patient‐years (95% CI) were 9.4 (3.8‐15.0) with NOACs, 10.4 (8.0‐12.9) with warfarin, 20.1 (16.4‐23.8) with aspirin, 21.3 (5.3‐37.2) with other antiplatelets and 43.6 (39.3‐47.8) in patients without AF prescription. Major bleeding occurred at a similar rate with different treatments. All‐cause mortality rates were 42.8 (31.4‐54.3) with NOACs, 46.3 (41.1‐51.5) with warfarin, 56.5 (50.5‐62.4) with aspirin, 102.2 (76.2‐128.3) with other antiplatelets and 412.8 (399.6‐426.0) with no AF prescription. Mean annual National Health Service healthcare costs up to 1 year post‐index were lowest in patients receiving aspirin plus other antiplatelets without an event (£6152), and highest in patients with an event without AF prescriptions (£17 957). By extrapolation, national AF HRU in the United Kingdom in 2016 was estimated at £8‐16 billion annually.

Conclusions

These data provide temporal insights into AF treatment patterns and outcomes for NVAF patients in England and highlight the need to review higher stroke risk AF patients not receiving antiplatelet/antithrombotic prescriptions.
The nature and consequences of co‐infections in tilapia: A review
Authors: Abdel‐Latif Hany M. R. , Dawood Mahmoud A. O. , Menanteau‐Ledouble Simon , El‐Matbouli Mansour
Published: April 2020

Co‐infections commonly arise when two or multiple different pathogens infect the same host, either as simultaneous or as secondary concurrent infection. This potentiates their pathogenic effects and leads to serious negative consequences on the exposed host. Numerous studies on the occurrence of the bacterial, parasitic, fungal and viral co‐infections were conducted in various tilapia species. Co‐infections have been associated with serious negative impacts on susceptible fish because they increase the fish susceptibility to diseases and the likelihood of outbreaks in the affected fish. Co‐infections can alter the disease course and increase the severity of disease through synergistic and, more rarely, antagonistic interactions. In this review, reports on the synergistic co‐infections and their impacts on the affected tilapia species are highlighted. Additionally, their pathogenic mechanisms are briefly discussed. Tilapia producers should be aware of the possible occurrence of co‐infections and their effects on the affected tilapia species and in particular of the clinical signs and course of the disease. To date, there is still limited information regarding the pathogenicity mechanisms and pathogen interactions during these co‐infections. This is generally due to low awareness regarding co‐infections, and in many cases, a dominant pathogen is perceived to be of vital importance and hence becomes the target of treatment while the treatment of the co‐infectious agents is neglected. This review article aimed at raising awareness regarding co‐infections and helping researchers and fish health specialists pay greater attention to these natural cases, leading to increased research and more consistent diagnosis of co‐infectious outbreaks in order to improve control strategies to protect tilapia when infected with multiple pathogens.
A remarkable new species of Salacia (Celastraceae: Salacioideae) from the Western Ghats, India
Authors: Page Navendu V. , Nandikar Mayur D.
Published: April 2020

A new species of Salacia is described from Karnataka and Kerala states of the Western Ghats, India. It is unique within the genus on account of its obliquely dehiscing anthers and 7–10 cm long, prolate to broadly ellipsoid or ovoid, keeled, greenish‐yellow 5‐ to 8‐seeded fruit with thin epicarp and dry mesocarp. Salacia megacarpa sp. nov. can be grouped with S. fruticosa Heyne ex M.A.Lawson and S. oblonga Wight & Arn. which are the only other species from the sub‐continent which exhibit axillary, ramiflorous, dichotomously branched cymes.
The trends in the usage of breast milk in neonatal intensive care setting
Authors: Çelik Kıymet , Asena Muhammed , İpek Mehmet Şah
Published: April 2020

Background

Many interventions have been designed to increase breast milk (BM) consumption among preterm and critical‐term infants in neonatal units. The aim of this study was to determine the trends in the usage of BM in a neonatal unit and the risk factors for insufficient breast‐milk feeding at discharge.

Methods

This retrospective study included newborn infants who hospitalized in the neonatal unit during two periods in different years, a 15‐month period in 2012–2013 and in 2017–2018. The primary outcomes were the availability of BM within 24 h after delivery and the status of infant feeding at discharge.

Results

During two periods of the study, a total of 3,018 infants were included in the study. The rate of BM expression within the first 24 h after delivery was 92.9%, and it was found that the first period of the study, caesarean section delivery, very low birth weight, being first‐time mother, and young maternal age were each independently associated with the delayed initiation of BM expression (P < 0.05). At discharge, 87.6% of the infants had been feeding with BM. Multiple births, the delayed initiation of BM expression, and the length of hospital stay were associated with inadequate BM feeding at discharge (P < 0.001).

Conclusion

This study showed that interventions supporting BM feeding, which have recently been carried out, made improvements to the initiation of BM expression among mothers whose babies were admitted to the neonatal unit, and in the rate of BM feeding among infants at discharge.
Early tonsillectomy for severe immunoglobulin A nephropathy significantly reduces proteinuria
Authors: Enya Takuji , Miyazaki Kohei , Miyazawa Tomoki , Oshima Rina , Morimoto Yuichi , Okada Mitsuru , Takemura Tsukasa , Sugimoto Keisuke
Published: April 2020

Background

Early multiple‐drug therapy for severe childhood immunoglobulin A (IgA) nephropathy prevents the progression of nephritis and improves the long‐term prognosis. Recent studies have focused on the relationship between the pathophysiology of IgA nephropathy and tonsillar focal infection, and the efficacy of tonsillectomy with methylprednisolone pulse therapy in children has been demonstrated. However, no study has reported on the relationship between the period from diagnosis to tonsillectomy and the long‐term prognosis of IgA nephropathy.

Methods

To clarify the long‐term effects of an early tonsillectomy, 40 patients who were diagnosed with severe IgA nephropathy in childhood and underwent a tonsillectomy were divided into two groups based on the period from diagnosis to undergoing tonsillectomy: Group A, less than 3 years; and Group B, more than 3 years. The primary endpoint of this study was the change in the amount of proteinuria. Renal prognosis was evaluated 10 years after the diagnosis.

Results

This study enrolled 40 patients diagnosed with severe IgA nephropathy in childhood who underwent tonsillectomy after multiple‐drug therapy with/without methylprednisolone pulse therapy at Kindai University Hospital; eight patients were excluded based on the exclusion criteria. Group A consisted of 18 patients and Group B, 14 patients. Proteinuria and hematuria levels were significantly reduced in the early surgery group (P < 0.01). No significant differences were found in serum creatinine, uric acid, and IgA/C3 ratio.

Conclusions

High proteinuria levels worsen the renal prognosis in IgA nephropathy. Tonsillectomy in less than 3 years combined with multiple‐drug therapy after the initial diagnosis could improve long‐term prognosis.
On Bandwidth Choice for Spatial Data Density Estimation
Authors: Jiang Zhenyu , Ling Nengxiang , Lu Zudi , Tj⊘stheim Dag , Zhang Qiang
Published: April 2020

Bandwidth choice is crucial in spatial kernel estimation in exploring non-Gaussian complex spatial data. The paper investigates the choice of adaptive and non-adaptive bandwidths for density estimation given data on a spatial lattice. An adaptive bandwidth depends on local data and hence adaptively conforms with local features of the spatial data. We propose a spatial cross-validation (SCV) choice of a global bandwidth. This is done first with a pilot density involved in the expression for the adaptive bandwidth. The optimality of the procedure is established, and it is shown that a non-adaptive bandwidth choice comes out as a special case. Although the cross-validation idea has been popular for choosing a non-adaptive bandwidth in data-driven smoothing of independent and time series data, its theory and application have not been much investigated for spatial data. For the adaptive case, there is little theory even for independent data. Conditions that ensure asymptotic optimality of the SCV-selected bandwidth are derived, actually, also extending time series and independent data optimality results. Further, for the adaptive bandwidth with an estimated pilot density, oracle properties of the resultant density estimator are obtained asymptotically as if the true pilot were known. Numerical simulations show that finite sample performance of the SCV adaptive bandwidth choice works quite well. It outperforms the existing R routines such as the ‘rule of thumb’ and the so-called ‘second-generation’ Sheather–Jones bandwidths for moderate and big data sets. An empirical application to a set of spatial soil data is further implemented with non-Gaussian features significantly identified.
Effect of marital satisfaction on self‐regulation efforts in couples: Value of heart rate variability measurements
Authors: Constant Emilie , Leuchtmann Lorena , Christophe Véronique , Bodenmann Guy , Gabrielli François , Ott Laurent , Nandrino Jean‐Louis
Published: April 2020

This study explored self‐regulatory efforts during the viewing of couple interactions and their association with relationship satisfaction. High‐frequency heart rate variability (HF‐HRV) was measured for each participant during a video recall of a recent couple interaction to quantify the self‐regulatory processes governed by parasympathetic activity. Among 30 couples, HF‐HRV was measured continuously during three specific periods to explore its change over time using a video‐recall procedure: (1) resting state; (2) viewing of couple interactions (expressing daily life situations and conflictual interactions); and (3) recovery. Results of multilevel models revealed a u‐shaped pattern of HF‐HRV responses for men and women across the three periods with a nadir at the midway through the process. This pattern of physiological change (vagal suppression) reflects a flexible response to a stressful situation. Nevertheless, the pattern of physiological responses varied according to the level of relationship satisfaction. Men who were more satisfied in their couple relationship presented greater vagal suppression than dissatisfied men. In contrast, no significant HF‐HRV changes were found in women over the different periods of the video‐recall procedure and no moderating effect of relationship satisfaction. We discuss the different patterns of physiological responses observed both for men and women in terms of interindividual variability according to the level of their relationship satisfaction. The present study highlights the important role of relationship satisfaction in regulatory processes.
‘Close the Ports to African Migrants and Asian Rice!’: The Politics of Agriculture and Migration and the Rise of a ‘New’ Right‐Wing Populism in Italy
Authors: Iocco Giulio , Lo Cascio Martina , Perrotta Domenico Claudio
Published: April 2020

This article contributes to the debate on the rural dimensions of the current global surge of right‐wing populism through an analysis and genealogy of the political discourse of Matteo Salvini’s Lega on agriculture and migrant farm labour. In 2018–2019, this party emerged as one of the most successful radical right populist parties in Italy and Western Europe. After a description of the Italian political debate in the fields of agriculture and migration over the last two decades, we analyse how the issues of agriculture, food and migrant farm labour are articulated in the Lega’s discourse in relation to the ideological features of nativism, authoritarianism, populism as well as neomercantilism and corporatism. We argue that agriculture and food are central in the representation of the ‘Italian’ cultural identity as proposed by the Lega. Moreover, we contend that the Lega has disarticulated and rearticulated ‘old’ ideas – such as the protection of ‘Made in Italy’ food – in a ‘new’ nativist discourse. The article is based upon a discourse analysis of speeches and documents produced by this party since 2013.
Partially Premixed Flame Stabilization in the Presence of a Combined Swirl and Bluff Body Influenced Flowfield: An Experimental Investigation
Authors: Sadanandan Rajesh , Chakraborty Aritra , Arumugam Vinoth Kumar , Chakravarthy Satyanarayanan R.
Published: April 2020

Optical and laser diagnostic measurements in a nonpremixed model gas turbine (GT) burner have been performed to investigate the effect of an increase in thermal power on the flame stabilization. The model GT burner has a large bluff body base with an annular swirl region, leading to a convergent-divergent flow field at the burner exit. Under the investigated conditions, the flame stabilizes predominantly in the diverging section characterized by the swirl flow with a central recirculation zone. With increasing thermal power, the reverse flow of hot burned gases is strengthened, with the hydroxyl radical (OH) planar laser induced fluorescence (PLIF) images indicating an increase in the temperature of the burned gases. The preferred flame stabilization location coincides with the inner shear layer between the reactant inflow and the reverse flow of hot burned gases. At high thermal power, the flame seems to stabilize in regions of high fluid dynamic strain rate, highlighting the influence of the reverse flowing burned gases in the evolution of the flammable mixture upstream. However, simultaneous and time-resolved measurements of the flow-field and scalar field are needed for direct quantification of this. The results are in agreement with the flame stabilization theories based on partial fuel-air mixing and streamline divergence. The flow is seen to decelerate upstream of the flame front and the flame stabilizes in a region of low velocity, created as a result of heat release diverging the streamlines ahead of it.
Partial Disassembly Line Balancing Problem Analysis Based on Sequence-Dependent Stochastic Mixed-Flow
Authors: Xia Xuhui , Liu Wei , Zhang Zelin , Wang Lei
Published: April 2020

Given the characteristics of decommissioning product diversity, wear difference, and structural complexity, we analyzed the disassembly line balance problems of minimum disassembly workstation, station load balancing, priority disassembly of high-demand parts and the lowest cost of invalid operations, and further considered the influence of random factors on actual disassembly operations. The purpose of this paper is to establish a model of sequence-dependent stochastic mixed-flowed partial disassembly line balancing problem and propose an adaptive hybrid particle swarm genetic algorithm to solve the model. The algorithm replaces the fixed value genetic operator with an adaptive crossover and mutation operator to improve the global optimization ability. The introduction of adaptive weighted particles leads to improved local optimization ability of the algorithm so that the algorithm has strong global and regional optimization ability to improve algorithm accuracy. The effectiveness of the proposed algorithm is verified by solving the classic disassembly line balancing problem with different scales and comparing it with the solution results of underlying genetic and particle swarm optimization algorithm. Meanwhile, the proposed model and algorithm are applied to the mixed-flow disassembly engineering project of a 25-task reducer. The results indicate that the proposed model is superior to the control group in terms of minimal disassembly workstation, station load balancing, invalid operation cost, and overall performance of the disassembly line, which verifies the validity of the model.
A Lightweight Robotic Device Based on a Micro-Macro Actuation Concept for the Inspection of Railway Pantograph
Authors: Santamato Giancarlo , Chiaradia Domenico , Solazzi Massimiliano , Frisoli Antonio
Published: April 2020

Functional verification of railway pantographs is performed within periodic maintenance programs by means of specifically designed automation and robotic devices that can check their structural integrity and correct functionality. In this paper, we present the design and validation of a new portable inspection robotic device that through structural dynamic excitation and passive movement can assess the health status of railway pantographs. The device is endowed with a new actuation system that combines the large range of force attained through a macro-actuator with the high-frequency capabilities of a micro-actuator while preserving lightweight structure. The reported design and experiments confirm that excitation transmission by accurate force control can be achieved in the entire frequency range, despite the interaction between actuator and structure, and that simulated defects can be revealed by low and high-frequency alterations.
Numerical Model for Thermal and Material Characterization of FRP Composite Pipes Exposed to Hydrocarbon Fire
Authors: Mensah Patrick F. , Stubblefield Michael A. , Soysal Omer , Li Guoqiang
Published: April 2020

Modeling of the fire performance of fiberglass reinforced composite pipe was investigated in this study. A multidimensional heat transfer model was developed and used to capture the essentials of thermal transport and material decomposition. A finite difference modeling (FDM) numerical approach is used in solving the coupled multidimensional Fourier equation with chemical decomposition response model. The fire resistance of a dry hydrocarbon fire test is simulated in this analysis. Transient temperature distributions in the joined section of a composite-to-composite FRP pipe where failure is most likely to occur were predicted for comparison with experimental results. The FRP materials used in the analysis were E-glass and glass-phenolic.
Modeling of Heat-Activated Coupled Composite Pipes in a Cryogenic Thermal Environment
Authors: Mensah Patrick F. , Stubblefield Michael A. , Soysal Omer , Li Guoqiang
Published: April 2020

Modeling of heat-activated coupled graphite fiber reinforced composite piping in a cryogenic environment was investigated in this study. A 2-dimensional heat diffusion model was used to capture the essentials of thermal transport through the thickness of a heat-activated coupled (HAC) graphite epoxy composite-to-composite pipe joint. The resulting boundary value problem was solved using an Alternating Direction Implicit (ADI) finite difference model (FDM). Simulated numerical transient temperature distributions are predicted for comparison with experimental results.
Experiments on Annular Liquid Jet Breakup
Authors: Li Xianguo , Shen Jihua
Published: April 2020

Experimental investigations have been carried out for the breakup process of an annular water jet exposed to an inner air stream by videographic and photographic techniques. Three flow regimes for the jet breakup process have been identified, i.e., bubble formation, annular jet formation and atomization. Within the bubble formation regime, the jet breakup characteristics measured from the photographs taken under various liquid and gas velocities indicate that nearly uniform bubbles are observed for various air-to-water velocity ratios; both the jet breakup length and the wavelength for bubble formation decrease as the air-to-water velocity ratio is increased. The measurements are compared with the predictions by the linear instability analysis, and fair agreement is obtained.
Abnormal Release of Toxic Gases From Natural Gas Processing Plants
Authors: Badr O. , Al-Kuwari R. , Abdel-Sattar A.
Published: April 2020

Qatar, one of the Arabian Gulf States, possesses one of the world’s largest non-associated gas fields. Most of the country’s development plans are based on the preparation of natural gas for export and local use.

Under normal operation of gas processing plants, the residual, H2S-rich Acid Gas is treated in a sulfur recovery unit to produce pure sulfur. However, under abnormal situations, the acid gas is burned in incinerators or flares releasing SO2–rich combustion products. Under severe weather conditions, such a flare may get extinguished and the acid gas is released unignited into the atmosphere.

This paper studies the environmental hazards due to the release of such dangerous gases. Dispersion models developed by the US EPA have been used to determine the size and map location of the dangerous zones.

For ignited acid gas, the results indicated the possible formation of SO2-toxic clouds extending to 110 km from the flare location in the downwind direction and 210 m above ground level. For the less common case of releasing unignited acid gas, the H2S-toxic cloud may extend to 20 km and 110 m in the downwind and vertical directions, respectively. A parametric study has been conducted to consider the effects of some meteorological conditions (wind speed and atmospheric stability) as well as the number of operating trains in a typical gas processing plant.
Analysis of Grid Stiffened Cylinders
Authors: Helms Jack E. , Li Guoqiang , Smith Brett H.
Published: April 2020

Advanced Grid Stiffened composite structures are desirable building components for space flight vehicles because they provide enhanced stiffness yet are relatively low-cost, long-lasting, and light-weight. Analysis of a grid stiffened structure presents significant challenges. The stiffener design is discrete and involves a set of stiffener orientations which complicates the solution process. Most optimization algorithms only provide a single global optimum, while a designer would want to obtain all of the local minima that have performance close to the global optimum. As a preliminary to the optimization analysis, the bending stiffness of grid stiffened cylinders will be modeled analytically with in-plane loads. The model developed in this paper will be used in further research with a hybrid optimization algorithm to conduct the optimization analysis.