bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Machine Learning-Driven Automatic Modulation Classifiers Under Various Signal Models
Authors: Ghasemzadeh Pejman , Banerjee Subharthi , Hempel Michael , Sharif Hamid , Omar Tarek
Published: August 2020

Automatic Modulation Classification (AMC) is becoming an essential component in receiver designs for next-generation communication systems, such as Cognitive Radios (CR). AMC enables receivers to classify an intercepted signal’s modulation scheme without any prior information about the signal. This is becoming increasingly vital due to the combination of congested frequency bands and geographically disparate frequency licensing for the railroad industry across North America. Thus, a radio technology is needed that allows train systems to adapt automatically and intelligently to changing locations and corresponding RF environment fluctuations. Three AMC approaches have been proposed in the scientific literature. The performance of these approaches depends especially on the particular environment where the classifiers are employed. In this work, the authors present a performance evaluation of the Feature-based AMC approach, as this is the most promising approach for railroads in real-time AMC operations under various different wireless channel environments. This study is done as the first one for railroads application where it considers different environments models including Non-Gaussian Class A noise, Multipath fast fading, and their combination. The evaluation is conducted for signals using a series of QAM modulation schemes. The authors selected the signal’s Cumulant statistical features for the feature extraction stage in this study, coupled with three different machine learning classifiers: Support Vector Machine (SVM), Deep Neural Network (DNN) and Recurrent Neural Network (RNN) utilizing long-short term memory (LSTM), in order to maintain control over the classifiers’ accuracy and computational complexity, especially for the non-linear cases. Our results indicate that when the signal model noise shows higher non-linear behavior, the RNN classifier on average achieves higher classification accuracy than the other classifiers.
Wireless Sensor Nodes for Freight Trains Condition Monitoring
Authors: Cii Stefano , Tomasini Gisella , Tarsitano Davide , Bacci Maria Laura
Published: August 2020

Objective of the present work is to present the design and the laboratory tests of Wireless Sensor Nodes (WSNs) equipped with three different on-board energy production systems, to be installed on freight trains for condition monitoring and structural diagnosis of the railway vehicle. The three sensor nodes are designed to be completely energetically autonomous, exploiting three different energy sources easily available on a moving train: Solar, Wind and Mechanical vibration power. a PCB board hosts different ICs, able to convert the uncontrolled and unregulated power sources in order to properly feed all the on-board components and possibly to charge the battery. The electronics for the acquisition, elaboration and wireless transmission of data, is presented and analyzed in terms of performances and consumptions. The three WSNs, based on the different energy sources, are designed and compared in terms of fatigue behavior and performances by means of laboratory tests.
A recombinant oncolytic Newcastle virus expressing MIP-3α promotes systemic antitumor immunity
Authors: Huang Feng-Ying , Wang Jin-Yan , Dai Shu-Zhen , Lin Ying-Ying , Sun Yan , Zhang Liming , Lu Zhuoxuan , Cao Rong , Tan Guang-Hong
Published: August 2020

Background

The oncolytic Newcastle disease virus (NDV) is inherently able to trigger the lysis of tumor cells and induce the immunogenic cell death (ICD) of tumor cells and is also an excellent gene-engineering vector. The macrophage inflammatory protein-3α (MIP-3α) is a specific chemokine for dendritic cells (DCs). Thus, we constructed a recombinant NDV expressing MIP-3α (NDV-MIP3α) as an in vivo DC vaccine for amplifying antitumor immunities.

Methods

The recombinant NDV-MIP3α was constructed by the insertion of MIP-3α cDNA between the P and M genes. Western blotting assay and ELISA were used to detect MIP-3α, HMGB1, IgG, and ATP in the supernatant and sera. The chemotaxis of DCs was examined by Transwell chambers. The phenotypes of the immune cells (eg, DCs) were analyzed by flow cytometry. The antitumor efficiency of NDV-MIP3α was observed in B16 and CT26 tumor-bearing mice. Immunofluorescence and immunohistochemistry were applied to observe the ecto-calreticulin (CRT) and intratumoral attraction of DCs. Adoptive transfer of splenocytes and antibodies and depletion of T-cell subsets were used to evaluate the relationship between antitumor immunities and the role of the T-cell subtype.

Results

The findings show that NDV-MIP3α has almost the same capabilities of tumor lysis and induction of ICD as the wild-type NDV (NDV-WT). MIP-3α secreted by NDV-MIP3α could successfully attract DCs in vitro and in vivo. Both B16 and CT26 cells infected with NDV-MIP3α could strongly promote DC maturation and activation. Compared with NDV-WT, intratumoral injection of NDV-MIP3α and the adoptive transfer of T lymphocytes from mice injected with NDV-MIP3α resulted in a significant suppression of B16 and CT26 tumor growth. The NDV-MIP3α-induced production of tumor-specific cellular and humoral immune responses was dependent on CD8+T cells and partially on CD4+T cells. A significant reversion of tumor microenvironments was found in the mice injected with NDV-MIP3α.

Conclusions

Compared with NDV-WT, the recombinant NDV-MIP3α as an in vivo DC vaccine demonstrates enhanced antitumor activities through the induction of stronger system immunities and modulation of the tumor microenvironment. This strategy may be a potential approach for the generation of an in vivo DC vaccine.
Rationalized inhibition of mixed lineage kinase 3 and CD70 enhances life span and antitumor efficacy of CD8+T cells
Authors: Kumar Sandeep , Singh Sunil Kumar , Viswakarma Navin , Sondarva Gautam , Nair Rakesh Sathish , Sethupathi Periannan , Dorman Matthew , Sinha Subhash C , Hoskins Kent , Thatcher Gregory , Rana Basabi , Rana Ajay
Published: August 2020

Background

The mitogen-activated protein kinases (MAPKs) are important for T cell survival and their effector function. Mixed lineage kinase 3 (MLK3) (MAP3K11) is an upstream regulator of MAP kinases and emerging as a potential candidate for targeted cancer therapy; yet, its role in T cell survival and effector function is not known.

Methods

T cell phenotypes, apoptosis and intracellular cytokine expressions were analyzed by flow cytometry. The apoptosis-associated gene expressions in CD8+CD38+T cells were measured using RT2PCR array. In vivo effect of combined blockade of MLK3 and CD70 was analyzed in 4T1 tumor model in immunocompetent mice. The serum level of tumor necrosis factor-α (TNFα) was quantified by enzyme-linked immunosorbent assay.

Results

We report that genetic loss or pharmacological inhibition of MLK3 induces CD70-TNFα-TNFRSF1a axis-mediated apoptosis in CD8+T cells. The genetic loss of MLK3 decreases CD8+T cell population, whereas CD4+T cells are partially increased under basal condition. Moreover, the loss of MLK3 induces CD70-mediated apoptosis in CD8+T cells but not in CD4+T cells. Among the activated CD8+T cell phenotypes, CD8+CD38+T cell population shows more than five fold increase in apoptosis due to loss of MLK3, and the expression of TNFRSF1a is significantly higher in CD8+CD38+T cells. In addition, we observed that CD70 is an upstream regulator of TNFα-TNFRSF1a axis and necessary for induction of apoptosis in CD8+T cells. Importantly, blockade of CD70 attenuates apoptosis and enhances effector function of CD8+T cells from MLK3−/−mice. In immune-competent breast cancer mouse model, pharmacological inhibition of MLK3 along with CD70 increased tumor infiltration of cytotoxic CD8+T cells, leading to reduction in tumor burden largely via mitochondrial apoptosis.

Conclusion

Together, these results demonstrate that MLK3 plays an important role in CD8+T cell survival and effector function and MLK3-CD70 axis could serve as a potential target in cancer.
Reactive arthritis after COVID-19 infection
Authors: Ono Keisuke , Kishimoto Mitsumasa , Shimasaki Teppei , Uchida Hiroko , Kurai Daisuke , Deshpande Gautam A , Komagata Yoshinori , Kaname Shinya
Published: August 2020

Reactive arthritis (ReA) is typically preceded by sexually transmitted disease or gastrointestinal infection. An association has also been reported with bacterial and viral respiratory infections. Herein, we report the first case of ReA after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This male patient is in his 50s who was admitted with COVID-19 pneumonia. On the second day of admission, SARS-CoV-2 PCR was positive from nasopharyngeal swab specimen. Despite starting standard dose of favipiravir, his respiratory condition deteriorated during hospitalisation. On the fourth hospital day, he developed acute respiratory distress syndrome and was intubated. On day 11, he was successfully extubated, subsequently completing a 14-day course of favipiravir. On day 21, 1 day after starting physical therapy, he developed acute bilateral arthritis in his ankles, with mild enthesitis in his right Achilles tendon, without rash, conjunctivitis, or preceding diarrhoea or urethritis. Arthrocentesis of his left ankle revealed mild inflammatory fluid without monosodium urate or calcium pyrophosphate crystals. Culture of synovial fluid was negative. Plain X-rays of his ankles and feet showed no erosive changes or enthesophytes. Tests for syphilis, HIV, anti-streptolysin O (ASO),Mycoplasma, Chlamydia pneumoniae, antinuclear antibody, rheumatoid factor, anticyclic citrullinated peptide antibody and Human Leukocyte Antigen-B27 (HLA-B27) were negative. Gonococcal andChlamydia trachomatisurine PCR were also negative. He was diagnosed with ReA. Nonsteroidal Anti-Inflammatory Drug (NSAID)s and intra-articular corticosteroid injection resulted in moderate improvement.
Amphibian ranaviruses in Europe: important directions for future research
Authors: Campbell Lewis J. , Pawlik Alice H. , Harrison Xavier A.
Published: August 2020

Ranaviruses are an emerging group of pathogens capable of infecting all cold-blooded vertebrates. In Europe, ranaviruses pose a particularly potent threat to wild amphibian populations. Since the 1980s research on amphibian-infecting ranaviruses in Europe has been growing. The wide distribution of amphibian populations in Europe, the ease with which many are monitored, and the tractable nature of counterpart ex situ experimental systems have provided researchers with a unique opportunity to study many aspects of host–ranavirus interactions in the wild. These characteristics of European amphibian populations will also enable researchers to lead the way as the field of host–ranavirus interactions progresses. In this review, we provide a summary of the current key knowledge regarding amphibian infecting ranaviruses throughout Europe. We then outline important areas of further research and suggest practical ways each could be pursued. We address the study of potential interactions between the amphibian microbiome and ranaviruses, how pollution may exacerbate ranaviral disease either as direct stressors of amphibians or indirect modification of the amphibian microbiome. Finally, we discuss the need for continued surveillance of ranaviral emergence in the face of climate change.
Improved Flower Pollination Algorithm for Optimal Groundwater Management
Authors: Akram Sedki
Published: August 2020

Groundwater management problems are typically of a large-scale nature, involving complex nonlinear objective functions and constraints, which are commonly evaluated through the use of numerical simulation models. Given these complexities, metaheuristic optimization algorithms have recently become popular choice for solving such complex problems which are difficult to solve by traditional methods. However, the practical applications of metaheuristics are severely challenged by the requirement of large number of function evaluations to achieve convergence. To overcome this shortcoming, many new metaheuristics and different variants of existing ones have been proposed in recent years. In this study, a recently developed algorithm called flower pollination algorithm (FPA) is investigated for optimal groundwater management. The FPA is improved, combined with the widely used groundwater flow simulation model MODFLOW, and applied to solve two groundwater management problems. The proposed algorithm, denoted as IFPA, is first tested on a hypothetical aquifer system, to minimize the total pumping to contain contaminated groundwater within a capture zone. IFPA is then applied to maximize the total annual pumping from existing wells in Rhis-Nekor unconfined coastal aquifer on the northern of Morocco. The obtained results indicate that IFPA is a promising method for solving groundwater management problems as it outperforms the standard FPA and other algorithms applied to the case studies considered, both in terms of convergence rate and solution quality.
Single-Incision Percutaneous Closure of Pediatric Inguinal Hernia: A New Modification for Intracorporeal Suture Knotting
Authors: Helal Ahmed Abdelghaffar , Daboos Mohammad , Othman Alsayed , Abdelhafez Muhammad
Published: August 2020

Background. Single-incision percutaneous closure (SIPC) of pediatric inguinal hernia under laparoscopic guidance is a well-developed feasible technique; however, suture knotting remains a major challenge during this technique. Most laparoscopic surgeons prefer extracorporeal subcutaneous suture knotting, which may be associated with consequent formation of stitch sinus and increased recurrence rate. On the other hand, intracorporeal suture knotting necessitates the availability of special devices or homemade instruments with a long learning curve. Therefore, the present study innovates new and simple modification allowing intracorporeal suture knotting during SIPC of pediatric inguinal hernia that does not require any special operating devices or homemade instruments. Patients and Methods. Four-hundred children suffering from inguinal hernia of congenital type, submitted to SIPC using Epidural needle (EN), under laparoscopic guidance with intracorporeal suture knotting. Results. Children ages were 6 months to 10 years (the range). There were 300 boys and 100 girls, and two-hundred children suffered from left side hernia, 150 with right-side hernia, and 50 children with both left- and right-side hernia. 10 ± 2.2 minutes was the recorded operation time in one side hernia repair, while 14 ± 4.3 minutes was recorded for both side repair. Postoperative results reported recurrent hernia in one child and postoperative hydrocele in 3 children which resolved spontaneously after 3 weeks of follow-up. Conclusion. Intracorporeal suture knotting during SIPC of pediatric inguinal hernia allows for the transformation of a formally extraperitoneal procedure to an intraperitoneal procedure. This new modification for intracorporeal suture knotting does not require any special operating devices or homemade instruments. It seems to be an attractive way during SIPC of pediatric inguinal hernia when intracorporeal suture knotting is considered.
Personality Disturbances as Emergent Phenomena Reflective of Underlying Neurobehavioral Systems: Beyond Dimensional Measurement, Phenotypic Trait Descriptors, and Factor Analysis
Authors: Lenzenweger Mark F. , Depue Richard A.
Published: August 2020

Background and Overview: The conceptualization of personality pathology, or personality disturbance, is now at a substantive crossroads. Some researchers (and clinicians) prefer a focus on the domains of personality pathology that are well-described and captured in traditional categorical diagnostic approaches that, in some instances, abut normal personality constructs. Other workers argue to move the study of personality disorder (PD) closer to personality science seeking continuous connections between PD and established dimensions of healthy-range, normal personality. Most of the latter efforts revolve around correlational and factor analytic study of phenotypic expressions of PD features and normal personality dimensions. It is notable, however, that both visions of the PD/personality interface are essentially unlinked to an understanding of shared neurobiological underpinnings (i.e., neurotransmitter-influenced neurobehavioral systems) of both personality disturbance and normal personality1. Here, we present a nontechnical, conceptual overview of our approach to this problem, advancing a neurobehavioral approach that seeks to anchor both normal personality and personality disturbance within a matrix of brain-based neurobiological systems, incorporating genetic, epigenetic, and environmental inputs. In this brief paper, we seek only to provide a necessarily cursory introduction to how we conceptualize this area and illustrate, in broad outline, our effort to characterize both personality and personality disturbance anchored in neurobehavioral systems. Our approach, which we began developing in the middle 1990s, can be juxtaposed with the more recently proposed DSM-5 Alternative Model of Personality Disorders as well as the well-established five-factor approach to PD.
Choroidal Thickness Changes after Orthokeratology Lens Wearing in Young Adults with Myopia
Authors: Lee Jang Hun , Hong In Hwan , Lee Tae Yeem , Han Jae Ryong , Jeon Gang Seok
Published: August 2020

Introduction: Recently in South Korea, there are increasing number of young adults undergoing orthokeratology treatment for myopia control. They prefer orthokeratology treatment more than wearing spectacles or having a refractive surgery for several reasons. However, there is little research on the effect of orthokeratology treatment on choroids. Objective: The aim of this study was to analyze the change in choroidal thickness (CT) in the horizontal axis in young myopic adults after orthokeratology treatment. Methods: This was a retrospective research among young myopic patients (−1.0 to −5.0 diopters) aged 19–29 years (n = 36; 23.6 ± 2.5 years). We selected patients who were treated with orthokeratology for 12 months. CT values of the horizontal axis near the fovea before and after orthokeratology treatment were analyzed using optical coherence tomography. The value was measured at the beginning of treatment and at 3, 6, and 12 months after orthokeratology treatment. Three regional areas of choroid on the horizontal plane including fovea were analyzed. Result and Conclusions: In the beginning of orthokeratology treatment, CT of the horizontal axis was 248.9 ± 45.7 μm in the temporal region, 259.9 ± 55.3 μm in the macular region, and 219.2 ± 46.4 μm in the nasal region. Three months after orthokeratology treatment, thickness values of choroids in the 3 divided areas increased significantly (p < 0.05). Mean CT at 6 or 12 months after orthokeratology treatment was greater than before ortho­-keratology treatment. CT increased after 3 months of orthokeratology treatment in each regional area. In young myopic adults, CT in nasal area was thinner than that in foveal or temporal area before treatment. CT recovered to near baseline when it was observed for more than 6 months after orthokeratology treatment.
Intra-Aortic Balloon Pump Bridging to Heart Transplantation
Authors: Huckaby Lauren V. , Seese Laura M. , Mathier Michael A. , Hickey Gavin W. , Kilic Arman
Published: August 2020

Background:

This study evaluates the impact of the 2018 allocation policy change on outcomes of orthotopic heart transplantation (OHT) in patients bridged with intra-aortic balloon pumps (IABPs).

Methods:

Adult (≥18 years) patients undergoing OHT between 2013 and 2019 who were bridged with an IABP were stratified based on temporal relation to the policy change. Univariate analysis was used to compare baseline characteristics and postoperative outcomes. Multivariate Cox regression analysis was used to estimate risk-adjusted predictors of post-transplant mortality.

Results:

A total of 1342 (8.6%) OHT patients were bridged with an IABP during the study period. Rates of bridging with IABP to OHT increased significantly after the policy change (7.0% versus 24.9%,
P
<0.001). The mean recipient age was 54.1±12.1 years with 981 (73.1%) patients being male. Baseline characteristics were similar between the 2 groups whereas post–policy change patients spent fewer days on the waitlist (15 versus 35 days,
P
<0.001), had longer ischemic times (3.5 versus 3.0 hours,
P
<0.001), and received organs from a greater distance (301 versus 105 miles,
P
<0.001). By multivariable analysis, days on the waitlist (for every 30 days; odds ratio, 1.01 [95% CI, 1.00–1.02],
P
=0.031) and diabetes mellitus (odds ratio, 1.87 [95% CI, 1.16–3.02],
P
=0.011) emerged as significant predictors of post-transplant mortality. After the policy change, waitlisted patients requiring IABP support were more likely to survive to transplant (76.4 versus 89.8%,
P
<0.001).

Conclusions:

IABP utilization has increased over 3-fold since the 2018 policy change with improved waitlist outcomes and comparable post-OHT survival. Thus, bridging patients to OHT with IABPs appears to be an effective strategy in the current era.
Challenges Facing the Economic Partnership Agreement between the EU and West Africa
Authors: Ogbodo Juliet A.
Published: August 2020

Six years after negotiations, the Economic Partnership Agreement between the European Union and the West African region is still in abeyance pending signatures from Nigeria. Following the fallout from the Cotonou Agreement, the proposed EPA was designed to comply with WTO rules on preferential trade agreements while reinforcing the long-standing relationship between the two parties. This article analyses the crucial challenges facing the ratification of the Agreement and the potential landmines that may be encountered with the harmonisation of the proposed agreement in the region. It shows that although the EPA provides a progressive agenda for the economic development of West Africa, effective implementation and proactive regional integration are key to realising the full potential of the Agreement.
Combined prognostic nutritional index ratio and serum amylase level during the early postoperative period predicts pancreatic fistula following pancreaticoduodenectomy
Authors: Sakamoto Teruhisa , Yagyu Takuki , Uchinaka Ei , Morimoto Masaki , Hanaki Takehiko , Watanabe Joji , Yamamoto Manabu , Matsunaga Tomoyuki , Tokuyasu Naruo , Honjo Soichiro , Fujiwara Yoshiyuki
Published: August 2020

Background

The aim of this study was to investigate the usefulness of the range of change in prognostic nutritional index (PNI) during the early postoperative period as a predictor of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy.

Methods

Data were retrospectively analyzed for 192 patients who underwent pancreaticoduodenectomy. Univariate and multivariate logistic regression analyses were used to evaluate perioperative variables. PNIP3-Pre ratio represented the range of change in PNI from before surgery to postoperative day (POD) 3, PNIP1-Pre ratio represented the range of change in PNI from before surgery to POD 1, and PNIP3-P1 ratio represented the range of change in PNI from POD 1 to POD 3.

Results

The area under the curve (AUC) for PNIP3-P1 for prediction of POPF following pancreaticoduodenectomy was 0.683 (P <  0.001), which was highest among PNI ratios and higher than PNI on POD 3. The AUC for serum amylase level on POD 1 was 0.704 (P <  0.001), which was superior to the corresponding AUC on POD 3. The AUC for the combination of PNIP3-P1 ratio and serum amylase level on POD 1 for prediction of POPF was higher than the AUC of either indicator alone (0.743, P <  0.001). The combination of PNIP3-P1 ratio and serum amylase level on POD 1 was an independent predictor of POPF following pancreaticoduodenectomy (P = 0.018).

Conclusions

The combination of the range of change in PNI from POD 1 to POD 3 and serum amylase levels on POD 1 may be useful for prediction of POPF following pancreaticoduodenectomy.
Health insurance benefit package in Iran: a qualitative policy process analysis
Authors: Mohamadi Efat , Takian Amirhossein , Olyaeemanesh Alireza , Rashidian Arash , Hassanzadeh Ali , Razavi Moaven , Ghazanfari Sadegh
Published: August 2020

Background

Insufficient transparency in prioritization of health services, multiple health insurance organizations with various and not-aligned policies, plus limited resources to provide comprehensive health coverage are among the challenges to design appropriate Health Insurance Benefit Package (HIBP) in Iran. This study aims to analyze Policy Process of Health Insurance Benefit Package in Iran.

Method

Data were collected through semi-structured interviews with 25 experts, plus document analysis and observation, from February 2014 until October 2016. Using both deductive and inductive approaches, two independent researchers conducted data content analysis. We used MAXQDA.11 software for data management.

Results

We identified 10 main themes, plus 81 sub-themes related to development and implementation of HIBP. These included: lack of transparent criteria for inclusion of services within HIBP, inadequate use of scientific evidence to determine the HIBP, lack of evaluation systems, and weak decision-making process. We propose 11 solutions and 25 policy options to improve the situation.

Conclusion

The design and implementation of HIBP did not follow an evidence-based and logical algorithm in Iran. Rather, political and financial influences at the macro level determined the decisions. This is rooted in social, cultural, and economic norms in the country, whereby political and economic factors had the greatest impact on the implementation of HIBP. To define a cost-effective HIBP in Iran, it is pivotal to develop transparent and evidence-based guidelines about the processes and the stewardship of HIBP, which are in line with upstream policies and societal characteristics. In addition, the possible conflict of interests and its harms should be minimized in advance.
Mechanisms affecting exercise ventilatory inefficiency-airflow obstruction relationship in male patients with chronic obstructive pulmonary disease
Authors: Chuang Ming-Lung
Published: August 2020

Background

Exercise ventilatory inefficiency is usually defined as high ventilation ($$ \dot{\mathrm{V}}\mathrm{E} $$

V
̇

E
) versus low CO2 output ($$ \dot{\mathrm{V}}\mathrm{CO}2 $$

V
̇

CO
2
). The inefficiency may be lowered when airflow obstruction is severe because $$ \dot{\mathrm{V}}\mathrm{E} $$

V
̇

E
cannot be adequately increased in response to exercise. However, the ventilatory inefficiency-airflow obstruction relationship differs to a varying degree. This has been hypothesized to be affected by increased dead space fraction of tidal volume (VD/VT), acidity, hypoxemia, and hypercapnia.

Methods

A total of 120 male patients with chronic obstructive pulmonary disease were enrolled. Lung function and incremental exercise tests were conducted, and $$ \dot{\mathrm{V}}\mathrm{E} $$

V
̇

E
versus $$ \dot{\mathrm{V}}\mathrm{CO}2 $$

V
̇

CO
2
slope ($$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
) and intercept ($$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{I} $$

V
̇

E
/

V
̇

CO
2
I
) were obtained by linear regression. Arterial blood gas analysis was also performed in 47 of the participants during exercise tests. VD/VT and lactate level were measured.

Results

VD/VTpeak was moderately positively related to $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
(r = 0.41) and negatively related to forced expired volume in 1 sec % predicted (FEV1%) (r = − 0.27), and hence the FEV1%- $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
relationship was paradoxical. The higher the $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
, the higher the pH and PaO2, and the lower the PaCO2 and exercise capacity. $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{I} $$

V
̇

E
/

V
̇

CO
2
I
was marginally related to VD/VTrest. The higher the $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{I} $$

V
̇

E
/

V
̇

CO
2
I
, the higher the inspiratory airflow, work rate, and end-tidal PCO2peak.

Conclusion

1) Dead space ventilation perturbs the airflow- $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
relationship, 2) increasing ventilation thereby increases $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
to maintain biological homeostasis, and 3) the physiology- $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{S} $$

V
̇

E
/

V
̇

CO
2
S
- $$ \dot{\mathrm{V}}\mathrm{E}/\dot{\mathrm{V}}\mathrm{CO}2\mathrm{I} $$

V
̇

E
/

V
̇

CO
2
I
relationships are inconsistent in the current and previous studies.

Trial Registration

MOST 106–2314-B-040-025.
The effect of an antibiotic stewardship program on tigecycline use in a Tertiary Care Hospital, an intervention study
Authors: Moghnieh Rima , Abdallah Dania , Awad Lyn , Jadayel Marwa , Haddad Nicholas , Tamim Hani , Zaiter Aline , Awwad Diana-Caroline , Sinno Loubna , El-Hassan Salam , Lakkis Rawad , Khalil Rabab , Jisr Tamima
Published: August 2020

Background

A drug-oriented antibiotic stewardship intervention targeting tigecycline utilization was launched at Makassed General Hospital, Beirut, Lebanon, in 2016 as a part of a comprehensive Antibiotic Stewardship Program (ASP). In this study, we evaluated the effect of this intervention on changing tigecycline prescription behavior in different types of infections, patient outcome and mortality, along with tigecycline drug use density, when compared to an earlier period before the initiation of ASP.

Methods

This is a retrospective chart review of all adult inpatients who received tigecycline for more than 72 h between Jan-2012 and Dec-2013 [period (P) 1 before ASP] and between Oct-2016 and Dec-2018 [period (P) 2 during ASP].

Results

Tigecycline was administered to 153 patients during P1 and 116 patients during P2. The proportion of patients suffering from cancer, those requiring mechanical ventilation, and those with hemodynamic failure was significantly reduced between P1 and P2. The proportion of patients who received tigecycline for FDA-approved indications increased from 19% during P1 to 78% during P2 (P < 0.001). On the other hand, its use in off-label indications was restricted, including ventilator-associated pneumonia (26.1% in P1, 3.4% in P2, P < 0.001), hospital-acquired pneumonia (19.6% in P1, 5.2% in P2, P = 0.001), sepsis (9.2% in P1, 3% in P2, P = 0.028), and febrile neutropenia (15.7% in P1, 0.9% in P2, P < 0.001). The clinical success rate of tigecycline therapy showed an overall significant increase from 48.4% during P1 to 65.5% during P2 (P = 0.005) in the entire patient population. All-cause mortality in the tigecycline-treated patients decreased from 45.1% during P1 to 20.7% during P2 (P < 0.0001). In general, mean tigecycline consumption decreased by 55% between P1 and P2 (P < 0.0001).

Conclusion

The drug-oriented ASP intervention targeting tigecycline prescriptions improved its use and patient outcomes, where it helped curb the over-optimistic use of this drug in off-label indications where it is not a suitable treatment option.
CAS: corpus of clinical cases in French
Authors: Grabar Natalia , Dalloux Clément , Claveau Vincent
Published: August 2020

Background

Textual corpora are extremely important for various NLP applications as they provide information necessary for creating, setting and testing those applications and the corresponding tools. They are also crucial for designing reliable methods and reproducible results. Yet, in some areas, such as the medical area, due to confidentiality or to ethical reasons, it is complicated or even impossible to access representative textual data. We propose the CAS corpus built with clinical cases, such as they are reported in the published scientific literature in French.

Results

Currently, the corpus contains 4,900 clinical cases in French, totaling nearly 1.7M word occurrences. Some clinical cases are associated with discussions. A subset of the whole set of cases is enriched with morpho-syntactic (PoS-tagging, lemmatization) and semantic (the UMLS concepts, negation, uncertainty) annotations. The corpus is being continuously enriched with new clinical cases and annotations. The CAS corpus has been compared with similar clinical narratives. When computed on tokenized and lowercase words, the Jaccard index indicates that the similarity between clinical cases and narratives reaches up to 0.9727.

Conclusion

We assume that the CAS corpus can be effectively exploited for the development and testing of NLP tools and methods. Besides, the corpus will be used in NLP challenges and distributed to the research community.
Genetic diversity and risk factors for the transmission of antimicrobial resistance across human, animals and environmental compartments in East Africa: a review
Authors: Katale Bugwesa Z. , Misinzo Gerald , Mshana Stephen E. , Chiyangi Harriet , Campino Susana , Clark Taane G. , Good Liam , Rweyemamu Mark M. , Matee Mecky I.
Published: August 2020

Background

The emergence and spread of antimicrobial resistance (AMR) present a challenge to disease control in East Africa. Resistance to beta-lactams, which are by far the most used antibiotics worldwide and include the penicillins, cephalosporins, monobactams and carbapenems, is reducing options for effective control of both Gram-positive and Gram-negative bacteria. The World Health Organization, Food and Agricultural Organization and the World Organization for Animal Health have all advocated surveillance of AMR using an integrated One Health approach. Regional consortia also have strengthened collaboration to address the AMR problem through surveillance, training and research in a holistic and multisectoral approach. This review paper contains collective information on risk factors for transmission, clinical relevance and diversity of resistance genes relating to extended-spectrum beta-lactamase-producing (ESBL) and carbapenemase-producing Enterobacteriaceae, and Methicillin-resistant Staphylococcus aureus (MRSA) across the human, animal and environmental compartments in East Africa.

Main body

The review of the AMR literature (years 2001 to 2019) was performed using search engines such as PubMed, Scopus, Science Direct, Google and Web of Science. The search terms included ‘antimicrobial resistance and human-animal-environment’, ‘antimicrobial resistance, risk factors, genetic diversity, and human-animal-environment’ combined with respective countries of East Africa. In general, the risk factors identified were associated with the transmission of AMR. The marked genetic diversity due to multiple sequence types among drug-resistant bacteria and their replicon plasmid types sourced from the animal, human and environment were reported. The main ESBL, MRSA and carbapenem related genes/plasmids were the blaCTX-Ms (45.7%), SCCmec type III (27.3%) and IMP types (23.8%), respectively.

Conclusion

The high diversity of the AMR genes suggests there may be multiple sources of resistance bacteria, or the possible exchange of strains or a flow of genes amongst different strains due to transfer by mobile genetic elements. Therefore, there should be harmonized One Health guidelines for the use of antibiotics, as well as regulations governing their importation and sale. Moreover, the trend of ESBLs, MRSA and carbapenem resistant (CAR) carriage rates is dynamic and are on rise over time period, posing a public health concern in East Africa. Collaborative surveillance of AMR in partnership with regional and external institutions using an integrated One Health approach is required for expert knowledge and technology transfer to facilitate information sharing for informed decision-making.
Psychological resilience and positive coping styles among Chinese undergraduate students: a cross-sectional study
Authors: Wu Yu , Yu Wenzhou , Wu Xiuyun , Wan Huihui , Wang Ying , Lu Guohua
Published: August 2020

Background

Psychological resilience and coping strategies have been found to be related to various psychological and mental health problems. Evaluations of the relationship between resilience and coping style among university students are important for developing effective health promotion strategies focused on resilience intervention to benefit students’ health and well-being. The relationship between psychological resilience and coping styles has usually been examined among adults and patients. Very few studies have investigated the relationship between resilience and coping style in university students. The present study aimed to investigate the associations between psychological resilience, students’ characteristics (gender, major and grade) and coping styles among undergraduate students.

Methods

A cross-sectional survey was conducted among undergraduate students in Shandong Province, China. Undergraduate students were randomly selected from 6 universities in 3 cities of the province using a stratified random sampling method. The questionnaire included questions on the participants’ demographic information, including gender, grade and major, measures of psychological resilience and coping style. Coping style was measured by the Simplified Coping Style Questionnaire (SCSQ). The Asian Resilience Scale (ARS) was applied to evaluate undergraduates’ psychological resilience. Multivariable regression analysis was used to examine the relationships between resilience, students’ characteristics and positive coping styles.

Results

A sample of 1743 undergraduates was analysed. The mean psychological resilience score was 70.41. The mean score for positive coping style was 24.72. Multiple regression analysis showed that three factors of psychological resilience, mood control, self-plasticity and coping flexibility, were all significant factors for positive coping styles (regression coefficient = 0.34, 0.35, 0.14, p < 0.01 for the three factors, respectively). Medical students and females had higher scores for positive coping styles than non-medical students and males (p < 0.01).

Conclusions

The research revealed that females and medical students are more likely than males and non-medical students to adopt positive coping styles. Higher psychological resilience is associated with a better positive coping style. The findings suggest that psychological education and health promotion programmes that target strengthening psychological resilience among undergraduate students may help foster positive coping styles to benefit their mental health and psychological well-being.
Differential and shared effects of psychological skills training and mindfulness training on performance-relevant psychological factors in sport: a randomized controlled trial
Authors: Röthlin Philipp , Horvath Stephan , Trösch Severin , Holtforth Martin grosse , Birrer Daniel
Published: August 2020

Background

Mental training intends to support athletes in mastering challenges in sport. The aim of our study was to investigate the differential and shared effects of psychological skills training and mindfulness training on psychological variables relevant to athletic performance (e.g., handling emotions or attention control). We assumed that each approach has its own strengths (e.g., mindfulness has a differential effect on the acceptance of emotions), but for some goals (e.g., attention control), both training forms are expected to be equally successful (i.e., shared effects).

Methods

A total of 95 athletes (Mage = 24.43, SDage = 5.15; 49% female) were randomly assigned into three groups: psychological skills training intervention (PST), mindfulness training intervention (MT), and wait-list control group (WL). Participants completed a questionnaire battery before and after the training (pretest and posttest). We assessed mindfulness, use of mental strategies, handling of emotions, attention in training and competition, as well as the dealing with failure. The two intervention programs each consisted of four 90-min group workshops conducted over a period of 4 weeks.

Results

Both interventions passed the manipulation check, that is, PST led to more mental strategies being used (probabilities > 95%), and MT led to an increase in two of three aspects of mindfulness (probabilities > 98%) when compared to WL. Compared to WL, both interventions equally improved in the ability to not let emotions interfere with performance (probabilities > 99%) and in controlling attention in training and competition (probabilities > 89%). To a lesser extend, both interventions showed shared improvements in dealing with failure indicated by more action orientation (probabilities > 82%). We found a differential effect of MT on decreased experiential avoidance: MT decreased compared to WL and PST (probabilities > 92%), whereas PST did not differ from WL.

Conclusion

We conclude that both forms of mental training lead to improvements in performance-relevant psychological factors, especially concerning the handling of emotions and attention control. The results of our study suggest that different paths may lead to the desired outcomes, and accordingly, both forms of mental training seem justified.

Trial registration number

ISRCTN11147748, date of registration: July 11, 2016.
Upregulating β-hexosaminidase activity in rodents prevents α-synuclein lipid associations and protects dopaminergic neurons from α-synuclein-mediated neurotoxicity
Authors: Brekk Oeystein R. , Korecka Joanna A. , Crapart Cecile C. , Huebecker Mylene , MacBain Zachary K. , Rosenthal Sara Ann , Sena-Esteves Miguel , Priestman David A. , Platt Frances M. , Isacson Ole , Hallett Penelope J.
Published: August 2020

Sandhoff disease (SD) is a lysosomal storage disease, caused by loss of β-hexosaminidase (HEX) activity resulting in the accumulation of ganglioside GM2. There are shared features between SD and Parkinson’s disease (PD). α-synuclein (aSYN) inclusions, the diagnostic hallmark sign of PD, are frequently found in the brain in SD patients and HEX knockout mice, and HEX activity is reduced in the substantia nigra in PD. In this study, we biochemically demonstrate that HEX deficiency in mice causes formation of high-molecular weight (HMW) aSYN and ubiquitin in the brain. As expected from HEX enzymatic function requirements, overexpression in vivo of HEXA and B combined, but not either of the subunits expressed alone, increased HEX activity as evidenced by histochemical assays. Biochemically, such HEX gene expression resulted in increased conversion of GM2 to its breakdown product GM3. In a neurodegenerative model of overexpression of aSYN in rats, increasing HEX activity by AAV6 gene transfer in the substantia nigra reduced aSYN embedding in lipid compartments and rescued dopaminergic neurons from degeneration. Overall, these data are consistent with a paradigm shift where lipid abnormalities are central to or preceding protein changes typically associated with PD.
A University-industry knowledge transfer online education approach via a cloud-based database global solution
Authors: Tzavidas Emmanouil , Enevoldsen Peter , Xydis George
Published: August 2020

Knowledge sharing between different types of organisations, in this case the University-Industry (U-I) relation, contains barriers related to the differentiation of structure and purpose for each organisation. Both the university and industry have to make sure that they have access to data and information. This accessibility enables the value-added process of transforming data into knowledge. The purpose of this paper is the analysis of U-I cooperation– especially under the new online requirements – an illustration of how the knowledge is created and shared in the organisation based on the socialisation, externalisation, combination, and internalisation (SECI) model and how this is aligned to the value proposition. As a knowledge management example case, a database for the Centre for Energy Technologies of Aarhus University was developed that will overtime help the university to increase its value proposition and be the heart of knowledge exchange with the industry in an organised way. The value of this work is intended to pave the way in building structured working relations between the industry and academia, facilitating the means in order to achieve a higher degree of overall efficiency.
Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review
Authors: Yang Wei , Ge Ming , Chen Chenghao , Zeng Qi
Published: August 2020

Background

Pleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat. Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.

Case presentation

A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment. He was finally cured by down-step treatment of mannitol, avoiding form ventricle-peritoneal shunt. Then, we reviewed the literature of pleural-subarachnoid fistula. Fifty-six cases have been reported so far. Most of the cases (51.8%) were caused by surgery; only 17.9% were caused by car accidents. Regarding the treatment, half of the cases cured by surgery and the other by conservative measures. Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.

Conclusions

A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies. Secondary acute intracranial hypertension may be cured by down step treatment of mannitol, evading from the long-term ventriculoperitoneal shunt.
Intracranial vasculature 3D printing: review of techniques and manufacturing processes to inform clinical practice
Authors: Cogswell Petrice M. , Rischall Matthew A. , Alexander Amy E. , Dickens Hunter J. , Lanzino Giuseppe , Morris Jonathan M.
Published: August 2020

Background

In recent years, three-dimensional (3D) printing has been increasingly applied to the intracranial vasculature for patient-specific surgical planning, training, education, and research. Unfortunately, though, much of the prior literature regarding 3D printing has focused on the end-product and not the process. In addition, for 3D printing/manufacturing to occur on a large scale, challenges and bottlenecks specific to each modeled anatomy must be overcome.

Main body

In this review article, limitations and considerations of each 3D printing processing step, as they relate to printing individual intracranial vasculature models and providing an active clinical service for a quaternary care center, are discussed. Relevant advantages and disadvantages of the available acquisition techniques (computed tomography, magnetic resonance, and digital subtraction angiography) are reviewed. Specific steps in segmentation, processing, and creation of a printable file may impede the workflow or degrade the fidelity of the printed model and are, therefore, given added attention. The various available printing techniques are compared with respect to printing the intracranial vasculature. Finally, applications are discussed, and a variety of example models are shown.

Conclusion

In this review we provide insight into the manufacturing of 3D models of the intracranial vasculature that may facilitate incorporation into or improve utility of 3D vascular models in clinical practice.