bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy
Authors: Lasalvia Antonio , Amaddeo Francesco , Porru Stefano , Carta Angela , Tardivo Stefano , Bovo Chiara , Ruggeri Mirella , Bonetto Chiara
Published: January 2021

Objective

To determine burn-out levels and associated factors among healthcare personnel working in a tertiary hospital of a highly burdened area of north-east Italy during the COVID-19 pandemic.

Design

Observational study conducted from 21 April to 6 May 2020 using a web-based questionnaire.

Setting

Research conducted in the Verona University Hospital (Veneto, Italy).

Participants

Out of 2195 eligible participants, 1961 healthcare workers with the full range of professional profiles (89.3%) completed the survey.

Primary outcome measure

Levels of burn-out, assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). Multivariable logistic regression analysis was performed to identify factors associated with burn-out in each MBI-GS dimension (emotional exhaustion, EX; professional efficacy, EF; cynicism, CY).

Results

Overall, 38.3% displayed high EX, 46.5% low EF and 26.5% high CY. Burn-out was frequent among staff working in intensive care units (EX 57.0%; EF 47.8%; CY 40.1%), and among residents (EX 34.9%; EF 63.9%; CY 33.4%) and nurses (EX 49.2%; EF 46.9%; CY 29.7%). Being a resident increased the risk of burn-out (by nearly 2.5 times) in all the three MBI subscales and being a nurse increased the risk of burn-out in the EX dimension in comparison to physicians. Healthcare staff directly engaged with patients with COVID-19 showed more EX and CY than those working in non-COVID wards. Finally, the risk of burn-out was higher in staff showing pre-existing psychological problems, in those having experienced a COVID-related traumatic event and in those having experienced interpersonal avoidance in the workplace and personal life.

Conclusions

Burn-out represents a great concern for healthcare staff working in a large tertiary hospital during the COVID-19 pandemic and its impact is more burdensome for front-line junior physicians. This study underlines the need to carefully address psychological well-being of healthcare workers to prevent the increase of burn-out in the event of a new COVID-19 healthcare emergency.
COVID-19-related social support service closures and mental well-being in older adults and those affected by dementia: a UK longitudinal survey
Authors: Giebel Clarissa , Pulford Daniel , Cooper Claudia , Lord Kathryn , Shenton Justine , Cannon Jacqueline , Shaw Lisa , Tetlow Hilary , Limbert Stan , Callaghan Steve , Whittington Rosie , Rogers Carol , Komuravelli Aravind , Rajagopal Manoj , Eley Ruth , Downs Murna , Reilly Siobhan , Ward Kym , Gaughan Anna , Butchard Sarah , Beresford Jules , Watkins Caroline , Bennett Kate , Gabbay Mark
Published: January 2021

Background

The COVID-19 pandemic has had a major impact on delivery of social support services. This might be expected to particularly affect older adults and people living with dementia (PLWD), and to reduce their well-being.

Aims

To explore how social support service use by older adults, carers and PLWD, and their mental well-being changed over the first 3 months since the pandemic outbreak.

Methods

Unpaid dementia carers, PLWD and older adults took part in a longitudinal online or telephone survey collected between April and May 2020, and at two subsequent timepoints 6 and 12 weeks after baseline. Participants were asked about their social support service usage in a typical week prior to the pandemic (at baseline), and in the past week at each of the three timepoints. They also completed measures of levels of depression, anxiety and mental well-being.

Results

377 participants had complete data at all three timepoints. Social support service usage dropped shortly after lockdown measures were imposed at timepoint 1 (T1), to then increase again by T3. The access to paid care was least affected by COVID-19. Cases of anxiety dropped significantly across the study period, while cases of depression rose. Well-being increased significantly for older adults and PLWD from T1 to T3.

Conclusions

Access to social support services has been significantly affected by the pandemic, which is starting to recover slowly. With mental well-being differently affected across groups, support needs to be put in place to maintain better well-being across those vulnerable groups during the ongoing pandemic.
Paediatric relapsed acute leukaemia: curative intent chemotherapy improves quality of life
Authors: Salaverria Carmen , Plenert Erin , Vasquez Roberto , Fuentes-Alabi Soad , Tomlinson George A , Sung Lillian
Published: January 2021

Objectives

Paediatric patients with leukaemia with relapse or induction failure have poor prognosis. Anticipated quality of life (QoL) is important in treatment decision making. The objective was to determine if curative intent at relapse or induction failure, when compared with palliative intent, was associated with child’s physical health, pain or general fatigue and parents’ QoL over time among patients with paediatric leukaemia in El Salvador.

Methods

This was a prospective observational cohort study. Children 2–18 years with acute leukaemia at first relapse or induction failure were eligible. Assessments occurred every 2 months for up to 2 years using validated proxy report and self-report scales, where guardians were the primary respondents. Initial curative or palliative intent was categorised at enrolment by physicians. The impact of initial intent on QoL was assessed using linear mixed effects models and interaction between QoL and time.

Results

Of the 60 families enrolled, initial treatment intent was curative in 31 (51.7%) and palliative in 29 (48.3%). During the 2-year observation period, 44 children died. Initial curative intent significantly improved child’s physical health (estimate=8.4, 95% CI 5.1 to 11.6), pain (estimate=5.4, 95% CI 1.5 to 9.2) and fatigue (estimate=6.6, 95% CI 3.2 to 9.9) compared with palliative intent, but not parents’ QoL (estimate=1.0, 95% CI −0.8 to 2.8).

Conclusions

Among paediatric patients with acute leukaemia at relapse or induction failure, initial curative intent treatment plan was associated with better physical health, pain and fatigue when compared with palliative intent. A curative approach may be a reasonable option for patients with acute leukaemia even when prognosis is poor.
Dual opioid therapy in a cancer patient with myasthenia gravis who developed respiratory depression from codeine
Authors: Mercadante Sebastiano , Adile Claudio , Ferrera Patrizia
Published: January 2021

This case report describes a patient who was referred to our unit after an emergency room admission for respiratory depression induced by codeine, and was successfully managed with tapentadol.
170 A closed loop audit on oxygen prescription in the emergency department in Ipswich Hospital
Authors: Sudin Ellhia , Kathwadia Devraj , Udofa Eddie , Bose Abhijit
Published: January 2021

Aims/Objectives/Background

The British Thoracic Society (BTS) produced the world’s first guidelines on oxygen therapy in the emergency setting in 2008, with subsequent updates in 2017. The key recommendation was that oxygen should be prescribed with target saturations tailored to individual patients.

Whilst most clinicians appreciate the dangers of under-oxygenation, there is a lesser regard for the dangers of over-oxygenation. This is particularly important in certain conditions which may predispose to hypercapnic respiratory failure and acidosis.

We therefore set out to assess compliance to the BTS guidelines, and to educate clinicians on the importance of good oxygen prescribing practice.

Methods/Design

The first cycle was conducted in August 2019. The results were presented in a series of departmental teaching sessions, along with the BTS recommendations and the importance of good oxygen prescribing practice. The second cycle was later conducted in April 2020.

For each cycle, we randomly selected records of 50 adult patients who either: (1) arrived with oxygen saturations less than 93%; or (2) were already on oxygen on arrival to the emergency department. For each record, we assessed whether the target oxygen saturations were prescribed.

Results/Conclusions

A total of 100 patients were included in this study. Prior to the departmental teaching sessions, only 14% of patients had target oxygen saturations prescribed. The teaching sessions on oxygen prescription resulted in a small but statistically non-significant improvement in oxygen prescription to 20% (p=0.595).

This study shows that departmental teaching sessions alone are not sufficient to improve compliance with oxygen prescribing practice. Further efforts are required to change ingrained behaviours and culture, particularly in settings such as the emergency department with high rates of clinician turnover and ad-hoc locum cover. Further recommendations to facilitate these changes will require engagement from the multidisciplinary team, such as prompting from the nursing team, and spot checks by senior clinicians.
How to obtain informed consent for psychotherapy: a reply to criticism
Authors: Leder Garson
Published: January 2021

In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy (CBT)). I also argued that the minimal requirements for informed consent do not include information about the role of therapeutic common factors in healing (eg, expectancy effects and therapist effects); practitioners may discuss the common factors with patients, but they are not part of the ‘core set’ of information necessary to obtain informed consent.

In a recent reply, Charlotte Blease criticises these two arguments by claiming they are not supported by empirical findings about the therapeutic common factors. Blease’s response is based on serious misunderstandings of both CBT and what the common factor findings actually find. Nevertheless, addressing the reasons for these misunderstandings is instructive and gives us an opportunity to clarify what, exactly, needs to be explained to patients in order to obtain informed consent for psychotherapy.
Occurrence of respiratory symptoms and lung function deficits among fruit and vegetable market workers
Authors: Heibati Behzad , Jaakkola Maritta S , Lajunen Taina K , Ducatman Alan , Zafari Zinat , Yekkalam Marzieh , Karimi Ali , Jaakkola Jouni J K
Published: January 2021

Objective

The objective of this study was to investigate the potential effects of occupational exposures among fruit and vegetable market workers on the occurrence of respiratory symptoms and on the level of lung function parameters.

Methods

We conducted a cross-sectional study of 140 men working as fruit and vegetable market workers (response rate 100%) and a reference group of 77 male office workers as the reference group (response rate 55%) from Shiraz, Iran. The outcomes of interest included occurrence of respiratory symptoms assessed by a standard respiratory questionnaire and lung function assessed by spirometry.

Results

In Poisson regression analyses, the exposed group showed increased prevalence ratio (PR) of wheezing (adjusted PR 5.32, 95% CI 1.40 to 20.26), after controlling for confounding. Cough (PR 3.30, 95% CI 1.16 to 9.40) and wheezing (PR 9.40, 95% CI 2.28 to 38.64) showed increased PRs among vegetable distributors. Forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity were significantly decreased among exposed workers after controlling for confounders. The absolute value of FEV1level was reduced significantly among fruit and vegetable carters (−0.99, 95% CI −1.68 to −0.32) and vegetable (−0.51, 95% CI −0.93 to −0.10) and fruit (−0.51, 95% CI −0.86 to −0.15) distributors in comparison with the reference group in the adjusted full model.

Conclusions

This study provides evidence that fruit and vegetable market workers are at an increased risk of respiratory symptoms and reduced lung function. Workplace conditions and safety training clearly need improvement, and there is a likely role for proper use of personal protective equipment.
Physical workload and increased frequency of musculoskeletal pain: a cohort study of employed men and women with baseline occasional pain
Authors: Badarin Kathryn , Hemmingsson Tomas , Hillert Lena , Kjellberg Katarina
Published: January 2021

Objectives

Musculoskeletal pain (MSP) is prevalent among the workforce. This study investigates the long-term association between physical workload (PWL) and increased frequency of MSP among male and female employees with pre-existing occasional MSP.

Methods

This study uses the Stockholm Public Health cohort survey data from the baseline 2006. The sample includes 5715 employees with baseline occasional MSP (no more than a few days per month). Eight PWL exposures and overall PWL were estimated using a job-exposure matrix (JEM). The JEM was assigned to occupational titles from a national register in 2006. Follow-up survey data on frequent MSP (a few or more times a week) were collected from 2010. Logistic regressions produced sex-specific ORs with 95% CIs and were adjusted for education, health conditions, psychological distress, smoking, BMI, leisure-time physical activity and decision authority.

Results

Associations were observed between several aspects of heavy PWL and frequent MSP for men (eg, OR 1.57, 95% CI 1.13 to 2.20, among those in the highest exposure quartile compared with those in the lowest quartile for heavy lifting) and women (eg, OR 1.76, 95% CI 1.35 to 2.29, among those in the highest exposure quartile compared with those in the the lowest quartile for physically strenuous work). Small changes were observed in the OR after adjustment, but most of the ORs for PWL exposures among the men were no longer statistically significantly increased.

Conclusion

A high level of exposure to heavy PWL was associated with increased frequency of MSP 4 years later for men and women with baseline occasional pain.
Minimally invasive surgery versus transcatheter aortic valve replacement: a systematic review and meta-analysis
Authors: Sayed Ahmed , Almotawally Salma , Wilson Karim , Munir Malak , Bendary Ahmed , Ramzy Ahmed , Hirji Sameer , Ibrahim Abushouk Abdelrahman
Published: January 2021

Transcatheter aortic valve replacement (TAVR) has recently been approved for use in patients who are at intermediate and low surgical risk. Moreover, recent years have witnessed a renewed interest in minimally invasive aortic valve replacement (miAVR). The present meta-analysis compared the outcomes of TAVR and miAVR in the management of aortic stenosis (AS). We conducted an electronic search across six databases from 2002 (TAVR inception) to December 2019. Data from relevant studies regarding the clinical and length of hospitalisation outcomes were extracted and analysed using R software. We identified a total of 11 cohort studies, of which seven were matched/propensity matched. Our analysis demonstrated higher rates of midterm mortality (≥1 year) with TAVR (risk ratio (RR): 1.93, 95% CI: 1.16 to 3.22), but no significant differences with respect to 1 month mortality (RR: 1.00, 95% CI: 0.55 to 1.81), stroke (RR: 1.08, 95% CI: 0.40 to 2.87) and bleeding (RR: 1.45, 95% CI: 0.56 to 3.75) rates. Patients undergoing TAVR were more likely to experience paravalvular leakage (RR: 14.89, 95% CI: 6.89 to 32.16), yet less likely to suffer acute kidney injury (RR: 0.38, 95% CI: 0.21 to 0.69) compared with miAVR. The duration of hospitalisation was significantly longer in the miAVR group (mean difference: 1.92 (0.61 to 3.24)). Grading of Recommendations Assessment, Development and Evaluation assessment revealed ≤moderate quality of evidence in all outcomes. TAVR was associated with lower acute kidney injury rate and shorter length of hospitalisation, yet higher risks of midterm mortality and paravalvular leakage. Given the increasing adoption of both techniques, there is an urgent need for head-to-head randomised trials with adequate follow-up periods.
Preferred protonation site of a series of sulfa drugs in the gas phase revealed by IR spectroscopy
Authors: Uhlemann Thomas , Berden Giel , Oomens Jos
Published: January 2021

Sulfa drugs are an important class of pharmaceuticals in the treatment of bacterial infections. The amido/imido tautomerism of these molecules in their neutral form has been widely discussed in the literature. Here, we study the protonation preferences of sulfa drugs upon electrospray ionization (ESI) using IR action spectroscopy of the ionized gas-phase molecules in a mass spectrometer. Our set of molecules includes sulfanilamide (SA), the progenitor of the family of sulfa drugs, and the actual, sulfonamide nitrogen substituted, sulfa drugs sulfamethoxazole (SMX), sulfisoxazole (SIX), sulfamethizole (SMZ), sulfathiazole (STZ), sulfapyridine (SP) and sulfaguanidine (SG). IR multiple photon dissociation (IRMPD) spectra were recorded for the protonated sulfa drugs using a Fourier transform ion cyclotron resonance mass spectrometer (FT-ICR-MS) and an optical parametric oscillator/amplifier (OPO/OPA) as well as the FELIX free electron laser (FEL) as IR sources. The OPO provides tunable IR radiation in the NH stretch region (3100–3700 cm$$^{-1}$$

-
1

), while the FEL covers the fingerprint region (520–1750 cm$$^{-1}$$

-
1

). Comparison of experimental IR spectra with spectra predicted using density functional theory allowed us to determine the gas-phase protonation site. For SA, the sulfonamide NH$$_2$$

2

group was identified as the protonation site, which contrasts the situation in solution, where the anilinic NH$$_2$$

2

group is protonated. For the derivative sulfa drugs, the favored protonation site is the nitrogen atom included in the heterocycle, except for SG, where protonation occurs at the sulfonamide nitrogen atom. The theoretical investigations show that the identified protonation isomers correspond to the lowest-energy gas-phase structures.
KDD 2020 Highlights
Authors: Gupta Rajesh K. , Liu Yan
Published: January 2021

KDD made history in 2020. It was planned to be held in the San Diego Convention Center in an environment that would attract a large number of participants, companies to an attractive location. The program planners also made a concerted effort to broaden the intellectual scope of the forum as well as participation by diverse communities. In particular, the conference planned for offering complimentary full-time daycare to enable participation by women and parents with young children. The emergence of COVID-19 disease in March, however, caused considerable uncertainty leading to a final determination for a first-ever entirely virtual conference. This shift was dramatic at multiple levels since KDD is more than a meeting of presenters and their audience. It is also a place for demonstrations, chance encounters and a very engaging floor exhibition with its own ongoing events. Without exhibitors, their sponsors, and missing attendees, KDD won't be KDD. And it will also have a significant financial liability to the conference for the event contracts already in place. With significant cooperation from ACM and support from SIGKDD Executive Committee the team not only avoided financial impact but emerged with a net positive financial outcome even after reducing the registration fees by over 80%.
An Interview with Dr. Michael Zeller, Winner of ACM SIGKDD 2020 Service Award
Authors: Zeller Michael
Published: January 2021

Michael Zeller, Ph.D. is the recipient of the 2020 ACM SIGKDD Service Award, which is the highest service award in the field of knowledge discovery and data mining. Conferred annually on one individual or group in recognition of outstanding professional services and contributions to the field of knowledge discovery and data mining, Dr. Zeller was honored for his years of service and many accomplishments as the secretary and treasurer for ACM SIGKDD, the organizing body of the annual KDD conference. Zeller is also head of AI strategy and solutions at Temasek, a global investment company seeking to make a difference always with tomorrow in mind. He sat down with SIGKDD Explorations to discuss how he first got involved in the KDD conference in 1999, what he learned from the first-ever virtual conference, his work at Temasek, and what excites him about the future of machine learning, data science and artificial intelligence.
Recent Advances in Reinforcement Learning for Traffic Signal Control
Authors: Wei Hua , Zheng Guanjie , Gayah Vikash , Li Zhenhui
Published: January 2021

Traffic signal control is an important and challenging real-world problem that has recently received a large amount of interest from both transportation and computer science communities. In this survey, we focus on investigating the recent advances in using reinforcement learning (RL) techniques to solve the traffic signal control problem. We classify the known approaches based on the RL techniques they use and provide a review of existing models with analysis on their advantages and disadvantages. Moreover, we give an overview of the simulation environments and experimental settings that have been developed to evaluate the traffic signal control methods. Finally, we explore future directions in the area of RLbased traffic signal control methods. We hope this survey could provide insights to researchers dealing with real-world applications in intelligent transportation systems
Techniques for Automated Machine Learning
Authors: Chen Yi-Wei , Song Qingquan , Hu Xia
Published: January 2021

Automated machine learning (AutoML) aims to find optimal machine learning solutions automatically given a problem description, its task type, and datasets. It could release the burden of data scientists from the multifarious manual tuning process and enable the access of domain experts to the off-the-shelf machine learning solutions without extensive experience. In this paper, we portray AutoML as a bi-level optimization problem, where one problem is nested within another to search the optimum in the search space, and review the current developments of AutoML in terms of three categories, automated feature engineering (AutoFE), automated model and hyperparameter tuning (AutoMHT), and automated deep learning (AutoDL). Stateof- the-art techniques in the three categories are presented. The iterative solver is proposed to generalize AutoML techniques. We summarize popular AutoML frameworks and conclude with current open challenges of AutoML.
HER-2/neu Amplification Testing in Breast Cancer by Multiplex Ligation-Dependent Probe Amplification in Comparison with Immunohistochemistry and In Situ Hybridization
Authors: Moelans Cathy B. , de Weger Roel A. , van Blokland Marja T.M. , Ezendam Chantal , Elshof Sabrina , Tilanus Marcel G. J. , van Diest Paul J.
Published: January 2021

Background: Assessment of HER-2/neu status in invasive breast cancer is crucial to establish eligibility for trastuzumab and taxane based chemotherapy. Next to immunohistochemistry (IHC) to evaluate protein overexpression, a second line gene amplification test is required for cases with equivocal protein expression. This study aimed to validate a new PCR based test, called Multiplex Ligation-dependent Probe Amplification (MLPA), as a simple and quick method to assess HER-2/neu gene amplification status in invasive breast cancer.

Methods: MPLA results were compared with gene amplification status assessed by fluorescence in situ hybridization (FISH) and chromogenic in situ hybridization (CISH) as gold standard, and with protein overexpression by IHC in 518 breast carcinoma patients.

Results: About 10% of cases overexpressed HER-2/neu at the protein level (IHC), and 11% of cases showed gene-amplification by MLPA. A high concordance was found between FISH and CISH, MLPA and IHC, and MLPA and CISH. MLPA showed amplification in 7/36 (19%) of the equivocal IHC 2+ cases. However, of the IHC 0/1+ cases, 6/434 (1.4%) were also amplified by MLPA, and amplification was confirmed in all of these cases by FISH/CISH. On the other hand, one of the 48 (2%) IHC 3+ cases was normal by MLPA and lack of amplification was confirmed by FISH/CISH.

Conclusion: MLPA is a fast, accurate and cheap method to detect breast cancer HER-2/neu amplification in small quantities of DNA extracted from paraffin blocks, and thereby a reliable alternative to FISH and CISH.
Gene Expression of ERβ Isoforms in Laser Microdissected Human Breast Cancers: Implications for Gene Expression Analyses
Authors: Cummings Michele , Iremonger James , Green Caroline A. , Shaaban Abeer M. , Speirs Valerie
Published: January 2021

Background: Despite many published studies on ERβ, progress towards understanding its role in breast cancer remains slow. This is largely due to discordant data between mRNA and protein studies as well as failure to take into account the biologically distinct ERβ isoforms and their heterogeneous expression profile.

Methods: We compared expression of ERβ, -2 and -5 genes in HB2 and MCF-7 breast cell lines, primary breast fibroblasts (n=5) and whole tissue and laser microdissected epithelial and stromal cells obtained from 25 human breast tumours.

Results: Our study shows that the level of gene expression of ERβ isoforms depends on the cell population within a given tumour and varies dramatically in different cellular compartments. This has implications for gene expression analyses and could explain some of the contradictory data published to date, rendering “grind and bind” analyses of ERβ uninformative.

Conclusions: With the technology now available, we suggest a more refined approach be adopted to help resolve some of the controversy surrounding ERβ.
Promiscuous Behavior of HPV16E6 Specific T Cell Receptor Beta Chains Hampers Functional Expression in TCR Transgenic T Cells, Which Can Be Restored in Part by Genetic Modification
Authors: Scholten Kirsten B. J. , Ruizendaal Janneke J. , Graf Marcus , Schoedl Thomas , Kramer Duco , Meijer Chris J. L. M. , Man Stephen , Hooijberg Erik
Published: January 2021

Background: T cell receptor gene transfer is a promising strategy to treat patients suffering from HPV induced malignancies. Therefore we isolated the TCRαβ open reading frames of an HPV16E6 specific CTL clone and generated TCR transgenic T cells. In general low level expression of the transgenic TCR in recipient human T cells is observed as well as the formation of mixed TCRs dimers. Here we addressed both issues employing three different expression platforms.

Methods: We isolated the HVP16E6 specific TCRα and TCRβ open reading frames and retrovirally transduced human T cells with either wild-type (wt), or codon-modified (cm) chains to achieve enhanced TCR expression levels, or used codon-modification in combination with cysteinization (cmCys) of TCRs to facilitate preferential pairing of the introduced TCRα and TCRβ chains.

Results: Careful analysis of recipient T cells carrying the HPV16E6 TCRβ and endogenous TCR chains revealed the transgenic TCRβ chain to behave very promiscuously. Further analysis showed that the percentage of tetramer positive T cells in codon-modified/cysteinized TCR transgenic T cells was four-fold higher compared to wild-type and two-fold higher compared to codon-modification only. Functional activity, as determined by IFN-γ production, was high in cmCysTCR transgenic T cells, where it was low in cm and wt TCR transgenic T cells. Recognition of endogenously processed HPV16E6 antigen by cmCysTCR transgenic T cells was confirmed in a cytotoxicity assay.

Conclusions: Promiscuous behavior of the HPV16E6 specific TCRβ chain can in part be forced back into specific action in TCR transgenic T cells by codon modification in combination with the inclusion of an extra cysteine in the TCR chains.
Transient Hypophosphatemia: A Dangerous Event in Multiple Myeloma
Authors: Jeffs Paula , Mangual-García Michelle , González-Bóssolo Alex , Rivera-Santana Nadyeschka
Published: January 2021

Patients with malignancies frequently experience multiple electrolyte disturbances. In multiple myeloma, hypercalcemia and hyperphosphatemia are one of the most common metabolic disturbances observed as part of pathogenesis of the disease. However, in rare occasions and during the course of the disease, many patients can develop hypophosphatemia due to multiple factors that affects the phosphate absorption and excretion. We hereby present a 56 y/o woman recently diagnosed with multiple myeloma who developed severe hypophosphatemia during medical treatment. We should note that the following manuscript was presented at the 2019 American Association of Clinical Endocrinologists (AACE) 28th Annual Scientific and Clinical Congress.
Robust Trajectory Planning for Hypersonic Glide Vehicle with Parametric Uncertainties
Authors: Dong Chunyun , Guo Zhi , Chen Xiaolong
Published: January 2021

A hybrid double-loop optimization algorithm combing particle swarm optimization (PSO) and nonintrusive polynomial chaos (NIPC) is proposed for solving the robust trajectory optimization of hypersonic glide vehicle (HGV) under uncertainties. In the outer loop, the PSO method searches globally for the robust optimal control law according to a penalized fitness function that contains the system robustness considerations. In the inner loop, uncertainty propagation of the stochastic system is performed using the NIPC method, to provide statistical moments for the iterative scheme of the PSO method in the outer loop. Only control variables are discretized, and the state constraints are satisfied implicitly through the numerical integration process, which reduces the number of decision variables as well as the huge amount of computation increased by NIPC. In the end, the robust optimal control law is achieved conveniently. Numerical simulations are carried out considering a classical time-optimal trajectory optimization problem of HGV with uncertainties in both initial states and aerodynamic coefficients. The results demonstrate the feasibility and effectiveness of the proposed method.
The Effect of Momordica charantia in the Treatment of Diabetes Mellitus: A Review
Authors: Liu Zhuo , Gong Jing , Huang Wenya , Lu Fuer , Dong Hui
Published: January 2021

In recent years, many studies of Momordica charantia (MC) in the treatment of diabetes mellitus (DM) and its complications have been reported. This article reviewed the effect and mechanism of MC against diabetes, including the results from in vitro and in vivo experiments and clinical trials. The common side effects of MC were also summarized. We hope that it might open up new ideas for further mechanism exploration and clinical application as well as provide a scientific theoretical basis for the development of drugs or foods derived from MC.
Novel Nanoparticle Biomaterial of Alginate/Chitosan Loading Simultaneously Lovastatin and Ginsenoside RB1: Characteristics, Morphology, and Drug Release Study
Authors: Vo-An Quan , Nguyen Thuy Chinh , Nguyen Quang Tung , Vu Quoc Trung , Truong Cong Doanh , Nguyen Thi Len , Ly Thi Ngoc Lien , Bach Long Giang , Thai Hoang
Published: January 2021

Recently, plenty of interesting studies on improvement of bioavailability for poorly soluble drugs were implemented with different approaches such as using of combined biopolymers as a delivery system that allowed to enhancing drug solubility and bioavailability. In this work, alginate and chitosan were blended together in the form of polymeric particles, loaded with both lovastatin and ginsenoside Rb1 to producing the four-component nanoparticles by ionic gelation method. CaCl2 and sodium tripolyphosphate were used as gelation agent and cross-linking agent, respectively. The characteristics of obtained nanoparticles were studied by means of infrared spectra (IR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and dynamic light scattering (DLS). In combination, ginsenoside Rb1 and lovastatin both interacted with each other to improve the drug release ability of the polymer particles. The change of initial content of drugs in the nanoparticles has a negligible effect on the functional groups in the structure of the nanoparticles but has a significant impact on drug release process of both lovastatin and ginsenoside Rb1 from the nanoparticles in selective simulated body fluids. In addition, the synergistic interaction of lovastatin and ginsenoside Rb1 could be also observed through the modification of relative crystal degree and drug release efficiency.
Association of Vitamin D Deficiency and Newly Diagnosed Pulmonary Tuberculosis
Authors: Jaimni Vijay , Shasty Barkur Ananthakrishna , Madhyastha Sharath P. , Shetty Ganesh V. , Acharya Raviraja V. , Bekur Ragini , Doddamani Akhila
Published: January 2021

Introduction. Vitamin D has a significant role in host immune defense against Mycobacterium tuberculosis. It has been suggested that pulmonary tuberculosis may be associated with lower levels of vitamin D. Present study was therefore undertaken to identify the association between vitamin D deficiency and pulmonary tuberculosis. Methods. A case-control study was conducted in a tertiary care hospital from 2014 to 2016, including 50 adult newly diagnosed sputum positive pulmonary tuberculosis patients as cases and 50 age and sex-matched healthy participants as control groups. All participants in the study group had undergone detailed clinical examination and routine laboratory investigations, including vitamin D, calcium, and sputum for AFB. The clinical characteristics, X-ray findings, sputum AFB, and vitamin D levels were analyzed and compared with data obtained from healthy controls. Results. In both groups, the majority were men (88%). BMI was significantly (<0.0001

∗

) lower in the tuberculosis group (19.40 (17.20, 22.0) vs. 24.00 (22.50, 25.47)). Serum vitamin D levels were significantly lower (

P
=
0.012

) in the tuberculosis group (19 (7.75, 27.25) ng/dl) as compared to the control group (25 (19.75, 32.00) ng/dl). Out of 50 TB patients, 27 (54%) had vitamin D deficiency, while among healthy controls, only 13 (26%) had vitamin D deficiency. Among vitamin D deficient PTB patients, 44% had 3+/hpf AFB in sputum smear examination. Conclusion. The prevalence of vitamin D deficiency in pulmonary tuberculosis cases is very high. Hypovitaminosis D was associated with more severe clinical symptoms, higher sputum smear positivity, and extensive lesions in chest radiograph among pulmonary tuberculosis patients.
Forecasting the COVID-19 Diffusion in Italy and the Related Occupancy of Intensive Care Units
Authors: Fenga Livio
Published: January 2021

This paper provides a model-based method for the forecast of the total number of currently COVID-19 positive individuals and of the occupancy of the available intensive care units in Italy. The predictions obtained—for a time horizon of 10 days starting from March 29th—will be provided at a national as well as at a more disaggregated level, following a criterion based on the magnitude of the phenomenon. While those regions hit the most by the pandemic have been kept separated, those less affected regions have been aggregated into homogeneous macroareas. Results show that—within the forecast period considered (March 29th–April 7th)—all of the Italian regions will show a decreasing number of COVID-19 positive people. The same will be observed for the number of people who will need to be hospitalized in an intensive care unit. These estimates are valid under constancy of the government’s current containment policies. In this scenario, northern regions will remain the most affected ones, whereas no significant outbreaks are foreseen in the southern regions.
Mirabilite with Ice Pack after Total Knee Arthroplasty: A Randomized Controlled Trial Study
Authors: Zhong Ying , Zheng Cheng , Du Wenxi , Zheng Jiahui , Xu Shanchun , Tong Peijian
Published: January 2021

Background. Total knee arthroplasty (TKA) is a well-established procedure for end-stage arthritis of the knee with complications such as swelling and pain. The aim of this study is to estimate the effect of mirabilite with ice pack versus ice pack in relieving pain, swelling, range of motion (ROM), and serum CRP level on patients after TKA. Methods. Eighty patients undergoing primary unilateral TKA were randomly assigned to two groups (MIP group and WIP group). We used VAS to measure knee pain at 24 h, 48 h, and 72 h after the surgery, respectively. Knee swelling degree was evaluated by measuring the girth of the leg at the center of the patella and 10 cm above and below it at the same frequency. The active ROM of the knee was measured by using a universal goniometer of plastic material at 72 h postoperatively. The serum CRP level was also measured at 72 h postoperatively. Results. The MIP group showed statistically significant lower knee girth at 48 h (

p
<
0.05

) and 72 h (

p
<
0.05

) postoperatively and VAS score at 72 h (

p
=
0.018

) postoperatively after TKA than the WIP group. The ROM of the MIP group was significantly wider than the WIP group (

p
=
0.024

). The CRP level (

p
=
0.036

) and length of stay (LOS) (

p
=
0.037

) of the MIP group were significantly lower than the WIP group. Conclusion. Mirabilite with ice pack after TKA showed superiority in relieving pain, reducing swelling, and improving ROM than ice pack only.
Semisupervised Deep Embedded Clustering with Adaptive Labels
Authors: Chen Zhikui , Li Chaojie , Gao Jing , Zhang Jianing , Li Peng
Published: January 2021

Deep embedding clustering (DEC) attracts much attention due to its outperforming performance attributed to the end-to-end clustering. However, DEC cannot make use of small amount of a priori knowledge contained in data of increasing volume. To tackle this challenge, a semisupervised deep embedded clustering algorithm with adaptive labels is proposed to cluster those data in a semisupervised end-to-end manner on the basis of a little priori knowledge. Specifically, a deep semisupervised clustering network is designed based on the autoencoder paradigm and deep clustering, which well mine the clustering representation and clustering assignment by preventing the shift of labels in DEC. Then, to train parameters of the deep semisupervised clustering network, a back-propagation-based algorithm with adaptive labels is introduced based on the pretrain and fine-tune strategies. Finally, extensive experiments on representative datasets are conducted to evaluate the performance of the proposed method in terms of clustering accuracy and normalized mutual information. Results show the proposed method outperforms the state-of-the-art methods of DEC.
Removal of Acid Red 88 Using Activated Carbon Produced from Pomelo Peels by KOH Activation: Orthogonal Experiment, Isotherm, and Kinetic Studies
Authors: Liu Zheng , Xing Konglong
Published: January 2021

Activated carbon (PPAC) from pomelo peels was prepared by carbonization and KOH activation. The performance of PPAC was assessed by removing acid red 88 (AR88) in aqueous solution. The most suitable activation processes were found by orthogonal experiments, aimed to achieve the maximum of removal capacity of AR88. Moreover, the possible mechanisms of adsorption were studied through the results of characterization, isotherm fitting, and kinetics simulation. Results showed the preparation parameter that mattered the most to AR88 removal efficiency was the activation temperature of PPAC, followed by impregnation ratio and activation time. The optimal preparation conditions of PPAC were at activation temperature 800°C, activation time 90 min, and impregnation ratio 2.5 : 1. The characterization results showed optimal PPAC had a microporous and amorphous carbon structure whose BET specific area and total pore volume were 2504 m2/g and 1.185 cm3/g, respectively. The isotherm fitting demonstrated that the sorption process followed the Langmuir model, and theoretical maximal sorption value was 1486 mg/g. The kinetics simulation showed that the pseudo-second-order model described the sorption behavior better, suggesting chemisorption seemed to be the rate-limiting step in the adsorption process. This work presented that PPAC was a promising and efficient adsorbent for AR88 from water.
Study on Unsteady Cavitation Flow and Pressure Pulsation Characteristics in the Regulating Valve
Authors: Xiumei Liu , Jie He , Beibei Li , Chi Zhang , Huawen Xu , Wei Li , Fangwei Xie
Published: January 2021

A combined numerical‐experiment investigation on the unsteady cavitation flow and pressure fluctuation characteristics in the regulating valves is conducted in this paper. The cavitation flow in the regulating valve is an unsteady and periodic flow which could be divided into fixed and travelling cavitation bubbles. The fixed cavitation bubbles are formed in the gap in the initial stage and then fell off and formed the travelling cavitation bubbles because of the re‐entrant jet. The travelling cavitation bubbles move downstream, oscillate, and break up into several smaller bubbles. Changes in the length/radius ratio (L/R0) of the valve spool is an important factor affecting unsteady cavitation flow and pressure pulsation characteristics in the regulating valve. The length of travelling cavitation bubbles increases firstly and then decreases with increasing time. With the increase of the length/radius ratio (L/R0), the oscillation period of cavitation bubbles also increases. In the initial stage of cavitation bubbles, the velocity distribution inside the regulating valve is relatively stable, and no re‐entrant jet could be found although L/R0 is different. In the collapse stage of cavitation bubbles, the velocity distribution becomes extremely unstable because the collapsing cavitation bubbles affect the pressure drop and velocity field in the flow channel. Furthermore, the amplitude of pressure pulsation increases gradually, and the peak time of the pressure pulsation is gradually delayed while increasing the length/diameter ratio.
Multimedia Communication Security in 5G/6G Coverless Steganography Based on Image Text Semantic Association
Authors: Hao Yajing , Yan Xinrong , Wu Jianbin , Wang Huijun , Yuan Linfeng
Published: January 2021

Recently, researchers have shown that coverless steganography is relatively safe. On this basis, to improve the payload of the coverless steganography, a novel semiconstruction coverless steganography algorithm is introduced in the paper. Firstly, web crawler technology is applied to crawl a wide range of small icons and hot news images from the Internet. These icons can be used as the training subset, and the hot news can be designed according to construction rules. Secondly, the Alex-Net network is introduced for training in the algorithm, and the adversarial samples are added to the training set. Thirdly, using the preset template, certain small icons and a hot news image are spliced into a secret carrier image according to the construction principle. The hot news image is in the top half of the carrier, and those small icons are in the bottom half. The image on the upper part of the carrier and the icons of the lower part can be connected by image and text semantics, and the semantic matching can be realized between image semantics and explanatory. The experimental results and analysis show that the proposed algorithm can resist steganalysis tools effectively and has good robustness against various image attacks. Meanwhile, the secret information payload has been greatly improved, the maximum payload can reach 180 bits of a single

512
×
512

image. This promising algorithm can be applied to build covert communications.
Solitary Wave Diffraction with a Single and Two Vertical Circular Cylinders
Authors: Hafsia Zouhair , Nouri Saliha , Boulaaras Salah Mahmoud , Allahem Ali , Alkhalaf Salem , Vazquez Aldo Munoz
Published: January 2021

This study investigates the three-dimensional (3-D) solitary wave interaction with two cylinders in tandem and side-by-side arrangements for two wave heights. The solitary wave generation and propagation are predicted using the volume of fluid method (VOF) coupled with the NavierStokes transport equations. The PHOENICS code is used to solve these transport equations. The solitary wave generation based on the source line developed by Hafsia et al. (2009) is extended in three-dimensional wave flow and is firstly validated for solitary waves propagating on a flat bottom. The comparison between numerical results and analytical solution for small wave height

H
/
h

=
0.1

and 0.2 shows good agreements. The wave crest and the pseudo-wavelength are well reproduced. Excellent agreements were found in terms of maximum run-up and wave forces by comparison with the present model and analytical studies. The present model can be tested for the extreme solitary wave to extend its application to a more realistic case study as the solitary wave diffraction with an offshore oil platform.
Sparse Graph Embedding Based on the Fuzzy Set for Image Classification
Authors: Wan Minghua , Ge Mengting , Zhan Tianming , Yang Zhangjing , Zheng Hao , Yang Guowei
Published: January 2021

In recent years, many face image feature extraction and dimensional reduction algorithms have been proposed for linear and nonlinear data, such as local‐based graph embedding algorithms or fuzzy set algorithms. However, the aforementioned algorithms are not very effective for face images because they are always affected by overlaps (outliers) and sparsity points in the database. To solve the problems, a new and effective dimensional reduction method for face recognition is proposed—sparse graph embedding with the fuzzy set for image classification. The aim of this algorithm is to construct two new fuzzy Laplacian scattering matrices by using the local graph embedding and fuzzy k‐nearest neighbor. Finally, the optimal discriminative sparse projection matrix is obtained by adding elastic network regression. Experimental results and analysis indicate that the proposed algorithm is more effective than other algorithms in the UCI wine dataset and ORL, Yale, and AR standard face databases.