bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoventilation disproportionate to OSAS severity in children with Prader-Willi syndrome
Authors: Abel Francois , Tan Hui-Leng , Negro Valentina , Bridges Nicola , Carlisle Thomas , Chan Elaine , Laverty Aidan , Miligkos Michael , Samuels Martin , Kaditis Athanasios G
Published: July 2018

Objective

To test the hypothesis that children with Prader-Willi syndrome (PWS) and obstructive sleep apnoea syndrome (OSAS) have hypercapnia for higher proportion of total sleep time (TST) than non-syndromic children with similar obstructive apnoea–hypopnoea index (OAHI).

Design

Cross-sectional study.

Setting

Two tertiary care hospitals.

Patients

Patients with PWS and non-syndromic children with snoring who underwent polygraphy and were of similar age, body mass index (BMI) z-score and OAHI.

Main outcome measure

The two groups were compared regarding %TST with transcutaneous CO2 (PtcCO2) >50 mm Hg. The interaction between PWS diagnosis and OSAS severity (OAHI <1 episode/h vs 1–5 episodes/h vs >5 episodes/h) regarding %TST with PtcCO2 >50 mm Hg was tested using multiple linear regression.

Results

48 children with PWS and 92 controls were included (median age 2.3 (range 0.2–14.1) years vs 2.2 (0.3–15.1) years; BMI z-score 0.7±1.9 vs 0.8±1.7; median OAHI 0.5 (0–29.5) episodes/h vs 0.5 (0–33.9) episodes/h; p>0.05). The two groups did not differ in %TST with PtcCO2 >50 mm Hg (median 0% (0–100%) vs 0% (0–81.3%), respectively; p>0.05). However, the interaction between PWS and OSAS severity with respect to duration of hypoventilation was significant (p<0.01); the estimated mean differences of %TST with PtcCO2 >50 mm Hg between children with PWS and controls for OAHI <1 episode/h, 1–5 episodes/h and >5 episodes/h were +0.2%, +1% and +33%, respectively.

Conclusion

Increasing severity of upper airway obstruction during sleep in children with PWS is accompanied by disproportionately longer periods of hypoventilation when compared with non-syndromic children with similar frequency of obstructive events.
Health-related quality of life, participation, and physical and cognitive function of patients with intensive care unit-acquired muscle weakness 1 year after rehabilitation in Germany: the GymNAST cohort study
Authors: Thomas Simone , Mehrholz Jan
Published: July 2018

Objective

To describe predictors for health-related quality of life, participation, physical activity and cognitive function in patients with intensive care unit (ICU)-acquired muscle weakness 1 year after discharge from rehabilitation.

Design

This is a cohort study.

Participants

We included 150 chronic critically ill individuals with ICU-acquired muscle weakness.

Setting

Postacute ICU and rehabilitation units in Germany.

Measures

We measured health-related quality of life using the EQ-5D, participation using the Reintegration of Normal Living Index, physical activity using the Physical Activity Scale for Individuals With Physical Disabilities, and basal cognitive function using the Montreal Cognitive Assessment (MoCA) at 6 months, and the Clock Drawing Test 6 and 12 months after discharge from postacute treatment. We described the predictors of the results at 12 months.

Results

The best predictors for good health-related quality of life 1 year after discharge were the time until regaining walking ability (OR=0.96, OR per day, 95% CI 0.93 to 0.99) and the mean MoCA score on admission to our postacute ICU and rehabilitation units (OR=1.25,95% CI 1.02 to 1.52).The best predictor for good participation 1 year after discharge was the MoCA sum score on admission to our postacute ICU and rehabilitation units (OR=0.85,95% CI 0.72 to 1.00). The best predictor for good physical activity 1 year after discharge was the Apache sum score on admission to our postacute ICU and rehabilitation units (OR=1.68,95% CI 0.89 to 3.13). The best predictor for normal cognitive function 1 year after discharge was regaining walking function in rehabilitation (OR=8.0,95% CI 0.49 to 13.69).

Conclusion

Recovery of health-related quality of life, participation, physical activity and basal cognitive function was still not complete 12 months after discharge from postacute treatment. We described the predictors for these important outcomes in participants with ICU-acquired muscle weakness 1 year after discharge from rehabilitation.

Trial registration number

DRKS00007181.
Different predictors of pain severity across age and gender of a Chinese rural population: a cross-sectional survey
Authors: Liu Xiao-kun , Xiao Shui-yuan , Zhou Liang , Hu Mi , Liu Hui-ming
Published: July 2018

Objectives

To investigate a 4-week period of pain prevalence and the risk factors of experiencing pain among a rural Chinese population sample. To explore the psychosocial and health condition predictors of pain severity and the interactions of age and gender with these factors in real-life situations among the general adult population in China.

Methods

Data were collected from a random multistage sample of 2052 participants (response rate=95%) in the rural areas of Liuyang, China. Visual analogue scale was used to assess participants’ pain experienced and a series of internationally validated instruments to assess their sociodemographic characteristics, self-reported health status, depression symptoms, anxiety symptoms, sleep quality, self-efficacy and perceived stress.

Results

The pain prevalence over the 4-week period in rural China was 66.18% (62.84% for men and 68.82% for women). A logistic regression model revealed that being female (adjusted OR=1.58, 95% CI 1.24 to 2.02), age (adjusted OR=1.03, 95% CI 1.02 to 1.05), depressive symptoms (adjusted OR=1.07, 95% CI 1.02 to 1.13) and medium-quality sleep (adjusted OR=2.14, 95% CI 1.26 to 3.64) were significant risk factors for experiencing pain. General linear model analyses revealed that (1) pain severity of rural Chinese was related to self-rated physical health and social health; (2) the interactions of age, gender with employment status, depression symptoms, perceived stress and physical health were significant. Simple effect testing revealed that in different age groups, gender interacted with employment status, depression symptoms, perceived stress and physical health differently.

Conclusions

Improving physical and social health could be effective in reducing the severity of pain and the treatment of pain should be designed specifically for different ages and genders among the general population.
Out-of-hospital endotracheal intubation experience, confidence and confidence-associated factors among Northern Japanese emergency life-saving technicians: a population-based cross-sectional study
Authors: Ono Yuko , Tanigawa Koichi , Kakamu Takeyasu , Shinohara Kazuaki , Iseki Ken
Published: July 2018

Objective

Clinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors.

Design

Population-based cross-sectional study conducted from January to September 2017.

Setting

Northern Japan, including eight prefectures.

Participants

Emergency life-saving technicians (ELSTs) authorised to perform ETI.

Outcome measures

Annual ETI exposure and confidence in performing ETI, according to a five-point Likert scale. To determine factors associated with ETI confidence, differences between confident ELSTs (those scoring 4 or 5 on the Likert scale) and non-confident ELSTs were evaluated.

Results

Questionnaires were sent to 149 fire departments (FDs); 140 agreed to participate. Among the 2821 ELSTs working at responding FDs, 2620 returned the questionnaire (response rate, 92.9%); complete data sets were available for 2567 ELSTs (complete response rate, 91.0%). Of those 2567 respondents, 95.7% performed two or fewer ETI annually; 46.6% reported lack of confidence in performing ETI. Multivariable logistic regression analysis showed that years of clinical experience (adjusted OR (AOR) 1.09; 95% CI 1.05 to 1.13), annual ETI exposure (AOR 1.79; 95% CI 1.59 to 2.03) and the availability of ETI skill retention programmes including regular simulation training (AOR 1.31; 95% CI 1.02 to 1.68) and operating room training (AOR 1.44; 95% CI 1.14 to 1.83) were independently associated with confidence in performing ETI.

Conclusions

ETI is an uncommon event for most ELSTs, and nearly half of respondents did not have confidence in performing this procedure. Since confidence in ETI was independently associated with availability of regular simulation and operating room training, standardisation of ETI re-education that incorporates such methods may be useful for prehospital rescuers.
Evaluating the validity of the selection measures used for the UK’s foundation medical training programme: a national cohort study
Authors: Smith Daniel T , Tiffin Paul A
Published: July 2018

Objectives

Currently relative performance at medical school (educational performance measure (EPM) decile), additional educational achievements and the score on a situational judgement test (SJT) are used to rank applicants to the UK Foundation Years postgraduate medical training programme. We sought to evaluate whether these three measures were predictive of subsequent successful completion of the programme, and thus were valid selection criteria.

Methods

Data were obtained from the UK Medical Education Database (UKMED) on 14 131 UK applicants to the foundation programme starting in 2013 and 2014. These data included training outcomes in the form of Annual Reviews of Competency Progression (ARCPs), which indicated whether the programme was successfully completed. The relationship between applicants’ performance on the three selection measures to the odds of successful programme completion were modelled.

Results

On univariable analyses, all three measures were associated with the odds of successful completion of the programme. Converting the SJT score to deciles to compare the effect sizes suggested that one decile increase in the EPM increased the odds of completing the programme by approximately 15%, whereas the equivalent value was 8% for the SJT scores. On multivariable analyses (with all three measures included in the model), these effects were only independently and statistically significant for EPM decile (OR 1.14, 95% CI 1.10 to 1.18, p<0.001) and SJT z-score decile (OR 1.05, 95% CI 1.01 to 1.09, p=0.02).

Conclusions

The EPM decile and SJT scores may be effective selection measures for the foundation programme. However, educational achievements does not add value to the other two measures when predicting programme completion. Thus, its usefulness in this context is less clear. Moreover, our findings suggest that the weighting for the EPM decile score, relative to SJT performance, should be increased.
Gut commensal Parabacteroides goldsteinii plays a predominant role in the anti-obesity effects of polysaccharides isolated from Hirsutella sinensis
Authors: Wu Tsung-Ru , Lin Chuan-Sheng , Chang Chih-Jung , Lin Tzu-Lung , Martel Jan , Ko Yun-Fei , Ojcius David M , Lu Chia-Chen , Young John D , Lai Hsin-Chih
Published: July 2018

Objective

The medicinal fungus Ophiocordyceps sinensis and its anamorph Hirsutella sinensis have a long history of use in traditional Chinese medicine for their immunomodulatory properties. Alterations of the gut microbiota have been described in obesity and type 2 diabetes. We examined the possibility that H. sinensis mycelium (HSM) and isolated fractions containing polysaccharides may prevent diet-induced obesity and type 2 diabetes by modulating the composition of the gut microbiota.

Design

High-fat diet (HFD)-fed mice were treated with HSM or fractions containing polysaccharides of different molecular weights. The effects of HSM and polysaccharides on the gut microbiota were assessed by horizontal faecal microbiota transplantation (FMT), antibiotic treatment and 16S rDNA-based microbiota analysis.

Results

Fraction H1 containing high-molecular weight polysaccharides (>300 kDa) considerably reduced body weight gain (∼50% reduction) and metabolic disorders in HFD-fed mice. These effects were associated with increased expression of thermogenesis protein markers in adipose tissues, enhanced gut integrity, reduced intestinal and systemic inflammation and improved insulin sensitivity and lipid metabolism. Gut microbiota analysis revealed that H1 polysaccharides selectively promoted the growth of Parabacteroides goldsteinii, a commensal bacterium whose level was reduced in HFD-fed mice. FMT combined with antibiotic treatment showed that neomycin-sensitive gut bacteria negatively correlated with obesity traits and were required for H1’s anti-obesogenic effects. Notably, oral treatment of HFD-fed mice with live P. goldsteinii reduced obesity and was associated with increased adipose tissue thermogenesis, enhanced intestinal integrity and reduced levels of inflammation and insulin resistance.

Conclusions

HSM polysaccharides and the gut bacterium P. goldsteinii represent novel prebiotics and probiotics that may be used to treat obesity and type 2 diabetes.
Paternal uniparental disomy of chromosome 19 in a pair of monochorionic diamniotic twins with dysmorphic features and developmental delay
Authors: Yeung Kit San , Ho Matthew Sai Pong , Lee So Lun , Kan Anita Sik Yau , Chan Kelvin Yuen Kwong , Tang Mary Hoi Yin , Mak Christopher Chun Yu , Leung Gordon Ka Chun , So Po Lam , Pfundt Rolph , Marshall Christian R , Scherer Stephen W , Choufani Sanaa , Weksberg Rosanna , Hon-Yin Chung Brian
Published: July 2018

Background

We report here clinical, cytogenetic and molecular data for a pair of monochorionic diamniotic twins with paternal isodisomy for chromosome 19. Both twins presented with dysmorphic features and global developmental delay. This represents, to our knowledge, the first individual human case of paternal uniparental disomy for chromosome 19 (UPD19).

Methods

Whole-exome sequencing, together with conventional karyotype and SNP array analysis were performed along with genome-wide DNA methylation array for delineation of the underlying molecular defects.

Results

Conventional karyotyping on amniocytes and lymphocytes showed normal karyotypes for both twins. Whole-exome sequencing did not identify any pathogenic sequence variants but >5000 homozygous exonic variants on chromosome 19, suggestive of UPD19. SNP arrays on blood and buccal DNA both showed paternal isodisomy for chromosome 19. Losses of imprinting for known imprinted genes on chromosome 19 were identified, including ZNF331, PEG3, ZIM2 and MIMT1. In addition, imprinting defects were also identified in genes located on other chromosomes, including GPR1-AS, JAKMP1 and NHP2L1.

Conclusion

Imprinting defects are the most likely cause for the dysmorphism and developmental delay in this first report of monozygotic twins with UPD19. However, epigenotype-phenotype correlation will require identification of additional individuals with UPD19 and further molecular analysis.
Finite element analysis for rockfall and debris flow mitigation works
Authors: Kwan Julian S.H. , Sze Eric H.Y. , Lam Carlos
Published: July 2018

Landslide risks arising from boulder falls and debris flows are commonly mitigated using rigid and flexible barriers. Debris–barrier interaction is a complicated process, so current design methods rely on the use of the pseudo-static force approach. In addition to physical testing, numerical simulations can be used to provide insight into the impact mechanism. This paper presents the applications of numerical models to simulate rigid and flexible barriers subjected to rockfall and debris-flow impacts, respectively. For rigid barriers, rock-filled gabions, a recycled glass cullet, cellular glass aggregates, and ethylene-vinyl acetate (EVA) foam were assessed for their performance as cushioning materials. From the results, empirical equations were established for predicting the boulder impact forces and penetration into the cushion layer. Amongst the materials considered in this study, rock-filled gabions appear to be the most promising for use in practice. For flexible barriers, finite-element models, calibrated using documented case histories, were developed to simulate the debris–barrier interaction. The models were used to investigate the barriers’ behavior under debris impacts from both force and energy perspectives. From the results, the hydrodynamic pressure coefficient was found to be lower than the current recommended value whilst only a small amount of debris energy was transferred to the barrier.
Strategies for LEED certified projects: the building layer versus the service layer
Authors: Pushkar Svetlana , Verbitsky Oleg
Published: July 2018

The study aims to evaluate the correlation between building layer (BL) and service layer (SL) (i.e., shearing layer concept) in the (i) design of new buildings under the LEED-NCv3 rating scheme and (ii) renewal of existing buildings under the LEED-EBv3 rating scheme. To decrease the influence that green policy, which can change over several years, has on the Energy and Atmosphere category of LEED, LEED-certified projects were selected exclusively from the US over the course of a year. The total number of LEED certified projects analyzed was 594. These projects were nested into 32 groups (eight US states × two types of buildings × two LEED certification levels). In 19 of 32 groups, reciprocal negative correlations between BL and SL were observed. The following three design strategies, BL-emphasized, SL-emphasized, and random, were identified. It was concluded that LEED rating schemes should be enhanced by emphasizing long time expectancy BL design strategies.
Boreal river impoundments caused nearshore fish community assemblage shifts but little change in diversity: a multiscale analysis
Authors: Turgeon Katrine , Turpin Christian , Gregory-Eaves Irene
Published: July 2018

River flow regulation, fragmentation, and changes in water quality caused by dams have varying effects on aquatic biodiversity and ecosystem functions, but are not clearly resolved in boreal ecosystems. We adopted a multiscale approach to quantify fish community trajectories over 20 years using a network of sites spread across four reservoirs in two hydroelectricity complexes in northern Quebec, where other anthropogenic factors have been negligible. Across three spatial scales, we found little evidence of directional temporal trends in diversity relative to reference sites. Using beta-diversity analyses, we also detected a high degree of stability in fish composition over time and space at the complex and reservoir scales. However, changes in species assemblage following impoundment were detected at the scale of the sampling station. At this scale, we found that some species consistently benefited (coregonids and pikes) from impoundment, whereas others were detrimentally affected (suckers and one salmonid). Overall, we conclude that examining different scales is key when trying to understand the impacts of humans on biodiversity and in formulating management recommendations.
Genetic divergence correlates with the contemporary landscape in populations of Slimy Salamander (Plethodon glutinosus) species complex across the lower Piedmont and Coastal Plain of the southeastern United States
Authors: Smith Walter H. , Wooten Jessica A. , Camp Carlos D. , Stevenson Dirk J. , Jensen John B. , Turner Megan , Alexander N. Reed
Published: July 2018

A primary goal of landscape genetics is to elucidate factors associated with genetic structure among populations. Among the important patterns identified have been isolation by distance (IBD), isolation by barrier (IBB), and isolation by environment (IBE). We tested hypotheses relating each of these possible patterns to genetic divergence in the Slimy Salamander (Plethodon glutinosus (Green, 1818)) species complex across the lower Piedmont and Coastal Plain of Georgia, USA, and adjacent areas of South Carolina, USA. We sequenced 2148 total bp, including three regions of the mitochondrial genome and a nuclear intron, and related genetic distance to GIS-derived surrogate variables representing possible IBD (geographic distance), IBE (principal components of 19 climate variables, watershed, and normalized difference vegetation index (NDVI)), and IBB (streams of fourth order and higher). Multiple matrix regression with randomization analysis indicated significant relationships between genetic distance and two principal components of climate, as well as NDVI. These results support roles for environment (IBE) in helping to drive genetic divergence in this group of salamanders. The absence of a significant influence of IBD and IBB was surprising. It is possible that the signal effects of geographic distance and barriers on genetic divergence may have been erased by more recent responses to the environment.
Dynamic Fractional Frequency Reuse Diversity Design for Intercell Interference Mitigation in Nonorthogonal Multiple Access Multicellular Networks
Authors: Mehmood Kashif , Niaz Muhammad Tabish , Kim Hyung Seok
Published: July 2018

Nonorthogonal multiple access (NOMA) is one of the few promising techniques that can ensure the achievement of benefits foreseen in next‐generation 5G wireless networks and beyond. By using superposition coding, NOMA allows multiple users to share the same time and frequency resources, thereby enhancing user connectivity, spectral efficiency, and a considerable increase in user throughput. Interference mitigation is an important consideration in NOMA and is considerably more influencing in multicellular environments. First, a brief description of the impairments that can arise in a NOMA cellular network along with responsible factors is provided. Second, different approaches adopted to minimize these impairments are discussed. Finally, a possible solution is proposed that consists of a coordinated approach between the individual cells in the NOMA domain to minimize interferences and improve user throughput. Adaptive fractional frequency reuse (FFR) is used to allocate distinct frequency resources to edge users of different cells to minimize intercell interference in NOMA. Simulation results prove that the proposed NOMA scheme plays an important role in minimizing impairment effects and enhancing the SINR and the throughput performance of edge users while ensuring fairness in its design.
Optimization of Process Variables in the Synthesis of Tributyl Citrate Using a Polyvinylpolypyrrolidone-Supported Brønsted Acidic Ionic Liquid Catalyst
Authors: Wang Song , Xu Lanlan , Xu Linlin , Tian Chengcheng , Guan Yinyan
Published: July 2018

A polyvinylpolypyrrolidone- (PVPP-) supported Brønsted acidic ionic liquid catalyst ([BsPVPP]HSO4) was synthesized by the reaction between SO3H-functionalized PVPP and H2SO4. The prepared catalyst was characterized by IR, XRD, FESEM, TG, and DSC. The catalytic activity of [BsPVPP]HSO4 in the preparation of tributyl citrate (TBC) by the esterification reaction between citric acid and n-butanol was investigated. Response surface methodology (RSM) was applied to optimize the process variables of the esterification reaction. The variables, including the reaction time, the n-butanol-to-citric acid mole ratio, the reaction temperature, and the catalyst amount, were optimized by a Box-Behnken design. Under optimized conditions, with a n-butanol-to-citric acid mole ratio of 5.2 : 1 and a reaction temperature of 120°C, the TBC yield reached 92.9% within 5.5 h in the presence of 6.6 wt% of catalyst; this result is in good agreement with the values predicted by the mathematical model. Moreover, the catalyst could be recycled four times with high catalytic activity.
Wear Properties of Nanocomposite Traffic Marking Paint
Authors: Taheri Maryam , Jahanfar Mehdi , Ogino Kenji
Published: July 2018

Durability and wear properties of traffic marking paints are one of the most important challenges in traffic management. This provides high-value cost-benefit, crowd reducing, improving journey times and decreasing environmental targets which are made by standing or slow-moving traffic. Because of the volume of traffic passing, climatic conditions, type of road surface, and drivers’ behavior, a traffic marking paint gradually loses its basic properties such as durability and night visibility (RL) that may potentially lead to accidents because of a loss of cognitive perception for drivers. Therefore, an effective wear resistance traffic marking paint is desirable to reduce wear, extending the lifetime and durability of paints. Analyzing this effect via microgranules, nanoclay application is the aim of this study. Clay/acrylic resin nanocomposite is synthesized using Cloisite® 30B with different percentages. Finally, production of traffic marking paint nanocomposites with this nanocomposite acrylic resins can offer the promising prospect for these aims.
Analysis of the Evacuation Capacity of Parallel Double Running Stairs in Different Merging Form Based on Simulation
Authors: Zheng Xia-zhong , Xie Xue-ling , Tian Dan , Zhou Jian-lan , Zhang Ming
Published: July 2018

In order to analyze the evacuation capacity of parallel double running stairs, a dozen stairs merging forms are set by investigation and statistics, and the improved agent-based evacuation model that considers the merging behavior is used to simulate the process of merging and evacuation in the stairs. The stairs evacuation capacity is related to the evacuation time and the robustness of stairs, and the evacuation time can be calculated by using the improved agent-based model based on computer simulation. The robustness of each merging form can be obtained according to the fluctuation degree of evacuation time under the different pedestrian flow. The evaluation model of stairs evacuation capacity is established by fusing the evacuation time and the robustness of stairs. Combined with the specific example to calculate the evacuation capacity of each stairs form, it is found that every merging form has different evacuation time and different robustness, and the evacuation time has not positive correlation with the robustness for the same form stairs. Meanwhile, the evacuation capacity of stairs is not related to the number of the floor entrances. Finally, the results show that the evacuation capacity of stairs is optimal when the floor entrances are close to out stairs in parallel double running stairs and suitable to the case where pedestrian flow and the change of pedestrian flow are large.
Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia?
Authors: Djordjevic Dragan , Rondovic Goran , Surbatovic Maja , Stanojevic Ivan , Udovicic Ivo , Andjelic Tamara , Zeba Snjezana , Milosavljevic Snezana , Stankovic Nikola , Abazovic Dzihan , Jevdjic Jasna , Vojvodic Danilo
Published: July 2018

Background. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count (MPV/PC) ratio are readily available parameters that might have discriminative power regarding outcome. The aim of our study was to assess prognostic value of these biomarkers regarding outcome in critically ill patients with secondary sepsis and/or trauma. Methods. A total of 392 critically ill and injured patients, admitted to surgical ICU, were enrolled in a prospective observational study. Leukocyte and platelet counts were recorded upon fulfilling Sepsis-3 criteria and for traumatized Injury Severity Score > 25 points. Patients were divided into four subgroups: peritonitis, pancreatitis, trauma with sepsis, and trauma without sepsis. Results. NLR and MPV/PC levels were significantly higher in nonsurvivors (AUC/ROC of 0.681 and 0.592, resp., in the peritonitis subgroup; 0.717 and 0.753, resp., in the pancreatitis subgroup); MLR and PLR did not differ significantly. There was no significant difference of investigated biomarkers between survivors and nonsurvivors in trauma patients with and without sepsis except for PLR in the trauma without sepsis subgroup (significantly higher in nonsurvivors, AUC/ROC of 0.719). Independent predictor of lethal outcome was NLR in the whole cohort and in the peritonitis subgroup as well as MPV in the pancreatitis subgroup. Also, there were statistically significant differences in MPV/PC, MLR, and PLR values regarding nature of bacteremia. In general, the lowest levels had been found in patients with Gram-positive blood cultures. Conclusions. NLR and MPV were very good independent predictors of lethal outcome. For the first time, we demonstrate that nature of bacteremia influences MPV/PC, MLR, and PLR. In heterogeneous cohort subgroup, analysis is essential.
Research on High-Precision Form Grinding Technology of Gear Based on Ambient Temperature Adaptability
Authors: Liu Xinrong , Wang Zhonghou
Published: July 2018

The thermal error of high-precision computer numerical control (CNC) form grinding machine has become the critical factor affecting its locating precision. Because the thermal error is more complicated to be measured directly, most of the measurement tests are usually aimed at no-load conditions. In this article, a method to evaluate the machine tool thermal error based on the principle of tooth profile error through the gear grinding precision is presented. Based on high-precision CNC form grinding machine need to maintain isoperibol, this paper proposed the ambient temperature as a variable, for different ambient temperature to measure the thermal error of the machine tool. According to the measurement results of the thermal error, the method of partial least squares neural network is used to structure the thermal error prediction model of the machine tool. The experimental data show that the grade of the gear precision can reach four levels at different temperatures. This approach shows a promising prospect in the application of high-precision CNC gear form grinding machine in the future.
Equivalent Viscous Damping Ratio Model for Flexure Critical Reinforced Concrete Columns
Authors: Zhang Qin , Wei Zong-yan , Gong Jin-xin , Yu Ping , Zhang Yan-qing
Published: July 2018

In order to determine the energy dissipation capacity of flexure critical reinforced concrete (RC) columns reasonably, an expression for describing the hysteretic behavior including loading and unloading characteristics of flexure critical RC columns is presented, and then, a new equivalent viscous damping (EVD) ratio model including its simplified format, which is interpreted as a function of a displacement ductility factor and a ratio of secant stiffness to yield stiffness of columns, is developed based on the proposed hysteretic loop expression and experimental data from the PEER column database. To illustrate the application of the proposed equivalent damping ratio model, a case study of pushover analysis on a flexure critical RC bridge with a single‐column pier is provided. The analytical results are also compared with the results obtained by other models, which indicate that the proposed model is more general and rational in predicting energy dissipation capacity of flexure critical RC structures subjected to earthquake excitations.
DOA Estimation for Multiple Targets in MIMO Radar with Nonorthogonal Signals
Authors: Cao Zhenxin , Chen Peng , Chen Zhimin , Jin Yi
Published: July 2018

This paper addresses the direction of arrival (DOA) estimation problem in the colocated multiple-input multiple-output (MIMO) radar with nonorthogonal signals. The maximum number of targets that can be estimated is theoretically derived as rankRsN, where N denotes the number of receiving antennas and Rs is the cross-correlation matrix of the transmitted signals. Therefore, with the rank-deficient cross-correlation matrix, the maximum number that can be estimated is less than the radar with orthogonal signals. Then, a multiple signal classification- (MUSIC-) based algorithm is given for the nonorthogonal signals. Furthermore, the DOA estimation performance is also theoretically analyzed by the Carmér-Rao lower bound. Simulation results show that the nonorthogonality degrades the DOA estimation performance only in the scenario with the rank-deficient cross-correlation matrix.
Tualang Honey Reduced Neuroinflammation and Caspase‐3 Activity in Rat Brain after Kainic Acid‐Induced Status Epilepticus
Authors: Mohd Sairazi Nur Shafika , Sirajudeen Kuttulebbai N. S. , Muzaimi Mustapha , Mummedy Swamy , Asari Mohd Asnizam , Sulaiman Siti Amrah
Published: July 2018

The protective effect of tualang honey (TH) on neuroinflammation and caspase‐3 activity in rat cerebral cortex, cerebellum, and brainstem after kainic acid‐ (KA‐) induced status epilepticus was investigated. Male Sprague‐Dawley rats were pretreated orally with TH (1.0 g/kg body weight) five times at 12 h intervals. KA (15 mg/kg body weight) was injected subcutaneously 30 min after last oral treatment. Rats were sacrificed at 2 h, 24 h, and 48 h after KA administration. Neuroinflammation markers and caspase‐3 activity were analyzed in different brain regions 2 h, 24 h, and 48 h after KA administration. Administration of KA induced epileptic seizures. KA caused significant (p < 0.05) increase in the level of tumor necrosis factor alpha (TNF‐α), interleukin 1 beta (IL‐1β), glial fibrillary acidic protein (GFAP), allograft inflammatory factor 1 (AIF‐1), and cyclooxygenase‐2 (COX‐2) and increase in the caspase‐3 activity in the rat cerebral cortex, cerebellum, and brainstem at multiple time points. Pretreatment with TH significantly (p < 0.05) reduced the elevation of TNF‐α, IL‐1β, GFAP, AIF‐1, and COX‐2 level in those brain regions at multiple time points and attenuated the increased caspase‐3 activity in the cerebral cortex. In conclusion, TH reduced neuroinflammation and caspase‐3 activity after kainic acid‐ (KA‐) induced status epilepticus.
Ingesting Self-Grown Produce and Seropositivity for Hepatitis E in the United States
Authors: Diehl Thomas M. , Adams Daniel J. , Nylund Cade M.
Published: July 2018

Background. Hepatitis E virus (HEV) is a major cause of hepatitis in developing and industrialized countries worldwide. The modes of HEV transmission in industrialized countries, including the United States, remain largely unknown. This study is aimed at evaluating the association between HEV seropositivity and consumption of self-grown foods in the United States. Methods. Cross-sectional data was extracted from the 2009–2012 National Health and Nutrition Examination Survey (NHANES). Data from the dietary interview and the serum HEV IgG and IgM enzyme immunoassay test results were linked and examined. Univariate and multivariable logistic regression models were used to evaluate the significance and effect size of an association between self-grown food consumption and hepatitis E seropositivity. Results. The estimated HEV seroprevalence in the civilian, noninstitutionalized US population was 6.6% in 2009–2012, which corresponds to an estimated hepatitis E national seroprevalence of 17,196,457 people. Overall, 10.9% of participants who ingested self-grown foods had positive HEV antibodies versus 6.1% of participants who did not consume self-grown foods (P<0.001; odds ratio (OR) 1.87; 95% CI 1.41–2.48). In the age-stratified multivariable analysis, the correlation between ingesting self-grown foods and HEV seropositivity was significant for participants 40–59 years old, but not overall, or for those < 40 years or ≥60 years. Conclusions. Ingesting self-grown food, or simply the process of gardening/farming, may be a source of zoonotic HEV transmission.
Extended Injection Intervals after Switching from Ranibizumab to Aflibercept in Macular Edema due to Central Retinal Vein Occlusion
Authors: Nghiem-Buffet Sylvia , Glacet-Bernard Agnès , Addou-Regnard Manar , Souied Eric H. , Cohen Salomon Y. , Giocanti-Auregan Audrey
Published: July 2018

Purpose. To assess treatment interval extension after switching from ranibizumab to aflibercept intravitreal injections in macular edema (ME) due to central retinal vein occlusion (CRVO) with an insufficient response or frequent recurrences to initial treatment. Methods. CRVO eyes treated with ranibizumab injections on a treat-and-extend (TAE) basis with an insufficient response or frequent recurrences were switched to aflibercept. Primary endpoint was the change in injection intervals before and after the switch. Results. Eleven eyes were included in this retrospective bicentric study. Before switching, patients received a mean number of 15.3 ranibizumab injections (range, 6–34) during a mean follow-up of 23.4 months (range, 6–57). After switching to aflibercept, patients received a mean number of 12.4 injections (range, 6–20) during a mean follow-up of 25.5 months (range, 16–38). Treatment interval could be extended from 6.1 (range, 4–8) to 11 weeks (range, 8–16) (p=0.001) corresponding to a mean extension of injection interval of +4.9 weeks. Conclusion. In case of insufficient response or frequent recurrences of ME due to CRVO in patients treated with ranibizumab on a TAE basis, switching to aflibercept could allow extending treatment intervals, which could reduce the injection burden for these patients.
Deep Sparse Autoencoder for Feature Extraction and Diagnosis of Locomotive Adhesion Status
Authors: Zhang Changfan , Cheng Xiang , Liu Jianhua , He Jing , Liu Guangwei
Published: July 2018

The model is difficult to establish because the principle of the locomotive adhesion process is complex. This paper presents a data-driven adhesion status fault diagnosis method based on deep learning theory. The adhesion coefficient and creep speed of a locomotive constitute the characteristic vector. The sparse autoencoder unsupervised learning network studies the input vector, and the single-layer network is superimposed to form a deep neural network. Finally, a small amount of labeled data is used to fine-tune training the entire deep neural network, and the locomotive adhesion state fault diagnosis model is established. Experimental results show that the proposed method can achieve a 99.3% locomotive adhesion state diagnosis accuracy and satisfy actual engineering monitoring requirements.
Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013–2014
Authors: Jaber Rana M. , Mirbolouk Mohammadhassan , DeFilippis Andrew P. , Maziak Wasim , Keith Rachel , Payne Thomas , Stokes Andrew , Benjamin Emelia , Bhatnagar Aruni , Blankstein Ron , Saxena Anshul , Blaha Michael J. , Nasir Khurram
Published: July 2018

Background

To examine the prevalence and patterns of recent electronic cigarette (e‐cigarette) use in a nationally representative sample of
US
adults and adolescents.

Methods and Results

Using tobacco information from NHANES (National Health and Nutrition Examination Survey) 2013–2014, 5423 adults and 895 adolescents (aged 13–17 years) were included in this analysis. Demographic, tobacco use, and drug use information were self‐reported. Recent e‐cigarette use (within the previous 5 days) was stratified by smoking status. Of 125 e‐cigarette users, 116 participants were aged ≥18 years, corresponding to 2.6% (95% confidence interval [
CI
], 2.0–3.1) and 1.21% (95%
CI
, 0.3–2.1) prevalence of e‐cigarette use among
US
adults and adolescents, respectively. E‐cigarette adult users were current smokers (68.1%), former smokers (23.7%), and never smokers (8.2%). The highest prevalence of e‐cigarette use was among current smokers (8.2%; 95%
CI
, 6.3–10.1), followed by former smokers (2.7%; 95%
CI
, 1.4–4.1), and then never smokers (0.4%; 95%
CI
, 0.2–0.6). After adjusting for age, sex, and ethnicity, e‐cigarette users had higher odds of being exposed to secondhand smoke (odds ratio: 6.3; 95%
CI
, 3.6–11.1) and drinking alcohol (odds ratio: 4.2; 95%
CI,
1.8–10.0) and lower odds of having at least a college education or a higher income, compared with tobacco nonusers.

Conclusions

Between 2013 and 2014, e‐cigarette use in the United States was more common among younger people, those with low socioeconomic status, and current and former smokers. These findings will help inform future research as well as public policy and regulatory actions.
Phenotypes of Pregnant Women Who Subsequently Develop Hypertension in Pregnancy
Authors: McLaughlin Kelsey , Zhang Jianhong , Lye Stephen J. , Parker John D. , Kingdom John C.
Published: July 2018

Background

Hypertensive disorders complicating pregnancy are a major cause of maternal death. Our objective was to evaluate maternal clinical, hemodynamic, and placental prognostic indicators in a consolidated manner to identify women who develop hypertension in pregnancy.

Methods and Results

Twenty‐six normotensive pregnant women from a specialized Placenta Clinic at increased risk of developing de novo hypertension and 20 normotensive healthy pregnant controls were recruited at 22 to 26 weeks' gestation. Fourteen maternal clinical, hemodynamic, and placental characteristics were assessed in the second trimester and aggregated. Principal component analysis of this combined data set determined that 3 dimensions accounted for 56% of the cohort variability. The first dimension accounted for 31% of the cohort variability, with significant contributions from total peripheral resistance, endoglin, and cardiac output. The second dimension was predominantly influenced by body mass index and mean arterial pressure, while uric acid and myeloperoxidase mainly contributed to the third dimension. Unsupervised clustering identified 3 groups within this combined data set. Total peripheral resistance was the most significant distinguishing parameter between these groups (
P
<0.0001), followed by placental growth factor, endoglin, and cardiac output (
P
<0.0001). Using these 4 parameters, a receiver operating curve was constructed with an area under the curve of 0.975 (95% confidence interval 0.93–1) for the prediction of developing hypertension in pregnancy.

Conclusions

Consolidated assessment of prognostic indicators in the second trimester of pregnancy may be useful to characterize and distinguish pathways by which women may develop hypertension in pregnancy. This approach could contribute to the development of pathway‐specific preventative and antihypertensive treatment strategies.
Why External Witnesses Report Organizational Misconduct to Inspectorates: A Comparative Case Study in Three Inspectorates
Authors: van Erp Judith , Loyens Kim
Published: July 2018

Inspectorates and enforcement agencies increasingly depend on information from societal actors to detect and enforce business offenses, but little is known about the factors underlying external reporting. This paper aims to contribute to a better understanding of what drives external reporters to report offenses to enforcement agencies, and how reporters experience the reporting process. Potential reasons to report are derived of the literature on whistleblowing and on business relations within organizational fields. The article then presents findings of an extensive comparative, qualitative empirical study on reporting businesses. We find that reporters aim to incapacitate competitors who gain economic advantage by bending the rules, and regard inspectorates as their ally in maintaining a level playing field.
Carotid endarterectomy: neither shunting nor patching technique
Authors: Baram Aram , Majeed Goran , Subhi Abdel-Majeed Allaa
Published: July 2018

Introduction

The role of carotid shunting in carotid endarterectomy is controversial. Many studies have concluded that patch angioplasty is preferable to primary closure, while others found that it had no value. The aim of this study was to report the results of our first series of patients undergoing carotid endarterectomy with a non-shunting technique and primary closure of the arteriotomy.

Methods

From October 2014 to October 2017, 63 patients with unilateral or bilateral carotid artery stenosis underwent carotid endarterectomy. There were 48 males and 15 females, the mean age was 63.16 years, and all were symptomatic. Conventional endarterectomy was performed without a shunt in all cases. All arteriotomies were closed primarily. We analysed the early and late outcomes of this procedure with at least 18 months of follow-up.

Results

Diabetes was the most frequent comorbidity. Most of the patients had a history of transient ischemic attack (49.2%) or stroke (44.4%). All patients had significant (moderate to severe) carotid artery stenosis. Postoperatively, 2 (3.2%) patients developed ischemic stroke, one (1.6%) suffered hypoglossal nerve injury, and one had a postoperative cervical hematoma. During follow-up, one patient developed asymptomatic total occlusion of the endartrectomized carotid artery at 18 months.

Conclusion

Carotid endarterectomy without shunting is a safe procedure. The short- and longer-term outcomes are not significantly inferior to those of the routine or selective shunting technique, and the rate of restenosis is not higher than that of patch angioplasty closure.
Investigation on surface morphology and tribological property generated by vibration assisted strengthening on aviation spherical plain bearings
Authors: Yuan Zewei , Qin Yue , Cheng Kai , Zhao Wenzhen , Zheng Peng
Published: July 2018

The extreme and complex working conditions require aviation spherical plain bearings not only to have high machining accuracy and low surface roughness, but also to possess high surface microhardness and lubricant retaining capability. This paper presents a vibration assisted strengthening approach to achieving the synergistic effects of the surface property-improving and appearance-improving. The research attempts to answer how vibration assisted strengthening technique can improve the surface tribological properties of aviation spherical plain bearing components particularly in light of proposing the flat-headed asperity distribution model and the corresponding elastic–plastic contact modelling for the special processed surface morphology. Subsequently, the models are corroborated by the experimental results of characterizing the surface morphology produced by vibration assisted strengthening with different parameters such as rolling times and rolling static force. The surface tribological properties of spherical plain bearing specimens were studied by employing the UMT-TriboLab platform. The theoretical analysis and experimental results indicate that the surface asperities of spherical plain bearing components processed with repeated high frequency strikes present a flat-headed distribution but not Gauss distribution. It characterizes with a marked majority of produced small asperities with similar height, which is beneficial to frictional couple contacts and a lot of original valleys retaining lubricants. The processing technique contributes to increasing the surface microhardness by 20% and decreasing the surface roughness from about Ra 0.4 µm to below Ra 0.1 µm. The ball-on-flat friction tests demonstrate that both the special flat-headed surface structure and the elevated microhardness can attribute the improvement of tribological properties and wear resistance performance of spherical plain bearings.