bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined hepatocellular carcinoma-cholangiocarcinoma in a patient with Fontan-associated liver disease
Authors: Jou Jonathan , Li Jennifer , Kaldas Fady M
Published: November 2022

We present a rare case of combined hepatocellular carcinoma-cholangiocarcinoma in a woman with a history of univentricular congenital heart disease requiring multiple corrective operations including Fontan procedure. During workup for elevated alpha fetal protein, a right hepatic lobe lesion was identified with biopsy showing poorly differentiated hepatocellular carcinoma. She underwent successful segment 5 liver resection. Final pathology demonstrated combined hepatocellular carcinoma-cholangiocarcinoma. She was treated with gemcitabine/oxaliplatin adjuvant chemotherapy and had no evidence of recurrent disease at her 12-month follow-up. To our knowledge, this is the first case reported in of successful treatment of this rare malignancy in the setting of Fontan-associated liver disease and highlights the importance of a robust screening protocol in this patient population. Semiannual screening for the development of primary liver malignancy should start by 10 years post-Fontan and continue until heart–liver transplantation may be performed. It is important to note that cirrhosis is not a pre-requisite for the development of hepatocellular carcinoma or cholangiocarcinoma in these patients.
Magnitude and factors associated with musculoskeletal disorder among patients with diabetes attending chronic care at Arba Minch General Hospital, Arba Minch, southern Ethiopia, 2021: a cross-sectional study
Authors: Abebe Getachew , Hailu Tadiwos , Fikadu Teshale , Gebremickael Abinet , Temesgen Rodas , Shibru Tamiru , Kefelew Etenesh , Dawit Firehiwot , Atnafu Kaleb , Wale Tesega Wondwossen , Bekele Alehegn
Published: November 2022

Objective

This study aimed to assess the prevalence and determinants of musculoskeletal disorders (MSDs) among patients with diabetes in southern Ethiopia.

Design

Facility-based cross-sectional study.

Setting

Data collected from 1 March 2021 to 30 August 2021 at Arba Minch General Hospital.

Participants

Three hundred and sixty-five patients with diabetes attending care at Arba Minch General Hospital.

Main outcome measures

The magnitude and determinants of the MSDs.

Results

The prevalence of MSDs among patients with diabetes was 23.29% (95% CI 19.00 to 27.76). The likelihood of developing MSDs was 6.8 times higher among women than men (AOR=6.787, 95% CI 2.08 to 22.19). Rural participants were about 2.4 times (AOR=2.38, 95% CI 1.06 to 5.33) more likely to develop MSDs as compared with urban participants. Participants aged >50 years were 5.9 times more likely to develop MSDs as compared with those aged ≤50 years (AOR=5.864, 95% CI 2.663 to 12.914). The odds of developing MSDs was 6.2 times (AOR=6.247, 95% CI 1.158 to 33.702) and 5.5 times (AOR=5.451 95% CI 1.174 to 25.312) higher among participants who attended primary and secondary education as compared with those who attended college and above, respectively. Participants with cardiovascular disease were 3.9 times more likely to develop MSDs as compared with their counterparts (AOR=3.854, 95% CI 1.843 to 8.063).

Conclusions

This study showed that age, sex, educational status, place of residence and cardiovascular disease were found to be determinants of MSDs. Thus, clinical and public health interventions working on diabetes mellitus should consider these determinants.
Understanding the mental health impact and needs of public healthcare professionals during COVID-19 in Pakistan : a qualitative study
Authors: Hameed Waqas , Feroz Anam Shahil , Avan Bilal Iqbal , Khan Bushra , Fatmi Zafar , Afzal Noreen , Jafri Hussain , Wassan Mansoor Ali , Siddiqi Sameen
Published: November 2022

Objectives

A dearth of qualitative studies constrains in-depth understanding of health service providers’ perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.

Design

An exploratory qualitative study.

Setting

Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.

Participants

In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.

Results

The study identified three overarching themes: (1) mental health impact of COVID-19 on health service providers that included the fear of acquiring the infection and transmitting it to their family members, fear of social isolation and stigma, anxiety related to the uncertainty of COVID-19, nervousness due to media exaggeration and stress associated with excessive workload; (2) mental health needs of health service providers involved in the COVID-19 crisis and available support from the healthcare system, including the expression of the need for counselling services and safe working conditions, the need for paid rest periods, and the need for appreciation and motivation to work in the pandemic; and (3) suggestions to address mental health needs of healthcare workers, including provision of specialised mental healthcare/services, formal training of health managers on managing mental health needs of health facility staff, and assessment and addressing of these needs of the health workforce.

Conclusion

The study emphasises the need to strengthen health system preparedness for recognising and addressing the needs of healthcare professionals. At the system level, there is a need for a specialised unit to provide mental health services and better communication strategies. At the staff level, continuous motivation and appreciation should be given to healthcare professionals either through monetary incentives or formal acknowledgement of their performance.
Agreement between the laboratory-based and non-laboratory-based WHO cardiovascular risk charts: a cross-sectional analysis of a national health survey in Peru
Authors: Guzman-Vilca Wilmer Cristobal , Quispe-Villegas Gustavo A , Váscones Román Fritz Fidel , Bernabe-Ortiz Antonio , Carrillo-Larco Rodrigo M
Published: November 2022

Objective

To determine the agreement between the cardiovascular disease (CVD) risk predictions computed with the WHO non-laboratory-based model and laboratory-based model in a nationally representative sample of Peruvian adults.

Design

Cross-sectional analysis of a national health survey.

Methods

Absolute CVD risk was computed with the 2019 WHO laboratory-based and non-laboratory-based models. The risk predictions from both models were compared with Bland-Altman plots, Lin’s concordance coefficient correlation (LCCC), and kappa statistics, stratified by sex, age, body mass index categories, smoking and diabetes status.

Results

663 people aged 30–59 years were included in the analysis. Overall, there were no substantial differences between the mean CVD risk computed with the laboratory-based model 2.0% (95% CI 1.8% to 2.2%) and the non-laboratory-based model 2.0% (95% CI 1.8% to 2.1%). In the Bland-Altman plots, the limits of agreement were the widest among people with diabetes (−0.21; 4.37) compared with people without diabetes (−1.17; 0.95). The lowest agreement as per the LCCC was also seen in people with diabetes (0.74 (95% CI 0.63 to 0.82)), the same was observed with the kappa statistic (kappa=0.36). In general, agreement between the scores was appropriate in terms of clinical significance.

Conclusions

The absolute cardiovascular predicted risk was similar between the laboratory-based and non-laboratory-based 2019 WHO cardiovascular risk models. Pending validation from longitudinal studies, the non-laboratory-based model (instead of the laboratory-based) could be used when assessing CVD risk in Peruvian population.
Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)
Authors: Kytö Mikko , Markussen Lisa Torsdatter , Marttinen Pekka , Jacucci Giulio , Niinistö Sari , Virtanen Suvi M , Korhonen Tuuli E , Sievänen Harri , Vähä-Ypyä Henri , Korhonen Ilkka , Heinonen Seppo , Koivusalo Saila B
Published: November 2022

Introduction

Gestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes.

Methods and analysis

This randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24–28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35–37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child.

Ethics and dissemination

The study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences.

Trial registration number

NCT04714762.
Use of the National Early Warning Score for predicting deterioration of patients with acute pulmonary embolism: a post-hoc analysis of the YEARS Study
Authors: Bavalia Roisin , Stals Milou A M , Mulder Frits I , Bistervels Ingrid M , Coppens Michiel , Faber Laura M , Hendriks Stephan V , Hofstee Herman M A , Huisman Menno V , van der Hulle Tom , Mairuhu Albert T A , Kruip Marieke J H A , Middeldorp Saskia , Klok Frederikus A , Hutten Barbara A , Holleman Frits
Published: November 2022

Background

The Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are validated scores for mortality prediction in patients with pulmonary embolism (PE). National Early Warning Score (NEWS) is a general prognostic risk score for multiple clinical settings. We investigated whether the NEWS had a comparable performance with the PESI and sPESI, for predicting intensive care unit (ICU) admission and death in patients with acute PE.

Methods

In haemodynamically stable patients with confirmed PE from the YEARS Study (2013–2015), we evaluated the performance of the NEWS, PESI and sPESI for predicting 7-day ICU admission and 30-day mortality. Receiver operating characteristic curves were plotted and the area under the curve (AUC) was calculated.

Results

Of 352 patients, 12 (3.4%) were admitted to the ICU and 5 (1.4%) died. The AUC of the NEWS for ICU admission was 0.80 (95% CI 0.66 to 0.94) and 0.92 (95% CI 0.82 to 1.00) for 30-day mortality. At a threshold of 3 points, NEWS yielded a sensitivity and specificity of 92% and 53% for ICU admission and 100% and 52% for 30-day mortality. The AUC of the PESI was 0.64 (95% CI 0.48 to 0.79) for ICU admission and 0.94 (95% CI 0.87 to 1.00) for mortality. At a threshold of 66 points, PESI yielded a sensitivity of 75% and a specificity of 38% for ICU admission. For mortality, these were 100% and 37%, respectively. The performance of the sPESI was similar to that of PESI.

Conclusion

In comparison with PESI and sPESI, NEWS adequately predicted 7-day ICU admission as well as 30-day mortality, supporting its potential relevance for clinical practice.
Rationalising the use of specimen pots following colorectal polypectomy: a small step towards greener endoscopy
Authors: Yong Karl King , He Yun , Cheung Hoi Ching Annie , Sriskandarajah Ramya , Jenkins William , Goldin Robert , Beg Sabina
Published: November 2022

Aims

In this study, we aim to determine whether combining multiple small colorectal polyps within a single specimen pot can reduce carbon footprint, without an associated deleterious clinical impact.

Methods

This was a retrospective observational study of colorectal polyps resected during 2019, within the Imperial College Healthcare Trust. The numbers of pots for polypectomy specimens were calculated and corresponding histology results were extracted. We modelled the potential reduction in carbon footprint if all less than 10 mm polyps were sent together and the number of advanced lesions we would not be able to locate if we adopted this strategy. Carbon footprint was estimated based on previous study using a life-cycle assessment, at 0.28 kgCO2e per pot.

Results

A total of 11 781 lower gastrointestinal endoscopies were performed. There were 5125 polyps removed and 4192 pots used, equating to a carbon footprint of 1174 kgCO2e. There were 4563 (89%) polyps measuring 0–10 mm. 6 (0.1%) of these polyps were cancers, while 12 (0.2%) demonstrated high-grade dysplasia. If we combined all small polyps in a single pot, total pot usage could be reduced by one-third (n=2779).

Conclusion

A change in practice by placing small polyps collectively in one pot would have resulted in reduction in carbon footprint equivalent to 396 kgCO2e (emissions from 982 miles driven by an average passenger car). The reduction in carbon footprint from judicious use of specimen pots would be amplified with a change in practice on a national level.
Evaluation of the First Lap learn to swim voucher programme: protocol
Authors: Macniven Rona , Angell Blake , Srinivasan Nivi , Awati Kailash , Chatman James , Peden Amy E
Published: November 2022

Introduction

Swimming skills are an evidence-based component of drowning prevention. However, in Australia, many children miss out on learn to swim education. Voucher programmes may reduce swimming lesson cost and increase participation, especially among priority populations. The First Lap voucher programme provides two New South Wales state government-funded $100 vouchers for parents/carers of preschool children to contribute to swimming lesson costs. This evaluation aims to determine the effectiveness of the programme in meeting objectives of increasing preschool-aged children participating in learn to swim programmes and building parent/carer knowledge and awareness of the importance of preschool-aged children learning to swim.

Methods and analysis

A programme logic model was developed to explain the inputs, activities and intended outputs, and outcomes, which guided this mixed-methods evaluation design of quantitative and qualitative analysis within an impact/outcome evaluation. Baseline sociodemographic registration data will be provided by the parent/carer of each child participant and linked to swim school provider data on voucher redemption. Data will be collected on voucher use, knowledge, and attitudes to swimming lessons at registration and across two surveys. An economic evaluation will assess programme cost-effectiveness.

Conclusion

This evaluation will determine impacts on participation rates in learn to swim programmes, particularly within priority populations. It will examine whether the programme has influenced attitudes and motivations of parents and carers toward learn to swim programmes and water safety, whether the programme has impacted or enhanced the ability of the aquatics sector to deliver learn to swim programmes and assess its cost-effectiveness.
Mental health inequalities in times of crisis: evolution between 2005 and 2021 among the Spanish salaried population
Authors: Esteve-Matalí Laura , Llorens-Serrano Clara , Alonso Jordi , Vilagut Gemma , Moncada Salvador , Navarro-Giné Albert
Published: November 2022

Background

Studying the working population’s mental health in times of crisis (such as the 2008 recession or the COVID-19 pandemic) is very relevant. This study aims to assess the prevalence of poor mental health among the Spanish salaried population, according to the labour market inequality axes (2005–2021).

Methods

Repeated cross-sectional study by comparing different surveys from 2005, 2010, 2016 and 2021 on workers residing in Spain who had been working in a salaried job during the week preceding the survey. n=7197 (2005), n=4985 (2010), n=1807 (2016) and n=18 870 (2021). Outcome variable: poor mental health (Mental Health Inventory of the 36-item Short Form Health Survey scale). Explanatory variables: gender, age, occupational class and type of contract. Prevalence of poor mental health was estimated for each year by means of logistic regression models with robust clustered SEs, stratifying by the explanatory variables. Additionally, prevalence ratios (PR) were estimated by means of robust Poisson regression models to assess differences between the explanatory variables’ categories. All analyses were weighted to address unrepresentativeness.

Results

Poor mental health significantly increased in 2021 (55.92%), compared with the previous years of study (15%–17.72%). Additionally, pattern changes were identified on inequality axes in 2021, with better mental health status among older workers (oldest group PR: 0.76; 95% CI 0.71 to 0.8) and permanent workers (PR: 0.9; 95% CI 0.85 to 0.94).

Conclusion

This study shows a steep worsening of mental health among the salaried population in 2021 compared with previous periods. In 2021, health inequalities have apparently narrowed, although not by improving the disadvantaged groups’ mental health but by worsening the typically advantaged groups’ mental health.
Water quality parameters and constituent concentrations measured in the Peel and Arctic Red Rivers, 2007–2010
Authors: Gareis Jolie A.L. , Lesack Lance F.W.
Published: November 2022

Outflow from north-flowing circumpolar rivers has a strong influence on the Arctic Ocean. The Peel and Arctic Red Rivers are tributaries of the Mackenzie Delta, a large, lake-rich floodplain that forms the interface between the Mackenzie River and the Beaufort Sea basin of the Arctic Ocean. Here, we present water quality data that were collected from the Peel and Arctic Red Rivers between 2007 and 2010 as part of an International Polar Year project that investigated the seasonal hydrology and biogeochemistry of the Mackenzie River and its delta. The Peel River was sampled 57 times between May 2007 and September 2010 upstream of the community of Fort McPherson, Northwest Territories (NT), while the Arctic Red River was sampled 32 times between May 2007 and August 2008 (with one additional sample in June 2010) approximately 0.5 km upstream of its confluence with the Mackenzie River near the community of Tsiigehtchic, NT. Each water sample was analyzed for up to 22 water quality parameters, including water temperature, specific conductivity, pH, chlorophyll a, total suspended sediments, particulate nutrients (carbon, nitrogen, and phosphorus), soluble reactive silica, major ions (calcium, magnesium, potassium, sodium, chloride, and sulfate), dissolved carbon (inorganic and organic fractions), and dissolved nutrients (three nitrogen and two phosphorus fractions). This data set, which is available for download and reuse, provides important baseline information about water quality in the Peel and Arctic Red Rivers, complements other data that have been collected in these watersheds, and will be of interest to researchers, resource managers, Indigenous organizations, and governments that are active in the region.
Reheating and particle creation in unimodular f(R, T) gravity
Authors: Rajabi Fateme , Nozari Kourosh
Published: November 2022

We study cosmological inflation and reheating in the unimodular f(R, T) gravity. During the reheating era, which takes place just after the end of inflation, the energy density of inflaton is converted to radiation energy through, for instance, rapid oscillation about the minimum of the potential. We quantify our investigation by calculating the reheating temperature. This quantity is written in terms of the spectral index and the power spectrum, which provides a suitable framework to constrain the parameter space of the model. We discuss the massless particle creation for a spatially flat, homogeneous and isotropic universe in the context of unimodular f(R, T) gravity. We obtain the number of created particles per unit volume of space. To avoid the complexity of solving the fourth order equations, we analyze the reheating in the Einstein frame by considering some specific illustrative examples and obtain the corresponding analytical solutions in addition to some numerical estimations.
Neutrino specific spin-3/2 dark matter
Authors: Goyal Ashok , Khojali Mohammed Omer , Kumar Mukesh , Cornell Alan S.
Published: November 2022

In this paper we consider a spin-$$\frac{3}{2}$$32dark matter (DM) particle which couples to neutrinos, as a viable candidate to produce the observed DM relic density through the thermal freeze-out mechanism. The couplings of DM to neutrinos is considered first in a general dimension-6 effective field theory framework. We then consider two specific neutrino-portal models discussed in the literature. In the first model DM couples to the standard model neutrinos through mixing generated by a sterile pseudo-Dirac massive neutrino, and in the second model we consider the$$U(1)_{L_\mu - L_\tau }$$U(1)Lμ-Lτgauge symmetric model. For each of these models we explore the parameter space required to generate the observed relic density. The constraints on the parameters of these models from the existing and proposed neutrino experiments, as well as from existing cosmological and astrophysical bounds, are considered in the context of the relic density calculations.
$$e^+e^-$$ annihilation on the stochastic background of primordial gravitational waves with BKP18
Authors: Malsawmtluangi N.
Published: November 2022

The evolution of inflationary primordial gravitational waves with the expansion of the universe is studied while taking into account the $$e^+e^-$$

e
+

e
-

annihilation which leads to step correction in the spectrum of primordial gravitational waves which is $$\sim 10\%$$

∼
10
%

in the amplitude and $$\sim 25\%$$

∼
25
%

in the energy density. The amplitudes and energy densities are studied for the $$\alpha $$
α
-attractor inflation models which are in agreement with the recent BICEP/Keck and Planck 2018 joint result. The energy densities are well within the big bang nucleosynthesis bound, but the spectra for these models are very much below the detection range of the currently operating and upcoming detectors.
Stochastic versus Periodic Quantum Collision Models
Authors: Ciccarello Francesco
Published: November 2022

Most literature on quantum collision models (CMs) usually considers periodic weak collisions featuring a fixed waiting time between two next collisions. Some works have yet addressed CMs with random waiting time and strong collisions (stochastic CMs). This short paper discusses how the open dynamics arising from these two types of models can be formally mapped with one another. This can be achieved for a given stochastic CM by constructing an associated periodic CM such that the waiting time randomness of the former is turned into the mixedness of the ancilla’s initial state of the latter, introducing at the same time an additional state of the ancilla. Through this mapping, non-Markovian behaviour arising from a constrained number of stochatic collisions can be linked to initial ancilla–ancilla correlations of the associated periodic CM.
Gap Detection in Pairs of Ultrasound Mid-air Vibrotactile Stimuli
Authors: Howard Thomas , Driller Karina , Frier William , Pacchierotti Claudio , Marchal Maud , Hartcher-O’Brien Jessica
Published: November 2022

Ultrasound mid-air haptic (UMH) devices are a novel tool for haptic feedback, capable of providing localized vibrotactile stimuli to users at a distance. UMH applications largely rely on generating tactile shape outlines on the users’ skin. Here we investigate how to achieve sensations of continuity or gaps within such two-dimensional curves by studying the perception of pairs of amplitude-modulated focused ultrasound stimuli. On the one hand, we aim to investigate perceptual effects that may arise from providing simultaneous UMH stimuli. On the other hand, we wish to provide perception-based rendering guidelines for generating continuous or discontinuous sensations of tactile shapes. Finally, we hope to contribute toward a measure of the perceptually achievable resolution of UMH interfaces. We performed a user study to identify how far apart two focal points need to be to elicit a perceptual experience of two distinct stimuli separated by a gap. Mean gap detection thresholds were found at 32.3-mm spacing between focal points, but a high within- and between-subject variability was observed. Pairs spaced below 15 mm were consistently (>95%) perceived as a single stimulus, while pairs spaced 45 mm apart were consistently (84%) perceived as two separate stimuli. To investigate the observed variability, we resort to acoustic simulations of the resulting pressure fields. These show a non-linear evolution of actual peak pressure spacing as a function of nominal focal point spacing. Beyond an initial threshold in spacing (between 15 and 18 mm), which we believe to be related to the perceived size of a focal point, the probability of detecting a gap between focal points appears to linearly increase with spacing. Our work highlights physical interactions and perceptual effects to consider when designing or investigating the perception of UMH shapes.
Mechanistic Studies of the Electrocatalytic Carbon–Bromine Cleavage and the Hydrogen Atom Incorporation from 1,1,1,3,3,3-Hexaflouroisopropanol
Authors: Rudman Kelly K. , Thapa Bishnu , Tapash Arifuzzaman , Mubarak Mohammad S. , Raghavachari Krishnan , Hosseini Seyyedamirhossein , Minteer Shelley D.
Published: November 2022

Electrochemical dehalogenation of polyhalogenated compounds is an inefficient process as the working electrode is passivated by the deposition of short-chain polymers that form during the early stages of electrolysis. Herein, we report the use of 1, 1, 1, 3, 3, 3-hexaflouroisopropanol (HFIP) as an efficient reagent to control C–H formation over the radical association. Debromination of 1,6-dibromohexane was examined in the presence of Ni(II) salen and HFIP as the electrocatalyst and hydrogen atom source, respectively. Electrolysis of 10 mM 1,6-dibromohexane and 2 mM Ni(II) salen in the absence of HFIP yields 50% unreacted 1,6-dibromohexane and ∼40% unaccounted for starting material, whereas electrolysis with 50 mM HFIP affords 65% n-hexane. The mechanism of hydrogen atom incorporation was examined via deuterium incorporation coupled with high-resolution mass spectrometry, and density functional theory (DFT) calculations. Deuterium incorporation analysis revealed that the hydrogen atom originated from the secondary carbon of HFIP. DFT calculations showed that the deprotonation of hydroxyl moiety of HFIP, prior to the hydrogen atom transfer, is a key step for C–H formation. The scope of electrochemical dehalogenation was examined by electrolysis of 10 halogenated compounds. Our results indicate that through the use of HFIP, the formation of short-chain polymers is no longer observed, and monomer formation is the dominant product.
Body mass index, but not sex, influences exertional heat stroke risk in young healthy men and women
Authors: Giersch Gabrielle E. W. , Taylor Kathryn M. , Caldwell Aaron R. , Charkoudian Nisha
Published: November 2022

Exertional heat stroke (EHS) remains a persistent threat for individuals working or playing in the heat, including athletes and military and emergency service personnel. However, influence of biological sex and/or body mass index (BMI) on the risk of EHS remain poorly understood. The purpose of this study was to retrospectively assess the influence of sex and BMI on risk of EHS in the active-duty US Army. We analyzed data from 2016 to 2021, using a matched case-control approach, where each individual with a diagnosis of EHS was matched to five controls based on calendar time, unit ID, and job category, to capture control individuals who were matched to EHS events by location, time, and activity. We used a multivariate logistic regression model mutually adjusted for sex, BMI, and age to compare 745 ( n = 61 F) individuals (26 ± 7 yr) with a diagnosed EHS to 4,290 ( n = 384 F) case controls (25 ± 5 yr). Group average BMI were similar: 26.6 ± 3.1 (EHS) and 26.5 ± 3.6 kg/m2 (CON). BMI was significantly ( P < 0.0001) associated with higher risk of EHS with a 3% increase in risk of EHS for every unit increase in BMI. Notably, sex was not associated with any difference in risk for EHS ( P = 0.54). These data suggest that young healthy people with higher BMI have significantly higher risk of EHS, but, contrary to what some have proposed, this risk was not higher in young women.
Mixed Strategy Analysis in Attack-Defense Game Model Based on 5G Heterogeneous Network of CPS Using ncPSO
Authors: Liu Ning , Chai Qing-Wei , Liu Shangkun , Meng Fanying , Zheng Wei-Min
Published: November 2022

The development of the 5th Generation Mobile Communication Technology not only brings convenience to people but also brings many network security problems. Based on the static game theory of complete information, a game model of attack and defense with limited resources in heterogeneous networks of Cyber Physical Systems is established. This model analyzes the basic rules of the offensive and defensive strategies of both parties when the offensive and defensive resources are limited in the 5th Generation Mobile Communication Technology network environment. The model can also describe the interaction between attackers and defenders. A novel compact particle swarm optimization algorithm is proposed to solve the difficult problem of solving the Nash equilibrium of this game model. The simulation experiment proves that novel compact particle swarm optimization algorithm has good optimization ability and shows that the algorithm can effectively solve the Nash equilibrium of the model. The simulation experiment provides a strategic reference for the attack-defense game with limited resources.
An Efficient Multilevel Thresholding Scheme for Heart Image Segmentation Using a Hybrid Generalized Adversarial Network
Authors: Reddy A. Mallikarjuna , Reddy K. S. , Jayaram M. , Venkata Maha Lakshmi N. , Aluvalu Rajanikanth , Mahesh T. R. , Kumar V. Vinoth , Stalin Alex D.
Published: November 2022

Most people worldwide, irrespective of their age, are suffering from massive cardiac arrest. To detect heart attacks early, many researchers worked on the clinical datasets collected from different open-source datasets like PubMed and UCI repository. However, most of these datasets have collected nearly 13 to 147 raw attributes in textual format and implemented traditional data mining approaches. Traditional machine learning approaches just analyze the data extracted from the images, but the extraction mechanism is inefficient and it requires more number of resources. The authors of this research article proposed a system that is aimed at predicting heart attacks by integrating the techniques of computer vision and deep learning approaches on the heart images collected from the clinical labs, which are publicly available in the KAGGLE repository. The authors collected live images of the heart by scanning the images through IoT sensors. The primary focus is to enhance the quality and quantity of the heart images by passing through two popular components of GAN. GAN introduces noise in the images and tries to replicate the real-time scenarios. Subsequently, the available and newly created images are segmented by applying a multilevel threshold operation to find the region of interest. This step helps the system to predict the accurate attack rate by considering various factors. Earlier researchers have obtained sound accuracy by generating similar heart images and found the ROI parts of the 2D echo images. The proposed methodology has achieved an accuracy of 97.33% and a 90.97% true-positive rate. The reason for selecting the computed tomography (CT-SCAN) images is due to the gray scale images giving more reliable information at a low computational cost.
Molecular Characterization of Grass Carp GIPR and Effect of Nutrition States, Insulin, and Glucagon on Its Expression
Authors: Yang Guokun , Liang Xiaomin , Jiang Yanle , Li Chengquan , Zhang Yanmin , Zhang Xindang , Chang Xulu , Shen Yawei , Meng Xiaolin
Published: November 2022

GIP plays an important regulatory role in glucose and lipid metabolism. As the specific receptor, GIPR is involved in this physiological process. To assess the roles of GIPR in teleost, the GIPR gene was cloned from grass carp. The ORF of cloned GIPR gene was 1560 bp, encoding 519 amino acids. The grass carp GIPR was the G-protein-coupled receptor which contains seven predicted transmembrane domains. In addition, two predicted glycosylation sites were contained in the grass carp GIPR. The grass carp GIPR expression is in multiple tissues and is highly expressed in the kidney, brain regions, and visceral fat tissue. In the OGTT experiment, the GIPR expression is markedly decreased in the kidney, visceral fat, and brain by treatment with glucose for 1 and 3 h. In the fast and refeeding experiment, the GIPR expression in the kidney and visceral fat tissue was significantly induced in the fast groups. In addition, the GIPR expression levels were markedly decreased in the refeeding groups. In the present study, the visceral fat accumulation of grass carp was induced by overfed. The GIPR expression was significantly decreased in the brain, kidney, and visceral fat tissue of overfed grass carp. In primary hepatocytes, the GIPR expression was promoted by treatment with oleic acid and insulin. The GIPR mRNA levels were significantly reduced by treatment with glucose and glucagon in the grass carp primary hepatocytes. To our knowledge, this is the first time the biological role of GIPR is unveiled in teleost.
Liquefaction and Reliquefaction Characteristics of Aeolian Sand Foundation Reinforced by Precast Cement Piles Based on Shaking Table Test
Authors: Zhu Zhaorong , Zhou Yuan , Han Kan , Wu Honggang , Zhao Shouquan
Published: November 2022

With the continuous development of traffic construction, road engineering inevitably crosses the aeolian sand river valley area. Compared with general sandy soil and silty soil, cohesionless aeolian sand foundation has similar properties with fluid and higher liquefaction potential. Precast cement pile can greatly improve the vertical bearing capacity of foundation, but this paper finds that it also has antiliquefaction effect when it is used to reinforce aeolian sand foundation. In addition, there may be more than one liquefaction of aeolian sand foundation in areas with frequent earthquakes. Therefore, this paper explores the liquefaction and reliquefaction characteristics of aeolian sand foundation reinforced by precast cement piles through shaking table test. The test results show that under the excitation of 0.4 g EL Centro wave: (1) the increase of pore pressure in aeolian sand foundation will have multiple instantaneous peaks, which will promote the surface to float or sink. The phenomenon will be weakened by multiple earthquakes or pile reinforcement. (2) The prefabricated cement pile can improve the liquefaction and reliquefaction resistance of aeolian sand foundation. The effect is the best in the shallow layer of the foundation, which is increased by more than 30%, and the deeper the buried depth, the lower the effect. (3) The antiliquefaction ability of foundation will be improved after strong earthquake, but the dynamic response will be significantly increased in the next earthquake. (4) When the aeolian sand foundation reinforced by precast cement piles is reliquefied, the main frequency of the foundation will migrate to low frequency. The liquefied layer will inhibit the low frequency (2 ~ 15 Hz) energy transfer and promote the high frequency (25~30 Hz) energy transfer. The results provide reference for antiliquefaction design of aeolian sand foundation and improve the application of precast cement pile in liquefied foundation.
Nonlinear Response and Collapse Analysis of Double‐Channel Aqueduct under Strong Earthquake
Authors: Wu Chong , Zhang Jinpeng , Xu Jianguo , Zhang Chunyu , Geng Yupeng
Published: November 2022

As a common water conveyance structure, aqueduct is widely used in cross‐regional water conveyance and diversion projects. However, large double‐trough aqueduct structures are prone to damage under earthquake, resulting in water leakage and even interruption, endangering the safety of people’s lives and property in surrounding areas. In this paper, the nonlinear reinforced‐concrete material program is compiled based on the FORTRAN language. Taking the Shuangji River aqueduct project as an example, the numerical model of the fiber beam element of the double‐trough aqueduct structure is established, and the nonlinear dynamic time‐history response analysis of different ground motion inputs is carried out. Based on the midspan displacement and acceleration time history, pier bottom bending moment and shear force time history, the nonlinear response law of large aqueduct structure is studied. A criterion for determining the overall collapse of aqueduct structure based on effective energy is proposed. The correctness and feasibility of the nonlinear numerical model of the aqueduct structure and the dynamic catastrophe analysis method are verified by focusing on the overall seismic response of the aqueduct structure and the material yield status of key parts, and comparing with the collapse criterion based on the limit value of pier top displacement angle. The conclusions will provide a basis for seismic analysis, optimization design, and operation and maintenance safety assessment of large aqueduct structures and have important theoretical significance and engineering application value.
CD44v6+ Hepatocellular Carcinoma Cells Maintain Stemness Properties through Met/cJun/Nanog Signaling
Authors: Chen Wei , Wang Ronghua , Zhao Yuchong , Li Yawen , Wang Xiju , Peng Wang , Bai Shuya , Zheng Mengli , Liu Man , Cheng Bin
Published: November 2022

Cancer stem cells (CSCs) are characterized by their self-renewal and differentiation abilities. CD44v6 is a novel CSC marker that can activate various signaling pathways. Here, we hypothesized that the HGF/Met signaling pathway promotes stemness properties in CD44v6+ hepatocellular carcinoma (HCC) cells via overexpression of the transcription factor, cJun, thus representing a valuable target for HCC therapy. Magnetic activated cell sorting was used to separate the CD44v6+ from CD44v6- cells, and Met levels were regulated using lentiviral particles and the selective Met inhibitor, PHA665752. An orthotopic liver xenograft tumor model was used to assess the self-renewal ability of CD44v6+ cells in immunodeficient NOD/SCID mice. Luciferase reporter and chromatin immunoprecipitation assays were also conducted using cJun-overexpressing 293 T cells to identify the exact binding site of cJun in the Nanog promoter. Our data demonstrate that CD44v6 is an ideal surface marker of liver CSCs. CD44v6+ HCC cells express higher levels of Met and possess self-renewal and tumor growth abilities. Xenograft liver tumors were smaller in nude mice injected with shMet HCC cells. Immunohistochemical analysis of liver tissue specimens revealed that high Met levels in HCC cells were associated with poor patient prognosis. Further, a cJun binding site was identified 1700 bp upstream of the Nanog transcription start site and mutation of the cJun binding site reduced Nanog expression. In conclusion, the HGF/Met signaling pathway is important for maintenance of stemness in CD44v6+ HCC cells by enhancing expression of cJun, which binds 1700 bp upstream of the Nanog transcription start site.
Laboratory Performance Evaluation of Hot Mix Asphalt Mixture Using Belessa Kaolin as a Filler with Superpave Aggregate Gradation
Authors: Tamiru Amanuel , Geremew Anteneh , Jemal Abubekir
Published: November 2022

Mineral fillers and different aggregate gradations have a great effect on the mechanical property of asphalt concrete pavements. In this research, the effect of nonconventional material so‐called Belessa kaolin and Superpave gradation on marshal properties, moisture susceptibilities, and permanent deformation in asphalt mixtures was investigated. The chemical composition of Belessa kaolin shows that the total content of silicon dioxide (SiO2), iron oxide (Fe2O3), and aluminum oxide (Al2O3) was 63%, 24.1%, and 2.84%, respectively. The physical properties of Belessa kaolin were conducted on specific gravity, and the plastic index was 2.62 and 3.24, respectively. Based on the study area characteristics and temperature, a bitumen grade of 60/70 penetration is selected. Hot mix asphalt (HMA) specimens were prepared from three different Superpave gradations with conventional filler crushed stone dust (CSD) of different proportions (5.0, 6.0, and 7.0%) and five different bitumen contents (4, 4.5, 5, 5.5 and 6%). A hot mix asphalt with 5.0% of CSD was selected as the control mix based on Ethiopian Road Authority (ERA) standard specifications. The conventional filler was replaced by Belessa kaolin at different replacement rates (0, 10, 20, 30, 40, and 50%) on the basis of the control mix with 5% CSD and 5.1% optimum bitumen content (OBC). The replacement rate of 30% of Belessa kaolin provides better marshal properties and resistance to moisture susceptibility. The results of the experiments indicated that the use of Belessa kaolin on HMA has fulfilled the criteria specified on the specification as a filler with Superpave aggregate gradation up to 30% replacement of conventional filler in HMA.
Effects of Polypropylene Waste Addition as Coarse Aggregates in Concrete: Experimental Characterization and Statistical Analysis
Authors: Naveen D. C. , Naresh K. , Keerthi Gowda B. S. , Reddy G Madhu Sudana , Prasad C. Durga , Shanmugam Ragavanantham
Published: November 2022

In recent times, thermoplastic waste materials are being extensively used as fine and coarse aggregates in the concrete mix as an environmentally friendly construction material. This study aims at utilizing polypropylene (PP) as a partial substitute for the conventional coarse aggregates in M30 grade concrete. The different replacement levels of coarse aggregates such as 0%, 20%, 40%, and 60% by weight were used in concrete. Sieve analysis, specific gravity, and water absorption tests were performed in all replacement levels of aggregates. The mechanical (compressive and split tensile tests) tests were conducted after 3, 14, and 28 days. The change in mechanical properties of concrete with the addition of different weight proportions of plastics was studied experimentally. Further, experimental values were predicted using the two-parameter Weibull distribution and artificial neural network (ANN)-based statistical approaches. The Levenberg–Marquardt algorithm was used in predicting the mechanical properties using the ANN. A good correlation was obtained between the experimental and predicted values with an error (%) of less than 10. The decrease in mechanical properties with the increase in replacement levels of coarse aggregates in concrete was observed in both experimental and predicted approaches. This can be attributed to poor bonding between concrete and PP aggregate owing to the development of agglomerations and the hydrophobic nature of PP. However, the strength values of 20% PP-embedded concrete specimens are closer to 0% PP-embedded concrete specimens. Therefore, 20% PP-embedded concrete specimens can be used for primary load-bearing applications to utilize plastic waste and reduce the cost of the component.
Study on the Cracking Mechanism of Arch Foot of CFST Tied Arch Bridge Based on Multiscale Numerical Simulation
Authors: Yang Zeying , Cai Changhao , Qu Zhilin , Wang Chenghe , Sun Yinglin
Published: November 2022

In order to study the causes of arch foot cracking, a multiscale numerical simulation method was used to establish the finite element model of Xizha Bridge during the construction stage of the Xiaoqing River restoration project in Jinan by using Midas Civil, and the internal forces under adverse conditions were extracted. On this basis, Abaqus was used to establish the local model of arch foot, and the plastic damage model parameters were introduced to conduct stress analysis. The results show that the anchorage stress of prestressed steel bundle is too high. On the one hand, the stress component produced by the bending of the prestressed steel bundle can squeeze the concrete inside the bending angle, and on the other hand, it will stretch the concrete outside the bending angle, resulting in concrete cracking. There is a tendency of relative displacement between arch rib and arch foot, and the interface surface of arch foot and arch rib is pulled by the displacement of arch rib, resulting in cracking. Arch foot inner bend produces a certain tensile stress, and if this place is not paid enough attention to, insufficient reinforcement will produce large cracks. Finally, it is suggested that concrete cracking can be avoided by arranging enough reinforcement bars under anchor and sealing reinforcement bars, encrypting steel mesh, arranging shear studs, and extending insertion depth.
Risk Factors in the Prediction of Leg Numbness after Spinal Endoscopic Surgery: Evaluation and Development of a Nomogram
Authors: Yi Ming , Wang Wenjun , Pan Shixin , Huang Shengsheng , Sun Xuhua , Chen Liyi , Liu Chong , Zhan Xinli
Published: November 2022

Purpose. This study aims at constructing a clinical predictive model that predicted the risk factors for leg numbness after spinal endoscopic surgery. Methods. We collected the clinical data of patients, including general information, imaging parameters, and clinical score, from our hospital’s electronic database. Based on the postoperative leg numbness visual analog scale (LN‐VAS), the clinical data were divided into the leg numbness group (≥25) and the improvement group (<25). All parameters were included in the least absolute shrinkage and selection operator (LASSO) regression analysis, while the parameters with the area under the curve (AUC) greater than 0.7 were selected to construct nomograms. Furthermore, the accuracy and validity of the model were evaluated using the C‐index, decision curve analysis (DCA), calibration curve, and receiver operating characteristic curve (ROC). Results. A total of 73 patients’ clinical data were included in the training set, where 51 patients were assigned to the improvement group and 22 to the leg numbness group. The nomogram was constructed using four selected parameters, including symptom duration, lumbar spinal stenosis (LSS), pelvic incidence (PI), and preoperative low back pain visual analog scale (LBP‐VAS). The nomogram predictions were found to range between 0.01 and 0.99. The values of the C‐index, AUC, and internally validated C‐index were 0.96, 0.96, and 0.94, respectively. Our result showed that the clinical net benefit of the nomogram ranged between 0.01 and 0.99. Conclusion. Our clinical prediction model demonstrated high predictive ability and clinical validity. Moreover, we found that symptom duration, LSS, PI, and preoperative LBP‐VAS were the predictive risk factors for leg numbness after spinal endoscopic surgery.