bluuebunny/crossref_metadata_2025 huggingface dataset:
Robot-Assisted Instrumented Fusion of a T8-9 Extension Distraction Fracture and Epidural Hematoma Evacuation: 2-Dimensional Operative Video
Authors: Al Saiegh Fadi , Leibold Adam , Mouchtouris Nikolaos , Sabourin Victor , Stefanelli Anthony , Franco Daniel , Harrop James , Jallo Jack , Prasad Srinivas , Heller Joshua
Published: April 2020

The utilization of robotics has been gaining increased popularity in spine surgery. It can be used to assist in pedicle screw insertion when anatomy is complex in deformity surgery, but is also helpful in degenerative spine as it can minimize tissue dissection and fluoroscopy use.
1-6
We present an operative video that demonstrates the use of a robotic system (Globus Excelsius GPS, Audubon, Pennsylvania) for thoracic instrumentation in an unstable fracture. The patient we present is a 64-yr-old male who sustained a T8-9 distraction extension fracture after falling down a flight of stairs. His computed tomography (CT) scan showed ossification of the anterior longitudinal ligament making ankylosing spondylitis the likely underlying condition.
7,8
His magnetic resonance imaging showed an epidural hematoma extending from T7 to T11. Due to the unstable nature of this fracture and the presence of the hematoma, informed consent was obtained and the patient underwent thoracic pedicle screw fixation from T7 to T11 and laminectomy for hematoma evacuation. A preoperative CT was done for screw trajectory planning. Paraspinal muscle dissection was limited to the hematoma level to allow for laminectomy and evacuation. After registration of the patient to the robotic system using C-arm fluoroscopy, pilot burr holes are drilled using a rigid robotic arm and with optical tracking in real time. This reduces the degrees of freedom and allows for higher precision of screw placement. To the authors’ knowledge, this video is the first one to show the utilization of robotics for thoracic instrumentation in an acute fracture.
Hydrogen Protons Modulate Perivascular Axo–axonal Interactions in the Middle Cerebral Artery of Rats
Authors: Huang Kuo-Feng , Chang Hsi-Hsien , Hsieh Cheng-Hsing , Shei-Dei Yang Stephen , Chang Shang-Jen
Published: April 2020

Previous studies have demonstrated that nicotine can induce relaxation of the middle cerebral artery (MCA). However, whether this relaxation is associated with the activity of sensory calcitonin gene–related peptide (CGRP) nerves and whether this is modulated by hydrogen protons (H+), facilitating the release of CGRP from sensory CGRPergic nerve terminals in the MCA, remains unclear. In this study, we examined the role of H+ in the modulation of neurogenic vasomotor responses in the rat-isolated endothelium-denuded MCA. Wire myography was used to measure vasoreactivity and indicated that nicotine-induced relaxation was sensitive to tetrodotoxin and lidocaine and drastically reduced levels of guanethidine (an adrenergic neuronal blocker), NG-nitro-L-arginine (L-NNA), CGRP8-37, vasoactive intestinal polypeptide (VIP)6-28, capsaicin, capsazepine (a transient receptor potential vanilloid-1 inhibitor), and tetraethylammonium. However, this nicotine-induced relaxation was not sensitive to propranolol. Lowering the pH of the buffer solution with HCl caused pH-dependent vasorelaxation and deceased intracellular pH in the MCA rings, which was sensitive to L-NNA, CGRP8-37, VIP6-28, capsazepine, 4-aminopyridine (a voltage-gated potassium channel antagonist), and paxilline (a large conductance Ca2+-activated K+ channel antagonist). However, HCl-induced relaxation was not inhibited by glibenclamide (an ATP-sensitive K+ channel blocker). These results suggested that electrical and chemical activation of cerebral perivascular adrenergic nerves led to the release of H+, which then facilitated the release of NO, VIP, and CGRP, resulting in vasorelaxation. Lowering the pH of the buffer solution caused potassium channels of vascular smooth muscle cells and perivascular nerves to open. In conclusion, our results demonstrated that H+ may act as a modulator on MCA perivascular nerves and/or smooth muscles.
High-flow Nasal Oxygen Versus Standard Oxygen During Flexible Bronchoscopy in Lung Transplant Patients
Authors: Ben-Menachem Erez , McKenzie Jane , O’Sullivan Chris , Havryk Adrian P.
Published: April 2020

Background:

Diagnostic and interventional flexible bronchoscopy (FB) is increasingly utilized in complex and high-risk patients. Patients are often sedated for comfort and procedure facilitation and hypoxia is commonly observed in this setting. We hypothesized that high-flow nasal oxygen (HFNO) would reduce the incidence of patients experiencing oxygen desaturation.

Methods:

In this randomized controlled trial, postlung transplant patients booked for FB with transbronchial lung biopsy were assigned to either HFNO or low-flow nasal oxygen (LFNO). The patient and bronchoscopist were blinded to group allocation. The primary endpoint was the proportion of patients experiencing mild desaturation [peripheral oxygen saturation (SpO2)<94%]. Secondary endpoints included desaturation (SpO2<90%), the number of airway interventions required and procedure interruptions, the duration of oxygen desaturation and patient, bronchoscopist and anesthesiologist satisfaction scores.

Results:

The trial analyzed data from 76 patients (LFNO, n=39; HFNO, n=37). HFNO reduced the proportion of patients experiencing SpO2<94% (43.2% vs. 89.7%, P<0.001) and SpO2<90% (16.2% vs. 69.2%, P<0.001). The FB was interrupted 11 times in 9 patients in the LFNO group, whereas there were no interruptions in the HFNO group. There were no differences in patient and bronchoscopist satisfaction scores between groups, anesthesiologists had higher satisfaction scores when using HFNO (P<0.001).

Conclusion:

Hypoxia occurred less commonly in postlung transplant patients receiving HFNO during FB. Further studies are warranted in other high-risk populations undergoing longer duration FB.
Practice Patterns for Women With Overactive Bladder Syndrome: Time Between Medications and Third-Line Treatments
Authors: Kirby Anna C. , Park Sungchul , Cook Sara B. , Odem-Davis Katherine , Gore John L. , Wolff Erika M.
Published: April 2020

Objective

The aims of this study are to determine how long it takes female patients with overactive bladder (OAB) to receive third-line treatment after starting OAB medications and identify factors associated with increased time.

Methods

This was a retrospective observational cohort study of adult female patients with OAB who received third-line treatment between 2013 and 2015 using insurance claims databases. Primary outcome was time between first OAB medication and first third-line treatment. Additional variables were patient demographics, diagnostic tests, and medical comorbidities.

Results

Of 3232 patients included in this study, 48.8% underwent sacral neuromodulation, 31.6% percutaneous tibial nerve stimulation, and 23% intradetrusor onabotulinumtoxin A injections. Twenty-one percent of patients filled medication prescriptions for 3 or more antimuscarinic medications, 30.4% took mirabegron, and 32.3% had advanced diagnostic tests suggestive of a specialist evaluation prior to starting medications. Median time to third-line treatment was 37.7 (interquartile range, 14.9, 16.3) months. Adjusted linear regression model revealed 2 predominant predictors of time to third-line treatments: each antimuscarinic medication trial was associated with 5.3 (95% confidence interval, 4.4–6.3) more months before third-line treatment (P < 0.001), and advanced diagnostic evaluations prior to starting medications were associated with 28.2 (95% confidence interval, 21–35) fewer months before third-line treatment (P < 0.001).

Conclusions

Women with OAB who undergo third-line therapy do so on average more than 3 years after starting medications. Time to third-line treatment is largely driven by the number of antimuscarinic medications tried and timing of diagnostic evaluation by a specialist. Based on these results, we suggest providers consider limiting antimuscarinic trials to 2 medications prior to moving on to other treatment options.
The distress of Iranian adults during the Covid-19 pandemic – More distressed than the Chinese and with different predictors
Authors: Jahanshahi Asghar Afshar , Dinani Maryam Mokhtari , Madavani Abbas Nazarian , Li Jizhen , Zhang Stephen X.
Published: April 2020

Early papers on the mental health of the public during the Covid-19 pandemic surveyed participants from China. Outside of China, Iran has emerged as one of the most affected countries with a high death count and rate. The paper presents the first empirical evidence from Iranian adults during the Covid-19 pandemic on their level of distress and its predictors. On March 25–28, 2020, a dire time for Covid-19 in Iran, we surveyed 1058 adults from all 30 provinces in Iran using the Covid-19 Peritraumatic Distress Index (CPDI). The distress level of Iranian adults (mean: 34.54; s.d.: 14.92) was significantly higher (mean difference: 10.9; t=22.7; p<0.0001; 95% CI: 10.0 to 11.8) than that of Chinese adults (mean: 23.65; s.d.: 5.45) as reported in a prior study with the same measure of Covid-19 Peritraumatic Distress Index (CPDI). We also found the predictors of distress in Iran vary from those in China. Our findings that the predictors of distress in Iran vary from those in China suggest the need to study the predictors of mental health in individual countries during the Covid-19 pandemic to effectively identify and screen for those more susceptible to mental health issues.

Funding

None
Familial clustering of erosive hand osteoarthritis in a large statewide cohort
Authors: Kazmers Nikolas H. , Meeks Huong D. , Novak Kendra A. , Yu Zhe , Fulde Gail L. , Thomas Joy L. , Barker Tyler , Jurynec Michael J.
Published: April 2020

Objectives

Erosive hand osteoarthritis (EOA) is a severe and rapidly progressing form of osteoarthritis. Its etiology remains largely unknown, which has hindered development of successful treatments. Our primary goal was to test the hypothesis that EOA would demonstrate familial clustering in a large statewide population linked to genealogical records, which would suggest a genetic contribution to the pathogenesis of this condition. Our secondary purpose was to determine the association of potential risk factors with EOA.

Methods

Patients diagnosed with EOA were identified by searching medical records from a comprehensive statewide database, the Utah Population Database (UPDB). Affected individuals were then mapped to pedigrees to identify high-risk families with excess clustering of EOA as defined by a Familial Standardized Incidence Ratio (FSIR) of ≥ 2.0. The magnitude of familial risk of EOA in related individuals was calculated using Cox regression models. Association of potential EOA risk factors was analyzed using conditional logistic regression and logistic regression models.

Results

We identified 703 affected individuals linked to 240 unrelated high-risk pedigrees with excess clustering of EOA (FSIR ≥ 2.0). The relative risk of developing EOA was significantly elevated in first-degree relatives. There was a significant association with the diagnosis of EOA and age, sex, diabetes, and obesity.

Conclusions

Familial clustering of EOA observed in a statewide database indicates a potential genetic contribution to the etiology of the disease. Identification of causal gene variants in these high-risk families may provide insight into the genes and pathways that contribute to EOA onset and progression.
The effect of event experience quality on the satisfaction and behavioral intentions of motocross World Championship spectators
Authors: Çevik Hüseyin , Şimşek Kerem Yıldırım
Published: April 2020

Purpose

The purpose of this study is to examine the theoretical relationship between experience quality (EXQ), satisfaction and the behavioral intentions (BI) of Motocross World Championship spectators.

Design/methodology/approach

The research data were collected from spectators who participated in the World Motocross Championship race held in Afyon, Turkey in 2018. The structural equation model (SEM) was used to test the relationship among the research variables.

Findings

The results showed EXQ had significant and direct effects on satisfaction and BI. In addition to this, satisfaction had a partial mediating effect between EXQ and BI.

Originality/value

To date there has been no empirical study examining the consumer behaviors of motocross event spectators. Consequently, this research provides important contributions to the literature and informs event organizers about the role of EXQ in terms of understanding the behavior of motocross event spectators.
Preparation, mechanical properties, and toughening mechanisms of SiCw/SiCp‐reinforced zirconia‐toughened alumina ceramics
Authors: Liu Longyang , Chen Xianzhi , Li Qiyu , Chen Shuaifeng , Chen Yongjun , Li Jianbao , Li Changjiu , Luo Lijie
Published: April 2020

Zirconia‐toughened alumina (ZTA) ceramics with high mechanical properties were sintered by hot‐pressing method using SiC particles (SiCp) and SiC whiskers (SiCw) as the reinforcing agents simultaneously. The influences of sintering temperature, SiCp, and SiCw contents on the microstructure and mechanical properties of ZTA ceramics were investigated. It was found that both SiCp and SiCw could contribute to grain refinement significantly and promote the mechanical properties of the ceramics. However, the excess addition of SiCp or SiCw led to the formation of pores with large sizes and degraded the mechanical properties instead. When 13 wt% SiCp was introduced, the maximum flexural strength of 1180.0 MPa and fracture toughness of 15.9 MPa·m1/2 were obtained, whereas the maximum flexural strength of 1314.0 MPa and fracture toughness of 14.7 MPa·m1/2 were achieved at 20 wt% SiCw. Interestingly, the simultaneous addition of SiCp and SiCw could further improve the mechanical properties, and the highest flexural strength of 1334.0 MPa and fracture toughness of 16.0 MPa·m1/2 were achieved at a SiCw/SiCp ratio of 16/4. The reinforcement mechanisms in the ceramics mainly included the phase transformation toughening of ZrO2, the crack deflection and bridging of SiCp and SiCw, and the pull‐out of SiCw.
Further Details of a Numerical Analysis on the Thermal Hydraulic Effect of Wrapped Wire Spacers in Fuel Bundle
Authors: Kiss Attila , Mervay Bence
Published: April 2020

The application of relatively simple and cheap wrapped wire spacer in the European supercritical water-cooled reactor (SCWR) (high-performance light water reactor (HPLWR)) has been proposed in order to provide enhanced heat transfer in the fuel assembly without unacceptable penalty in pressure loss. The wires cause twisting flow in the fuel assembly, which means the coolant not only flows straight in the axial direction but also has a significant transverse velocity component, and strong mixing between neighboring subchannels occurs. The aim of this ongoing research is to numerically investigate the effect of wrapped wire spacers on thermal hydraulics of the turbulent coolant flow and its heat transfer in a small bundle of four fuel rods. One bare and six-wired geometries with varying wire pitches (1–6 turn(s) of wires) have been studied. It was found that the wires generate significant amount of transverse velocity, decrease the wall temperature, and increase the heat transfer coefficient mostly in corner subchannels which were the hottest in bare geometry. Thus, the presence of wires enhances heat transfer where it is most needed. Temperature hot spots with moderate values have been identified on the cladding wall of fuel rods. Based on the results, a technically optimal choice of number of wire turns from thermal hydraulic sense has been proposed.
Supplemental Material: Sustainable densification of the deep crust
Authors: Malvoisin Benjamin
Published: April 2020

Materials and methods, Figures S1–S9 (fluid-inclusion mapping and point analyses of garnet and clinopyroxene with FTIR, sensitivity analyses for the two numerical models, results of the diffusion-reaction model in open system conditions, X-ray mapping of amphibole inclusions in clinopyroxene, evolution in space of the plagioclase composition), Tables S1 and S2 (chemical composition of the main minerals, and local bulk composition used for numerical modelling), and Movies S1 and S2 (results in 2-D of the model coupling reaction, fluid flow, and deformation).
Comparing the efficacy and safety of insulin detemir versus neutral protamine hagedorn insulin in treatment of diabetes during pregnancy: a randomized, controlled study
Authors: ji Jing , He Zhangya , Yang Zhao , Mi Yang , Guo Na , Zhao Hong , Gao Jiayi , Ma Zhengfeei , Luo Xiaoqin , Han Zhen
Published: April 2020

Objective

To compare the efficacy and safety of insulin detemir (IDet) versus neutral protamine Hagedorn (NPH) insulin used in pregnant women with diabetes.

Research design and methods

A randomized study was conducted in diabetic pregnant women (n=240) (including 132 with pregestational diabetes and 108 with gestational diabetes). All patients were randomly divided into two groups: IDet group (n=120) treated with IDet plus short acting insulin Novolin-R before three meals (RRR–IDet plan), and NPH group treated with NPH plus Novolin-R before three meals (RRR–NPH plan). Patients were enrolled during 12–28 gestation weeks and followed up until delivery.

Results

Basal characteristics, such as age, enrollment gestational weeks, average HbA1c, fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) were similar between two groups. After 1 week of treatment, the FPG of IDet group were significantly lower than NPH group (p<0.05) and the time required to reach the targeted blood glucose level was significantly shorter (p<0.001). After 3 months of treatment, the HbA1c level in the two groups was normalized but there was no significant difference in HbA1c level. Maternal and neonatal outcomes were comparable between the two therapeutic approaches; however, the incidence of hypoglycemia in IDet group was remarkably lower than that of NPH group (p<0.05). The adverse drug reactions were rare and similar between the two groups.

Conclusions

For the treatment of gestational diabetes, both RRR–IDet plan and RRR–NPH plan were reported to control blood glucose effectively. Compared with NPH, IDet could control blood glucose and reached the targets faster and more effectively, thus reducing the number of insulin injections and the incidence of hypoglycemia in pregnant women without increasing adverse birth outcomes. Therefore, for pregnant women with gestational diabetes, who require insulin therapy, IDet would be an ideal basal insulin being worthy of promotion in clinical settings.
Impact of intravitreal aflibercept dosing regimens in treatment-naïve patients with neovascular age-related macular degeneration in routine clinical practice in France: results from the RAINBOW study
Authors: Weber Michel , Kodjikian Laurent , Coscas Florence , Faure Céline , Aubry Isabelle , Dufour Ingrid , Cohen Salomon Y
Published: April 2020

Objective

To evaluate 12-month outcomes in treatment-naïve patients with neovascular (wet) age-related macular degeneration (AMD) stratified by intravitreal aflibercept (IVT-AFL) regimen.

Methods and analysis

Patients included in the 12-month interim analysis of Real life of intravitreal Aflibercept In FraNce: oBservatiOnal Study in Wet AMD (RAINBOW), a 4-year, ongoing observational study conducted in France, were stratified by IVT-AFL dosing regimen. Safety (n=593) and effectiveness (n=428) data were analysed. Regimens included a regular cohort (three initial monthly IVT-AFL injections and ≥6 injections) and irregular cohorts (<6 injections) with and without three initial monthly injections. The main outcome measure was mean gain in best-corrected visual acuity (BCVA) at 12 months.

Results

Mean number of IVT-AFL injections was 6.0 (all patients, n=513), 7.2 (regular cohort, n=102), 6.1 (irregular cohort with three initial monthly injections, n=266) and 5.2 (irregular cohort without three initial monthly injections, n=60). Overall mean gain in BCVA at 12 months was 5 letters; +7.1 letters (regular cohort) and +5.6 letters (irregular cohort with three initial monthly injections), both p<0.001 versus baseline, and –1.1 letters (irregular cohort without three initial monthly injections), p=0.669. Improvements in BCVA were also significantly greater in the regular cohort (p<0.001) and irregular cohort with three initial monthly injections (p=0.003) compared with the irregular cohort without three initial monthly injections. Ocular and non-ocular adverse events were reported in 14.7% and 17.4% of all patients, respectively.

Conclusion

Treatment-naïve patients with neovascular AMD receiving three initial monthly injections followed by regular or irregular injections over 12 months experienced better visual acuity outcomes than those receiving irregular treatment without three initial monthly injections.

Trial registration number

NCT02279537.
Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study
Authors: Gunaseelan Vinusha , Parkin Patricia C. , Wahi Gita , Birken Catherine S. , Maguire Jonathon L. , Macarthur Colin , Borkhoff Cornelia M.
Published: April 2020

Objectives

This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.

Methods

This was a cross-sectional study of healthy children 1–3 years of age. Adjusted multivariable logistic regression analyses were used to evaluate the association between maternal ethnicity and ID (serum ferritin <12 µg/L) and the association between maternal ethnicity and five infant feeding practices (breastfeeding duration; bottle use beyond 15 months; current formula use; daily cow’s milk intake >2 cups; meat consumption).

Results

Of 1851 children included, 12.2% had ID. Compared with the European referent group, we found higher odds of ID among children of South Asian and West Asian/North African maternal ethnicities, and lower odds of ID among children of East Asian maternal ethnicity. Statistically significant covariates associated with higher odds of ID included longer breastfeeding duration and daily cow’s milk intake >2 cups. Current infant formula use was associated with lower odds of ID. Children of South Asian maternal ethnicity had higher odds of bottle use beyond 15 months of age and lower odds of meat consumption.

Conclusions

We found increased odds of ID among children of South Asian and West Asian/Northern African maternal ethnicities. We found a higher odds of feeding practices linked to ID in children of South Asian maternal ethnicity, but not in children of West Asian/North African maternal ethnicity. Culturally tailored approaches to providing guidance to parents on healthy infant feeding practices may be important to prevent ID in early childhood.

Trial registration number

NCT01869530.
СУЧАСНА ДІАГНОСТИКА ТА ЛІКУВАННЯ ХВОРИХ НА БОТУЛІЗМ
Authors: Kopcha V. S. , Bondarenko A. M.
Published: April 2020

Методичні рекомендації складені з урахуванням сучасних відомостей про клінічні прояви харчового, ранового, ятрогенного, інгаляційного ботулізму та хвороби у немовлят. Клінічна картина харчового, ранового, ятрогенного, інгаляційного та «дитячого» ботулізму подібна й зводиться до білатерального паралічу черепних нервів; диспепсичних проявів; респіраторної дисфункції; відсутності гарячки, сплутаності свідо­мості, загальмованості, порушення чутливості.

Наведено об’єктивні прояви при фізикальному обстеженні, методи лабораторної діагностики. Виділено фактори ризику захворювання. Стандартна лабораторна діагностика ботулізму ґрунтується на виявленні токсину у сироватці, шлунковому секреті, калі та зразках продуктів харчування шляхом постановки біологічної проби на мишах, зрідка – бактеріологічного та електрофізіологічного дослідження, імуноферментного аналізу, полімеразно-ланцюгової реакції.

Детально проаналізовано лікування хворих на різні клінічні форми ботулізму. Враховуючи відсутність вітчизняних імунобіологічних препаратів, зібрано відомості про протиботулінічні препарати різних виробників, що дозволяє використати доступні у конкретних умовах зарубіжні препарати. Розглянуто різні способи уникнення тяжких ускладнень після антитоксичної терапії.

Обговорено перспективу використання ефективних і безпечних вакцин від ботулізму.
Combined Detection of Exosome Concentration and Tumor Markers in Gastric Cancer
Authors: Xia Yanyan , Hu Xiaohan , Di Kaili , Liu Chang , Tan Tingting , Lin Yongjuan , Xu Hongpan , Xie Hui , Wang Su , Yang Zhengnan , Shen Han , He Nongyue , Li Zhiyang
Published: April 2020

It has been an established fact that exosomes act as a mediator in tumor microenvironment as well as participate actively in intercellular communication between cancer cells. Exosomes carry a variety of molecular cargoes that prevent cyclic degradation and represent the cells of their
origin. In this study, the difference in expression levels of exosomes was measured for diagnosis of gastric cancer. We isolated exosomes from plasma by size-selective method. The morphology of the exosomes was characterized by transmission electron microscopy, and the particle size and concentration
of the exosomes were detected by NanoSight's Nanoparticle Tracking Analysis. Results indicated that the expression level of exosomes in gastric cancer patients was higher than that in healthy individuals. The specificity and sensitivity were 65.2% and 73.1%, respectively. Currently, clinical
tumor markers for gastric cancer detection mainly included Carbohydrate antigen 72-4 (CA72-4), Alpha-fetoprotein, Carbohydrate antigen 125, Carbohydrate antigen 19-9 (CA19-9), Carcinoembryonic Antigen, Carbohydrate antigen 242. When we combined positive rate for combined gastric cancer biomarkers,
results showed that exosomes concentration +CA19-9 and exosomes concentration +CA72-4 in the two-combined test can provide enough positive rate. Therefore, it can be concluded that for gastric cancer, the concentration of exosomes may be regarded as a diagnostic indicator, eventually.
Increased resistance of a methicillin-resistant Staphylococcus aureus Δagr mutant with modified control in fatty acid metabolism
Authors: Song Hun-Suk , Choi Tae-Rim , Han Yeong-Hoon , Park Ye-Lim , Park Jun Young , Yang Soo-Yeon , Bhatia Shashi Kant , Gurav Ranjit , Kim Yun-Gon , Kim Jae-Seok , Joo Hwang-Soo , Yang Yung-Hun
Published: April 2020

Methicillin-resistant Staphylococcus aureus (MRSA) strains are distinct from general Staphylococcus strains with respect to the composition of the membrane, ability to form a thicker biofilm, and, importantly, ability to modify the target of antibiotics to evade their activity. The agr gene is an accessory global regulator of gram-positive bacteria that governs virulence or resistant mechanisms and therefore an important target for the control of resistant strains. However, the mechanism by which agr impacts resistance to β-lactam antibiotics remains unclear. In the present study, we found the Δagr mutant strain having higher resistance to high concentrations of β-lactam antibiotics such as oxacillin and ampicillin. To determine the influence of variation in the microenvironment of cells between the parental and mutant strains, fatty acid analysis of the supernatant, total lipids, and phospholipid fatty acids were compared. The Δagr mutant strain tended to produce fewer fatty acids and retained lower amounts of C16, C18 fatty acids in the supernatant. Phospholipid analysis showed a dramatic increase in the hydrophobic longer-chain fatty acids in the membrane. To target membrane, we applied several surfactants and found that sorbitan monolaurate (Span20) had a synergistic effect with oxacillin by decreasing biofilm formation and growth. These findings indicate that agr deletion allows for MRSA to resist antibiotics via several changes including constant expression of mecA, fatty acid metabolism, and biofilm thickening.
Regularized supervised Bayesian approach for image deconvolution with regularization parameter estimation
Authors: Laaziri Bouchra , Raghay Said , Hakim Abdelilah
Published: April 2020

Image deconvolution consists in restoring a blurred and noisy image knowing its point spread function (PSF). This inverse problem is ill-posed and needs prior information to obtain a satisfactory solution. Bayesian inference approach with appropriate prior on the image, in particular with a Gaussian prior, has been used successfully. Supervised Bayesian approach with maximum a posteriori (MAP) estimation, a method that has been considered recently, is unstable and suffers from serious ringing artifacts in many applications. To overcome these drawbacks, we propose a regularized version where we minimize an energy functional combined by the mean square error with H1 regularization term, and we consider the generalized cross validation (GCV) method, a widely used and very successful predictive approach, for choosing the smoothing parameter. Theoretically, we study the convergence behavior of the method and we give numerical tests to show its effectiveness.
Precision education with statistical learning and deep learning: a case study in Taiwan
Authors: Tsai Shuo-Chang , Chen Cheng-Huan , Shiao Yi-Tzone , Ciou Jin-Shuei , Wu Trong-Neng
Published: April 2020

The low birth rate in Taiwan has led to a severe challenge for many universities to enroll a sufficient number of students. Consequently, a large number of students have been admitted to universities regardless of whether they have an aptitude for academic studies. Early diagnosis of students with a high dropout risk enables interventions to be provided early on, which can help these students to complete their studies, graduate, and enhance their future competitiveness in the workplace. Effective prelearning interventions are necessary, therefore students’ learning backgrounds should be thoroughly examined. This study investigated how big data and artificial intelligence can be used to help universities to more precisely understand student backgrounds, according to which corresponding interventions can be provided. For this study, 3552 students from a university in Taiwan were sampled. A statistical learning method and a machine learning method based on deep neural networks were used to predict their probability of dropping out. The results revealed that student academic performance (regarding the dynamics of class ranking percentage), student loan applications, the number of absences from school, and the number of alerted subjects successfully predicted whether or not students would drop out of university with an accuracy rate of 68% when the statistical learning method was employed, and 77% for the deep learning method, in the case of giving first priority to the high sensitivity in predicting dropouts. However, when the specificity metric was preferred, then the two approaches both reached more than 80% accuracy rates. These results may enable the university to provide interventions to students for assisting course selection and enhancing their competencies based on their aptitudes, potentially reducing the dropout rate and facilitating adaptive learning, thereby achieving a win-win situation for both the university and the students. This research offers a feasible direction for using artificial intelligence applications on the basis of a university’s institutional research database.
The climate crisis and forensic mental healthcare: what are we doing?
Authors: Tomlin Jack
Published: April 2020

The climate crisis poses the greatest threat to human health this century. Mental health services will be called on to address the psychological consequences of its effects on peoples’ lives, particularly the socially disadvantaged and those on low incomes. However, healthcare systems are also contributors to the climate crisis. This editorial discusses how services can continue to provide care while contributing less to climate change. Specifically, it suggests what services such as forensic mental healthcare, which is constrained by legal, political and resourcing concerns, can do differently.
Bridging the Gap Among Clinical Practice Guidelines for Pain Management in Cancer and Sickle Cell Disease
Authors: Schatz Alyssa A. , Oliver Thomas K. , Swarm Robert A. , Paice Judith A. , Darbari Deepika S. , Dowell Deborah , Meghani Salimah H. , Winckworth-Prejsnar Katy , Bruera Eduardo , Plovnick Robert M. , Richardson Lisa , Vapiwala Neha , Wollins Dana , Hudis Clifford A. , Carlson Robert W.
Published: April 2020

Opioids are a critical component of pain relief strategies for the management of patients with cancer and sickle cell disease. The escalation of opioid addiction and overdose in the United States has led to increased scrutiny of opioid prescribing practices. Multiple reports have revealed that regulatory and coverage policies, intended to curb inappropriate opioid use, have created significant barriers for many patients. The Centers for Disease Control and Prevention, National Comprehensive Cancer Network, and ASCO each publish clinical practice guidelines for the management of chronic pain. A recent JAMA Oncology article highlighted perceived variability in recommendations among these guidelines. In response, leadership from guideline organizations, government representatives, and authors of the original article met to discuss challenges and solutions. The meeting featured remarks by the Commissioner of Food and Drugs, presentations on each clinical practice guideline, an overview of the pain management needs of patients with sickle cell disease, an overview of perceived differences among guidelines, and a discussion of differences and commonalities among the guidelines. The meeting revealed that although each guideline varies in the intended patient population, target audience, and methodology, there is no disagreement among recommendations when applied to the appropriate patient and clinical situation. It was determined that clarification and education are needed regarding the intent, patient population, and scope of each clinical practice guideline, rather than harmonization of guideline recommendations. Clinical practice guidelines can serve as a resource for policymakers and payers to inform policy and coverage determinations.
Recomendações para cirurgia de emergência durante a pandemia do COVID-19
Authors: Lima Daniel Souza , Leite Filho José Alberto Dias , Gurgel Marcus Vinicius Silva Araujo , Aguiar Neto Antônio Fontes de , Da Costa Eduardo de Farias Melo , Maia Filho Francisco Xavier Fernandes , Castro Marcelo de Vasconcelos , Diniz Aline Garcias , Borges Gleydson Cesar de Oliveira , Ribeiro Junior Marcelo Augusto Fontenelle
Published: April 2020

Introdução: a pandemia provocada pelo 2019 Novel Coronavírus (COVID-19) provocou um desafio global de saúde pública, com repercussões em diversos setores da sociedade. As práticas médicas necessitaram adaptar-se no atendimento ao doente portador do COVID-19 ou suspeito. Métodos: realizou-se pesquisa bibliográfica de publicações e de diretrizes de sociedades médicas em relação às abordagens cirúrgicas de emergência nesta atual pandemia. Resultados: o material bibliográfico ainda é escasso, indefinido e de baixa evidência, mas são adequados neste momento inicial de enfrentamento do COVID-19 no Brasil. Conclusão: para reduzir o risco de contaminação dos profissionais de saúde, as técnicas e decisões cirúrgicas precisam adaptar-se ao cenário de pandemia do COVID-19.
Ethno-Psychological Aspects of Youth Identity with the City
Authors: Mahakova Larisa
Published: April 2020

The object of the study is the identity with the city among regional youth. Subject: psychological aspects of youth identity in different ethnic groups. Purpose: to determine the psychological basis for identification with the city of residence among young people, as well as the structure of identity with the city in its various ethnic groups.
A modified identification scale with the city developed by M. Lalli was the methodological toolkit. For statistical data processing, the Friedman analysis of variance by Chi-square criterion was used.
The results of the work contribute to the search for the psychological foundations of the rooting of young people in their cities in order to minimize the internal migration of the able-bodied young urban population, set their development and prosperity, and implement their personal and professional plans.
Graphene-based multifunctional three-port THz and long-wave infrared components
Authors: Dmitriev Victor , Melo Geraldo , Castro Wagner
Published: April 2020

Two graphene-based T-shaped multifunctional components for THz and long-wave infrared regions are proposed and analyzed. The first component can serve as a divider, a switch, and a dynamically controllable filter. This T-junction presents a circular graphene resonator and three graphene waveguides with surface plasmon-polariton waves connected frontally to the resonator. The resonator can be adjusted to work with dipole, quadrupole, or hexapole modes. The graphene elements are deposited on a SiO2 (silica) and Si (silicon) two-layer substrate. The dynamical control and switching of the component are provided by the electrostatic field, which defines the graphene Fermi energy. Numerical simulations show that the first component in the division regime (which is also the ON regime) has a transmission coefficient of

−

4.3

d
B

at the central frequency for every two output ports, and the FWHM is 9.5%. In the OFF regime, the isolation of the two output ports from the input one is about

−

30

d
B

. The second component is a T-junction without a resonator, which fulfills the function of the divider–switch in more than an octave frequency band.
Etched multicore fiber Bragg gratings for refractive index sensing with temperature in-line compensation
Authors: Hu Wenbin , Li Chi , Cheng Shu , Mumtaz Farhan , Du Cheng , Yang Minghong
Published: April 2020

A novel refractive index sensor based on etched multicore fiber Bragg gratings with temperature in-line compensation is proposed and experimentally demonstrated. By chemically etching the cladding of the multicore fiber, the six outer cores exhibit the sensitive responses to the surrounding refractive index change, with refractive index insensitive and temperature-sensitive central core inside of the multicore fiber. By using the a central Bragg wavelength in the multicore fiber as temperature compensators, the refractive index sensing can be in-line compensated. Moreover, the distribution of multiple outer cores enables the capability of avoiding the nonhomogeneous performance by averaging and balancing the read-out data. Theoretical analysis and experimental results demonstrate that this structure can easily discriminate the RI and temperature. The maximum sensitivity 42.83 nm/ RIU could be obtained at around 1.435 RIU, and the temperature sensitivity is 9.89 pm/°C. The proposed structure is able to in-line and in-situ determine refractive index and temperature simultaneously.
The Carceral Airport
Authors: Gidaris Constantine
Published: April 2020

This paper considers the site of the modern airport as a space of biopower that facilitates and manages risk by subjecting Muslim travelers to more intense levels of scrutiny than others. I consider Canadian airports, in particular, as spaces that not only facilitate and perpetuate the production of racialized knowledges and practices of racial profiling against Canadian Muslims, but, moreover, as race-based, spatial enclosures that produce what I refer to as the ‘anxiety of stuckedness.’ Despite the rapid evolution of automated and biometric systems, which are now found in many airports across the globe, and are often touted as race-neutral technologies (Bigo 2006), I argue that the airport’s security and surveillance infrastructure attempt to conceal old and new logics of colonialism and governmentality within the invisibility of transnational databases, data flows and, increasingly, biometric systems.
Health Biometrics and the Narrative Self
Authors: Laforest Daniel
Published: April 2020

This essay aims to highlight how the current state of medical biometrics produces a transitional state of being between measurement and data recollection in which there no longer is an analogon for the self, how this is affecting our traditional image of the narrative self, and consequently how it directly impacts our very belief in a life-story.
Virtual Bodies Inc.
Authors: Harley Daniel
Published: April 2020

As a response to contemporary discourse that declaims the transformative potential of virtual reality (VR), I examine corporate discourse that literally and figuratively objectifies bodies, framing technological mediations as natural and necessary. I argue that these corporate ambitions for bodies in VR have physical, raced, gendered, and political implications, reproducing unequal relations while normalizing an understanding of bodies and worlds as commodifiable data.
Selection of Informational Signs for Forecasting Employment of Graduates
Authors: Smykova N.V. , Avdeev A.S. , Guner M.V.
Published: April 2020

The article is devoted to solving the problem of forming the space of information signs for the model of forecasting the employment of graduates by their progress. Several variants of the recognition space were formed using different methods of automated selection of information signs. The evaluation of the informativeness of the signs is understood as determining the extent of their impact on the level of the potential of labor activity of graduates of the university and job applicants.The effectiveness of the methods of automated selection of information features was determined empirically: on the generated samples, training experiments were carried out using gradient boosting and random forests.The greatest accuracy of the forecast was achieved in the formation of the recognition space by means of one-dimensional selection and training by the method of random forests. The results obtained can be used in the development of an automated information system for assessing the potential of work activity of graduates and job applicants.
Treatment of Esophageal Stricture After Lye Ingestion
Authors: Srivatsav Ashwin , Ghanayem Rami , Dahdal Sami , Khalaf Natalia
Published: April 2020

Caustic ingestions represent a well-known public health concern. Ingestion of highly alkali agents (lye ingestion) from the consumption of cleaning products is common, with an estimated 200,000 cases reported annually in the United States. Long-term complications of lye ingestion include esophageal strictures, gastric stenosis, and cancer. We describe a 53-year-old woman who suffered from lye ingestion as a child complicated by refractory esophageal strictures. Twenty years after esophagectomy and colon interposition, she developed debilitating dysphagia with daily regurgitation. The case highlights the long-term gastrointestinal consequences of lye ingestion and the evolution of endoscopic and surgical treatments of known complications.
Theophrastus’De sensibusin A-fragments of Diels-Kranz. Revisiting the Testimonia and their Value
Authors: Baltussen Han
Published: April 2020

As a crucial source for Presocratic theories of sense perception, Theophrastus’De sensibusdeserves a closer scrutiny than the placement among A-fragments, as often suggested or instigated. This paper proposes to refine our terminology for labelling the varying quality of reporting within the A-fragments has. It supplements the existing criticism of Diels’ division by analysing neglected features. A reassessment of the assumptions underlying the terms ‘fragment’ and ‘paraphrase’ can contribute to dissolving the sharp distinction between A- and B-fragments in DK. It advocates, not equality for A-fragments, but a more inclusive and accurate evaluation of the passages.
Russell McCormmach and the Empathetic Worldview
Authors: Seth Suman
Published: April 2020

This essay is part of a special issue entitled “Looking Backward, Looking Forward: HSNS at 50,” edited by Erika Lorraine Milam.
ОСОБЛИВОСТІ ПРОЯВІВ СТРЕСОВИХ СТАНІВ СУЧАСНИХ СТУДЕНТІВ ЗАКЛАДІВ ВИЩОЇ ТА ПРОФЕСІЙНОЇ ОСВІТИ
Authors: Дубчак Галина
Published: April 2020

У статті представлені результати емпіричного дослідження особливостей стресових реакцій, які проявляються в навчальній діяльності сучасних студентів, що навчаються в закладах вищої та професійної освіти. Обґрунтовано актуальність вивчення проблеми навчального стресу сучасних українських студентів. Описано процедуру дослідження з використанням методики вивчення навчального стресу Ю. В. Щербатих та вибірку, яка нараховувала 600 студентів освітніх закладів міста Чернівці, серед яких студенти закладів вищої освіти склали 316 осіб, професійних училищ – 284. Серед досліджуваних було 283 чоловіків та 317 жінок. Вік досліджуваних студентів – від 15 до 45 років. На основі аналізу результатів емпіричного дослі­дження вивчено психологічні особливості проявів стресових станів сучасних українських студентів, що навчаються в закладах вищої та професійної освіти, визначено їхні спільні та відмінні особливості. З’ясовано, що за останнє десятиліття в загальній картині стресу зросла значущість проблем, пов’язаних з навчальною діяльністю та повсякденним функціонуванням студентів. Найбільш вираженими проявами навчальних стре­сів сучасних українських студентів є поведінкові, найменш вираженими – фізіологічні. Рівень екзаме­наційного стресу студентів закладів вищої та професійної освіти є істотно вищим, ніж десятиліття тому (до­слідження Ю. В. Щербатих, 2006). Рівень стресового навантаження студентів закладів вищої освіти є значно вищим, ніж в учнів професійних училищ. Дослідження дозволило виявити низку проблем, які потре­бують цілеспрямованої системної роботи, оскільки в усіх групах досліджуваних виявлено факт вживання частиною студентів алкоголю, наркотиків та паління сигарет. Саме ці особи, передусім, потребують психологічної допомоги фахівців щодо ефективних прийомів зняття стресового навантаження
Estimación de par basada en electromiografía de superficie: potencial herramienta para la rehabilitación de rodilla
Authors: Portela Mario Andrés , Sánchez-Romero Juanita Irina , Pérez Vera Zasúlich , Betancur Manuel José
Published: April 2020

Introducción. Múltiples estudios de procesamiento de señales han reportado la aplicación de las señales de electromiografía de superficie (sEMG) en robótica y en procesos de rehabilitación motora.Objetivo. Realizar una revisión de la literatura sobre el uso de señales de sEMG como alternativa para la estimación del par de rodilla con el fin de medir objetivamente el progreso de los pacientes en las diferentes etapas de rehabilitación de lesiones de rodilla.Materiales y métodos. Se realizó una revisión de la literatura publicada entre 1986 y 2018, sin límites geográficos, en las bases de datos Engineering Village, IEEE Xplore, ScienceDirect, Web of Science, Scopus y PubMed mediante la combinación de 8 términos de búsqueda.Resultados. Al finalizar la búsqueda inicial se obtuvieron 355 registros. Luego de realizar la remoción de duplicados esta cifra descendió a 308, los cuales fueron analizados para determinar si cumplían con los criterios de inclusión. Finalmente se incluyeron 18 estudios que describen de forma comparativa cómo estimar el par a partir de señales de sEMG.Conclusiones. El uso de señales de sEMG para calcular el par en una articulación es una herramienta alternativa que permite al terapeuta acceder a parámetros cuantitativos y, de esta forma, valorar el progreso de los pacientes durante el proceso de rehabilitación de rodilla.