bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of Early Decline in eGFR due to Intensive BP Control for Cardiovascular Outcomes in SPRINT
Authors: Beddhu Srinivasan , Shen Jincheng , Cheung Alfred K. , Kimmel Paul L. , Chertow Glenn M. , Wei Guo , Boucher Robert E. , Chonchol Michel , Arman Farid , Campbell Ruth C. , Contreras Gabriel , Dwyer Jamie P. , Freedman Barry I. , Ix Joachim H. , Kirchner Kent , Papademetriou Vasilios , Pisoni Roberto , Rocco Michael V. , Whelton Paul K. , Greene Tom
Published: July 2019

Significance Statement

In the Systolic BP Intervention Trial (SPRINT), intensive targeting of systolic BP (goal <120 mm Hg) versus standard targeting (goal of <140 mm Hg) significantly reduced risks of cardiovascular events and all-cause mortality. However, the intensive intervention also resulted in greater early reduction of eGFR in the first 6 months, raising the question of whether reductions in eGFR resulting from intensive BP control worsen an individual’s health status. In causal mediation analyses of SPRINT data, the authors found no evidence that this early eGFR decline either mediated or modified the beneficial effects of intensive systolic BP lowering on cardiovascular events or all-cause mortality. However, longer-term follow-up studies with causal modeling are needed to better understand the downstream effects of the early reduction in eGFR that results from intensive systolic BP lowering.

Background

The Systolic BP Intervention Trial (SPRINT) found that intensive versus standard systolic BP control (targeting <120 or <140 mm Hg, respectively) reduced the risks of death and major cardiovascular events in persons with elevated cardiovascular disease risk. However, the intensive intervention was associated with an early decline in eGFR, and the clinical implications of this early decline are unclear.

Methods

In a post hoc analysis of SPRINT, we defined change in eGFR as the percentage change in eGFR at 6 months compared with baseline. We performed causal mediation analyses to separate the overall effects of the randomized systolic BP intervention on the SPRINT primary cardiovascular composite and all-cause mortality into indirect effects (mediated by percentage change in eGFR) and direct effects (mediated through pathways other than percentage change in eGFR).

Results

About 10.3% of the 4270 participants in the intensive group had a ≥20% eGFR decline versus 4.4% of the 4256 participants in the standard arm (P<0.001). After the 6-month visit, there were 591 cardiovascular composite events during 27,849 person-years of follow-up. The hazard ratios for total effect, direct effect, and indirect effect of the intervention on the cardiovascular composite were 0.67 (95% confidence interval [95% CI], 0.56 to 0.78), 0.68 (95% CI, 0.57 to 0.79), and 0.99 (95% CI, 0.95 to 1.03), respectively. All-cause mortality results were similar.

Conclusions

Although intensive systolic BP lowering resulted in greater early decline in eGFR, there was no evidence that the reduction in eGFR owing to intensive systolic BP lowering attenuated the beneficial effects of this intervention on cardiovascular events or all-cause mortality.
China: entre el sueño y la utopía
Authors: Barbosa Fernando
Published: July 2019

El propósito de este artículo es el de plantear que el formidable crecimiento de China en las últimas décadas se ha inspirado en el denominado “sueño chino”. Se mostrará que este propósito corresponde a un proceso de gran aliento que tiene raíces profundas y que está anclado en la historia y en la cultura de los chinos.
iGEM Calibration Protocol - Flow Cytometry Cell Size v1
Authors: Beal Jacob , Telmer Cheryl , Tennant Richard , Rutten Paul
Published: July 2019

Conversion from forward scatter to Eμm is not a linear function, so data cannot be converted simply by multiplying with a scaling factor. We thus recommend use of software tools for processing data with size calibration. This protocol can be combined with bead-based fluorescence calibration.
Renaming of modern Ukrainian oikonyms
Authors:   Taras Shevchenko national University of Kyiv, Kravchenko Liudmyla
Published: July 2019

The active nominating processes, caused by the necessity of renaming oikonyms and town objects, have started in the linguistic landscape of cities and villages of Ukraine. This article is dedicated to 32 names of Ukrainian cities before and after the decommunization process. Among the astionyms of the Soviet era, which were to be renamed, seven contained the component Krasny or Chervony, two of them contained the component Komsomol (Chervonopartyzansk, Krasny Lyman, Krasnoarmiysk, Komsomolsk), other names were based on pseudonyms or the names of party leaders and communist ideologues. In general, they were not distinguished by the variety of names neither in terms of the lexical base nor in the aspect of word-formation formants. As a result of the analysis of renamed oikonyms, two main directions of motivational processes were revealed: the first of them was the return of former (old) names to cities (20 units, 62,5%), and the second was the creation of new names (12 units, 37,5%). Returning the historical names, inhabitants, as a rule, took as the basis the names of former towns, villages, small villages, and sometimes microtoponyms and ergonyms, which denoted objects that had existed before, and around which the cities were formed (Kamyanske, Bakhmut, Snovsk, Kadiivka, Golubivka, Gorishni Plavni, Kypuche). New names were chosen for two reasons. The first reason was that the historical name of the city was inconceivable, alien and irrelevant for contemporary inhabitants, and the second reason was that there was no historical name. The new names were chosen primarily according to orientation-spatial and physical-geographical principles of the nomination. They were based on hydronyms, ergonyms and oikonyms, which were somehow tangent to renamed settlements (Kalmiuske, Podilsk, Dovzhansk, Pokrovsk, Zavodske). Only one name represents the memorable principle of the nomination (Kropyvnytsky) and one name represents an aesthetic criterion (Myrnograd). For further research, it is promising and relevant to study renamed comonyms (village names), as well as other classes of onyms, primarily urbanonyms and ergonyms.
Distorted Love: Mapplethorpe, the Neo/Classical Sculptural Black Nude, and Visual Cultures of Transatlantic Enslavement
Authors: Nixon Lindsay
Published: July 2019

In the fall of 2016 and the winter of 2017, the Montreal Museum of Fine Arts exhibited a retrospective of photography by Robert Mapplethorpe (1946-1989) entitled “Focus: Perfection.” Tenets of queer possibility exhibited in the “Sculptural Body” portion of “Focus: Perfection” depicted a white modernity that reproduced the biopolitics of the transatlantic slave trade among contemporary white and Black queer peoples in America—namely, in New York’s queer community—through the reinforcement and circulation of imagery depicting sexualized Black peoples in psychic and physical bondage. With his photographs depicting the body parts of Black men, Mapplethorpe reifies the biopolitics of the transatlantic slave trade in two ways. First, the classical use of marble as sculptural material, or in Mapplethorpe’s case the neoclassical use of photographed skin as sculptural material that references the classical use of marble, adheres to aesthetic principles devised from Western, colonial discourse that sexualize and degrade Black bodies. Secondly, Mapplethorpe reproduces what Michal Hatt has called a “structure of spectatorship. By constructing Black men’s bodies in inherent opposition to whiteness, no matter how idealized, it is a white audience that is presumed as the patron of Mapplethorpe’s sculptural photography of Black men. Given the themes of sadomasochism throughout Mapplethorpe’s photographs of Black men, these images outright reference fantasies of domination from an era transatlantic enslavement in the U.S. With “Focus: Perfection,” the MMFA unwittingly condoned Mapplethorpe’s portrayal of Black men in chattel bondage, available to be owned by Mapplethorpe’s presumed white viewership through intimate knowledge of, and control over, their bodies and sexual lives.
Fishy Pleasures: Unsettling Fish Hatching and Fish Catching on Pacific Frontiers
Authors: Woelfle-Erskine Cleo
Published: July 2019

In debates over Puget Sound salmon recovery, the Wild Steelhead Federation, a settler sportfishing advocate, argues that hatchery-raised steelhead lack fighting spirit, and figures them as unnatural. The Northwest Indian Fisheries Commission and its member tribes operate hatcheries as strategy for maintaining fish runs until degraded habitats can be restored, and figure hatcheries as one of many sites of making relations. Although the genetic science mobilized on all sides of this debate is fairly new, settler discourses that, on the one hand, blame tribal harvest for salmon decline and, on the other hand, construe sportfishing as central to settler family-making and masculinities, have roots going back to the notion of the frontier itself. As a slantwise intervention in this debate, I consider sportfishing as a site and strategy for making settler sexualities, by examining visual archives that document historical practices of sportfishing and the technologies on which contemporary salmon and trout sportfishing depends: the reservoir, the fish hatchery, and the fishing pole. Tracing arguments about Nature and settler masculinities back to the origins of fish culture in hatcheries through the writing of George Perkins Marsh, I argue labeling either normative settler sexualities and gender relations or the flooded spawning grounds beneath reservoirs as unnatural threatens co-constituted settler sexualities and reworkings of “natural” landscapes.
The impact of different conservation soil tillage and nitrogen fertilization on wheat grain infection with Fusarium sp.
Authors: Vrandečić Karolina , Jug Danijel , Ćosić Jasenka , Ilić Jelena , Jug Irena
Published: July 2019

The effect of different conservation soil tillage (CST) treatments and different level of nitrogen fertilization on Fusarium wheat grain infection on two locations are presented in this paper. The research was conducted on winter wheat with different soil tillage treatments: conventional tillage to 30 cm depth, subsoiling to 35-40 cm depth, chiselling up to 25 cm, disk-harrowing to 10-15 cm and no-tillage, without any tillage treatments and three different nitrogen rates (N1 - amount reduced by 30% of recommended; N2 - according to standard recommendation and N3 - amount increased by 30% of recommended). The occurrence of Fusarium species was determined in all the tested variants of tillage and fertilization treatments. The effect of reduced fertilization (N1) on Fusarium sp. grain infection in all tillage treatments was statistically lower in comparison with other (N2 and N3) nitrogen treatments. The lowest percentage of wheat grains infected with Fusarium sp. was recorded in conventional tillage on location Magadenovac and no tillage treatments on location Cacinci.
Researcher development in universities: Origins and historical context
Authors: Rospigliosi Asher , Bourner Tom
Published: July 2019

This article explores the origins of researcher development in British universities. Its principal aim is to provide a coherent, and reasonably succinct, account of the evolution and development of researcher development that is as consistent as possible with what is known about the
development of the Western university, the history of the research doctorate and the emergence of the research university. The main conclusion is that the origins of researcher development in the modern university can be found in the philology of the early modern university, which in turn
emerged from the accumulation of knowledge in Western Christendom from other places and other times. Other conclusions are that there was little researcher development in the medieval university, and that the 'traditional' model of researcher development, centred on the PhD, is much more recent
than is commonly supposed, so that, from a long-term perspective, the 'traditional model' may be but one stage in its continuing development. The article also develops a model that locates researcher development within a series of intellectual contexts: from the research process itself, to
the advancement of knowledge more generally, and, finally, to changes in conceptions of knowledge itself.
The problematic of tradition and future in art and design education
Authors: Nas Emine
Published: July 2019

In recent years, the traditional motifs and conceptual approach to the apparent authenticity of the design quality areobserved which are used in many areas. In this way, the tradition established in the future synthesis has led to the formationof a free and original design. Thus, new ideas to new situations, new problems have emerged in the need to turn to differentevents and phenomena. This method and the proliferation of studies aimed at the promotion of Turkish cultural heritageundoubtedly will be at the forefront of higher quality products. The suggestions of ‘interpreting the traditional designs’ andthe comprehension of what is ‘traditional’, as proposed by some academics and designers, are evaluated with a criticalapproach. The subject is examined within the frame of traditionalist suggestions offered from the time of the Ottomans tilltoday, with the conceptions of the Western science, culture, art and design developed through the period of the IndustrialRevolution. Keywords: Design; education; tradition; problem;
Single-Cell RNA Sequencing of Visceral Adipose Tissue Leukocytes Reveals that Caloric Restriction Following Obesity Promotes the Accumulation of a Distinct Macrophage Population with Features of Phagocytic Cells
Authors: Weinstock Ada , Brown Emily J. , Garabedian Michela L. , Pena Stephanie , Sharma Monika , Lafaille Juan , Moore Kathryn J. , Fisher Edward A.
Published: July 2019

Obesity can lead to type 2 diabetes and is an epidemic. A major contributor to its adverse effects is inflammation of the visceral adipose tissue (VAT). Life-long caloric restriction (CR), in contrast, results in extended lifespan, enhanced glucose tolerance/insulin sensitivity, and other favorable phenotypes. The effects of CR following obesity are incompletely established, but studies show multiple benefits. Many leukocyte types, macrophages predominantly, reside in VAT in homeostatic and pathological states. CR following obesity transiently increases VAT macrophage content prior to resolution of inflammation and obesity, suggesting that macrophage content and phenotype play critical roles. Here, we examined the heterogeneity of VAT leukocytes and the effects of obesity and CR. In general, our single-cell RNA-sequencing data demonstrate that macrophages are the most abundant and diverse subpopulation of leukocytes in VAT. Obesity induced significant transcriptional changes in all 15 leukocyte subpopulations, with many genes showing coordinated changes in expression across the leukocyte subpopulations. Additionally, obese VAT displayed expansion of one major macrophage subpopulation, which, in silico, was enriched in lipid binding and metabolic processes. This subpopulation returned from dominance in obesity to lean proportions after only 2 weeks of CR, although the pattern of gene expression overall remained similar. Surprisingly, CR VAT is dominated by a different macrophage subpopulation, which is absent in lean conditions. This subpopulation is enriched in genes related to phagocytosis and we postulate that its function includes clearance of dead cells, as well as excess lipids, contributing to limiting VAT inflammation and restoration of the homeostatic state.
Impact of RMT on Pulmonary Function and Vascular Compliance - a Case Report
Authors: Longoria Kevin , Bausek Nina , Aldarondo Sigfredo
Published: July 2019

Many lifestyle and occupational habits negatively impact on physical and mental health, increasing the risk of cardiovascular and other diseases. While larger institutions fulfill occupational health requirements to ensure their employees’ wellbeing at work, smaller business workers and entrepreneurs may neglect initial signs of stress or physical decline, putting themselves at increased risk. Early detection of compromised cardiopulmonary health or fitness has the potential to flag up indications for early interventions and reduce the risk of disease onset and progression. This case study highlights the usefulness of respiratory muscle training (RMT) in improving pulmonary and cardiovascular parameters as an early countermeasure to cardiopulmonary decline. We suggest RMT as an easily accessible, cost- and time effective opportunity to  support a healthy lifestyle.
PENGARUH KONSENTRASI STARTER Streptococcus thermophillus DAN LAMA FERMENTASI TERHADAP KARAKTERISTIK MINUMAN LAKTAT DARI BENGKUANG (Pachyrrhizus erosus)
Authors: Suharyono A. S. , Kurniadi Muhamad
Published: July 2019

Minuman laktat adalah minuman fermentasi yang dibuat dengan menggunakan starter bakteri asam laktat. Faktor
penting yang mempengaruhi keberhasilan dalam pembuatan minuman laktat ini adalah konsentrasi starter dan
waktu fermentasi. Masalah utama yang dihadapi adalah belum diketahui konsentrasi stater yang tepat dan waktu
fermentasi untuk menghasilkan minuman laktat dari bengkoang yang sesuai dengan standar produk minuman
laktat dan dengan karakteristik terbaik.
Penelitian ini bertujuan untuk memperoleh konsentrasi starter dan waktu fermentasi yang dapat menghasilkan
minuman laktat yang sesuai dengan standar produk minuman laktat dan dengan karakteristik terbaik. Percobaan
dalam penelitian ini terdiri atas dua faktor dan tiga kali ulangan. Faktor utama yang digunakan adalah
konsentrasi starter dan faktor kedua adalah waktu fermentasi pada proses pembuatan minuman laktat dari
bengkoang. Perlakuan konsentrasi starter (S) terdiri atas tga tahap yaitu 5%, 10% dan 15% (v/v) dan waktu
fermentasi (F) yang terdiri atas tiga tahap yaitu 18 jam, 20 jam dan 22 jam. Satu eksperimen menggunakan
volume 150 ml. Data hasil penelitian dianalisis secara deskriptif dan ditampilkan dalam bentuk tabel dan grafik.
Hasil penelitian ini adalah peningkatan konsentrasi starter dan waktu fermentasi memberikan pengaruh terhadap
peningkatan total bakteri asam laktat dan penerimaan rasa. Hasil penelitian menunjukkan bahwa perlakuan
terbaik dicapai pada perlakuan dengan konsentrasi starter 10% dan waktu fermentasi 22 jam dengan total asam
laktat 1,95%, pH 3,8, total bakteri asam laktat 9,67 log koloni/ml dan memiliki skor rasa 3,00 (agak suka).
Storage-Optimization Method for Massive Small Files of Agricultural Resources Based on Hadoop
Authors: Liu Jun ,   Facility Horticulture Laboratory of Universities in Shandong, Weifang University of Science and Technology Weifang, Shandong 262700, China
Published: July 2019

The main function of Hadoop is the storage and processing of big data, especially the processing of large datasets. However, in practice, there are numerous small files, and Hadoop has many flaws when dealing with these small files. A storage-optimization method for numerous agricultural resource small files based on Hadoop is proposed, using the precursor and subsequent relationship between different small files of agricultural resources to merge small files. By accessing small files and performing metadata caching through an index mechanism, as well as the prefetching mechanism of associated small files, the storage-optimization method improves the reading efficiency. Experimental results show that this method reduces the memory consumption of the Hadoop name node and improves the performance of the system.
Impact of Economic Policy Uncertainty on the Distribution of China’s Stock Returns: An External Perspective
Authors: Yao Yanyun , Yu Haijing , Wang Huimin , Tien-Liu Tsung-Kuo ,   Department of Applied Statistics, Shaoxing University 900 Chengnan Avenue, Yuecheng District, Shaoxing, Zhejiang 312000, China,   Research Institute of Economic Statistics and Quantitative Economics, Zhejiang Gongshang University 18 Xuezheng Road, Xiasha University Town, Hangzhou, Zhejiang 310018, China,   Office of Physical Education, Fu Jen Catholic University 8F.-2, No.127 Dazhong South Street, West District, Taichung City 40347, Taiwan
Published: July 2019

This study examines the impact of external economic policy uncertainty on the distribution of China’s stock returns. The Chinese Economic Policy Uncertainty (CEPU) and global EPU (GEPU) indexes compiled by [1] are employed as a measurement of the external uncertainty. An empirical study is conducted using the GARCH-MIDAS framework. The first innovation of this study is extending the symmetric GARCH-MIDAS model to the case of GJR; the leverage effect is therefore considered. The second innovation is considering the impact of EPU on the overall distribution of returns, rather than on the mean or volatility. Full-sample fitting shows that CEPU can explain around 14% of the return volatility, and CEPU together with GEPU can explain about 17%. Out-of-sample recursive forecasting demonstrates that it is meaningful to extend the models to GJR; the EPU information improves the return distribution forecasting. However, the impact of EPUs is limited, which implies that external uncertainty is quite different from the “internal” economic policy uncertainty directly driving the China’s stock market.
Scalable Change Detection Using Place-Specific Compressive Change Classifiers
Authors: Tanaka Kanji ,   University of Fukui 3-9-1 Bunkyo, Fukui, Fukui 910-8507, Japan
Published: July 2019

With recent progress in large-scale map maintenance and long-term map learning, the task of change detection on a large-scale map from a visual image captured by a mobile robot has become a problem of increasing criticality. In this paper, we present an efficient approach of change-classifier-learning, more specifically, in the proposed approach, a collection of place-specific change classifiers is employed. Our approach requires the memorization of only training examples (rather than the classifier itself), which can be further compressed in the form of bag-of-words (BoW). Furthermore, through the proposed approach the most recent map can be incorporated into the classifiers by straightforwardly adding or deleting a few training examples that correspond to these classifiers. The proposed algorithm is applied and evaluated on a practical long-term cross-season change detection system that consists of a large number of place-specific object-level change classifiers.
Designation of Candidate Solutions in Differential Evolution Based on Bandit Algorithm and its Evaluation
Authors: Sakakibara Masaya ,   Osaka Prefecture University 1-1 Gakuen-cho, Nakaku, Sakai, Osaka 599-8531, Japan, Notsu Akira , Ubukata Seiki , Honda Katsuhiro
Published: July 2019

We propose UCT-Grid Area Search (UCT-GAS), which is an efficient optimization method that roughly estimates specific values in areas, and consider exploration and exploitation in optimization problems. This approach divides the search space and imagines it to be a multi-armed bandit, which enables us to use bandit algorithms to solve mathematical programming problems. Although the search speed is fast than other search algorithm like differential evolution, it might converge to a local solution. In this study, we improve this algorithm by replacing its random search part with differential evolution after several searches. Comparative experiments confirmed the search ability of the optimal solution, and our method benefits by showing that it avoids falling into a local solution and that its search speed is fast.
Prediction of Shale-Gas Production at Duvernay Formation Using Deep-Learning Algorithm
Authors: Lee Kyungbook , Lim Jungtek , Yoon Daeung , Jung Hyungsik
Published: July 2019

Decline–curve analysis (DCA) is an easy and fast empirical regression method for predicting future well production. However, applying DCA to shale–gas wells is limited by long transient flow, a unique completion design, and high–density drilling. Recently, a long short-term-memory (LSTM) algorithm has been widely applied to the prediction of time–series data. Because shale–gas–production data are time–series data, the LSTM algorithm can be applied to predict future shale–gas production. After information for 332 shale–gas wells in Alberta, Canada, is obtained from a commercial database, the data are preprocessed in seven steps, including cutoffs for well list, data cleaning, feature extraction, train and test sets split, normalization, and sorting for input into the LSTM model. The LSTM model is trained in 405 seconds by two features of production data and a shut–in (SI) period from 300 wells. The two–feature case shows a better prediction accuracy than both the one–feature case (i.e., production data only) and the hyperbolic DCA, where the three methods are tested on unseen data from 15 wells. The two–feature case can predict future production rates according to the SI period and provide a stable result for available time–series data.
Voluntary Blood Donation Practice and Associated Factors among Civil Servants in Chiro Town of Western Hararghe Zone, Eastern Ethiopia: a Cross-sectional study
Authors: Mijena Gelana Fekadu , Nigussie Sintayehu , Gobena Tesfaye , Mitiku Habtamu , Abdi Hassen
Published: July 2019

Background

Despite blood transfusion has been available for the past 200 years; there is still a significant shortage of blood and blood products especially in low and middle income countries. In 2016 national blood demand of Ethiopia was estimated to be one million units per year, while only 17.4% (173,930) units of blood collected in the same year. Out of 25,400 units of blood requirement per year in West Hararghe, only 2750 units (10.8%) was collected in 2016 and 80% of these were from Civil servants. The aim of the study was to assess voluntary blood donation practice and associated factors among Chiro Town’s civil servants in 2018.

Methods

A cross-sectional study was conducted on 383 civil servants selected by multistage sampling technique. Data were collected using self-administer and pre-tested questionnaire. Data was analyzed using SPSS version 20 and binary logistic regression was performed to assess the association between determinant factors and voluntary blood donation practice. Adjusted odds ratios (AOR) with its 95% confidence interval (CI) were estimated to identify factors associated with the outcome variables in the multivariable analysis. A P<0.05 and AOR with 95% CI were used to report significance and strength of multivariable association, respectively.

Results

The life -time voluntary blood donation practice among civil servants was 43.7%(38.3,49.3). Having willingness to donate, [AOR=2.54; 95%CI=1.39, 4.65], being knowledgeable about blood donation [AOR=3.32; 95%CI=2.02, 5.46] and listening to mass media [AOR=1.83; 95%CI=1.01, 3.35] were variables significantly associated with voluntary blood donation practice.

Conclusions

This study shows poor Voluntary Blood donation practice while, having knowledge, willingness and access to mass media are attributable factors for blood donation practice in the study area.
The study of Wilson Disease in pregnancy management
Authors: Yu Xu-En , Pang Min , Han Yong-Zhu , Yang Ren-Min , Gao Shan
Published: July 2019

Abstract
Background: Pregnancy management in women with Wilson disease (WD) remains an important clinical problem. This research was conducted to investigate how to avoid worsening of WD symptoms during pregnancy and increase pregnancy success in women with WD by identifying the best pregnancy management approaches in these patients.

Methods: The clinical data of 117 pregnancies among 75 women with WD were retrospectively analyzed. Related information of the fetus was also recorded and analyzed. At the same time, regression analysis was performed for data of 22 pregnant women without WD, as normal controls.

Results: Of a total of 117 pregnancies among the 75 women with WD and 31 pregnancies among the 22control womenincluded in this study, there were 108 successful pregnancies and 9 spontaneous abortions. Among the 108 successful pregnancies, 97 women a history of copper chelation therapy before pregnancy; all 97 women stopped anti-copper therapy during pregnancy. The nine women with spontaneous abortion had no pre-pregnancy history of copper displacement therapy. The incidence of lower limb edema was higher in the WD group than in normal controls (P=0.036). Compared with the control group, there was a higher proportion in the WD group of male infants (P=0.022) and lower average infant birth weight (t=3.514, P=0.001).

Conclusion: It is relatively safe for women with WD patients to become pregnant. The best management method for pregnancy in women with WD may be intensive pre-pregnancy copper chelation therapy and no anti-copper treatment during pregnancy.
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Authors: SNG Ban Leong , Tan Daryl Jian'an , TAN Chin Wen , HAN Nian-Lin Reena , SULTANA Rehena , SIA Alex Tiong Heng
Published: July 2019

Background

We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodies in a novel algorithm that takes into account patients’ vital signs (oxygen saturation, heart rate). The system aims to allow responsive titration of personalized pain relief to optimise pain relief and reduce the risk of respiratory depression. Moreover, the system will be important to enable continuous monitoring of patients during delivery of opioid analgesia.

Methods

Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for up to 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.

Results

The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The average percentage time during treatment that oxygen saturation fell below 95% was 4.6%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median [IQR] pain scores at rest and at movement after post-op 24 hours were 0.0 [2.0] and 3.0 [2.0] respectively. The average ± SD morphine consumption in the first 24 hours was 12.5 ± 7.1mg. Majority of patients were satisfied with their experience with the VPIA analgesic infusion pump.

Conclusions

We have demonstrated the potential of VPIA analgesic infusion pump to increase the safety and patient satisfaction by incorporating vital signs monitoring to intravenous opioid analgesia.
Model Construction of Medical Endoscope Service Evaluation System-Based on the Analysis of Delphi Method
Authors: Zheng Jun , Lou Ligang , Xie Ying , Chen Siyao , Li Jun , Wei Jingming , Feng Jingyi
Published: July 2019

Background:
Medical endoscope is widely used in clinical practice for the purpose of diagnosis and treatment,occupying around 5% of the medical device market. Evaluating the true service level of medical endoscope is essential and necessary to improve overall performance of medical diagnosis and treatment, and to maintain competitiveness of endoscope manufacturers, however, such a tool is not available in the market. This study develops an Evaluation Index System (EIS) to assess service level of medical endoscope, and to provide suggestions for improving the service level through the Delphi method.

Methods:
Firstly, the possible factors influencing the service level were identified from literature review. In parallel, the Delphi expert method questionnaire was designed and 25 experts were invited to conduct three rounds of questionnaire, to evaluate and rate the possible factors. Finally, we determined the weights associated with the factors, using the analytic hierarchy process (AHP) and percentage method, and developed theservice level EIS.

Results:
The EIS consists of 3 first-level indicators, 24 second-level indicators and 68 third-level indicators. According to the weights computed using AHP, first-level indicators are ranked as post-sale (0.62), in-sale (0.25) and pre-sale (0.13). Through case verification, the medical endoscope brand Olympus had a total score of 4.17, Shanghai Aohua had a total score of 3.71, and Shanghai Chengyun had a total score of 3.28, which matches its market popularity and ranking in terms of market share. The results obtained from the EIS are consistent with the reality.

Conclusions:
The EIS established in this study is comprehensive, reliable and reasonable with strong practicality. The EIS can act as a tool for the endoscope users to evaluate potential products and make informed choices. It also provides a measurable basis for endoscope manufacturers and service providers to improve service quality.
The influence of depressive symptoms on the efficacy of a short-term group form of Schema Cognitive Behavioural Therapy for personality disorders: A naturalistic study
Authors: Koppers David , Van Henricus , Peen Jaap , Alberts Jet , Dekker Jack
Published: July 2019

Background
This naturalistic study looked at the effect of comorbid depressive symptoms on the outcomes – at treatment termination and three-month follow-up – of Short-Term Schema Cognitive Behavioural Therapy in groups for personality disorders.

Methods
We investigated 225 patients with personality disorders and comorbid depressive symptoms (PD-DEP) and patients without comorbidity (PD), focusing on symptom and schema severity and coping styles. We also measured the rate of symptom remission. The data obtained were subjected to multilevel analysis.

Results
Psychiatric symptoms and maladaptive schemas improved in both patient groups. Effect sizes were moderate. It proved more difficult to improve coping styles. Symptom remission was achieved in the minority of the total sample There were no differences in outcome between PD and PD-DEP at treatment termination. Psychiatric symptoms were more severe among PD-DEP patients at follow-up.

Conclusion
A short-term form of schema therapy in groups proved to be an effective approach for a broad group of patients with personality disorders, however, the majority of patients did not achieve symptom remission. This indicates that this type of short-term group therapy should be considered a valuable first step in a stepped-care model.
Management and outcome of pelvic fracture associated with vaginal injuries: a retrospective study of 25 cases
Authors: Li Pengyu , Zhou Dongsheng , Fu Baisheng , Song Wenhao , Dong Jinlei
Published: July 2019

Backgound: Pelvic ring fractures associated with vaginal injuries were rarely reported due to low incidence. We hope a retrospective study containing a relatively large number of patients would help improve clinical outcome.
Methods: We conducted a retrospective review of 25 patients with pelvic fractures associated with vaginal injury treated at our institution. The records of these patients were collected and 24 patients were followed-up for 10-36 months.
Results: All patients suffered anterior pelvic ring fracture. Disruption of anterior ring and Young-Burgess classification of bony fracture seemed to be related to severity vaginal injury. Gauze packing was done in 6 patients and 18 patients received surgical repair. Infection occurred in 6 patients among them 4 were due to delayed diagnosis. Factors associated with pelvic outcome were age, urethral injury, fixation strategy, infection and accuracy of reduction. Four patients suffered pain in sexual intercourse but no influence factor found correlated to sexual function due to small case series.
Conclusion: From our data, pelvic fractures caused by vertical shear forces and compromise pubic symphysis showed higher severity of vaginal injury. Age, associated urethral injury, fixation strategy and infection are prognostic factors of pelvic result. Significant relationship was shown between radiological and clinical outcomes. A thorough vaginal examination should be performed in female patients with pelvic fractures especially those with disruption of anterior pelvic ring to avoid missed diagnosis of vaginal laceration.
Key words: Pelvic fracture, Vaginal injury, Clinical outcome
New strategy of color and power doppler sonography combined with DMSA in the assessment of acute pyelonephritis in infants
Authors: Chen Min Guang , Yang Yan , Yang Qing , Zhuang Jie Qiu , Ye Xiao Hua , Zheng Wen Jie
Published: July 2019

Objectives

The purpose of this study was to evaluate the clinical value of color and power doppler sonography (CPDS) when combined it with 99mTc-dimercaptosuccinic acid scintigraphy (DMSA) in assessment of acute pyelonephritis (APN) in infants.

Methods

A total of 79 children with APN , including 52 males and 27 females, age range 1 month to 3 years old. All patients underwent laboratory inspection including urinary routine test, clean medium urine culture, urinary β2 microglobulin (β2-MG), urinary N-acetylglucosaminidase (NAG), blood routine test, C-reactive protein(CRP), renal function, serum electrolyte and urinary ultrasound. All 79 patients underwent CPDS and DMSA within 48 hours of fever.

Results

All 79 patients with fever. The peripheral blood routine showed elevated white blood cells in 75 cases, normal in 4 cases, CRP increased in 77 cases, normal in 2 cases. Urine β2-MG increased in 40 cases and normal in 39 cases. Urinary ultrasonography revealed 2 cases of renal cortical echo changes, 24 cases of kidney enlargement, and 1 left kidney shrinkage. Among 79 children, DMSA showed abnormal findings in 95 kidneys and CPDS, in 105 kidneys. The total sensitivity of CPDS was 69.4%, and the total positive predictive value was 62.8%. The sensitivity of CPDS under 6 months was 56.9%, which was 84.2% between 6 months to 1 year, and 94.4% from 1 to 3 years old, respectively. There was no significant correlation between CPDS levels and DMSA positive results. The abnormal rate of intermediate part in the kidneys was significantly lower than that in the upper and lower poles. Children with abnormal CPDS have a greater risk of renal scarring(p<0.05).

Conclusion

The sensitive of CPDS is highly age-related, it can as a non-invasive tool for assessment of acute pyelonephritis in infants, especially for infants more than 6 months old. CPDS is useful to be combined with DMSA to assess the APN of infants, for infants more than 6 months with febrile urinary tract infections, CPDS is the first recommendation, and followed by DMSA six months later to assess renal scar formation. For those less than 6 months, the DMSA assessment is still the preferred choice.
Gene expression profile of human T cells following a single stimulation of peripheral blood mononuclear cells with anti-CD3 antibodies
Authors: Sousa Isabel Garcia , Simi Kelly Cristina Rodrigues , Almo Manuela Maragno do , Bezerra Maryani Andressa Gomes , Doose Gero , Raiol Taina , Stadler Peter F , Hoffmann Steve , Maranhão Andrea Queiroz , Brigido Marcelo M
Published: July 2019

Background: Anti-CD3 immunotherapy was initially approved for clinical use for renal transplantation rejection prevention. Subsequently, new generations of anti-CD3 antibodies have entered clinical trials for a broader spectrum of therapeutic applications, including cancer and autoimmune diseases. Despite their extensive use, little is known about the exact mechanism of these molecules, except that they are able to activate T cells, inducing an overall immunoregulatory and tolerogenic behavior. To better understand the effects of anti-CD3 antibodies on human T cells, PBMCs were stimulated, and then, we performed RNA-seq assays of enriched T cells to assess changes in their gene expression profiles. In this study, three different anti-CD3 antibodies were used for the stimulation: two recombinant antibody fragments, namely, a humanized and a chimeric FvFc molecule, and the prototype mouse mAb OKT3.
Results: Gene Ontology categories and individual immunoregulatory markers were compared, suggesting a similarity in modulated gene sets, mainly those for immunoregulatory and inflammatory terms. Upregulation of interleukin receptors, such as IL2RA, IL1R, IL12RB2, IL18R1, IL21R and IL23R, and of inhibitory molecules, such as FOXP3, CTLA4, TNFRSF18, LAG3 and PDCD1, were also observed, suggesting an inhibitory and exhausted phenotype.
Conclusions: In conclusion, we used a deep transcriptome sequencing method for comparing three anti-CD3 antibodies in terms of Gene Ontology enrichment and immunological marker expression. The present data showed that both recombinant antibodies induced a compatible expression profile, suggesting that they might be candidates for a closer evaluation with respect to their therapeutic value. Moreover, the proposed methodology is amenable to be more generally applied for molecular comparison of cell receptor dependent antibody therapy.
Molecular analysis of Blastocystis sp. and its subtypes from treated wastewater routinely used for irrigation of vegetable farmlands in Iran
Authors: Javanmard Ehsan , Rahimi Hanieh Mohammad , Niyyati Maryam , Aghdaei Hamid Asadzadeh , Sharifdini Meysam , Mirjalali Hamed , Zali Mohammad Reza , Karanis Panagiotis
Published: July 2019

Treated wastewater samples were collected, filtered using sterile 47-mm cellulose nitrate membrane and DNA extracted from the filtered materials. The presence of Blastocystis sp. was confirmed via polymerase chain reaction (PCR) targeting the SSU rRNA gene of Blastocystis sp. in 5/12 of samples. Based on the subtype analysis after sequencing, 2, 2 and 1 of ST2, ST6 and ST8 were detected among the isolates, respectively. Furthermore, both ST6s were allele 139, alleles 11 and 138 were identified in ST2 and the only ST8 was allele 95. The phylogenetic tree showed that one of ST2 was clustered together with those ST2 that were already reported from humans and animals. The presence of Blastocystis sp. in treated wastewater can indicate the potential role of this type of water for irrigation in the transmission of pathogenic microorganisms to downstream farmlands.
Occurrence and molecular characterisation of Acanthamoeba isolated from recreational hot springs in Malaysia: evidence of pathogenic potential
Authors: Mohd Hussain Rosnani Hanim , Ishak Ahmad Razali , Abdul Ghani Mohamed Kamel , Ahmed Khan Naveed , Siddiqui Ruqaiyyah , Shahrul Anuar Tengku
Published: July 2019

This study aimed to identify the Acanthamoeba genotypes and their pathogenic potential in five recreational hot springs in Peninsular Malaysia. Fifty water samples were collected between April and September 2018. Physical parameters of water quality were measured in situ while chemical and microbiological analyses were performed in the laboratory. All samples were filtered through the nitrocellulose membrane and tested for Acanthamoeba using both cultivation and polymerase chain reaction (PCR) by targeting the 18S ribosomal RNA gene. The pathogenic potential of all positive isolates was identified using thermo- and osmotolerance tests. Thirty-eight (76.0%) samples were positive for Acanthamoeba. Water temperature (P = 0.035), chemical oxygen demand (P = 0.026), sulphate (P = 0.002) and Escherichia coli (P < 0.001) were found to be significantly correlated with the presence of Acanthamoeba. Phylogenetic analysis revealed that 24 samples belonged to genotype T4, nine (T15), two (T3) and one from each genotype T5, T11 and T17. Thermo- and osmotolerance tests showed that 6 (15.79%) of the Acanthamoeba strains were highly pathogenic. The existence of Acanthamoeba in recreational hot springs should be considered as a health threat among the public especially for high-risk people. Periodic surveillance of hot spring waters and posting warning signs by health authorities is recommended to prevent disease related to pathogenic Acanthamoeba.
Clonal Relatedness, Phylotyping and Antimicrobial Susceptibility of Extended- spectrum-beta-lactamase Producing Uropathogenic Escherichia coli Isolates from Outpatients and Inpatients
Authors: Azimzadeh Negar , Derakhshandeh Abdollah , Motamedifar Mohammad , Naziri Zahra
Published: July 2019

Objectives:

Antibiotic resistance, phylogenetic groups and Pulsed-Field Gel Electrophoresis
(PFGE) patterns were evaluated in urinary tract infection (UTI) Escherichia coli (E. coli)
isolates from outpatients and inpatients.

Methods:

In this study, antibiotic resistance to E. coli isolated from non-hospitalized and hospitalized
patients (153 outpatients and 147 inpatients ) was evaluated in Shiraz County, Iran. Phylogenetic
groups and Pulse Field Gel Electrophoresis (PFGE) patterns of 143 ESBLs-producing E. coli
were also assessed.

Results:

The prevalence of ESBL-producing E. coli was shown to be 46.4% and 49% in the outpatient
and inpatient UTI E. coli isolates, respectively. Most ESBL-producers were detected on patients
hospitalized in clinical surgery units (66.7%) and intensive care units (62.5%). Phylogenetic
group D was the dominant group in both the outpatient and inpatient isolates (67.6% and 61.1%,
respectively) and also in internal, clinical surgery and ICU units. PFGE results showed more relatedness
(>80% similarity) among inpatient isolates. PFGE analysis of 49 ESBL-producing inpatient
E.coli in hospital units revealed 17 different pulsotypes, consisting of 11 clones and 6 single
patterns. There were no clonal patterns in outpatient isolates, and similarity among the outpatient
isolates and also between inpatient and outpatient isolates was less than 80% (75% and 66%, respectively).

Conclusions:

The results showed extreme genomic diversity among the ESBL-producing E. coli
isolates in terms of the community and multiclonal dissemination of ESBL-producing E. coli isolated
from hospital units.
Suicide by Inhalation of Carbon Monoxide of Car Exhausts Fumes
Authors: Valente-Aguiar Murilo Sérgio , Magalhães Teresa , Dinis-Oliveira Ricardo Jorge
Published: July 2019

Background:

Carbon monoxide (CO) is a major and ubiquitous component of fire atmospheres
produced when organic matter is burned in an inadequate supply of oxygen. Accidental
poisoning by CO is common in cold climates where fireplaces, a gas, electric or kerosene heaters or
grills are used inside ill-ventilated buildings. In the Brazilian Amazon, with its hot and humid climate,
there is no need for the use of heaters and accidents may occur in cases of residential fires or
burning of the forests for land use in agriculture.

Objective:

We present a case of CO suicide of twenty-six-year-old men.

Methods:

A forensic autopsy was performed to evaluate the circumstances, cause and medio-legal
death etiology.

Results:

Autopsy evidenced the typical but also not commonly published cherry-red color of the hypostasis,
lungs and other organs, and the very fluid cherry-red blood. The cause of death was due to
a massive CO inhalation.

Conclusion:

While these poisonings are well recognized, and a vast number of publications on CO
toxicity exist, both in an environmental and industrial context, suicide is infrequently encountered in
forensic practice and the typical signs are rarely seen in the literature.
Полнопольный оптический когерентный томограф на базе микропрофилометра МИИ-4 с использованием микрообъективов с воздушной иммерсией
Authors: Абдурашитов А.С. , Гришин О.В. , Намыкин А.А. , Тучин В.В.
Published: July 2019

A modernized Linnik micro profilometer (MII-4) is introduced for the tomographic studies of transparent and relatively turbid media using air-immersion objectives. The construction of the reference channel
in standard MII-4 is reworked by adding the dynamic adjustment of reference arm length to compensate for the effect of the divergence between focal and coherent volumes, as well as spherical aberration arising from the focusing of the optical system into the deeper layers of an object without using immersion. An analysis of existing technical solutions for the reference arm is done, their main disadvantages are indicated. All stages are described including assembling and adjusting the system. The device was able to perform a tomographic studies transparent and turbid layered objects.