bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of short moderate intensity exercise bouts on cardiovascular function and maximal oxygen consumption in sedentary older adults
Authors: Magutah Karani , Thairu Kihumbu , Patel Nilesh
Published: February 2020

Aim

To investigate effect of <10 min moderate intensity exercise on cardiovascular function and maximal oxygen consumption (V˙O2max) among sedentary adults.

Methods

We studied 53 sedentary urbanites aged ≥50 years, randomised into: (1) male (MS) and (2) female (FS) undertaking three short-duration exercise (5–10 min) daily, and (3) male (ML) and (4) female (FL) exercising 30–60 min 3–5 days weekly. Resting systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate andV˙O2max were measured at baseline and 8 weekly for 24 weeks.

Results

At baseline, 50% MS, 61.5% ML, 53.8% FSand 53.8% FLhad SBP ≥120 mm Hg, and 14.3% MS, 53.8% ML, 23.1% FSand 38.5% FLhad DBP ≥80 mm Hg. At 24 weeks, where SBP remained ≥120 mm Hg, values decreased from 147±19.2 to 132.3±9.6 mm Hg (50% of MS), from 144±12.3 to 128±7.0 mm Hg (23.1% of ML), from 143.1±9.6 to 128.0±7.0 mm Hg (53.8% of FS) and from 152.3±23.7 to 129±3.7 mm Hg (30.8% of FL). For DBP ≥80 mm Hg, MSand FSpercentages maintained, but values decreased from 101±15.6 to 84.5±0.7 mm Hg (MS) and 99.0±3.6 to 87.7±4.9 mm Hg (FS). In MLand FL, percentage with DBP ≥80 mm Hg dropped to 15.4% (86.1±6.5 to 82.5±3.5 mm Hg) and (91.4±5.3 to 83.5±0.71 mm Hg).V˙O2max increased from 26.1±4.4 to 32.0±6.2 for MS, from 25.8±5.1 to 28.8±5.4 for ML(group differences p=0.02), from 20.2±1.8 to 22.7±2.0 for FSand from 21.2±1.9 to 24.2±2.7 for FL(groups differences p=0.38).

Conclusion

Accumulated moderate intensity exercise bouts of <10 min confer similar-to-better cardiovascular andV˙O2max improvements compared with current recommendations among sedentary adults.
Perceptions of the osteopathic profession in New York City’s Chinese Communities
Authors: Chin Justin , Li Sarah , Yim Gregory , Zhou YaQun Arlene , Wan Peter Justin , Dube Emily R , Volokitin Mikhail , Sahni Sonu , Terrell Mark A , Lomiguen Christine M
Published: February 2020

Objective

The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC).

Design

A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine.

Setting

Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York, New York borough of Manhattan.

Participants

Community members were selected using convenience sampling from high-density areas to participate. Information gathered from the survey included demographics, education level, healthcare habits and knowledge of the osteopathic profession.

Results

120 surveys were conducted with 68 males and 52 females, with an average age=40. Respondents in the age range of 18–29 years, those with fluent English-language proficiency, and participants with graduate-level education status demonstrated a higher proportion of knowledge of osteopathic manipulative medicine and osteopathic physicians (doctors of osteopathic medicine) among the study variables.

Conclusion

Compared with research on the general US population, a general lack of knowledge of osteopathic medicine exists within NYC’s Chinese immigrant community. Although this difference may be ascribed to linguistics and ethnosociological factors, greater outreach and education is needed in urban minority communities to make immigrants aware of all healthcare resources available during the current shortage of US primary care physicians.
Efficient acute and chronic infection of stem cell-derived hepatocytes by hepatitis C virus
Authors: Carpentier Arnaud , Sheldon Julie , Vondran Florian W R , Brown Richard JP , Pietschmann Thomas
Published: February 2020

Objective and design

Human stem cell-derived hepatocyte-like cells (HLCs) have shown high potential as authentic model for dissection of the HCV life cycle and virus-induced pathogenesis. However, modest HCV replication, possibly due to robust innate immune responses, limits their broader use. To overcome these limitations and to dissect the mechanisms responsible for control of HCV, we analysed expression of key components of the interferon (IFN) system in HLCs, assessed permissiveness for different HCV strains and blocked innate immune signalling by pharmacological intervention.

Results

Transcriptional profiling revealed that HLCs constitutively express messenger RNA of RLRs, and members of the IFN pathway. Moreover, HLCs upregulated IFNs and canonical interferon-regulated genes (IRGs) upon transfection with the double-stranded RNA mimic poly(I:C). Infection of HLCs with Jc1-HCVcc produced only limited viral progeny. In contrast, infection with p100, a Jc1-derived virus population with enhanced replication fitness and partial resistance to IFN, resulted in robust yet transient viraemia. Viral titres declined concomitant with a peak of IRG induction. Addition of ruxolitinib, a JAK/STAT inhibitor, permitted chronic infection and raised p100 infectious virus titres to 1×105FFU/mL. IRGs expression profiling in infected HLCs revealed a landscape of HCV-dependent transcriptional changes similar to HCV-infected primary human hepatocytes, but distinct from Huh-7.5 cells. Withdrawal of ruxolitinib restored innate immune responses and resulted in HCV clearance.

Conclusion

This authentic human cell model is well suited to examine acute and chronic host-HCV interactions, particularly IFN-triggered antiviral effector functions and mechanisms of innate immune control of HCV infection.
Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension
Authors: Tripathi Dhiraj , Stanley Adrian J , Hayes Peter C , Travis Simon , Armstrong Matthew J , Tsochatzis Emmanuel A , Rowe Ian A , Roslund Nicholas , Ireland Hamish , Lomax Mandy , Leithead Joanne A , Mehrzad Homoyon , Aspinall Richard J , McDonagh Joanne , Patch David
Published: February 2020

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.
Interstitial lung disease is a risk factor for ischaemic heart disease and myocardial infarction
Authors: Clarson Lorna Elise , Bajpai Ram , Whittle Rebecca , Belcher John , Abdul Sultan Alyshah , Kwok Chun Shing , Welsh Victoria , Mamas Mamas , Mallen Christian D
Published: February 2020

Objectives

Despite many shared risk factors and pathophysiological pathways, the risk of ischaemic heart disease (IHD) and myocardial infarction (MI) in interstitial lung disease (ILD) remains poorly understood. This lack of data could be preventing patients who may benefit from screening for these cardiovascular diseases from receiving it.

Methods

A population-based cohort study used electronic patient records from the Clinical Practice Research Datalink and linked Hospital Episode Statistics to identify 68 572 patients (11 688 ILD exposed (mean follow-up: 3.8 years); 56 884 unexposed controls (mean follow-up: 4.0 years), with 349 067 person-years of follow-up. ILD-exposed patients (pulmonary sarcoidosis (PS) or idiopathic pulmonary fibrosis (PF)) were matched (by age, sex, registered general practice and available follow-up time) to patients without ILD or IHD/MI. Rates of incident MI and IHD were estimated. HRs were modelled using multivariable Cox proportional hazards regression accounting for potential confounders.

Results

ILD was independently associated with IHD (HR 1.85, 95% CI 1.56 to 2.18) and MI (HR 1.74, 95% CI 1.44 to 2.11). In all disease categories, risk of both IHD and MI peaked between ages 60 and 69 years, except for the risk of MI in PS which was greatest <50 years. Men with PF were at greatest risk of IHD, while women with PF were at greatest risk of MI.

Conclusions

ILD, particularly PF, is independently associated with MI and IHD after adjustment for established cardiovascular risk factors. Our results suggest clinicians should prioritise targeted assessment of cardiovascular risk in patients with ILD, particularly those aged 60–69 years. Further research is needed to understand the impact of such an approach to risk management.
Contemporary issues in severe aortic stenosis: review of current and future strategies from the Contemporary Outcomes after Surgery and Medical Treatment in Patients with Severe Aortic Stenosis registry
Authors: Taniguchi Tomohiko , Morimoto Takeshi , Takeji Yasuaki , Kato Takao , Kimura Takeshi
Published: February 2020

Contemporary Outcomes after Surgery and Medical Treatment in Patients with Severe Aortic Stenosis (CURRENT AS) registry was a large Japanese multicentre retrospective registry of consecutive patients with severe aortic stenosis (AS) before introduction of transcatheter aortic valve implantation. We sought to overview the data from the CURRENT AS registry to discuss the three major contemporary issues related to clinical practice in patients with severe AS: (1) under-referral/underuse of surgical aortic valve replacement (SAVR) in symptomatic patients with severe AS, (2) management of asymptomatic patients with severe AS and (3) management of patients with low-gradient severe aortic stenosis (LG-AS). First, despite the dismal prognosis of symptomatic patients with severe AS, SAVR, including those performed during follow-up, was reported to be underused. In the CURRENT AS registry, overall 53% of symptomatic patients underwent aortic valve replacement (AVR) during follow-up. Second, we reported that compared with conservative strategy, initial AVR strategy was associated with lower risk of all-cause death and heart failure hospitalisation in asymptomatic patients with severe AS. Although current recommendations for AVR are mainly dependent on the patient symptoms, some patients may not complain of any symptom because of their sedentary lifestyle. We also reported several important objective factors associated with worse clinical outcomes in asymptomatic patients with severe AS for risk stratification. Finally, initial AVR strategy was associated with better long-term clinical outcomes than conservative strategy in both patients with high-gradient AS and patients with LG-AS. The favourable effect of initial AVR strategy was also seen in patients with LG-AS with left ventricular ejection fraction of ≥50%.
T-cell lymphoma secondary to checkpoint inhibitor therapy
Authors: Anand Kartik , Ensor Joe , Pingali Sai Ravi , Hwu Patrick , Duvic Madeleine , Chiang Stephen , Miranda Roberto , Zu Youli , Iyer Swaminathan
Published: February 2020

Background

Murine model suggests programmed cell death-1 (PD-1), an immune checkpoint not only plays role in tumor escape but is also a tumor suppressor for T-cells. But until, no reports of secondary T-cell lymphoma postuse of immune checkpoint inhibitors (ICIs) has been reported. Herein, we present a hitherto unreported phenomenon of secondary T-cell lymphoma when PD-1 inhibitor was used in a patient diagnosed with a tumor of epithelial origin.

Case report

A man in mid-70s presented with biopsy-proven metastatic tumor of epithelial origin. Patient received carboplatin in combination with paclitaxel for four cycles leading to partial remission. The patient was subsequently switched to pembrolizumab due to persistent disease in the mediastinum. After four cycles of PD-1 inhibitor, patient presented with progression of disease and was diagnosed with biopsy-proven peripheral T-cell lymphoma-not otherwise specified. Based on the reported tumor suppressor function of PD-1 in murine models, we hypothesized that the use of PD-1 inhibitor caused clonal proliferation of abnormal T-cell clone leading to T-cell lymphoma. T-cell receptor (TCR) sequencing was performed by TCRβ sequencing and T-cell clones from pre-ICI treatment specimen were compared with post-ICI treatment specimens. We show that one of the T-cell clones present in pre-ICI treatment specimen at a low frequency of had massive expansion to become most dominant clone in post-ICI treatment specimens leading to lymphoma. Moreover, targeted exome sequencing revealed a new TET2 mutation in the clone representing the lymphoma.

Next, we retrospectively reviewed the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS), the pharmacovigilance database from 2012 to 2018 to find the reported incidence of this phenomenon and calculated the reporting OR (ROR) for disproportionality analysis for risk of T-cell lymphoma due to checkpoint inhibitors compared with other drugs. In FAERS, the incidence of T-cell lymphoma post-ICIs (pembrolizumab, nivolumab and ipilimumab) was found to be 0.02% with 17% mortality. The ROR probability of risk of T-cell lymphoma compared with other drugs in pharmacovigilance database was increased at 1.91.

Conclusions

T-cell lymphoma is a rare sequela of ICIs with high mortality. Larger studies with long-term follow-up of patients receiving ICIs is needed.
Salvage ipilimumab associated with a significant response in sarcomatoid renal cell carcinoma
Authors: George Gemlyn , Schmidt Laura , Tolat Parag , Riese Mathew , Kilari Deepak
Published: February 2020

Background

Metastatic sarcomatoid renal cell carcinoma (sRCC) is an aggressive variant of RCC with generally poor prognosis. Treatment with vascular endothelial growth factor inhibitors or chemotherapy generates only short-lived responses. Recent research has suggested a role for combination checkpoint inhibition as first line treatment for metastatic sRCC. This therapy consists of induction with cytotoxic T-lymphocyte-associated protein 4 inhibitor, ipilimumab, administered with programmed cell death protein 1 (PD-1) inhibitor, nivolumab. After completion of four cycles of combination therapy, single-agent maintenance nivolumab is recommended until progression. Patients who progress on maintenance nivolumab are switched to alternate therapy. Herein, we present a case of a patient with RCC who progressed on maintenance nivolumab who, on retreatment with ipilimumab, demonstrated a significant response In addition, we summarize important findings to support the role of salvage ipilimumab in patients with sRCC.

Case presentation

A 46-year-old man presented with flank pain and hematuria, the work up of which noted a left kidney mass for which he underwent nephrectomy and was diagnosed with localized sRCC with 60% sarcomatoid differentiation. Within 3 months of nephrectomy, he presented with recurrent flank pain and was diagnosed with recurrence of disease. He was treated with ipilimumab 1 mg/kg and nivolumab 3 mg/kg for four doses and demonstrated a partial response. He was then transitioned to single agent nivolumab maintenance. After 3 months on maintenance therapy, he was noted to have progression of disease. Given prior response to immune check point combination, it was decided to rechallenge the patient with 1 mg/kg ipilimumab. After two doses of ipilimumab and nivolumab combination therapy, the patient was noted to have a partial response. He maintained a response for an additional 9 months and treatment was eventually discontinued due to grade 3 toxicity and progression.

Conclusions

This case report demonstrates the utility of retreatment with ipilimumab as a salvage option for patients progressing on maintenance PD-1 inhibitors in metastatic RCC. Further studies are needed to identify predictors of response and toxicity to this approach, as well as the optimal scheduling of ipilimumab with maintenance nivolumab.
Randomized phase II study of the Bruton tyrosine kinase inhibitor acalabrutinib, alone or with pembrolizumab in patients with advanced pancreatic cancer
Authors: Overman Michael , Javle Milind , Davis Richard E , Vats Pankaj , Kumar-Sinha Chandan , Xiao Lianchun , Mettu Niharika B , Parra Edwin R , Benson Al B , Lopez Charles D , Munugalavadla Veerendra , Patel Priti , Tao Lin , Neelapu Sattva , Maitra Anirban
Published: February 2020

Background

The immunosuppressive desmoplastic stroma of pancreatic cancer represents a major hurdle to developing an effective immune response. Preclinical studies in pancreatic cancer have demonstrated promising anti-tumor activity with Bruton tyrosine kinase (BTK) inhibition combined with programmed cell death receptor-1 (PD-1) blockade.

Methods

This was a phase II, multicenter, open-label, randomized (1:1) clinical trial evaluating the BTK inhibitor acalabrutinib, alone (monotherapy) or in combination with the anti-PD-1 antibody pembrolizumab (combination therapy). Eligible patients were adults with histologically confirmed metastatic or locally advanced unresectable pancreatic ductal adenocarcinoma with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≤1 who had received at least one prior systemic therapy. Oral acalabrutinib 100 mg twice daily was administered with or without intravenous pembrolizumab 200 mg on day 1 of each 3-week cycle. Peripheral blood was analyzed for changes in immune markers, and tumors from exceptional responders were molecularly analyzed.

Results

A total of 77 patients were enrolled (37 monotherapy; 40 combination therapy) with a median age of 64 years; 77% had an ECOG PS of 1. The median number of prior therapies was 3 (range 1–6). Grade 3–4 treatment-related adverse events were seen in 14.3% of patients in the monotherapy arm and 15.8% of those in the combination therapy arm. The overall response rate and disease control rate were 0% and 14.3% with monotherapy and 7.9% and 21.1% with combination therapy, respectively. Median progression-free survival was 1.4 months in both arms. Peripheral blood flow analysis demonstrated consistent reductions in granulocytic (CD15+) myeloid-derived suppressor cells (MDSCs) over time. Two exceptional responders were found to be microsatellite stable with low tumor mutation burden, low neoantigen load and no defects in the homologous DNA repair pathway.

Conclusions

The combination of acalabrutinib and pembrolizumab was well tolerated, but limited clinical activity was seen with either acalabrutinib monotherapy or combination therapy. Peripheral reductions in MDSCs were seen. Efforts to understand and target the pancreatic tumor microenvironment should continue.

Trial registration number

NCT02362048.
Deficient serum furin predicts risk of abdominal obesity: findings from a prospective cohort of Chinese adults
Authors: He Yan , Ren Liyun , Zhang Qiu , Zhang Mingzhi , Shi Jijun , Hu Weidong , Peng Hao
Published: February 2020

Background

As a key enzyme of natriuretic peptides system playing an integral role in energy homeostasis, furin may be a potential contributor to obesity. However, the association between furin and obesity has been scarcely studied. This study aims to examine the prospective association between serum furin and abdominal obesity.

Methods

Waist circumference (WC) was measured twice 4 years apart for a total of 892 Chinese adults free of abdominal obesity at baseline. Abdominal obesity was defined as WC over 85 cm for men and as WC over 80 cm for women. A Cox proportional hazard model was constructed to examine the association of baseline serum furin with incident abdominal obesity.

Results

After an average 4 years of follow-up, 184 participants developed new abdominal obesity. Baseline serum furin was significantly associated with dynamic body weight during follow-up (β=−0.593, p=0.003). Participants with a higher level of serum furin at baseline were less likely to develop new abdominal obesity compared with those with a lower level of serum furin (HR=0.81, 95% CI 0.67 to 0.97).

Conclusions

A lower level of serum furin predicts a higher risk of developing future abdominal obesity in Chinese adults. Furin deficiency may be a contributor to abdominal obesity but still needs further investigations.
H2FPEF score predicts 1-year rehospitalisation of patients with heart failure with preserved ejection fraction
Authors: Tao Yifei , Wang Wenjing , Zhu Jing , You Tao , Li Yi , Zhou Xiang
Published: February 2020

Background

Heart failure with preserved ejection fraction (HFpEF) has received widespread attention in recent years. There is currently a lack of valuable predictors for the prognosis of this disease. Here, we aimed to identify a non-invasive scoring system that can effectively predict 1-year rehospitalisation for patients with HFpEF.

Methods

We included 151 consecutive patients with HFpEF in a prospective cohort study and investigated the association between H2FPEF score and 1-year readmission for heart failure using multivariate Cox regression analysis.

Results

Our findings indicated that obesity, age >70 years, treatment with ≥2 antihypertensives, echocardiographic E/e’ ratio >9 and pulmonary artery pressure >35 mm Hg were independent predictors of 1-year readmission. Three models (support vector machine, decision tree in R and Cox regression analysis) proved that H2FPEF score could effectively predict 1-year readmission for patients with HFpEF (area under the curve, 0.910, 0.899 and 0.771, respectively; p<0.001).

Conclusion

Our study demonstrates that the H2FPEF score has excellent predictive value for 1-year rehospitalisation of patients with HFpEF.
Analysis of judicial precedent cases regarding epidural injection in chronic pain management in Republic of Korea
Authors: Cho Soo Ick , Shin SuHwan , Jung Haesun , Moon Jee Youn , Lee Ho-Jin
Published: February 2020

Background

Although there is a low incidence of complications associated with epidural injections, pain physicians should still remain vigilant for potentially serious adverse outcomes. This study aimed to identify and describe the major complications of epidural injections.

Methods

This retrospective, observational, medicolegal study analyzed closed cases of precedents involving complications of epidural injections from January 1997 to August 2019 using the database of the Supreme Court of Korea’s judgement system. Clinical characteristics and judgement statuses were analyzed.

Results

Of the 73 potential cases assessed for eligibility, a total of 49 malpractice cases were included in the final analysis. Thirty-three claims resulted in payments to the plaintiffs, with a median payment of US$103 828 (IQR: US$45 291–US$265 341). The most common complication was infection (n=13, 26.5%), followed by worsening pain (n=8, 16.3%). Physician malpractice before, during, and after the procedure was claimed by plaintiffs in 18 (36.7%), 44 (89.8%), and 31 (63.3%) cases, respectively. Of these cases, 6 (33.3%), 19 (43.2%), and 15 (48.4%), respectively, were adjudicated in favor of the plaintiffs by the courts. In cases involving postprocedural physician errors, the majority (13/15) of the plaintiff verdicts were related to delayed management. Violation of the physician’s duty of informed consent was claimed by plaintiffs in 31 (63.3%) cases, and 14 (45.2%) of these cases were judged medical malpractice.

Conclusions

Our data will allow pain physicians to become acquainted with the major epidural injection-associated complications that underlie malpractice cases.
LncRNA Gm4419 induces cell apoptosis in hepatic ischemia–reperfusion injury via regulating the miR-455–SOX6 axis
Authors: Ying Dongjian , Zhou Xinhua , Ruan Yi , Wang Luoluo , Wu Xiang
Published: February 2020

Long non-coding RNA (lncRNA) is known to be involved in a variety of diseases. However, the role of Gm4419 in hepatic ischemia–reperfusion (I/R) injury remains unknown. To study this, we first established a rat model of hepatic I/R, and a BRL-3A cell model of hypoxia–reoxygenation (H/R) for in vivo and in vitro studies. Staining with hematoxylin and eosin and hepatic injury scores were used to evaluate the degree of hepatic I/R injury. Cell apoptosis was assessed via staining with Edu, and with annexin V–FITC–propidium iodide assays. The interactions between Gm4419 and miR-455, as well as miR-455 and SOX6 were evaluated via luciferase reporter activity assays and RNA immunoprecipitation assays. In vivo, we found that Gm4419 was up-regulated in the rats subjected to I/R. Moreover, knockdown of Gm4419 alleviated the I/R-induced liver damage in the rats. In vitro, knockdown of Gm4419 alleviated H/R-induced apoptosis in BRL-3A cells. Interestingly, we found that miR-455 is a target of Gm4419, and Gm4419 regulates the expression of miR-455 via sponging. Furthermore, SOX6 was proven to be the target of miR-455. Finally, rescue experiments confirmed that knockdown of Gm4419 inhibits apoptosis by regulating miR-455 and SOX6 in H/R-treated BRL-3A cells. Therefore, our findings show that the lncRNA Gm4419 accelerates hepatic I/R injury by targeting the miR-455–SOX6 axis, which suggests a novel therapeutic target for hepatic I/R injury.
Bridging the gap between theory and practice in elucidating modular gene regulatory sequence organisation within genomes
Authors: Seto Kelly , Mok Wendy , Stone Jonny
Published: February 2020

Changes to promoter regions probably have been responsible for many morphological evolutionary transitions, especially in animals. This idea is becoming testable, as data from genome projects amass and enable bioinformaticians to conduct comparative sequence analyses and test for correlations between genotypic similarities or differences and phenotypic likeness or disparity. Although such practical pursuits have initiated some theoretical considerations, a conceptual framework for understanding promoter region evolution, potentially effecting morphological evolution, is only starting to emerge, predominantly resulting from computational research. We contribute to this framework by specifying three big problems for promoter region research; reviewing computational research on promoter region evolution; and exemplifying a topic for future promoter region research — module evolution.
Phase structures and transitions of Born–Infeld black holes in a grand canonical ensemble
Authors: Liang Kangkai , Wang Peng , Wu Houwen , Yang Mingtao
Published: February 2020

To make a Born–Infeld (BI) black hole thermally stable, we consider two types of boundary conditions, i.e., the asymptotically anti-de Sitter (AdS) space and a Dirichlet wall placed in the asymptotically flat space. The phase structures and transitions of these two types of BI black holes, namely BI-AdS black holes and BI black holes in a cavity, are investigated in a grand canonical ensemble, where the temperature and the potential are fixed. For BI-AdS black holes, the globally stable phases can be the thermal AdS space. For small values of the potential, there is a Hawking-Page-like first order phase transition between the BI-AdS black holes and the thermal-AdS space. However, the phase transition becomes zeroth order when the values of the potential are large enough. For BI black holes in a cavity, the globally stable phases can be a naked singularity or an extremal black hole with the horizon merging with the wall, which both are on the boundaries of the physical parameter region. The thermal flat space is never globally preferred. Besides a first order phase transition, there is a second order phase transition between the globally stable phases. Thus, it shows that the phase structures and transitions of BI black holes with these two different boundary conditions have several dissimilarities.
Adherence of North‐African Pulmonologists to the 2017‐Global Initiative for Chronic Obstructive Lung Disease (GOLD) Pharmacological Treatment Guidelines (PTGs) of Stable Chronic Obstructive Pulmonary Disease (COPD)
Authors: Aissa Sana , Knaz Asma , Maatoug Jihene , Khedher Ahmed , Benzarti Wafa , Abdelghani Ahmed , Garrouche Abdelhamid , Hayouni Abdelaziz , Benzarti Mohamed , Gargouri Imen , Ben Saad Helmi
Published: February 2020

Background. No previous study has investigated the adherence rate of North‐African pulmonologists to the 2017‐GOLD PTGs. Aims. To investigate the adherence rate of Tunisian pulmonologists to the 2017‐GOLD PTGs and to identify the barriers to their adherence. Methods. This was a cohort study involving clinically stable COPD patients who presented to a pulmonology outpatient consultation. The patients were classified as having been appropriately and inappropriately (over‐ or undertreatment) treated for the GOLD group. Logistic regression was performed to determine the adherence barriers to the 2017‐GOLD PTGs. Results. A total of 296 patients were included (88.1% males, mean age: 68 ± 10 years; GOLD A (7.1%), B (36.1%), C (4.1%), and D (52.7%)). The pulmonologists’ adherence rate to the 2017‐GOLD PTGs was 29.7%. There was a significant statistical difference between the adherence rates among the four GOLD groups (A: 19.0%, B: 20.6%, C: 8.3%, and D: 39.1%; p = 0.001). Differences were statistically significant between the GOLD group D and groups B (p = 0.001) and C (p = 0.033). The multivariate analysis showed that age (odds ratio (OR): 0.968), socioeconomic level (high/medium vs. low; OR: 2.950), insurance type (national health insurance vs. others; OR: 2.851), and GOLD groups (A/B vs. C/D; OR: 3.009) significantly influenced the adherence rate to the 2017‐GOLD PTGs. Conclusion. The adherence rate of Tunisian pulmonologists to the 2017‐GOLD PTGs is low. It seems that the patients’ age, socioeconomic level, national health insurance coverage, and GOLD groups influenced their adherence.
Involvement of lncRNAs and Macrophages: Potential Regulatory Link to Angiogenesis
Authors: Jia Yang , Zhou Yedi
Published: February 2020

Macrophages are involved in angiogenesis, an essential process for organ growth and tissue repair, and could contribute to the pathogenesis of angiogenesis-related diseases such as malignant tumors and diabetic retinopathy. Recently, long noncoding RNAs (lncRNAs) have been proved to be important in cell differentiation, organismal development, and various diseases of pathological angiogenesis. Moreover, it has been indicated that numerous lncRNAs exhibit different functions in macrophage infiltration and polarization and regulate the secretion of inflammatory cytokines released by macrophages. Therefore, the focus of macrophage-related lncRNAs could be considered to be a potential method in therapeutic targeting angiogenesis-related diseases. This review mainly summarizes the roles played by lncRNAs which associated with macrophages in angiogenesis. The possible mechanisms of the regulatory link between lncRNAs and macrophages in various angiogenesis-related diseases were also discussed.
Irreversible Acquired Noncompaction Cardiomyopathy in a Parturient with Corrected Atrial Septal Defect: A Case Report and Clinical Implications
Authors: Al-Aamri Is’haq , Derzi Simone , Moore Albert , Bottega Natalie , Ordoñez Maria V. , Villeneuve Valerie , Hatzakorzian Roupen
Published: February 2020

Left ventricular noncompaction (LVNC) is described as a cardiomyopathy with an increase in left ventricle trabeculations and recesses. We report a rare case of persistent pregnancy-acquired LVNC cardiomyopathy and review the anesthetic peripartum management strategies. A 33-year-old parturient was followed closely by the high-risk obstetric service for her second pregnancy. She had an unresolved LVNC cardiomyopathy that was diagnosed during her first pregnancy for which she had a caesarean section. Her symptoms included occasional palpitations and dyspnea. She was started on metoprolol and enoxaparin. A successful caesarean section was performed at 37 weeks gestation under regional anesthesia. Echocardiograms prior to and during the second pregnancy demonstrated persistence of the LV hypertrabeculations, LV systolic dysfunction, and a left ventricular ejection fraction (LVEF) of 35%. Pregnancy-induced LV hypertrabeculations occur in a significant proportion of women, but most cases spontaneously resolve completely. Favorable maternal and fetal outcomes require multidisciplinary care and careful selection of the anesthetic technique and drugs that maintain stable hemodynamics.
A Review on Oil-Based Nanofluid as Next-Generation Insulation for Transformer Application
Authors: Suhaimi Sabrina N. , Rahman Abdul R. A. , Din Muhamad F. Md. , Hassan Muhammad Zahir , Ishak Mohd Taufiq , Jusoh Mohd Taufik bin
Published: February 2020

Due to the increasing demand on developing good insulation, several researchers have performed experimental studies to prove the effectiveness and capabilities of transformer oil. This is done by suspending nanosized solid particles in the oil (nanofluid) for transformer applications. In brief, this paper presents a compilation of research studies which is divided into three parts. Part I discuss the preparation of the nanofluid which involves different types of nanomaterials, the optimal amount of concentrations, and applicable synthesisation methods for producing stably suspended nanofluids. In Part II, the nanofluid’s performances including the electrical breakdown voltages, impulse tests, and thermal and dielectric behaviour are reviewed in depth and compared. Part III emphasizes the limitation of nanofluids. Most researchers have agreed that appropriate concentrations of nanomaterials and the preparation method for nanofluids mainly affect the performance of nanofluids especially in terms of electrical properties. Meanwhile, types of nanomaterials and base oil also play a vital role in producing nanofluids as a better alternative transformer oil. However, among a few researchers, there are concerns regarding the issue of agglomeration and inconsistencies of findings that need to be resolved. Therefore, a few aspects must be taken into consideration to produce the next generation of high heat dissipation insulation.
Investigation of Microwave Irradiation Procedure for Synthesizing CdSe Quantum Dots
Authors: Strimaitis Jacob , Gunawansa Taliya , Pradhan Sangram , Bahoura Messaoud
Published: February 2020

In recent years, microwave heating techniques for quantum dot (QD) synthesis have come to supplement the typical hot‐injection methods. In addition to increasing control and replicability, microwave synthesis can be up‐scaled to industry standards, an advantage that increases its lucrativeness. This study depicts a strategy to take a hot‐injection procedure for cadmium selenide (CdSe) QD synthesis that is safe enough for undergraduate research labs and adapt it to an easier, more energy‐efficient microwave synthesis method. Additionally, this study details successes in synthesizing these QDs, along with some challenges, limitations, and peculiarities. For future users of this method, it is recommended to keep holding temperatures between 170°C and 240°C to achieve the highest monodispersity of CdSe QDs while also avoiding confounding effects, such as wide‐spectrum photoluminescence and bulk CdSe precipitation.
Deciphering N6‐Methyladenosine‐Related Genes Signature to Predict Survival in Lung Adenocarcinoma
Authors: Zhu Jie , Wang Min , Hu Daixing
Published: February 2020

Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer‐related death. Among these, lung adenocarcinoma (LUAD) accounts for most cases. Due to the improvement of precision medicine based on molecular characterization, the treatment of LUAD underwent significant changes. With these changes, the prognosis of LUAD becomes diverse. N6‐methyladenosine (m6A) is the most predominant modification in mRNAs, which has been a research hotspot in the field of oncology. Nevertheless, little has been studied to reveal the correlations between the m6A‐related genes and prognosis in LUAD. Thus, we conducted a comprehensive analysis of m6A‐related gene expressions in LUAD patients based on The Cancer Genome Atlas (TCGA) database by revealing their relationship with prognosis. Different expressions of the m6A‐related genes in tumor tissues and non‐tumor tissues were confirmed. Furthermore, their relationship with prognosis was studied via Consensus Clustering Analysis, Principal Components Analysis (PCA), and Least Absolute Shrinkage and Selection Operator (LASSO) Regression. Based on the above analyses, a m6A‐based signature to predict the overall survival (OS) in LUAD was successfully established. Among the 479 cases, we found that most of the m6A‐related genes were differentially expressed between tumor and non‐tumor tissues. Six genes, HNRNPC, METTL3, YTHDC2, KIAA1429, ALKBH5, and YTHDF1 were screened to build a risk scoring signature, which is strongly related to the clinical features pathological stages (p < 0.05), M stages (p < 0.05), T stages (p < 0.05), gender (p = 0.04), and survival outcome (p = 0.02). Multivariate Cox analysis indicated that risk value could be used as an independent prognostic factor, revealing that the m6A‐related genes signature has great predictive value. Its efficacy was also validated by data from the Gene Expression Omnibus (GEO) database.
Beta‐Thalassemia Intermedia: A Single Thalassemia Center Experience from Northeastern Iraq
Authors: Amin Shaema Salih , Jalal Sana Dlawar , Ali Kosar Muhammed , Mohammed Ali Ibrahim , Rasool Luqman Khalid , Osman Tara Jamel
Published: February 2020

Objective. To determine the molecular characterization and disease‐associated complications of beta‐thalassemia intermedia (β‐TI) patients in Sulaymaniyah province, northeastern Iraq. Methods. A total of 159 β‐TI patients from 114 families were enrolled. Detection of β‐thalassemia mutations was done by reverse hybridization technique and direct gene sequencing. Also, the clinical and hematological data were collected through an electronic‐based medical recording system using a designed comprehensive questionnaire. Results. Nineteen different β‐globin gene mutations arranged in 37 various genotypes were determined. The most frequent were IVS‐II‐I (G>A) (47.2%), followed by IVS‐I‐6 (T>C) (23.3%) and IVS‐I‐110 (G>A) (5%). Among disease‐related morbidities documented, bone disease amounted to 53% (facial deformity and osteoporosis), followed by endocrinopathies 17.6% (growth retardation and subclinical hypothyroidism), cholelithiasis 13.8%, pulmonary hypertension 11.3%, and abnormal liver function test 7.5%, whereas venous thrombosis, extramedullary hemopoiesis, and leg ulcer were less frequently observed. Age ≥ 35 and female sex were risk factors for cholelithiasis, while age was an independent risk for hypothyroidism and female sex was associated with increased risk for osteoporosis. Mean serum ferritin of ≥1000 μg/L was associated with an increased risk of osteoporosis, whereas chelation therapy was protective for a multitude of other complications. Transfusion, on the other hand, increased the risk of osteoporosis, yet it was protective for cholelithiasis and hypothyroidism. Moreover, splenectomy was protective for cholelithiasis, although it was an independent risk for hypothyroidism. Finally, hydroxyurea was associated with an increased risk of osteoporosis, while it was protective for cholelithiasis. Discussion and Conclusion. β+‐thalassemia mutation had contributed to 41.25 of families with a less severe β‐thalassemia phenotype in the northeastern part of Iraq, justifying the need to investigate the contribution of genetic modifiers in ameliorating disease severity. In addition, the substantial number of β‐TI patients developed disease‐related morbidities, which necessitates the need for more appropriate clinical management with earlier intervention.
Endocrine Composite Skyhook-Groundhook Control of Electromagnetic Linear Hybrid Active Suspension
Authors: Kou Farong , Jing Qiangqiang , Chen Chen , Wu Jianghao
Published: February 2020

In order to effectively improve vehicle riding comfort, handling stability, and realize vibration energy recovery, a new kind of electromagnetic linear hybrid active suspension (EMLHAS) integrated with linear motor and solenoid valve shock absorber is put forward. Firstly, for the analysis of the suspension performance, a quarter dynamic model of EMLHAS is established. At the same time, the mathematical models of a linear motor, including the active state and energy-regenerative state, are found. The correctness of mathematical models for the linear motor in the active and energy-regenerative states is verified by means of characteristic tests. Moreover, the velocity characteristic tests of solenoid valve shock absorber are carried out to determine its mathematical polynomial model in the semiactive state. Then, a new kind of multimode endocrine composite skyhook-groundhook control strategy is proposed. The suspension motion is divided into four modes according to the driving conditions of the vehicle. An endocrine control with long feedback and short feedback is combined with the skyhook-groundhook control. The control laws of the skyhook-groundhook controller and endocrine controller are, respectively, designed. Finally, the simulation analysis of suspension dynamic performance and energy-regenerative characteristic is done. The results show the control effect of endocrine composite skyhook-groundhook control is better than that of skyhook-groundhook control, which improves vehicle riding comfort and handling stability. Moreover, part of vibration energy is recovered.
Management of Instability following Pyogenic Sacroiliitis: Technical Case Report
Authors: Passaplan C. , Simonin A. , Maestretti G. , Gautier E.
Published: February 2020

Background. Septic arthritis of the sacroiliac joint (SI-joint) is a rare and often delayed diagnosis. Management usually consists of intravenous antibiotics and debridement of infected tissue. However, very few reports consider the management of the secondary instability of the sacroiliac joint.Case Presentation. We report a case of a 16-year-old girl diagnosed withS. aureuspyogenic sacroiliitis who benefited from aggressive surgical debridement and primary arthrodesis for infection-related SI-joint instability in the acute infection phase.Conclusion. Diagnosis of pyogenic sacroiliitis is often delayed. Destruction of the joint can lead to chronic pain and instability. In cases of obvious intraoperative instability, primary arthrodesis could be considered in young patients.
BD-ELM: A Regularized Extreme Learning Machine Using Biased DropConnect and Biased Dropout
Authors: Lai Jie , Wang Xiaodan , Li Rui , Song Yafei , Lei Lei
Published: February 2020

In order to prevent the overfitting and improve the generalization performance of Extreme Learning Machine (ELM), a new regularization method, Biased DropConnect, and a new regularized ELM using the Biased DropConnect and Biased Dropout (BD-ELM) are both proposed in this paper. Like the Biased Dropout to hidden nodes, the Biased DropConnect can utilize the difference of connection weights to keep more information of network after dropping. The regular Dropout and DropConnect set the connection weights and output of the hidden layer to 0 with a single fixed probability. But the Biased DropConnect and Biased Dropout divide the connection weights and hidden nodes into high and low groups by threshold, and set different groups to 0 with different probabilities. Connection weights with high value and hidden nodes with a high-activated value, which make more contribution to network performance, will be kept by a lower drop probability, while the weights and hidden nodes with a low value will be given a higher drop probability to keep the drop probability of the whole network to a fixed constant. Using Biased DropConnect and Biased Dropout regularization, in BD-ELM, the sparsity of parameters is enhanced and the structural complexity is reduced. Experiments on various benchmark datasets show that Biased DropConnect and Biased Dropout can effectively address the overfitting, and BD-ELM can provide higher classification accuracy than ELM, R-ELM, and Drop-ELM.
Influence of Circumferential Placement Position of Guide Vanes on Performance and Dynamic Characteristics of Nuclear Reactor Coolant Pump
Authors: Cheng Xiaorui , Lv Boru , Ji Chenying , Jia Ningning , N Dorah
Published: February 2020

In order to study the influence of the circumferential placement position of the guide vane on the flow field and stress-strain of a nuclear reactor coolant pump, the CAP1400 nuclear reactor coolant pump is taken as the research object. Based on numerical calculation and test results, the influence of circumferential placement position of the guide vane on the performance of the nuclear reactor coolant pump and stress-strain of guide vanes are analyzed by the unidirectional fluid-solid coupling method. The results show that the physical model and calculation method used in the study can accurately reflect the influence of the circumferential placement position of the guide vane on the nuclear reactor coolant pump. In the design condition, guide vane position has a great influence on the nuclear reactor coolant pump efficiency value, suction surface of the guide vane blade, and the maximum equivalent stress on the hub. However, it has a weak effect on the head value, pressure surface of the guide vane blade, and the maximum equivalent stress on the shroud. When the center line of the outlet diffuser channel of the case is located at the center of the outlet of flow channel of the guide vane, it is an optimal guide vane circumferential placement position, which can reduce the hydraulic loss of half of the case. Finally, it is found that the high stress concentration area is at the intersection of the exit edge of the vane blade and the front and rear cover, and the exit edge of the guide vane blade and its intersection with the front cover are areas where the strength damage is most likely to occur. This study provides a reference for nuclear reactor coolant pump installation, shock absorption design, and structural optimization.
Multiple Precast Component Orders Acceptance and Scheduling
Authors: Jiang Wen , Wu Lanjun , Cao Yunzhong
Published: February 2020

Precast components manufacturer generally operates under limited production capacity and produces products of one order which may delay another. This paper develops a precast component order acceptance and scheduling model that aims to maximize the total profit in a stochastic multiple orders environment. In that model, the increasing of the overall profit of the precast component manufacturer is achieved by using a heuristic algorithm and a dynamic order acceptance heuristic. Results of numerical examples indicate the proposed model realizes the increasing total profit in most cases comparing to accept all of the orders. Besides, this study tested three order acceptance criteria and found that the profit-based criterion is to be more stable in terms of maximum total profit. This approach is anticipated to provide support to precast component manufacturers when faced with multiple orders in long-term production.