bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Mechanistic Model To Predict Boosting Pressure of Electrical Submersible Pumps Under High-Viscosity Fluid Flow with Validations by Experimental Data
Authors: Zhu Jianjun , Zhu Haiwen , Cao Guangqiang , Zhang Jiecheng , Peng Jianlin , Banjar Hattan , Zhang Hong-Quan
Published: December 2019

As the second most widely used artificial-lift method in petroleum production (and first in accumulative production), electrical submersible pumps (ESPs) increase flow rates by converting kinetic energy to hydraulic pressure. ESPs are routinely characterized with water flow, and water performance curves are provided by the manufacturers (catalog curves) for designing ESP-based artificial-lift systems. However, the properties of hydrocarbon fluids are very different from those of water, especially the dynamic viscosities, which can significantly alter the ESP performance. Most of the existing methods to estimate ESP boosting pressure under high-viscosity fluid flow involve a strong empirical nature, and are derived by correlating experimental/field data with correction factors (e.g., Hydraulic Institute Standards 1955). A universally valid mechanistic model to calculate the ESP boosting pressure under viscous fluid flow is not yet available. In this paper, a new mechanistic model accounting for the viscosity effect of working fluids on ESP hydraulic performance is proposed, and it is validated with a large database collected from different types of ESPs.

The new model starts from the Euler equations for characterizing centrifugal pumps, and introduces a conceptual best-match flow rate QBM, at which the outlet flow direction of the impeller matches the designed flow direction. The mismatch of velocity triangles, resulting from the varying liquid-flow rates, is used to derive the recirculation losses. Other head losses caused by flow-direction change, friction, leakage flow, and other factors. are incorporated into the new model as well. QBM is obtained by matching the predicted H-Q performance curve of an ESP with the catalog curves. Once QBM is determined, the ESP hydraulic head under viscous-fluid-flow conditions can be calculated.

The specific speed (NS) of the studied ESPs in this paper ranges from 1,600 to 3,448, including one radial-type ESP and two mixed-type designs. The model-predicted ESP boosting pressure with water flow is found to match the catalog curves well if QBM is properly tuned. With high-viscosity fluid presence, the model predictions of ESP boosting pressure also agree well with the corresponding experimental data. For most calculation results within medium to high flow rates, the model prediction error is less than 15%. Unlike the empirical correlations that take experimental data points as inputs, the mechanistic model in this study does not require entering any experimental data, but can predict ESP boosting pressure under viscous fluid flow with a reasonable accuracy.
A Tangent-Line Approach for Effective Density Used in Ideal Mixing Rule: Part I—Prediction of Density for Heavy-Oil/Bitumen Associated Systems
Authors: Chen Zehua , Yang Daoyong
Published: December 2019

Accurate prediction of density of an oil/gas mixture by using the ideal mixing (IM) rule is a great challenge, and its progress is still far from satisfactory. The method proposed by Standing and Katz (1942) for determining methane and ethane apparent densities is limited to only black oils and volatile oils. The methods recently proposed by Saryazdi (2012) and Saryazdi et al. (2013) to determine effective densities of methane through n-heptane (C1 through n-C7) and CO2 have shown some success, respectively, though limitations remain and the extent of their applications is still constrained. In this study, we developed a tangent-line approach for the effective density of C1 through n-C8, CO2, N2, toluene, cyclohexane, and dimethyl ether (DME). This method is more general and flexible than the extrapolation method proposed by Saryazdi (2012). A comprehensive database is established to first develop new correlations with one set of data and then compare them with the other. We successfully extended using the IM rule with effective density (IM-E) to condensate/bitumen systems, solvent/bitumen fraction systems, and solvent/bitumen systems with substantial extraction [i.e., emergence of a solvent-rich liquid phase (denoted as the L1 phase)] by properly treating the densities of condensate, bitumen fractions, extracts, and residues. This study focuses on heavy-oil/bitumen-associated systems, and the observed patterns and trends for different systems will be presented and explained in Part II of this study (Chen and Yang 2020).
An outbreak of norovirus-related acute gastroenteritis associated with delivery food in Guangzhou, southern China
Authors: Lu Ying , Ma Mengmeng , Wang Hui , Wang Dahu , Chen Chun , Jing Qinlong , Geng Jinmei , Li Tiegang , Zhang Zhoubin , Yang Zhicong
Published: December 2019

Background
A large number of students at a school located in Guangzhou city developed a sudden onset of symptoms of diarrhea and vomiting. In order to control the outbreak, an epidemiological investigation was conducted to determine the causative agent, sources, role of transmission and risk factors of the infections.
Methods
The study population consisted of probable cases and confirmed cases. An active search was conducted for cases among all students, teachers and other staff members. A case control study was carried out using online standardised questionnaires. Data were obtained regarding demographic characteristics, gastrointestinal symptoms, personal hygiene habits, history of contact with a person with diarrhea and/or vomiting and dining place in the past 3 days. Rectal swabs or stool samples of the cases, food handlers and environmental smear swab samples were collected to detect potential intestinal viruses and bacteria. Odds ratios (ORs) and 95% confidence intervals were calculated.
Results
A total of 157 individuals fit the definition of a probable case, including 46 with laboratory-confirmed norovirus infection between March 8 and March 22, 2018. The proportion of the students who had eaten delivery food three days before the onset of disease in the case group was 2.69 times that in the control group (95% CI: 1.88-3.85 ). Intake of take-out food three days before, exposure to similar cases 72 hours before onset and case in the same dormitory were risk factors. A total of 20 rectal swab samples from students, 10 rectal swabs from food handlers and 2 environmental swab samples of out-campus restaurant were tested positive for norovirus (G Ⅱ , genogroup Ⅱ strain ).
Conclusions
The outbreak of norovirus infectious diarrhea was determined. Food handling practices carries potential risk of acute gastroenteritis outbreaks due to a lack of surveillance and supervision. More attention should be paid to the monitoring and supervision of food handlers to reduce the incidence of norovirus-related acute gastroenteritis associated with delivery food.
Can we optimise doxorubicin treatment regimens for children with cancer? Pharmacokinetic simulations and a Delphi consensus procedure
Authors: Siebel Christian , Würthwein Gudrun , Lanvers-Kaminsky Claudia , André Nicolas , Berthold Frank , Castelli Ilaria , Chastagner Pascal , Doz François , English Martin , Escherich Gabriele , Frühwald Michael C. , Graf Norbert , Groll Andreas , Ruggiero Antonio , Hempel Georg , Boos Joachim
Published: December 2019

Background:
Despite its cardiotoxicity doxorubicin is widely used for the treatment of paediatric malignancies. Current treatment regimens appear to be suboptimal as treatment strategies vary and do not follow a clear pharmacological rationale. Standardisation of dosing strategies in particular for infants and younger children is required but is hampered by scarcely defined exposure-response relationships. The aim is to provide a rational dosing concept allowing for a reduction of variability in systemic therapy intensity and subsequently unforeseen side effects.
Methods:
Doxorubicin plasma concentrations in paediatric cancer patients were simulated for different treatment schedules using a population pharmacokinetic model which considers age-dependent differences in doxorubicin clearance. Overall drug exposure and peak concentrations were assessed. Simulation results were used to support a three round Delphi consensus procedure with the aim to clarify the pharmacological goals of doxorubicin dosing in young children. A group of 28 experts representing paediatric trial groups and clinical centres were invited to participate in this process.
Results:
Pharmacokinetic simulations illustrated the substantial differences in therapy intensity associated with current dosing strategies. Consensus among the panel members was obtained on a standardised a priori dose adaptation that individualises doxorubicin doses based on age and body surface area targeting uniform drug exposure across children treated with the same protocol. Further, a reduction of peak concentrations in very young children by prolonged infusion was recommended.
Conclusions:
An approach to standardise current dose modification schemes in young children is proposed. The consented concept takes individual pharmacokinetic characteristics into account and involves adaptation of both the dose and the infusion duration potentially improving the safety of doxorubicin administration.
Changes in serum albumin and other nutritional markers when using sucroferric oxyhydroxide as phosphorus binder among hemodialysis patients: a historical cohort study
Authors: Kalantar-Zadeh Kamyar , Ficociello Linda H , Parameswaran Vidhya , Athienites Nicolaos V. , Mullon Claudy , Kossmann Robert J. , Coyne Daniel W.
Published: December 2019

Background Elevated serum phosphorus concentrations are common among maintenance hemodialysis patients. Protein is a major source of dietary phosphate, but restriction of protein intake can result in hypoalbuminemia and protein-energy wasting. We hypothesized that sucroferric oxyhydroxide (SO), a potent phosphate binder with a low pill burden, may reduce serum phosphorus levels in hemodialysis patients with hypoalbuminemia without adversely impacting albumin levels or dietary intake of protein.Methods We retrospectively examined de-identified data from 79 adult, in-center hemodialysis patients with baseline hypoalbuminemia (≤ 3.5 g/dL) switched to SO as part of routine clinical care for at least 1 year. Temporal changes (3-month intervals from baseline through Q4) in phosphate binder pill burden, serum phosphorous levels, nutritional markers, and equilibrated Kt/V were analyzed. Data from a matched reference group of non-hypoalbuminemic patients ( N = 79) switched to SO were also examined.Results SO therapy was associated with a mean reduction of 45.7% and 45.1% in daily phosphate binder pill burden, and a mean reduction of 0.4 mg/dL and 0.51 mg/dL in serum phosphorus levels for the hypoalbuminemic and non-hypoalbuminemic patients, respectively. Hypoalbuminemic patients demonstrated significant increases in mean serum albumin levels from 3.50 mg/dL at baseline to 3.69, 3.74, 3.70, and 3.69 mg/dL during Q1 through Q4, respectively ( P < 0.0001), whereas serum albumin levels remained unchanged in the non-hypoalbuminemic group.Conclusions Both hypoalbuminemic and non-hypoalbuminemic patients switching to SO exhibited significant reductions in serum phosphorus concentrations and daily phosphate binder pill burden. Among hypoalbuminemic patients, the initiation of SO therapy was also associated with increases in serum albumin, suggesting therapy may have allowed patients to increase their dietary intake of protein.
Multiple chronic conditions and associated health care expenses in US adults with cancer: A 2010-2015 Medical Expenditure Panel Survey study
Authors: Davis-Ajami Mary Lynn , Lu Zhiqiang K , Wu Jun
Published: December 2019

Background: Cancer increases the risk of developing one or more chronic conditions, yet little research describes the associations between health care costs, utilization patterns, and chronic conditions in adults with cancer. The objective of this study was to examine the treated prevalence of chronic conditions and the association between chronic conditions and health care expenses in US adults with cancer. Methods: This retrospective observational study used US Medical Expenditure Panel Survey (MEPS) Household Component (2010-2015) data sampling adults diagnosed with cancer and one or more of 18 select chronic conditions. The measures used were treated prevalence of chronic conditions, and total and chronic condition-specific health expenses (per-person, per-year). Generalized linear models assessed chronic condition-specific expenses in adults with cancer vs. without cancer and the association of chronic conditions on total health expenses in adults with cancer, respectively, by controlling for demographic and health characteristics. Accounting for the complex survey design in MEPS, all data analyses and statistical procedures applied longitudinal weights for national estimates. Results: Among 3,657 eligible adults with cancer, 83.9% (n = 3,040; representing 16 million US individuals per-year) had at least one chronic condition, and 29.7% reported four or more conditions. Among those with cancer, hypertension (59.7%), hyperlipidemia (53.6%), arthritis (25.6%), diabetes (22.2%), and coronary artery disease (18.2%) were the five most prevalent chronic conditions. Chronic conditions accounted for 30% of total health expenses. Total health expenses were $6,388 higher for those with chronic conditions vs. those without (p<0.001). Health expenses associated with chronic conditions increased by 34% in adults with cancer vs. those without cancer after adjustment. Conclusions: In US adults with cancer, the treated prevalence of common chronic conditions was high and health expenses associated with chronic conditions were higher than those without cancer. A holistic treatment plan is needed to improve cost outcomes.
Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis
Authors: Li Li , Li Zhenxing , Li Yuyan , Hu Xi , Zhang Yu , Fan Pei
Published: December 2019

Background: Inflammatory mediators in the synovial fluid (SF) play critical roles in the initiation and development of pain in knee osteoarthritis (KOA). However, data for inflammatory marker expression are conflicting, and the role of SF inflammatory mediators in neuropathic pain is not clear. Therefore, the aim of this study was to identify SF inflammatory mediators associated with nociceptive and neuropathic pain in KOA. Methods: Levels of IL-1β, IL-6, TNF-α, macrophage colony-stimulating factor, MMP-3, MMP-13, metalloproteinase with thrombospondin motifs 5, calcitonin gene-related peptide, neuropeptide Y, substance P and bradykinin were measured using enzyme-linked immunosorbent assays in 86 patients. Nociceptive pain was assessed using the numeric rating scale (NRS), visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Neuropathic pain was determined using the PainDETECT questionnaire. Moreover, knee function was evaluated by the WOMAC score and range of motion (ROM) assessments. Radiological grade was defined using the Kellgren-Lawrence (K-L) grading scale. Results: Pain scores measured using different methods correlated highly with each other. A worse K-L grade and knee function were associated with worse pain. Expression of IL-1β and IL-6 was increased in the early stage compared with the late stage. The NRS score correlated positively with age, K-L grade, and the WOMAC score and negatively with ROM and TNF-α expression. The VAS correlated positively with age, K-L grade, and the WOMAC score but negatively with ROM and levels of IL-1β, IL-6 and TNF-α. The WOMAC pain score did not correlate with any of the inflammatory mediators measured; it correlated only with ROM. The PainDETECT score correlated only with the WOMAC score. Expression of other inflammatory mediators did not correlate with any of the pain scores. Conclusions: IL-1β, IL-6 and TNF-α play critical roles in pain in the early stage of KOA and correlate with pain. The catabolic enzymes and neuropeptides measured do not correlate with nociceptive and neuropathic pain. New biomarkers related to pain in the late stage need to be further investigated.
Quantitative Bone SPECT/CT: High Specificity for Identification of Prostate Cancer Bone Metastases
Authors: Tabotta Flavian , Jre Mario , Schaefer Niklaus , Becce Fabio , Prior John O. , Nicod-Lalonde Marie
Published: December 2019

Purpose: Bone scintigraphy with 99mTc-labeled diphosphonates can identify prostate cancer bone metastases with high sensitivity, but relatively low specificity, because benign conditions such as osteoarthritis can also trigger osteoblastic reactions. We aimed to investigate the diagnostic performance of 99mTc-2,3-dicarboxy propane-1,1-diphosphonate (99mTc-DPD) uptake quantification by single-photon emission computed tomography coupled with computed tomography (SPECT/CT) for distinguishing prostate cancer bone metastases from spinal and pelvic osteoarthritic lesions.
Methods: We retrospectively assessed 26 bone scans from 26 patients with known prostate cancer bone metastases and 13 control patients with benign spinal and pelvic osteoarthritic changes without known neoplastic disease. Quantitative SPECT/CT (xSPECT, Siemens Symbia Intevo, Erlangen, Germany) was performed and standardized uptake values (SUVs) were quantified with measurements of SUVmax and SUVmean (g/mL) in all bone metastases for the prostate cancer group and in lumbar and pelvic osteoarthritic changes for the control group. We used receiver operating characteristics (ROC) curves to determine the optimum SUVmax cutoff value to distinguish between bone metastases and benign spinal and pelvic lesions.
Results: In total, 264 prostate cancer bone metastases were analyzed, showing a mean SUVmax and SUVmean of 34.6±24.6 and 20.8±14.7 g/mL, respectively. In 24 spinal and pelvic osteoarthritic lesions, mean SUVmax and SUVmean were 14.2±3.8 and 8.9±2.2 g/mL, respectively. SUVmax and SUVmean were both significantly different between the bone metastases and osteoarthritic groups (p≤0.0001). Using a SUVmax cutoff of 19.5 g/mL for prostate cancer bone metastases in the spine and pelvis, sensitivity, specificity, positive and negative predictive values were 87%, 92%, 99% and 49%, respectively.
Conclusion: This study showed significant differences in quantitative 99mTc-DPD uptake on bone SPECT/CT between prostate cancer bone metastases and spinal and pelvic osteoarthritic changes, with higher SUVmax and SUVmean in metastases. Using a SUVmax cutoff of 19.5 g/mL, high specificity and positive predictive value for metastases identification in the spine and pelvis were found, thus increasing accuracy of bone scintigraphy.
The Effects of Tai Chi on Grade 1 Hypertension: A Study Protocol for a Randomized Controlled Trial
Authors: Lee Sang Hyun , Kim Byung-Jun , Park In-Hwa , Hwang Eui-Hyoung , Park Eun Ju , Jang In-soo , Hwang Man-Suk
Published: December 2019

Background Medication is generally recommended to reduce the morbidity and mortality caused by cardiovascular disease in hypertensive patients. However, considering the difficulties and economic factors associated with long-term medication, interest in tai chi as an exercise treatment method has been recently increasing in Korean medical practice. Numerous studies have suggested that tai chi can be used to treat various diseases and affect psychosomatic factors such as anxiety. This study aims to evaluate the effect of tai chi in reducing blood pressure among grade 1 hypertensive patients.Methods In this randomized, active-controlled, assessor-blinded, two parallel-armed trial, 80 grade 1 hypertension patients will be recruited and randomly assigned to the usual care group or to the tai chi group (n = 40 in each group). Subjects who voluntarily signed a study agreement will be educated to manage their own blood pressure by restricting salt intake, losing weight, moderating alcohol consumption, performing exercise, and regulating dietary intake at their first visit. In addition to self-management, the tai chi group will perform two 60-minute tai chi sessions per week for a total of 8 weeks. Blood pressure will be measured as the primary outcome. In addition, body composition, heart rate, and the perceived strength and difficulty of the exercise will be measured as secondary outcomes.Discussion This study intends to conduct a randomized controlled trial of tai chi, which is not widely practiced in Korea. This study will provide valuable data on the effects of tai chi on hypertension, to inform non-pharmaceutical treatment options for this disorder.
Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada
Authors: Reid Connor B. , Steele Lisa , Pasquill Kelsey , Parfitt Elizabeth C. , Laupland Kevin
Published: December 2019

BACKGROUND Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.METHODS Population-based surveillance was conducted between April 1, 2010 and March 31, 2017.RESULTS 151 episodes were identified for an incidence of 12.1 per 100,000 population per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8-80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged Common.EditSubmissionSteps.Transform.EquationText 40 years old and no cases were observed among those aged Common.EditSubmissionSteps.Transform.EquationText 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3-9.9), renal disease 4.3; 2.5-7.0), cancer (3.8; 2.6-5.5), congestive heart failure (3.5; 1.6-6.6), dementia (2.9; 1.5-5.2), diabetes mellitus (2.6; 1.7-3.9), and chronic obstructive pulmonary disease (2.3; 1.5-3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4-17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.CONCLUSIONS Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.
Determinants of Undernutrition among Children Under-Five Years Old in Southern Ethiopia: Does Pregnancy Intention Matter? A Community-Based Unmatched Case-Control Study
Authors: Shaka Mohammed Feyisso , Woldie Yetayal Birhanu , Lola Hirbaye Mokona , Olkamo Kalkidan Yohannes , Anbasse Adane Tesfaye
Published: December 2019

Background: Stunting, which describes a small height for one’s age, is an indicator of chronic malnutrition. It develops mainly as a result of prolonged food deprivation or a chronic disease or illness. Unintended pregnancies and unplanned births are among the psychological factors that negatively affect the nutritional status of children. Therefore, this study aimed to determine the effects of unintended pregnancies and other family and child characteristics on the nutritional status of children under 5 years old.
Methods: A community-based unmatched case-control study was conducted among 302 children (151 cases and 151 controls) 6–59 months old in Wonago town, Gedeo Zone, Southern Ethiopia. The cases were stunted children and the controls were non-stunted children in the study area. The cases were randomly selected from among the stunted children, and the controls were randomly selected from among the non-stunted children. The descriptive characteristics of the respondents were compared using the chi-squared test, and a multivariable logistic regression was used to assess the effects of an unintended pregnancy on stunting, after controlling for the other variables, with a p value of 0.05.
Results: The result revealed that unintended pregnancy is found to be among predictors of stunting where children from unintended pregnancy were about three times more likely to be stunted [AOR: 2.62, CI: (1.26, 5.45)]. The other predictors identified in this study were educational status of the father, wealth index of the household and daily meal frequency. From the finding, children from illiterate fathers [AOR: 3.43, CI: (1.04, 11.29)], children from poorer household economic status [AOR: 2.32, CI: (1.20, 4.49)] and children whom their daily meal frequency is below the recommended number of feeding [AOR: 4.50, CI: (1.31, 15.49)] were found to be more stunted.
Conclusions: Based on the results of this study, the children born from unintended pregnancies exhibited a significantly higher risk of stunting. Therefore, preventing unintended pregnancy could play a great role in decreasing the risk of stunting in children.
Carbonate dual-phase improves the ionic conductivity and performance of mixed ionic and semiconductor single-layer fuel cell
Authors: Jouttijärvi S. , Yao Xueli , Asghar M. I. , Etula Jarkko , Reinecke A.-M. , Lippmann W. , Lund Peter
Published: December 2019

A mixed ionic and semiconducting composite in a single-layer configuration has been shown to work as a fuel cell at a lower temperature (500-600 oC) than a traditional solid-oxide fuel cell. The performance of such single-layer fuel cell (SLFC) is often limited by high resistive losses. Here, an eutectic mixture of alkali-carbonates was added to SLFC to improve the ionic conductivity. The dual-phase composite ionic conductor consisted of a ternary carbonate (sodium lithium potassium carbonate, NLKC) mixed with gadolinium-doped cerium oxide (GDC). Lithium nickel zinc oxide (LNZ) was used as the semiconducting material. The LNZ-GDC-NLKC SLFC reached a high power density, 582 mW/cm2 (conductivity 0.22 S/cm) at 600 °C, which is more than 30 times better than without the carbonate. The best results were obtained with the ternary carbonate which decreased the ohmic losses of the cell by more than 95%, whereas a binary carbonate (sodium lithium carbonate, NLC) showed a lower conductivity and performance (243 mW/cm2, 0.17 S/cm at 600°C). It is concluded that adding carbonates to the LNZ-GDC will improve the ionic conductivity and positively contribute to the cell performance. These results will help to design better-performing SLFCs in the future and highlight the potential of SLFCs as a candidate for future electricity generation.
Home parenteral nutrition with an omega-3 fatty acid enriched MCT/LCT lipid emulsion in patients with chronic intestinal failure (the HOME study): Study protocol for a randomized, controlled, multicenter, international clinical trial
Authors: Klek Stanislaw , Chambrier Cecile , Cooper Sheldon C , Gabe Simon , Kunecki Marek , Pironi Loris , Rahman Farooq , Sobocki Jacek , Szczepanek Kinga , Wanten Geert , Lincke Nicole , Glotzbach Bernhard , Forbes Alastair
Published: December 2019

Background Home parenteral nutrition (HPN) is a life-preserving therapy for patients with chronic intestinal failure (CIF) indicated for patients who cannot achieve their nutritional requirements by enteral intake. Intravenous lipid emulsions (ILEs) are an essential component of HPN providing energy and essential fatty acids, but can become a risk factor for intestinal failure-associated liver disease (IFALD). In HPN patients, major effort is taken in the prevention of IFALD. Novel ILEs containing a proportion of omega-3 polyunsaturated fatty acids (n-3 PUFA) could be of benefit, but the data on the use of n-3 PUFA in HPN patients are still limited.Methods The HOME study is a prospective, randomized, controlled, double-blind, multicenter, international clinical trial conducted in European hospitals that treat HPN patients. A total of 160 patients (80 per group) will be randomly assigned to receive the n-3 PUFA enriched medium/long-chain triglyceride (MCT/LCT) ILE (Lipidem / Lipoplus ® 200 mg/ml, B. Braun Melsungen AG) or the MCT/LCT ILE (Lipofundin ® MCT/LCT / Medialipide ® 20%, B. Braun Melsungen AG) for a projected period of eight weeks. The primary endpoint is the combined change of liver function parameters (total bilirubin, aspartate transaminase and alanine transaminase) from baseline to final visit. Secondary objectives are the further evaluation of safety and tolerability as well as the efficacy of the ILEs.Discussion Currently, there are only very few randomized controlled trials (RCTs) investigating the use of ILEs in HPN, and there are very few data at all on the use of n-3 PUFAs. The aim of the HOME study is to demonstrate that the n-3 PUFA enriched ILE is safe and well tolerated especially with regard to liver function in patients requiring HPN. The study will provide data from a considerable number of CIF patients and thus contribute to broaden the present evidence on the use of ILEs in HPN.
Minimally invasive versus conventional fixation of tracer in robot-assisted pedicle screw insertion surgery: a randomized control trial
Authors: Yongqi Li , Dehua Zhang , Hongzi Wu , Ke Zhang , Rui Yang , Zhou Fang , Shaobo Wang , Liao yi
Published: December 2019

Background This study evaluated the minimal invasiveness, safety, and accuracy of robot-assisted pedicle screw placement procedure using a modified tracer fixation device. Methods Patients were randomly assigned to conventional fixation group (25 patients) and modified fixation group (27 patients). Results No baseline statistical difference was observed between the groups ( P >0.05). The length of unnecessary incision, amount of bleeding, and fixation duration for tracer fixation respectively were 6.08±1.02 mm, 1.46±0.84 ml, and 1.56±0.32 min in the modified fixation group and 40.28±8.52 mm, 12.02±2.24 ml, and 5.08±1.06 min in the conventional group. The difference between both groups was significant ( P <0.05). However, no significant difference between the two groups was observed in terms of the accuracy of pedicle screw placement ( P >0.05). Conclusions The modified minimally invasive procedure for tracer fixation results in minimal trauma and is simple, reliable, and highly safe. Additionally, the procedure does not compromise the accuracy of pedicle screw placement. Thus, it has great clinical applicable value.
Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial
Authors: Li Huai Jin , Liu Shan , Geng Zhiyu , Li Xue Ying
Published: December 2019

Background: Few studies have investigated the effect of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients underwent gynecological laparoscopic surgery. We investigated if adding dexmedetomidine to a morphine-based patient-controlled analgesia (PCA) could decrease the incidence of PONV in this high-risk patient population.
Methods: In this prospective, randomized, double-blind and placebo-controlled study, 122 patients underwent gynecological laparoscopic surgery were assigned into two groups. Patients in the dexmedetomidine group (Group Dex) received a loading dose of dexmedetomidine 0.4μg/kg before the end of surgery, followed by morphine 0.5mg/ml plus dexmedetomidine 1μg/ml for postoperative i.v. PCA. Patients in the control group (Group Ctrl) received normal saline before the end of surgery, followed by morphine 0.5mg/ml alone for postoperative i.v. PCA. PCA pump was programmed as followed: bolus dose 2ml, lockout interval 8 minutes and background infusion at a rate of 1ml/h. The primary outcome was the incidence of nausea and vomiting within the first postoperative 24 hours.
Results: Although there were no significant differences in regard to the total incidence of PONV (41.0% vs 52.5%, P=0.204), PONV score, time to first onset of PONV, or the need for rescue antiemetics within the first postoperative 24 hr between the two groups, the incidence of nausea and total PONV during the first 2h period was significantly lower in the Group Dex than in the Group Ctrl (9.8% vs 24.6%, P=0.031 and 0.031, respectively). More patients in Group Dex were over sedated or had bradycardia during the PACU compared with Group Ctrl (P=0.040 and 0.036, respectively).
Conclusion: Adding dexmedetomidine to morphine-based PCA with a loading dose might reduce the incidence of early postoperative nausea but not total PONV within 24h after surgery in patients undergoing gynecological laparoscopic surgery.
Transcriptome Analysis Reveals the Potential Antioxidant Defense Mechanisms of Myzus persicae in Response to UV-B Stress
Authors: Yang Changli , Zhang Changyu , Meng Jianyu , Yao Mengshuang
Published: December 2019

Background: As an environmental stress factor, ultraviolet-B (UV-B) radiation directly affects the growth and development of Myzus persicae. Excessive UV-B stress leads to DNA, membrane lipid, and protein damage by the production of reactive oxygen species. However, M. persicae can adaptively respond to such environmental stress by activating the relevant mechanisms in the body. How M. persicae responds to UV-B stress and the molecular mechanisms underlying this adaptation remain unknown. Results: Here, we compared and analyzed transcriptome data for M. persicae following exposure to a light-emitting diode fluorescent lamp and UV-B radiation for 30 min. We identified 758 significant differentially expressed genes (DEGs) following exposure to UV-B stress, including 423 upregulated and 335 downregulated genes. In addition, enrichment analysis using the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes databases illustrated that these DEGs are associated with antioxidation and detoxification, metabolic and protein turnover, immune response, and stress signal transduction. Simultaneously, these DEGs are closely related to the adaptability to UV-B stress.Conclusions: Our results suggest that UV-B stress is associated with a wide range of physiological effects in M. persicae. Our research can raise awareness of the mechanisms of insect responses to UV-B stress.
The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair
Authors: Ni Jianlong , Shi Zhibin , Fan Lihong , Guo Ning , Wang Haoyu , Dang Xiaoqian , Li Dichen
Published: December 2019

Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an all-inside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. At the follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05). Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system.
Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study
Authors: Lin Po-Hsun , Chien Jui-Teng , Hung Jung-Pin , Hong Chih-Kai , Tsai Tzung-Yi , Yang Chang-Chen
Published: December 2019

Background With an increase in the elderly population, the occurrence of hip fractures, as well as femoral neck fractures and intertrochanteric fractures (ITFs), is also increasing. It is important to establish effective perioperative methods in order to reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop.Methods Seventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measurement and calculated as the change between pre- and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and use of anticoagulation medicine.Results Among the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.046). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05).Conclusions Patients with unstable ITFs showed a greater hemoglobin drop and suspected hidden blood loss around the fracture site. Therefore, aggressive presurgical blood transfusion for patients with unstable ITFs may reduce anemia and any associated postoperative complications, especially in patients with severe anemia or with a high mortality risk.
Validation of the Knee Osteoarthritis Patient Education Questionnaire (KOPEQ) in a sample of participants with knee osteoarthritis undergoing routine knee replacement by comparison of two measures
Authors: Huber Erika Omega , Boger Axel , Meichtry André , Bastiaenen Caroline H.
Published: December 2019

Background: Objective: The aim of this study was to investigate aspects of construct validity, as part of the ongoing developmental process of the Knee Osteoarthritis Patient Education Questionnaire (KOPEQ 2). The subjects were patients with severe knee osteoarthritis who participated routinely in a preoperative educational intervention prior to undergoing a knee replacement operation. Construct validity was compared to an alternative measure with a comparable construct. The design used was a mixed method approach. Methods: The first step was to reduce the number of items on the first version of the KOPEQ. This was followed by a cross-sectional validation study to compare the revised KOPEQ 2 to a patient-testing protocol GOLD (interview-based), which was tailored to the same patient educational material. The KOPEQ was also correlated with the Short Test of Functional Health Literacy and the Mini-Mental State Examination score, based on a priori hypotheses. Results: Following item reduction, a relatively high internal consistency for the revised 7-item KOPEQ 2 was found, with a Cronbach’s alpha of 0.84 (SE: 0.036). Explanatory factor analysis showed no evidence against a one-factor model (with the first and second eigenvalue being 3.8 and 0.31, respectively). Bayesian Estimation of the correlation between KOPEQ 2 and GOLD was 0.78 (mode) (95% HPD 0.58 – 0.89). Conclusions: The KOPEQ 2 shows good psychometric properties and can provide support to health professionals by giving valid feedback on how patients experienced the applied patient education intervention while waiting for a knee replacement operation. Further studies are needed to assess the applicability of the KOPEQ 2 outside the fields of knee osteoarthritis and knee replacement.
Resveratrol inhibit interleukin-1β induced inflammatory response in human osteoarthritis chondrocytes through NF-κB signaling pathway
Authors: Shen Xiao-Fei , Cheng Yi , Dong Qi-Rong , Zheng Min-Qian
Published: December 2019

Osteoarthritis (OA) is a common degenerative disease and affect millions of people. Resveratrol is a coumarin compound refined from traditional Chinese medicines with potential anti-inflammatory ability. This study aimed to evaluate protective anti-inflammatory effects of resveratrol in human OA chondrocytes. The chondrocytes were isolated from OA patients. CCK-8 method was used to explore the optimal dose of resveratrol for chondrocyte. Next, we used PCR and Western-blot method to assess the relative mRNA and protein expression in IL-1β group. We further explored relevant mechanism of resveratrol for anti-inﬂammatory in human OA chondrocytes by immunoﬂuorescence and Western-blot. The results showed that resveratrol blocked IL-1β-stimulated production of NO and PGE2. In addition, resveratrol inhibited the expression of COX-2, iNOs, MMP-1, MMP-3, MMP-13, and increased the levels of aggrecan and collagen-II. Mechanistically, resveratrol suppressed IL-1β-induced IκB-α degradation and NF-κB activation. In conclusion, our results demonstrate that resveratrol inhibits inflammation in OA via the regulation of NF-κB signaling pathway, and suggested that resveratrol may be a potential therapeutic agent for OA.
A Promising Prognostic Model combining VitaminB12,Mean Corpuscular Volume and Maddrey Discriminant Function for Alcohol Acute-on-Chronic Liver Failure
Authors: Pan Jing , Zhang Zhen-zhen , Yao Tian-tian , Qian Jian-dan , Cheng Hao , Wang Gui-qiang , Wang Yan
Published: December 2019

Background: Acute-on-chronic liver failure (ACLF) which has a high mortality, is frequent during the course of severe alcoholic hepatitis (SAH). Maddrey Discriminant Function (MDF), as a prognostic score special for alcoholic hepatitis, does not show a good prognostic value in ACLF associated with alcoholic liver disease (ALD). It is well-known that the serum levels of vitamin B12 (vitB12) and folic acid, as important substances in the methionine metabolism pathway, were altered in the patients of ALD and may impact on the outcomes of these patients. In this study, the relationship between vitB12 levels, erythrocyte parameters and severity of liver disease in patients with ALD was evaluated to improve the prediction of short-term prognosis in ALD-ACLF by combining with the valuable indexes.
Methods: 139 ALD patients were included in the cross-sectional cohort and grouped according to different prognostic scores, the factors that affect the scores were collected and statistically analyzed. In addition, a retrospective cohort of 79 patients was investigated to reveal the correlation between vitB12 and Mean Corpuscular Volume (MCV) with the 28‐day mortality of ALD-ACLF. SPSS (20.0) and Medcalc (15.2.2) were used to perform statistical analyses. T-test, chi-square test or Fisher's as well as multivariate Logistic regression analysis were used. The ROC curve was plotted for relevant indicators, and the area under curve (AUC), cut-off value, sensitivity and specificity were calculated.
Results: Patients with high scores in MDF, Model for End-stage Liver Disease (MELD) and Age-INR-Bilirubin-Creatine (AIBC), had higher vitB12 levels than those with low scores(1264.78±623.52 VS 634.04±426.57, P<0..001; 1498.47±640.48 VS 750.83±501.95, P<0.001; 1183.71±703.42 VS 813.24±553.32, P<0.05); MCV levels were higher in patients with high MDF scores (105.43±13.02 VS 99.24±13.52, P<0.05). The AUC of a new model of MDF combined with vitB12 and MCV for 28‐day mortality was 0.802, which was significantly higher than that of vitB12, MCV, and MDF scores.Conclusions: High levels of vitB12, MCV and the severity of ALD have a statistically significant correlation. MDF combined with vitB12 and MCV have been showed a good specificity to predict 28‐day mortality in ACLF-ALD and it may be a new promising prognostic model in ACLF-ALD.
Co-designing technology for ageing in place: A systematic review
Authors: Sumner Jennifer , Chong Lin Siew , Bundele Anjali , Lim Yee Wei
Published: December 2019

Background: Co-design in healthcare has become mainstream. Co-design with end-users can improve patient satisfaction, outcomes and reduce the cost of care. As populations age, there is a growing interest to involve the elderly in the co-design of health technology to maintain their well-being and independence. However, it is less clear if co-designed technology improves health and well-being outcomes. The aim of this study is to evaluate co-designed technology that supports elders to age in place. Methods: We conducted a systematic review to: i) investigate the health and well-being outcomes of co-designed technology for elders (≥ 60 years); ii) to identify co-design approaches and contexts where they are applied and; iii) to identify barriers and facilitators of the co-design process with elders. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey and Business Source Premiere databases using MeSH terms and key words. Results: We identified 14,649 articles of which 34 studies were included. Studies were from Europe (n=28), Australia (n=4), America (n=1) and Canada (n=1). Twenty of the 32 studies targeted older adults (≥ 60 years old) and 14 targeted specific medical conditions or elder-related issues. Technological solutions included robots, online applications and software, smart televisions, computer games for exercise, global positioning solutions, smart home systems and design of care pathways. Five studies reported health and well-being outcomes and were extracted. The health and well-being impact of co-designed technology was inconsistent. Co-design processes varied greatly and in their intensity of elder involvement. Common facilitators of and barriers to the co-design process included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, as well as expertise in the co-design methodology.Conclusions: The co-design approach was applied in the design of a diverse set of technologies. The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to the elderly population. More evaluation of the impact of co-designed technologies’ is needed and standardisation of the definition of co-design would be helpful to researchers and designers.