bluuebunny/crossref_metadata_2025 huggingface dataset:
Late Pleistocene glaciers and climate in the High Atlas, North Africa
Authors: Hughes Philip D. , Fink David , Fletcher William J.
Published: July 2020

Extensive glaciers covered the High Atlas mountains in Morocco during the late Pleistocene. On the northern escarpments of the Marrakech High Atlas, a series of cirques perched at ~3000–3500 m above sea level (asl) fed their valley glaciers that, in some cases, extended to as low as 2000 m asl. Cosmogenic exposure dating with 10Be and 36Cl has shown that at least three phases of glaciation are preserved in glacial deposits over the last glacial cycle at 50, 22, and 12 ka, which appear to correlate with marine isotope stage (MIS) 3, the global Last Glacial Maximum (LGM), and the Younger Dryas chronozone. This geochronological framework is sufficiently robust to allow for time-constrained glacier-climate reconstructions. The glaciers associated with these three phases of advance had equilibrium line altitudes (ELAs) of 2761 m asl (ca. 50 ka), 2919 m asl (ca. 22 ka), and 3213 m asl (ca. 12 ka). Glacier-climate modeling suggests that all of these phases were driven by both colder temperatures and wetter conditions than today. The dominant moisture supply to these glaciers in all phases would have been sourced from Atlantic depressions. The influence of an extended and enhanced West African monsoon on glacier development during African Humid Periods is unlikely to have been a significant influence on glacier dynamics. The climate conditions associated with the three glacier phases indicate sustained moisture supply to the highest mountain areas when records from other areas, such as the Middle Atlas lakes and marine sediment cores offshore, indicate marked aridity.
Rapidly recurring ovarian fibrosarcoma after optimal debulking surgery in a 46-year-old woman
Authors: Winarto Hariyono , Hellyanti Tantri , Purbadi Sigit , Sutrisno Sutrisno
Published: July 2020

Ovarian fibrosarcoma is an extremely rare tumour with no universally accepted guidelines for treatment. We present a 46-year-old nulliparous woman with ovarian fibrosarcoma who mainly presented with a painful abdominal enlargement. Optimal debulking surgery was performed, and a specimen of the tumour was examined. A frozen section examined during surgery revealed spindle cell morphology, raising the suspicion of ovarian fibrosarcoma, which was later confirmed by immunohistochemistry staining. Our patient refused to undergo chemotherapy and died 3 months after surgery due to tumour recurrence. Although no clear consensus exists for administering chemotherapy for fibrosarcoma, some published case reports have shown a lower chance of recurrence and better prognosis in patients who undergo chemotherapy compared with our patient.
Septic arthritis of the temporomandibular joint in an unvaccinated adolescent
Authors: Sachs Alexander , Ziegler Erik , Shupak Raymond Patrick
Published: July 2020

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition, particularly in the paediatric population. Our case involves a 15-year-old unvaccinated Amish man with acute pain and trismus of the TMJ. The diagnosis was reached after history, clinical examination, radiographic and laboratory examinations were performed. The patient improved after a minimally invasive surgical procedure and medical therapy. Failure to recognise and treat septic arthritis in a timely fashion can result in serious sequalae. Infectious aetiologies should be kept on the differential for any patient with acute TMJ pain.
What's new in equine recurrent uveitis?
Authors: Malalana Fernando
Published: July 2020

Background:Equine recurrent uveitis is a spontaneous disease characterised by repeated episodes of intraocular inflammation and pain. Uveitis can have very serious impacts on vision and it is the most common cause of blindness in horses. While an inciting cause is not always clear, microbial factors and genetic predisposition may play a significant role in a large number of cases.

Aim of the article:This article provides an overview of recent advances in the knowledge of this disease.
Effect of density on skin friction response of piles embedded in sand by simple shear interface tests
Authors: Fakharian Kazem , Vafaei Nasrin
Published: July 2020

This study focuses on a particular phenomenon related to the reduction in sand–pile skin friction with initial relative density increment from medium to dense. Frictional behaviour of a sand–pile interface is simulated using a simple shear-type device capable of inducing a constant normal stiffness condition. Sand–pile interface sliding and soil deformation components are distinguished quantitatively. The effects of initial relative density of sand, initial normal load, and constant normal stiffness on the magnitude of the pile skin friction and shear displacement at failure are examined. Results indicate that the magnitude of the mobilized shear stress at failure relies significantly on the shear stress state with respect to the inflexion point on the volume change graph, which is equivalent to the position of the peak stress ratio. Good correlations exist between results of this study and field data of several heavily instrumented piles embedded in dense to very dense sands. The presented procedure is a useful framework for establishing more accurate skin friction calculation methodologies and “t-z” curve developments of axially loaded piles.
Distributed Neural Observer-Based Formation Strategy of Non-Affine Nonlinear Multi-Agent Systems with Unknown Dynamics
Authors: Manouchehri Pejman , Ghasemi Reza , Toloei Alireza , Mohammadi Fazel
Published: July 2020

The state estimation in Multi-Agent Systems (MASs) is a challenging problem. This is due to the fact that (1) controlling nonaffine nonlinear MASs is a difficult task and also (2) the agents in MASs have direct impacts on each other. This paper presents a new distributed Neural Networks (NN) observer for the nonlinear dynamical model of MASs with nonaffine unknown dynamical agents. The proposed scheme uses the Backpropagation learning algorithm to estimate the unknown nonlinear functions of the agents. Compared with the previous studies, which primarily concentrated on the observer design for Multiple Input Multiple Output (MIMO) systems, the proposed method is applied to nonaffine nonlinear MASs. The advantages of this method are the overall stability, the fast convergence of the observer error to zero and the robustness against both uncertainties and disturbances. Nonlinear flexible-joint robots and nonlinear dynamic duffing chaotic systems are simulated to demonstrate the effectiveness and robustness of the proposed method. The proposed method is also compared with the Luenberger observer. The guaranteed stability, better performance in the presence of agents’ uncertainties, robustness against disturbances are the main advantages of the proposed method compared with the traditional observer.
A Path-Based Equivalence Checking Method Between System Level and RTL Descriptions Using Machine Learning
Authors: Hu Jian , Hu Yongyang , Lv Qi , Wang Wentao , Wang Guanwu , Chen Guilin , Wang Kang , Kang Yun , Yang Haitao
Published: July 2020

The growing complexity of modern digital design makes designers shift toward starting design exploration using high-level languages, and generating register transfer level (RTL) design from system level modeling (SLM) using high-level synthesis tools or manual transformation. Unfortunately, this translation process is very complex and error prone. The most important verification task is to check whether the RTL implementation is indeed equivalent to the system-level model. Equivalence checking is critical to ensure that the synthesized RTL conforms to its SLM specification.

In this paper, we propose a novel path-based sequential equivalence checking method to validate the transformed RTL description against its corresponding SLM description. We represent the original SLM and the transformed RTL descriptions using Finite state machines with datapath (FSMD) and compare the path-pairs of the FSMD to obtain the equivalence of the designs. Then we recognize the corresponding path-pairs from all the generated paths of FSMD with Machine learning (ML) technique, and compare the recognized path-pairs by symbolic simulation and a satisfiability modulo theories (SMT) solver. Our method can handle designs without mapping information and improve the efficiency of the state-of-the-art path-based equivalence checking methods. The promising experiments on representative benchmarks indicate the efficiency and effectiveness of our method.
Multi-Level Fine-Scaled Sentiment Sensing with Ambivalence Handling
Authors: Wang Zhaoxia , Ho Seng-Beng , Cambria Erik
Published: July 2020

Social media represent a rich source of information, such as critiques, feedback, and other opinions posted online by Internet users. Such information is typically a good reflection of users’ sentiments and attitudes towards various services, topics, or products. Sentiment analysis has become an increasingly important natural language processing (NLP) task to help users make sense of what is happening in the Internet blogosphere and it can be useful for companies as well as public organizations. However, most existing sentiment analysis techniques are only able to analyze data at the aggregate level, merely providing a binary classification (positive vs. negative), and are not able to generate finer characterizations of sentiments as well as emotions involved. This paper describes a new opinion analysis scheme, i.e., a multi-level fine-scaled sentiment sensing with ambivalence handling. The ambivalence handler is presented in detail along with the strength-level tune parameters for analyzing the strength and the fine-scale of both positive or negative sentiments. It is capable of drilling deeper into text in order to reveal multi-level fine-scaled sentiments as well as different types of emotions.
Wave Attenuation of a Pre-Tensioned Wire with Periodic Spring Supports Subjected to a Moving Force
Authors: Yang Y. B. , Yau J. D. , Urushadze S.
Published: July 2020

The pantograph-catenary system is essential to the operation of modern railways. The overhead catenary system serves to deliver steady electric power to the trains running on the railways. The propagation of waves in the catenary system can be significantly affected by its interaction with the pantograph. To investigate the wave transmission via the contact wires of a catenary system, a simplified model composed of a pre-tensioned wire suspended by periodic spring supports is adopted. For a periodic structure with wider band gaps (or stop bands), a larger cluster of frequencies of the transmitting waves can be filtered out. This is beneficial to the maintenance of the catenary system as unwanted vibrations have been reduced. To widen the band gaps, a resonator can be equipped on each of the spring supports for attenuation of a wider range of transmitting waves in the pre-tensioned wire. In this study, a unit cell conceived as the spring–resonator–wire unit is adopted to formulate the dispersion equation in closed form, from which the critical condition for widening the band gaps is derived. In addition, the moving pantograph is modeled as a moving force. From the exemplar study, it was shown that the installation of proper resonators on a catenary system can increase the gap bandwidth, such that the pantograph-induced wave transmission in the contact wires will be attenuated or filtered out.
Fermionic realization of twisted toroidal Lie algebras
Authors: Jing Naihuan , Mangum Chad R. , Misra Kailash C.
Published: July 2020

In this paper, we construct a fermionic realization of the twisted toroidal Lie algebra of type [Formula: see text] and [Formula: see text] based on the newly found Moody–Rao–Yokonuma-like presentation.
Partial Recovery of Erdős-Rényi Graph Alignment via k-Core Alignment
Authors: Cullina Daniel , Kiyavash Negar , Mittal Prateek , Poor H. Vincent
Published: July 2020

We determine information theoretic conditions under which it is possible to partially recover the alignment used to generate a pair of sparse, correlated Erdős-Rényi graphs. To prove our achievability result, we introduce the k-core alignment estimator. This estimator searches for an alignment in which the intersection of the correlated graphs using this alignment has a minimum degree of k. We prove a matching converse bound. As the number of vertices grows, recovery of the alignment for a fraction of the vertices tending to one is possible when the average degree of the intersection of the graph pair tends to infinity. It was previously known that exact alignment is possible when this average degree grows faster than the logarithm of the number of vertices.
N-Doped Porous Carbons Derived from Cross-Linked Polybenzoxazine as Efficient Catalysts for ORR in Alkaline Electrolyte
Authors: Li Xufeng , Yang Mei , Chen Hongbiao , Liu Yijiang , Li Huaming
Published: July 2020

As a promising class of metal-free oxygen reduction reaction (ORR) catalysts, N-doped carbon (NDC) catalysts have attracted widespread attention owing to their high stability, high conductivity, good poison tolerance, and environmental friendliness. We herein report the fabrication of NDC catalysts by using triphenylimidazole-containing polybenzoxazine (TPB) as the precursor. The TPB is firstly Friedel–Crafts cross-linked in CCl4 by using anhydrous AlCl3 as the catalyst. The cross-linked TPB is then pyrolyzed at 800 °C–1000 °C, giving O-containing NDC catalysts. The as-fabricated NDC-900 catalyst has a particulate morphology together with a high BET surface area (947 m2 g−1) and a highly ORR active N content (3.39 at%). Compared to the commercial Pt/C catalyst, the NDC-900 catalyst exhibits a higher ORR activity in alkaline media as evidenced by the higher onset potential (E
o, 0.986 vs 0.964 V), higher half-wave potential (E
1/2, 0.845 vs 0.815 V), and higher current density at 0.92 V (J
@0.92, 0.251 vs 0.141 mA cm−2). Moreover, the NDC-900-based Zn-air battery achieves a maximum power density of 131.4 mW cm−2 at 204.8 mA cm−2 and a high specific capacity of 818.4 mAh g−1
Zn at 5.0 mA cm−2.
Personalising Management of Behavioural and Psychological Symptoms of Dementia in Nursing Homes: Exploring the Synergy of Quantitative and Qualitative Data
Authors: Wang Gubing , Gong Haotian , Albayrak Armagan , van der Cammen Tischa J. M. , Kortuem Gerd
Published: July 2020

Researchers have been exploring how to manage Behavioural and Psychological Symptoms of Dementia (BPSD) in a personalised way, meanwhile, assistive technologies have been developed to collect a variety of personal data. This urges more research in investigating the combination of: data collected by the care team, which are mainly qualitative; and data collected by assistive technologies, the majority of which are quantitative. Previous studies, however, have yet to explore if and how a combination of quantitative and qualitative data could facilitate the care team to better understand each resident with dementia in the nursing home context for personalised BPSD management. Guided by a Research through Design approach, a prototype for collecting and visualising the quantitative and qualitative data towards personalised BPSD management was developed together with the care team. Via developing this prototype, knowledge was gained in what types of data could be combined for personalised BPSD management in nursing homes, what are their values, how to collect and present them, and how to introduce them in the working routine of the care team for analysis. The main findings suggest that the types of data to be collected could be unique for each resident with dementia; the quantitative and qualitative data are of value to each other during data collection and analysis; data collection should be quick and standardised yet flexible for the care team; the overview page is vital for data presentation; and user scenarios could be created to nudge the care team to analyse the data at certain points of their working routine. In general, a combination of qualitative data and quantitative data could help the care team to discover more insights about each resident with dementia and thus improve the current practice of personalised BPSD management.
Blood Lead Levels among Blood Donors and High-Risk Occupational Groups in a Mining Area in Ghana: Implications for Blood Transfusion among Vulnerable Populations
Authors: Agyemang Veronica , Acquaye Joseph K. , Harrison Samuel B. E. , Oppong Felix B. , Gyaase Stephany , Asante Kwaku P. , Olayemi Edeghonghon
Published: July 2020

Lead poisoning has been a major global health problem for decades, and blood transfusion has been suspected as a neglected potential source of lead exposure. Children and pregnant women are most vulnerable to the toxic effects of lead and over 40 percent of blood transfused in Ghana is given to children under 5 years. However, there is little data on the levels of lead in donor blood and the main sources of lead exposure in the Ghanaian population. This study compared blood lead levels (BLL) among selected occupations at risk of lead exposure with healthy blood donors in nonexposed occupations in a Ghanaian mining area. We enrolled 40 participants each from the following high-risk occupational groups: small scale miners, painters/sprayers, drivers/fuel station attendants, and auto-mechanics as well as 40 healthy blood donors (made up of teachers, traders, and office workers). One millilitre of blood was collected from each participant for determination of their BLL, haemoglobin concentration, and blood film morphology. A total of 200 participants made up of 186 (93%) males and 14 (7%) females were enrolled. The mean age of participants was 28.6 ± 8.2 years and their geometric mean (GM) BLL was 6.3 GSD 1.4 µg/dL [95% CI: 6.0 – 6.6]. Participants in high risk occupations had significantly higher GM BLL of 6.7 µg/dL [95% CI :6.4−7.0] compared to 5.0 µg/dL [95% CI: 4.4−5.7] for healthy blood donors [p < 0.001]. The prevalence of elevated BLL (≥5 µg/dL) among the entire study participants, high risk occupations and blood donors was 84.5%, 89.4% and 65% respectively. There was significant association between elevated BLLs and working in an at-risk occupational group [aOR = 3.58, p = 0.014]. Haemoglobin concentration was not significantly associated with elevated BLLs. Basophilic stippling was not observed in any of the blood smears. Blood lead levels were high in blood donors and at-risk occupations in the study area and occupation was associated with elevated BLLs. It is important that measures to safeguard the integrity of donor blood go beyond screening for infectious diseases to include screening individuals in high-risk occupations for lead and other heavy metals to ensure that donor blood from such individuals is safe and does not pose potential danger to the health of vulnerable populations such as children and pregnant women.
Risk and Secondary Prevention of Stroke Recurrence
Authors: Flach Clare , Muruet Walter , Wolfe Charles D.A. , Bhalla Ajay , Douiri Abdel
Published: July 2020

Background and Purpose:

With recent advances in secondary prevention management, stroke recurrence rates may have changed substantially. We aim to estimate risks and trends of stroke recurrence over the past 2 decades in a population-based cohort of patients with stroke.

Methods:

Patients with a first-ever stroke between 1995 and 2018 in South London, United Kingdom (n=6052) were collected and analyzed. Rates of recurrent stroke with 95% CIs were stratified by 5-year period of index stroke and etiologic TOAST (Trial of ORG 10172 in Acute Stroke Treatment) subtype. Cumulative incidences were estimated and multivariate Cox models applied to examine associations of recurrence and recurrence-free survival.

Results:

The rate of stroke recurrence at 5 years reduced from 18% (95% CI, 15%–21%) in those who had their stroke in 1995 to 1999 to 12% (10%–15%) in 2000 to 2005, and no improvement since. Recurrence-free survival has improved (35%, 1995–1999; 67%, 2010–2015). Risk of recurrence or death is lowest for small-vessel occlusion strokes and other ischemic causes (36% and 27% at 5 years, respectively). For cardioembolic and hemorrhagic index strokes around half of first recurrences are of the same type (54% and 51%, respectively). Over the whole study period a 54% increased risk of recurrence was observed among those who had atrial fibrillation before the index stroke (hazard ratio, 1.54 [1.09–2.17]).

Conclusions:

The rate of recurrence reduced until mid-2000s but has not changed over the last decade. The majority of cardioembolic or hemorrhagic strokes that have a recurrence are stroke of the same type indicating that the implementation of effective preventive strategies is still suboptimal in these stroke subtypes.
Sustained and Transient Processes in Event-based Prospective Memory in Adolescence and Adulthood
Authors: Magis-Weinberg Lucía , Custers Ruud , Dumontheil Iroise
Published: July 2020

Prospective memory (PM) refers to the cognitive processes associated with remembering to perform an intended action after a delay. Varying the salience of PM cues while keeping the intended response constant, we investigated the extent to which participants relied on strategic monitoring, through sustained, top–down control, or on spontaneous retrieval via transient bottom–up processes. There is mixed evidence regarding developmental improvements in event-based PM performance after the age of 13 years. We compared PM performance and associated sustained and transient neural correlates in 28 typically developing adolescents (12–17 years old) and 19 adults (23–30 years old). Lower PM cue salience associated with slower ongoing task (OT) RTs, reflected by increased μ ex-Gaussian parameter, and sustained increases in frontoparietal activation during OT blocks, both thought to reflect greater proactive control supporting cue monitoring. Behavioral and neural correlates of PM trials were not specifically modulated by cue salience, revealing little difference in reactive control between conditions. The effect of cue salience was similar across age groups, suggesting that adolescents are able to adapt proactive control engagement to PM task demands. Exploratory analyses showed that younger, but not older, adolescents were less accurate and slower in PM trials relative to OT trials than adults and showed greater transient activation in PM trials in an occipito-temporal cluster. These results provide evidence of both mature and still maturing aspects of cognitive processes associated with implementation of an intention after a delay during early adolescence.
How Much Does the Upward Advection of the Supergradient Component of Boundary Layer Wind Contribute to Tropical Cyclone Intensification and Maximum Intensity?
Authors: Li Yuanlong , Wang Yuqing , Lin Yanluan
Published: July 2020

Although the development of supergradient winds is well understood, the importance of supergradient winds in tropical cyclone (TC) intensification is still under debate. One view is that the spinup of the eyewall occurs by the upward advection of high tangential momentum associated with supergradient winds from the boundary layer. The other view argues that the upward advection of supergradient winds by eyewall updrafts results in an outward agradient force, leading to the formation of a shallow outflow layer immediately above the inflow boundary layer. As a result, the spinup of tangential wind in the eyewall by the upward advection of supergradient wind from the boundary layer is largely offset by the spindown of tangential wind due to the outflow resulting from the agradient force. In this study, the net contribution by the upward advection of the supergradient wind component from the boundary layer to the intensification rate and final intensity of a TC are quantified through ensemble sensitivity numerical experiments using an axisymmetric TC model. Results show that consistent with the second view above, the positive upward advection of the supergradient wind component from the boundary layer by eyewall updrafts is largely offset by the negative radial advection due to the outflow resulting from the outward agradient force. As a result, the upward advection of the supergradient wind component contributes little (often less than 4%) to the intensification rate and but it contributes about 10%–15% to the final intensity of the simulated TC due to the enhanced inner-core air–sea thermodynamic disequilibrium.
Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study
Authors: Doogue Róisín , McCann David , Fitzgerald Noirin , Murphy Andrew W. , Glynn Liam G. , Hayes Peter
Published: July 2020

Background

Uncontrolled blood pressure (BP) is an important modifiable risk factor for recurrent stroke. Secondary prevention measures when implemented can reduce stroke re-occurrence by 80%. However, hypertension control rates remain sub-optimal, and little data is available from primary care where most management occurs.

The aim of this study was to describe BP control in primary care-based patients with a previous stroke or transient ischaemic attack (TIA) in Ireland, and to concurrently examine antihypertensive medication-dosing.

Methods

Study participants most recent office-based BP reading was compared with the NICE (NG136) and European Society of Hypertension/ European Society of Cardiology (ESH/ESC 2013) goal of BP < 140/90 mmHg. Optimal anti-hypertensive medication dosing was determined by benchmarking prescribed doses for each drug with the World Health Organisation-Defined Daily Dosing (WHO-DDD) recommendations.

Results

We identified 328 patients with a previous stroke or TIA in 10 practices. Blood pressure was controlled in almost two thirds of patients when measured against the ESH/ESC and NICE guidelines (63.1%, n = 207). Of those with BP ≥140/90 (n = 116), just under half (n = 44, 47.3%) were adequately dosed in all anti-hypertensive medications when compared with the WHO-DDD recommendations.

Conclusion

Blood pressure control in patients post stroke/TIA appears sub-optimal in over one third of patients. A comparison of drug doses with WHO-DDD recommendations suggests that 47% of patients may benefit from drug-dose improvements. Further work is required to assess how best to manage blood pressure in patients with a previous stroke or TIA in Primary Care, as most consultations for hypertension take place in this setting.
Frequently abnormal serum gamma-glutamyl transferase activity is associated with future development of fatty liver: a retrospective cohort study
Authors: Fujii Hideki , Doi Haruna , Ko Tetsuhisa , Fukuma Taito , Kadono Toru , Asaeda Kohei , Kobayashi Reo , Nakano Takahiro , Doi Toshifumi , Nakatsugawa Yoshikazu , Yamada Shinya , Nishimura Takeshi , Tomatsuri Naoya , Sato Hideki , Okuyama Yusuke , Kimura Hiroyuki , Kishimoto Etsuko , Nakabe Nami , Shima Takatomo
Published: July 2020

Background

Nonalcoholic fatty liver disease is characterized by excessive hepatic fat accumulation. Some individuals frequently present elevated gamma-glutamyl transferase (GGT) levels without fatty liver ultrasound images and other abnormal liver enzymes levels. However, whether these individuals are at an elevated risk for developing fatty liver is unclear. We compared fatty liver change rates and risk factors between individuals with frequently elevated GGT levels and those with normal levels.

Methods

We designed a retrospective cohort study on the basis of complete medical checkup records. One group of individuals had presented normal serum GGT levels during the observation period (Normal-GGT group, n = 2713). Another group had had abnormal elevated serum GGT levels frequently (Abnormal-GGT group, n = 264). We determined the fatty liver change incident rates before and after propensity score matching. We explored confounding factors affecting fatty changes in each group using univariate and multivariate Cox models.

Results

The change incidence rates were 5.80/1000 and 10.02/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively. After propensity score matching, the incidence rates were 3.08/1000 and 10.18/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively (p = 0.026). The factors associated with fatty liver changes in the Normal-GGT group included body mass index (BMI), hemoglobin, alanine aminotransferase (ALT), albumin, triglyceride (TG), fasting blood sugar, and high-density lipoprotein levels. Those in the Abnormal-GGT group were platelet counts and TG. In our multivariable analysis, BMI, ALT, albumin, and TG levels were independent predictors of fatty changes in the Normal-GGT group, and high TG level was the only independent predictor in the Abnormal-GGT group.

Conclusions

The incidence rate of fatty liver change in the Abnormal-GGT group was higher than that in the Normal-GGT group. Consecutive elevated GGT levels increase the risk for fatty liver, and high TG levels in those individuals further independently increase the risk.
Protocol for understanding acute sarcopenia: a cohort study to characterise changes in muscle quantity and physical function in older adults following hospitalisation
Authors: Welch Carly , Greig Carolyn A. , Masud Tahir , Pinkney Thomas , Jackson Thomas A.
Published: July 2020

Background

Older adults are vulnerable to the effects of acute sarcopenia (acute muscle insufficiency) following hospitalisation. However, this condition remains poorly characterised to date. It is hypothesised that acute sarcopenia arises due to a combination of bed rest and inflammatory surge. This study aims to characterise changes in muscle quantity and function, determining which factors (clinical and biological) are most predictive, and how these relate to change in physical function at 13 weeks.

Methods

This study will include three groups of patients aged 70 years and older; patients undergoing elective colorectal surgery, patients admitted for emergency abdominal surgery, and patients admitted under general medicine with acute bacterial infections. Changes in muscle quantity (Bilateral Anterior Thigh Thickness with ultrasound and bioelectrical impedance analysis) and muscle function (muscle strength, physical performance) within 1 week of hospitalisation or surgery will be characterised, with follow-up of patients at 13 weeks. Physical function will be measured using the Patient Reported Outcome Measures Information System, and the Short Physical Performance Battery (or gait speed alone within 1 week of surgery).

Discussion

This study will fully characterise changes in muscle quantity and function in hospitalised older adults and enable risk stratification towards targeted interventions in clinical practice. The results of this study will inform further research involving interventions to ameliorate changes.

Trial registration

ClinicalTrials.govIdentifier:NCT03858192; Prospectively registered 28th February 2019.
Vitamin D receptor gene polymorphisms and susceptibility to urolithiasis: a meta-regression and meta-analysis
Authors: Imani Danyal , Razi Bahman , Khosrojerdi Arezou , Lorian Kaivan , Motallebnezhad Morteza , Rezaei Ramazan , Aslani Saeed
Published: July 2020

Background

The currently available data with respect to the association between vitamin D receptor (VDR) gene polymorphism and risk to urolithiasis are inconclusive and inconsistent. Hence, an exhaustive meta-analysis can solve the discrepancies and provide a hint for upcoming investigations. Herein, a meta-analysis was carried out to attain a conclusive estimate of the association between VDR gene single nucleotide polymorphisms (SNPs) and urolithiasis risk.

Methods

The major databases, including ISI Web of science, Scopus, and PubMed/MEDLINE were searched systematically from until June 2020 to retrieve all relevant studies. Association between VDR gene polymorphisms, including FokI (rs2228570), TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232), and urolithiasis risk was evaluated using pooled odds ratio (OR) and their corresponding 95% confidence interval (CI). Additionally, to seek for the potential source of heterogeneity, meta-regression analyses were exerted.

Results

Literature search led to finally finding of 33 studies evaluating the VDR gene SNPs and urolithiasis risk. It was observed that none of the four SNPs were significantly associated with urolithiasis predisposition. However, subgroup analysis confirmed higher risk of urolithiasis in East-Asian and Caucasian population with ApaI and TaqI gene polymorphism. The analyses of sensitivity acknowledged the results stability.

Conclusion

Although this meta-analysis did not support the association of FokI, TaqI, BsmI, and ApaI in the overall polled analysis, it suggests that ApaI and TaqI SNPs is associated with increased risk of urolithiasis in East-Asian and Caucasians populations.
A qualitative study of healthcare professionals’ experiences of providing maternity care for Muslim women in the UK
Authors: Hassan Shaima Mohamed , Leavey Conan , Rooney Jane S. , Puthussery Shuby
Published: July 2020

Background

A growing Muslim population in the UK suggests the need for healthcare professionals (HCPs) to gain a better understanding of how the Islamic faith influences health related perceptions and healthcare seeking behaviour. Although some researchers have explored the experiences of Muslim women as recipients of healthcare, little attention has been paid to the challenges HCPs face as service providers on a day-to-day basis whilst caring for Muslim women. The aim of this study was to investigate HPCs lived experiences of providing maternity care for Muslim women.

Method

Data was collected through twelve semi-structured one-to-one qualitative interviews with HCPs in a large National Health Service (NHS) maternity unit located in the North West of England. Interview participants included Community and specialist clinic (e.g. clinic for non-English speakers), Midwives in a variety of specialist roles (7), Gynaecology Nurses (2), Breastfeeding Support Workers (2) and a Sonographer (1). The audio-recorded interviews were transcribed and analysed thematically.

Results

The majority of participants expressed an understanding of some religious values and practices related to Muslim women, such as fasting the month of Ramadhan and that pregnant and breastfeeding women are exempt from this. However, HCPs articulated the challenges they faced when dealing with certain religious values and practices, and how they tried to respond to Muslim women’s specific needs. Emerging themes included: 1) HCPs perceptions about Muslim women; 2) HCPs understanding and awareness of religious practices; 3) HCPs approaches in addressing and supporting Muslim women’s religious needs; 4) Importance of training in providing culturally and religiously appropriate woman-centred care.

Conclusion

Through this study we gained insight into the day-to-day experiences of HCPs providing care provision for Muslim women. HCPs showed an understanding of the importance of religious and cultural practices in addressing the needs of Muslim women as part of their role as maternity care providers. However, they also identified a need to develop training programmes that focus on cultural and religious practices and their impact on women’s health care needs. This will help support HCPs in overcoming the challenges faced when dealing with needs of women from different backgrounds.
Validation of the effectiveness of a digital integrated healthcare platform utilizing an AI-based dietary management solution and a real-time continuous glucose monitoring system for diabetes management: a randomized controlled trial
Authors: Park Sung Woon , Kim Gyuri , Hwang You-Cheol , Lee Woo Je , Park Hyunjin , Kim Jae Hyeon
Published: July 2020

Background

Despite the numerous healthcare smartphone applications for self-management of diabetes, patients often fail to use these applications consistently due to various limitations, including difficulty in inputting dietary information by text search and inconvenient and non-persistent self-glucose measurement by home glucometer. We plan to apply a digital integrated healthcare platform using an artificial intelligence (AI)-based dietary management solution and a continuous glucose monitoring system (CGMS) to overcome those limitations. Furthermore, medical staff will be performing monitoring and intervention to encourage continuous use of the program. The aim of this trial is to examine the efficacy of the program in patients with type 2 diabetes mellitus (T2DM) who have HbA1c 53–69 mmol/mol (7.0–8.5%) and body mass index (BMI) ≥ 23 mg/m2.

Methods

This is a 48-week, open-label, randomized, multicenter trial consisting of patients with type 2 diabetes. The patients will be randomly assigned to three groups: control group A will receive routine diabetes care; experimental group B will use the digital integrated healthcare platform by themselves without feedback; and experimental group C will use the digital integrated healthcare platform with continuous glucose monitoring and feedback from medical staff. There are five follow-up measures: baseline and post-intervention at weeks 12, 24, 36, and 48. The primary end point is change in HbA1c from baseline to six months after the intervention.

Discussion

This trial will verify the effectiveness of a digital integrated healthcare platform with an AI-driven dietary solution and a real-time CGMS in patients with T2DM.

Trial registration

Clinicaltrials.gov NCT 04161170, registered on 08 November 2019.

https://clinicaltrials.gov/ct2/show/NCT04161170?term=NCT04161170&draw=2&rank=1
Identifying diagnosis evidence of cardiogenic stroke from Chinese echocardiograph reports
Authors: Qin Lu , Xu Xiaowei , Ding Lingling , Li Zixiao , Li Jiao
Published: July 2020

Background

Cardiogenic stroke has increasing morbidity in China and brought economic burden to patient families. In cardiogenic stroke diagnosis, echocardiograph examination is one of the most important examinations. Sonographers will investigate patients’ heart via echocardiograph, and describe them in the echocardiograph reports. In this study, we developed a machine learning model to automatically identify diagnosis evidences of cardiogenic stroke providing to neurologist for clinical decision making.

Methods

We collected 4188 Chinese echocardiograph reports of 4018 patients, with average length 177 Chinese characters in free-text style. Collaborating with neurologists and sonographers, we summarized 149 phrases on diagnosis evidence of cardiogenic stroke such as “二尖瓣重度狭窄” (severe mitral stenosis), “主动脉瓣退行性变” (aortic valve degeneration) and so on. Furthermore, we developed an annotated corpus via mapping 149 phrases to the 4188 reports. We selected 11 most frequent diagnosis evidence types such as “二尖瓣狭窄” (mitral stenosis) for further identifying. The generated corpus is divided into training set and testing set in the ratio of 8:2, which is used to train and validate a machine learning model to identify the evidence of cardiogenic stroke using BiLSTM-CRF algorithm.

Results

Our machine learning method achieved the average performance on the diagnosis evidence identification is 98.03, 90.17 and 93.94% respectively. In addition, our method is capable to identify the novel diagnosis evidence of cardiogenic stroke description such as “二尖瓣中-重度狭窄” (mitral stenosis), “主动脉瓣退行性病变” (aortic valve calcification) et al.

Conclusions

In this study, we analyze the structure of the echocardiograph reports and summarized 149 phrases on diagnosis evidence of cardiogenic stroke. We use the phrases to generate an annotated corpus automatically, which greatly reduces the cost of manual annotation. The model trained based on the corpus also has a good performance on the testing set. The method of automatically identifying diagnosis evidence of cardiogenic stroke proposed in this study will be further refined in the practice.
High prevalence of rare FBLIM1 gene variants in an Italian cohort of patients with Chronic Non-bacterial Osteomyelitis (CNO)
Authors: d’Adamo Adamo Pio , Bianco Anna Monica , Ferrara Giovanna , La Bianca Martina , Insalaco Antonella , Tommasini Alberto , Pardeo Manuela , Cattalini Marco , La Torre Francesco , Finetti Martina , Alizzi Clotilde , Simonini Gabriele , Messia Virginia , Pastore Serena , Cimaz Rolando , Gattorno Marco , Taddio Andrea ,   for the Italian Pediatric Rheumatology Study Group
Published: July 2020

Background

FBLIM1 gene has been recently demonstrated to be involved in the pathogenesis of bone sterile inflammation. The aim of the study is to evaluate the prevalence of FBLIM1 gene variants in a cohort of 80 Italian patients with Chronic Non-bacterial Osteomyelitis (CNO).

Methods

The coding regions of FBLIM1 gene were sequenced in a cohort of 80 patients with CNO using DNA extracted from blood lymphocytes, and PCR products were sequenced. Only rare (global MAF < 2%), coding variants detected were considered. Clinical evaluation of patients with rare variants and those without was performed. Fisher’s exact test was used to compare categorical and ordinal data, and Student’s t-test was used to analyze continuous data.

Results

Eighteen out of 80 patients (~ 22%) presented at least one rare coding variant in FBLIM1. Eight patients presented a variant never associated before with CNO. All patients presented classical features of CNO and no statistical difference between patients with presence of FBLMI1 variants and those without were found in terms of clinical manifestation, treatment, and outcome.

Conclusion

Considering the high frequency of rare variants in our CNO cohort, our data seem to confirm a possible role of FBLIM1 in the pathogenesis of CNO suggesting that CNO is a disorder of chronic inflammation and imbalanced bone remodeling.
Intermediate gastropod hosts of major feline cardiopulmonary nematodes in an area of wildcat and domestic cat sympatry in Greece
Authors: Dimzas Dimitris , Morelli Simone , Traversa Donato , Di Cesare Angela , Van Bourgonie Yoo Ree , Breugelmans Karin , Backeljau Thierry , di Regalbono Antonio Frangipane , Diakou Anastasia
Published: July 2020

Background

The metastrongyloid nematodes Aelurostrongylus abstrusus, Troglostrongylus brevior and Angiostrongylus chabaudi are cardiopulmonary parasites affecting domestic cats (Felis catus) and wildcats (Felis silvestris). Although knowledge on these nematodes has been improved in the past years, gaps in our knowledge of their distribution and role of gastropods as intermediate hosts in Europe still exist. This study reports on the presence of these nematodes and their intermediate hosts in an area in Greece where domestic cats and wildcats occur in sympatry.

Methods

Terrestrial gastropods were collected in the field and identified morphologically and by mitochondrial DNA-sequence analysis. Metastrongyloid larvae were detected by artificial digestion, morphologically identified to the species and stage level and their identity was molecularly confirmed.

Results

Aelurostrongylus abstrusus was found in the snails Massylaea vermiculata and Helix lucorum, T. brevior in the slug Tandonia sp., and A. chabaudi in the slug Limax sp. and the snails H. lucorum and M. vermiculata.

Conclusions

To the best of our knowledge this study provides the first reports of (i) terrestrial gastropods being naturally infected with A. chabaudi, (ii) T. brevior naturally infecting terrestrial gastropods in Europe, and (iii) A. abstrusus naturally infecting terrestrial gastropods in Greece. Furthermore, the present study describes for the first time developmental stages of A. chabaudi and T. brevior in naturally infected gastropods. The biological characteristics of various intermediate gastropod hosts that could influence the distribution and expansion of feline cardiopulmonary nematodes are discussed, along with epizootiological implications and perspectives.
Water content of the endothelial glycocalyx layer estimated by volume kinetic analysis
Authors: Hahn Robert G.
Published: July 2020

Background

The water volume of the endothelial glycocalyx layer has been estimated at 0.7 to 1.7 L using tracer methods of unclear value. The present study attempts to measure this fluid volume by analyzing the kinetics of a crystalloid fluid load.

Methods

An intravenous infusion of approximately 1 L of Ringer’s acetate was administered to 35 healthy volunteers, and the central volume of distribution of the water volume was calculated from the urinary excretion and frequent measurements of the fluid-induced hemodilution using mixed-effects modeling software. Comparisons were made with the plasma volume derived from three published anthropometric regression equations based on isotope measurements. In a second analysis, up to 2.5 L of Ringer’s was administered to 60 volunteers selected from a cohort of 160 to have as similar hematocrits as possible to the volunteers whose data were used to create the anthropometric equations.

Results

Volume kinetics showed that the infused crystalloid fluid occupied a larger central fluid space than was estimated with the isotope measurements. The first analysis of the 35 subjects indicated a mean difference of 0.51 L in males and 0.49 L in females. The second, larger analysis showed a mean excess volume of 0.43 L, which was approximately 15% of the circulating plasma volume.

Conclusions

A crystalloid fluid load expands a 0.4–0.5 L larger central fluid space than the circulating plasma volume. The excess volume is probably located in the glycocalyx layer.
Effects of randomly orienting penny-shaped cracks on the elastic properties of transversely isotropic rocks
Authors: Xu Denghui , Han Tongcheng , Liu Shengbiao , Fu Li-Yun
Published: July 2020

Fractured reservoirs, as one kind of unconventional reservoirs, have great potential for oil and gas development, and their accurate characterization requires the development of rock-physics models that better simulate real fractured rocks. However, current models focus mainly on the elastic properties of rocks with aligned cracks, while the effects of randomly orienting cracks in transversely isotropic (TI) rocks are poorly studied even though such conditions are frequently encountered in the earth. To address this problem, we have derived models for the elastic properties of rocks with a TI background permeated by 3D inclined cracks and randomly orienting cracks. Then, based on the developed models, we comprehensively study the effects of the two inclination angles (i.e., the dip angle between the cracks and the isotropic plane and the rotation angle between the cracks and the plane normal to the isotropic plane, respectively) of 3D inclined cracks on the elastic properties of TI rocks. We determine that the two angles have significant influences on the elastic coefficients and hence the elastic velocities, and that their influences on the elastic properties are varying in different directions. We further investigate the effects of crack density and aspect ratio of randomly orienting cracks on the elastic properties of the fractured rocks with a TI background. The results show that the increasing crack density and crack aspect ratio reduce the elastic coefficients and velocities for rocks with randomly orienting cracks, in which the relations between compressional-wave velocities and the crack properties (i.e., crack density and crack aspect ratio) are obtained to aid the interpretation of the acquired acoustic exploration data. The proposed new models can greatly improve the modeling capability for the elastic properties of rocks with a TI background permeated by inclined and randomly orienting cracks.