bluuebunny/crossref_metadata_2025 huggingface dataset:
Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) Spectroscopy Analysis of Saliva for Breast Cancer Diagnosis
Authors: Ferreira Izabella C. C. , Aguiar Emília M. G. , Silva Alinne T. F. , Santos Letícia L. D. , Cardoso-Sousa Léia , Araújo Thaise G. , Santos Donizeti W. , Goulart Luiz R. , Sabino-Silva Robinson , Maia Yara C. P.
Published: February 2020

Saliva biomarkers using reagent-free biophotonic technology have not been investigated as a strategy for early detection of breast cancer (BC). The attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy has been proposed as a promising tool for disease diagnosis. However, its utilization in cancer is still incipient, and currently saliva has not been used for BC screening. We have applied ATR-FTIR onto saliva from patients with breast cancer, benign breast disease, and healthy matched controls to investigate its potential use in BC diagnosis. Several salivary vibrational modes have been identified in original and second-derivative spectra. The absorbance levels at wavenumber 1041 cm−1 were significantly higher (p<0.05) in saliva of breast cancer patients compared with those of benign patients, and the ROC curve analysis of this peak showed a reasonable accuracy to discriminate breast cancer from benign and control patients. The 1433–1302.9 cm−1 band area was significantly higher (p<0.05) in saliva of breast cancer patients than in control and benign patients. This salivary ATR-FTIR spectral area was prevalidated as a potential diagnostic biomarker of BC. This spectral biomarker was able to discriminate human BC from controls with sensitivity and specificity of 90% and 80%, respectively. Besides, it was able to differentiate BC from benign disease with sensitivity and specificity of 90% and 70%, respectively. Briefly, for the first time, saliva analysis by ATR-FTIR spectroscopy has demonstrated the potential use of salivary spectral biomarkers (1041 cm−1 and 1433–1302.9 cm−1) as a novel alternative for noninvasive BC diagnosis, which could be used for screening purposes.
Migrated Tubal Ligation (Filshie) Clip as an Uncommon Cause of Chronic Abdominal Pain
Authors: Sharma Sahil , Martyniak Radek , Khokhotva Vladislav
Published: February 2020

Tubal ligation (TL) is an effective and common method of fertility control. In the year 2009, over 24,000 were performed in Canada alone. Migration of Filshie clips used during TL is estimated to occur in 25% of all patients; 0.1-0.6% of these patients subsequently experience symptoms or extrusion of the clip from anatomical sites such as the anus, vagina, urethra, or abdominal wall. Migrated clips may present as chronic groin sinus, perianal sepsis, or chronic abdominal pain. These symptoms can occur as early as 6 weeks or as late as 21 years after application. We present the case of a 49-year-old female with a 3.5-year history of intermittent dull nonradiating left upper quadrant (LUQ) pain lasting on average 2-3 days. There were no other associated symptoms, and the longest pain-free period was 4 days. Her past medical history includes COPD, GERD, IBS, and depression. Current medications are only remarkable for Symbicort. Pertinent past surgical history includes laparoscopic tubal ligation with Filshie clips in 1999, followed by a vaginal hysterectomy in 2013. Migrated tubal ligation clip was noted on an abdominal X-ray. The patient was then referred for surgical management. Subsequent CT scan confirmed a solitary clip present adjacent to the left lobe of the liver. No other abnormalities were reported. Patient underwent laparoscopy for removal of the clip, which was identified to be underneath the left lobe of the liver embedded in the gastrohepatic omentum. Please see the video link provided. Postoperative pathology report confirmed the presence of a Filshie clip. Patient reported complete resolution of her LUQ pain at a 5-week and 3.5-month follow-up. This case shows that although symptomatic clip migration is a rare phenomenon, it should be given special consideration in women with unexplained chronic abdominal pain and a history of TL. Additionally, removal of clip can provide resolution of symptoms.
Note on the Reformulated Zagreb Indices of Two Classes of Graphs
Authors: Qu Tongkun , He Mengya , Ji Shengjin , Li Xia
Published: February 2020

The reformulated Zagreb indices of a graph are obtained from the original Zagreb indices by replacing vertex degrees with edge degrees, where the degree of an edge is taken as the sum of degrees of its two end vertices minus 2. In this paper, we obtain two upper bounds of the first reformulated Zagreb index among all graphs with p pendant vertices and all graphs having key vertices for which they will become trees after deleting their one key vertex. Moreover, the corresponding extremal graphs which attained these bounds are characterized.
Bond Behavior between Steel Rebar and RCA Concrete after Exposure to Elevated Temperatures
Authors: Zou Wanjie , Liang Jiongfeng , Liu Dawei , Zhang Guangwu
Published: February 2020

To explore the bond behavior between steel rebar and recycled coarse aggregate (RCA) concrete after exposure to elevated temperatures, an experimental study was carried out. The results demonstrated that the bond strength of RCA concrete pullout specimens decreased greatly with increasing temperature. As the exposure temperature elevated, the slope of the ascending portion of the bond‐slip curves gradually declined, and the descending portion of the curves tended to flatten. A modified model was developed to predict the bond strength between RCA concrete and steel rebar after exposure to elevated temperature, and the predicted results showed a very good fit in the experimental test results. Besides, the proposed bond‐slip relations for steel rebar in RCA concrete after elevated temperatures showed satisfactory agreement with test results.
Modeling of Power Transition in Full Power Shift of Hydromechanical Transmission
Authors: Bao Yong , Zhong Zaimin , Yang Shujun
Published: February 2020

This paper shall explore the dynamics of power transition in full power shift of hydromechanical transmission (HMT) and focus on the ideal target displacement ratio. An arithmetic two-range HMT is taken as the research object. A mathematical model of power transition in full power shift is established, including the hydraulic transmission unit model and the brake torque model during the double brakes overlapping. Aiming at the constant output power of HMT in the shift process, a prediction model of the displacement ratio target value is established, and the prediction method is proposed. By combining theoretical analysis and experimental research, it proves that the power transition model can describe the power transition process. And the prediction method of the displacement ratio target value proposed in this paper can complete the power transition when the double brakes overlap. In the power shift process, the output power can be transmitted normally in full power. The power transition model and the prediction method of the displacement ratio target value can provide theoretical and engineering references for the full power shift of HMT.
Leader-Following Multiple Unmanned Underwater Vehicles Consensus Control under the Fixed and Switching Topologies with Unmeasurable Disturbances
Authors: Yan Zheping , Wu Yi , Liu Yibo , Ren Hongliang , Du Xue
Published: February 2020

We propose a consensus control strategy for multiple unmanned underwater vehicles (multi-UUVs) with unmeasurable disturbances under the fixed and switching topologies. The current methods presented in the literature mainly solve tracking consensus problems with the disturbances under the time-invariant and time-varying topologies, respectively. In the paper, considering the complex nonlinear and couple model of the UUV, the technique of the feedback linearization is employed to transform the nonlinear UUV model into a second-order integral UUV model. For unmeasurable disturbances consisting of unknown model uncertainties and external disturbance for each UUV, we design the distributed extended state observer (DESO) to estimate the disturbances using the UUV position information relative to its neighbours. Moreover, leader-following multi-UUVs consensus control algorithm that enables all following UUVs to track the leader UUV state information based on the estimation state information from the DESO is proposed for two types of topologies, the fixed and switching topologies. Finally, simulation results are shown to demonstrate the effectiveness of the algorithm proposed in the paper.
Fluid Permeability of Ground Steel Slag‐Blended Composites Evaluated by Pore Structure
Authors: Yang Jin , Jiang Jian , Su Ying , He Xingyang , Wang Yingbin , Chen Shun , Tan Hongbo , Oh Sang-Keun
Published: February 2020

The resource utilization of steel slag has attracted wide attention. In the present work, the pore structure of cement paste with and without ground basic oxygen furnace slag (BOFS) up to 180 days was investigated by mercury intrusion porosimetry. Permeability was evaluated from the tested pore structure. Results indicate that the porosity, critical pore radius, pore‐throat radius, and permeability are increased with the BOFS content and levels off after 28 days. Lower gel porosity and higher coarse capillary porosity were observed in BOFS‐blended composites. The calculated permeability (around 0.30–7.49 × 10−19 m2) based on the pore structure agrees well with the range of reported experimental measurements. Well‐correlated linear and power‐law relationship was noticed between permeability and porosity and characteristic pore radius, respectively.
Chloroquine and Rapamycin Augment Interleukin-37 Expression via the LC3, ERK, and AP-1 Axis in the Presence of Lipopolysaccharides
Authors: Shi Xiaoyi , Lai Chunhui , Zhao Lianyu , Zhang Mingying , Liu Xi , Peng Shanqin , Guo Weizhong , Xu Qiuying , Chen Song , Chen Guang-xing
Published: February 2020

IL-37 is a cytokine that plays critical protective roles in many metabolic inflammatory diseases, and its therapeutic potential has been confirmed by exogenous IL-37 administration. However, its regulatory mechanisms remain unclear. U937 cells were treated with autophagy-modifying reagents (3-MA, chloroquine, and rapamycin) with or without LPS stimulation. Thereafter, IL-37 expression and autophagic markers (Beclin1, P62/SQSTM1, and LC3) were determined. For regulatory signal pathways, phosphorylated proteins of NF-κB (p65 and IκBα), AP-1 (c-Fos/c-Jun), and MAPK signal pathways (Erk1/2 and p38 MAPK) were quantified, and the agonists and antagonists of MAPK and NF-κB pathways were also used. Healthy human peripheral blood mononuclear cells were treated similarly to confirm our results. Four rhesus monkeys were also administered chloroquine to evaluate IL-37 inductionin vivoand its bioactivity on CD4 proliferation and activation. IL-37 was upregulated by rapamycin and chloroquine in both U937 cells and human PBMCs in the presence of LPS. IL-37 was preferentially induced in autophagic cells associated with LC3 conversion. AP-1 and p65 binding motifs could be deduced in the sequence of the IL-37 promoter. Inductive IL-37 expression was accompanied with increased phosphorylated Erk1/2 and AP-1 and could be completely abolished by an Erk1/2 inhibitor or augmented by Erk1/2 agonists. In monkeys, chloroquine increased IL-37 expression, which was inversely correlated with CD4 proliferation and phosphorylated STAT3. IL-37 levels were induced by rapamycin and chloroquine through the LC3, Erk1/2, and NF-κB/AP-1 pathways. Functional IL-37 could also be inducedin vivo.
Experimental Research on Seismic Performance of Damaged Brick Walls Strengthened with Embedded Horizontal Steel Bars
Authors: Tingbin Liu , Rubo Jia , Xianke Pei , Jiawei Zhang , Jianchang Zhao
Published: February 2020

Six brick masonry specimens (two unreinforced specimens, two reinforced specimens, and two specimens reinforced after being damaged), which have different aspect ratios, were tested under low‐frequency cyclic loading. The seismic performances of these specimens, including failure characteristics, deformation capacity, carrying capacity, energy dissipation capacity, hysteresis characteristics, and stiffness degradation, were analyzed. The following results were obtained: the ductility of the damaged walls could be significantly improved after they were reinforced with embedded horizontal steel bars; the ultimate shear capacity of the damaged brick masonry walls with the aspect ratios of 1.8 and 0.5 was improved by 6.8% and 4.7%, respectively; the displacement corresponding to the ultimate bearing capacity was close to that of the unreinforced brick masonry wall; the hysteresis loop of the reinforced wall became plumper and encompassed a larger area; after the ultimate load was reached, a clear yielding platform appeared in the skeleton curve of the reinforced wall; the reinforced wall exhibited good ductility, after entering plastic stage; the energy dissipation capacity of the reinforced wall was significantly greater than that of the unreinforced wall. In conclusion, the seismic performance of the damaged brick masonry wall can be improved by embedding horizontal steel bars, and this reinforcing method can be applied in the postseismic reconstruction process.
Iterative Algorithms for Symmetric Positive Semidefinite Solutions of the Lyapunov Matrix Equations
Authors: Sun Min , Liu Jing
Published: February 2020

It is well-known that the stability of a first-order autonomous system can be determined by testing the symmetric positive definite solutions of associated Lyapunov matrix equations. However, the research on the constrained solutions of the Lyapunov matrix equations is quite few. In this paper, we present three iterative algorithms for symmetric positive semidefinite solutions of the Lyapunov matrix equations. The first and second iterative algorithms are based on the relaxed proximal point algorithm (RPPA) and the Peaceman–Rachford splitting method (PRSM), respectively, and their global convergence can be ensured by corresponding results in the literature. The third iterative algorithm is based on the famous alternating direction method of multipliers (ADMM), and its convergence is subsequently discussed in detail. Finally, numerical simulation results illustrate the effectiveness of the proposed iterative algorithms.
Dexmedetomidine Attenuates Monocyte-Endothelial Adherence via Inhibiting Connexin43 on Vascular Endothelial Cells
Authors: Chai Yunfei , Yu Runying , Liu Yong , Wang Sheng , Yuan Dongdong , Chen Jimei
Published: February 2020

Current studies have identified the multifaceted protective functions of dexmedetomidine on multiple organs. For the first time, we clarify effects of dexmedetomidine on monocyte-endothelial adherence and whether its underlying mechanism is relative to connexin43 (Cx43), a key factor regulating monocyte-endothelial adherence. U937 monocytes and human umbilical vein endothelial cells (HUVECs) were used to explore monocyte-endothelial adherence. Two special siRNAs were designed to knock down Cx43 expression on HUVECs. U937-HUVEC adhesion, adhesion-related molecules, and the activation of the MAPK (p-ERK1/2, p-p38, and p-JNK1/2) signaling pathway were detected. Dexmedetomidine, at its clinically relevant concentrations (0.1 nM and 1 nM), was given as pretreatments to HUVECs. Its effects on Cx43 and U937-HUVEC adhesion were also investigated. The results show that inhibiting Cx43 on HUVECs could attenuate the contents of MCP-1, soluble ICAM-1 (sICAM-1), soluble VCAM-1 (sVCAM-1), and the nonprocessed variants of the adhesion molecules ICAM-1 and VCAM-1 and ultimately result in U937-HUVEC adhesion decrease. Meanwhile, the activation of MAPKs was also inhibited. U0126 (inhibiting p-ERK1/2) and SB202190 (inhibiting p38) decreased the contents of MCP-1, sICAM-1, and sVCAM-1, but SP600125 (inhibiting p-JNK1/2) had none of these effects. ICAM-1 and VCAM-1 could be regulated in a similar way. Dexmedetomidine pretreatment inhibited Cx43 on HUVECs, the activation of MAPKs, and U937-HUVEC adhesion. Therefore, we conclude that dexmedetomidine attenuates U937-HUVEC adhesion via inhibiting Cx43 on HUVECs modulating the activation of MAPK signaling pathways.
U-Model-Based Finite-Time Control for Nonlinear Valve-Controlled Hydraulic Servosystem
Authors: Yan Hao , Li Jiafeng , Nouri Hassan , Xu Lingling
Published: February 2020

Valve-controlled servosystems are widely used in dynamic tracking, but, not properly studied, nonlinearity, perturbation of internal parameters, and external disturbance have significant impacts on the control performance and challenge in the controller design. This study, with consideration of the finite pressure gain of actual servovalves, proposes a new unified nonlinear model of the valve-controlled servosystem. Based on a U-control platform, this study makes the control strategy design independent from the nonlinear plant, and a virtual nominal plant is presented to eliminate the unmodeled high-frequency characteristics, acquire the desired control performance, and enable the control variable to be explicitly expressed. Then, there follows, designing the U-model-based finite-time control in the valve-controlled systems. Simulation demonstrations show the consistency with theoretical development that the valve-controlled system can smoothly track the command signal within the specified time, and the phase lag is eliminated. Moreover, U-model’s application effectively copes with the system chattering, and with the maximum of 1 m/s the dynamic position error caused by discretization of the controller is reduced to less than 0.15%, which can satisfy the demand of general valve-controlled servosystems.
Adult Literacy and Skill Acquisition Programmes as Correlates of Women Empowerment and Self-Reliance in The Gambia
Authors: Olagbaju Oladotun Opeoluwa
Published: February 2020

Self-reliance and empowerment for women have been at the centre of the agitations for gender balance in Africa. Women are largely marginalised, and obvious gender disparity exists in school enrolment and completion rates in most African countries, particularly in The Gambia. Efforts to address this shortfall led to the adoption of adult literacy and skill acquisition programmes to build the capacity of women and out-of-school adults. Training contents were developed and centres set up across the six educational regions in the country, but most graduates of the programme are neither financially empowered nor self-reliant. Therefore, the study examined the relationship between these capacity-building programmes and women empowerment and self-reliance. The research employed a descriptive design of survey type with 250 participants from two educational regions in The Gambia. Four null hypotheses were raised and data collected through a questionnaire were analysed using t-test, mean, and simple frequency. The result showed that adult literacy and skill acquisition programmes correlate significantly with women empowerment and self-reliance in The Gambia. Recommendations were made on how to improve on the existing training structure.
Central Role of Oxidative Stress in Age-Related Macular Degeneration: Evidence from a Review of the Molecular Mechanisms and Animal Models
Authors: Abokyi Samuel , To Chi-Ho , Lam Tim T. , Tse Dennis Y.
Published: February 2020

Age-related macular degeneration (AMD) is a common cause of visual impairment in the elderly. There are very limited therapeutic options for AMD with the predominant therapies targeting vascular endothelial growth factor (VEGF) in the retina of patients afflicted with wet AMD. Hence, it is important to remind readers, especially those interested in AMD, about current studies that may help to develop novel therapies for other stages of AMD. This study, therefore, provides a comprehensive review of studies on human specimens as well as rodent models of the disease, to identify and analyze the molecular mechanisms behind AMD development and progression. The evaluation of this information highlights the central role that oxidative damage in the retina plays in contributing to major pathways, including inflammation and angiogenesis, found in the AMD phenotype. Following on the debate of oxidative stress as the earliest injury in the AMD pathogenesis, we demonstrated how the targeting of oxidative stress-associated pathways, such as autophagy and nuclear factor erythroid 2-related factor 2 (Nrf2) signaling, might be the futuristic direction to explore in the search of an effective treatment for AMD, as the dysregulation of these mechanisms is crucial to oxidative injury in the retina. In addition, animal models of AMD have been discussed in great detail, with their strengths and pitfalls included, to assist inform in the selection of suitable models for investigating any of the molecular mechanisms.
The Ventilatory and Diffusion Dysfunctions in Obese Patients with and without Obstructive Sleep Apnea-Hypopnea Syndrome
Authors: Rouatbi Sonia , Ghannouchi Ines , Kammoun Rim , Ben Saad Helmi
Published: February 2020

Objective. To analyze the ventilatory and alveolar-capillary diffusion dysfunctions in case of obesity with or without an OSAS.Methods. It is a cross-sectional study of 48 obese adults (23 OSAS and 25 controls). Anthropometric data (height, weight, and body mass index (BMI)) were collected. All adults responded to a medical questionnaire and underwent polysomnography or sleep polygraphy for apnea-hypopnea index (AHI) and percentage of desaturation measurements. The following lung function data were collected: pulmonary flows and volumes, lung transfer factor for carbon monoxide (DLCO), and fraction of exhaled nitric oxide (FeNO).Results. Obesity was confirmed for the two groups with a total sample mean value of BMI = 35.06 ± 4.68 kg/m2. A significant decrease in lung function was noted in patients with OSAS compared with controls. Indeed, when compared with the control group, the OSAS one had a severe restrictive ventilatory defect (total lung capacity: 93 ± 14 vs.79 ± 12%), an abnormal DLCO (112 ± 20 vs. 93 ± 22%), and higher bronchial inflammation (18.40 ± 9.20 vs.31.30 ± 13.60 ppb) (p<0.05).Conclusion. Obesity when associated with OSAS increases the severity of pulmonary function and alveolar-capillary diffusion alteration. This can be explained in part by the alveolar inflammation.
Assessing Spatiotemporal Characteristics of Urban PM2.5 Using Fractal Dimensions and Wavelet Analysis
Authors: Wang Ligang , Zhang Haizhong , Mao Liang , Li Shan , Wu Hao
Published: February 2020

Due to rapid urbanization and industrialization, atmospheric fine particulate matter (PM2.5) has become a primary urban pollutant, seriously affecting air quality and resident health. Existing airborne remote sensing and ground sensor monitoring can efficiently collect PM2.5 data. It is urgent yet challenging to fully use these two monitoring modes to analyze the spatial distribution and dynamic changes of PM2.5. This paper proposes a method to analyze the spatiotemporal characteristics of urban PM2.5 concentration using airborne and ground monitoring data. The method utilizes the boundary dimension and the radius dimension to describe the spatial distribution characteristics of PM2.5 and then adopts wavelet analysis to detect the fluctuation periods of PM2.5 concentration. Case study was performed based on the moderate-resolution imaging spectroradiometer (MODIS) data and the daily ground monitoring concentration of PM2.5 from 2014 to 2017 in Beijing. The decrease results of boundary dimension indicate that the changes in PM2.5 concentration tend to be slower over time, and the fluctuation amplitude gradually becomes smaller. The increase results closer to 2.0 in the radius dimensions suggest that the PM2.5 distribution becomes more uniform, indicating that the pollution control in Beijing had achieved initial success. The frequency results of wavelet analysis reveal that PM2.5 concentration in Beijing is mainly subject to periodic variation of 190 days. These findings can help us to gain deeper insight into the complex spatiotemporal characteristics of urban PM2.5.
Secure Outsourced Medical Data against Unexpected Leakage with Flexible Access Control in a Cloud Storage System
Authors: Zhou Xingguang , Liu Jianwei , Zhang Zongyang , Wu Qianhong
Published: February 2020

The application of cloud storage system has been deployed widely in recent years. A lot of electronic medical records (EMRs) are collected and uploaded to the cloud for scalable sharing among the authority users. It is necessary to guarantee the confidentiality of EMRs and the privacy of EMR owners. To achieve this target, we summarize a series of attack behaviors in the cloud storage system and present the security model against many types of unexpected privacy leakage. Privacy of unassailed EMRs is guaranteed in this model, and the influence of privacy leakage is controlled in a certain scope. We also propose a role-based access control scheme to achieve flexible access control on these private EMRs. One can access medical records only if his/her role satisfies the defined access policy, which implies a fine-grained access control. Theoretical and experimental analyses show the efficiency of our scheme in terms of computation and communication.
Effect of Gender and Age on the Correlation between Helicobacter pylori and Colorectal Adenomatous Polyps in a Chinese Urban Population: A Single Center Study
Authors: Zhao Xia-Xia , Liu Ming-Hao , Wang Rui-Ling , Tian Tian
Published: February 2020

Objectives. To investigate whether Helicobacter pylori (H. pylori) infection increases the risk of colorectal adenomatous polyp (CAP) in the context of age and gender. Methods. A total of 563 study subjects (male/female, 368/195) from Beijing, China, with higher nursing level who underwent colonoscopy were retrospectively collected. H. pylori and CAP were detected by carbon-13 urea breath test and colorectal colonoscopy. The correlations between the number, size, distribution, and pathological grade of CAP and H. pylori infection were analyzed. The population was further stratified by age and gender in order to examine the risk of H. pylori and CAP in the context of these variables. The influence of H. pylori on the risk of CAP was assessed by logistic regression model. Results. 315 participants were diagnosed with CAP, and 207 participants were classified as healthy controls. The prevalence of H. pylori in the CAP group was significantly higher than that in the healthy control group (119/315, 37.8% versus 44/207, 21.3%) (p<0.001). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (p=0.033). Furthermore, H. pylori infection was identified as one of the major risk factors of CAP (OR=2.679; 95% CI: 1.717-4.179, p<0.001), independent of age, sex, and body mass index and was correlated with size, distribution, and pathological grading of CAP (p<0.001). Conclusions. H. pylori is a major risk factor for CAP. Further studies are needed to assess the effects of H. pylori treatment or persistent infection on the occurrence or recurrence of CAP.
Study on Flame Spread Characteristics of Flame-Retardant Cables in Mine
Authors: Ke Gao , Zimeng Liu , Jinzhang Jia , Zeyi Liu , Yisimayili Aiyiti , Zhipeng Qi , Yaju Wu , Shengnan Li
Published: February 2020

Polymer combustion is an important factor in mine fires. Based on the actual environment in a mine tunnel, a cable combustion experiment platform was established to study the regularities of the cable fire spread speed and smoke temperature under different conditions, including various fire loads and ventilation speeds. The flame change and molten dripping behaviour during the fire spread process were also analyzed. The experimental results show that the flame-retardant cable can be ignited and continuously burnt at a certain wind speed, but the combustion can be restrained at high wind speed. The combustion speed of the flame-retardant cable is affected by the fire load and ventilation speed. The combustion droplets can change the shape of the flame, which can consequently ignite other combustible materials. The analysis of the experimental results provides an important basis for the prevention of tunnel fires.
Effects of Air Injection on the Metabolic Activity of Emulsifier-Producing Bacteria from Oil Reservoirs
Authors: Gu Yi , Wu Zhenzhen , Wang Guan , Zhi Bo , Yu Jiliang , Fan Huiqiang , Guo Suzhen , Ma Ting , Li Guoqiang
Published: February 2020

Oil emulsification is one of the major mechanisms for microbially enhanced oil recovery (MEOR). Although air injection is generally recommended for field trials of MEOR in China, its influence on the microbial community structure in oil reservoirs remains poorly understood, especially activation of emulsifier-producing bacteria. Herein, the effects of air injection on oil emulsification, nutrient consumption, oil properties, and microbial community structures were compared for activated cultures under four different oxygen content conditions: anaerobic, facultative anaerobic, intermittent aeration, and aerobic. The results showed that crude oil in aerobic and intermittent aeration cultures was emulsified effectively when nutrients were thoroughly depleted. The particle diameter of emulsified droplets was 4.74-10.02 μm. High-throughput sequencing results showed that Bacillus and Aeribacillus were effectively activated under aerobic and intermittent aeration conditions, while Tepidimicrobium and Coprothermobacter were activated under facultative anaerobic and anaerobic conditions. Real-time quantitative PCR results showed that the initial emulsifying effect was positively correlated with the abundance of Aeribacillus pallidus.
Adequacy of Hemodialysis and Its Associated Factors among Patients Undergoing Chronic Hemodialysis in Dar es Salaam, Tanzania
Authors: Somji Samina S. , Ruggajo Pascal , Moledina Sibtain
Published: February 2020

The worldwide prevalence of maintenance hemodialysis continues to rise. An adequate delivery of hemodialysis dose as measured by Kt/V or urea reduction ratio is a crucial determinant of clinical outcome for chronic hemodialysis patients. The aim of this study was to assess the adequacy of hemodialysis and its associated factors among patients undergoing chronic hemodialysis in Dar es Salaam. This was a cross-sectional study done on patients undergoing chronic hemodialysis in four dialysis centers in Dar es Salaam. Sociodemographic information and treatment characteristics were collected. Urea reduction rate and single-pool Kt/V were calculated to determine the adequacy of hemodialysis. The data were analyzed and any associated factors for inadequate hemodialysis were determined using a chi-square test and a logistic regression analysis. A total of 143 patients participated in the study. Males represented 65.7% of the study population. The mean age (±SD) was 51.7 ± 1.2 years. Only 34.3% (based on urea reduction ratio (URR)) and 40.6% (based on Kt/V) of patients received adequate hemodialysis. The univariate analysis showed that males were more likely to have inadequate dialysis (65.6% versus 48.0%, p=0.048 based on Kt/V). Patients using hemodialyzers with dialyzer surface area less than 1.4 m2 received significantly less hemodialysis dose than those with more than 1.4 m2 (69.0% versus 41.2%, p=0.02, by URR) (62.7% versus 35.3%, p=0.03, by Kt/V criteria). Patients who had hemoglobin <10 g/dl received significantly inadequate hemodialysis dose as compared to patients with hemoglobin ≥10 g/dl by Kt/V criteria (69.8% versus 51.3%, p=0.03). None of the factors acquired significance in the multivariate analysis. The proportion of patients receiving an adequate hemodialysis dose is low (34.3% based on URR and 40.6% based on Kt/V). Male gender, dialyzer surface area of <1.4 m2, and hemoglobin level of <10 g/dl were associated with an inadequate delivered dose of hemodialysis in the univariate analysis but not in the multivariate analysis. This study can increase awareness about the importance of measuring hemodialysis adequacy and giving the correct hemodialysis dose to achieve the intended benefit.
In SilicoModels Accurately PredictIn VivoResponse for IL6 Blockade in Head and Neck Cancer
Authors: Nazari Fereshteh , Oklejas Alexandra E. , Nör Jacques E. , Pearson Alexander T. , Jackson Trachette L.
Published: February 2020

Malignant features of head and neck squamous cell carcinoma (HNSCC) may be derived from the presence of stem-like cells that are characterized by uniquely high tumorigenic potential. These cancer stem cells (CSC) function as putative drivers of tumor initiation, therapeutic evasion, metastasis, and recurrence. Although they are an appealing conceptual target, CSC-directed cancer therapies remain scarce. One promising CSC target is the IL6 pathway, which is strongly correlated with poor patient survival. In this study we created and validated a multiscale mathematical model to investigate the impact of cross-talk between tumor cell- and endothelial cell (EC)-secreted IL6 on HNSCC growth and the CSC fraction. We then predicted and analyzed the responses of HNSCC to tocilizumab (TCZ) and cisplatin combination therapy. The model was validated with in vivo experiments involving human ECs coimplanted with HNSCC cell line xenografts. Without artificial tuning to the laboratory data, the model showed excellent predictive agreement with the decrease in tumor volumes observed in TCZ-treated mice, as well as a decrease in the CSC fraction. This computational platform provides a framework for preclinical cisplatin and TCZ dose and frequency evaluation to be tested in future clinical studies.

Significance:

A mathematical model is used to rapidly evaluate dosing strategies for IL6 pathway modulation. These results may lead to nonintuitive dosing or timing treatment schedules to optimize synergism between drugs.
Model-Based Inference and Classification of Immunologic Control Mechanisms from TKI Cessation and Dose Reduction in Patients with CML
Authors: Hähnel Tom , Baldow Christoph , Guilhot Joëlle , Guilhot François , Saussele Susanne , Mustjoki Satu , Jilg Stefanie , Jost Philipp J. , Dulucq Stephanie , Mahon François-Xavier , Roeder Ingo , Fassoni Artur C. , Glauche Ingmar
Published: February 2020

Recent clinical findings in patients with chronic myeloid leukemia (CML) suggest that the risk of molecular recurrence after stopping tyrosine kinase inhibitor (TKI) treatment substantially depends on an individual's leukemia-specific immune response. However, it is still not possible to prospectively identify patients that will remain in treatment-free remission (TFR). Here, we used an ordinary differential equation model for CML, which explicitly includes an antileukemic immunologic effect, and applied it to 21 patients with CML for whom BCR-ABL1/ABL1 time courses had been quantified before and after TKI cessation. Immunologic control was conceptually necessary to explain TFR as observed in about half of the patients. Fitting the model simulations to data, we identified patient-specific parameters and classified patients into three different groups according to their predicted immune system configuration (“immunologic landscapes”). While one class of patients required complete CML eradication to achieve TFR, other patients were able to control residual leukemia levels after treatment cessation. Among them were a third class of patients that maintained TFR only if an optimal balance between leukemia abundance and immunologic activation was achieved before treatment cessation. Model simulations further suggested that changes in the BCR-ABL1 dynamics resulting from TKI dose reduction convey information about the patient-specific immune system and allow prediction of outcome after treatment cessation. This inference of individual immunologic configurations based on treatment alterations can also be applied to other cancer types in which the endogenous immune system supports maintenance therapy, long-term disease control, or even cure.

Significance:

This mathematical modeling approach provides strong evidence that different immunologic configurations in patients with CML determine their response to therapy cessation and that dose reductions can help to prospectively infer different risk groups.

See related commentary by Triche Jr, p. 2083
“Essential Tremor Plus”: A Problematic Concept: Implications for Clinical and Epidemiological Studies of Essential Tremor
Authors: Louis Elan D.
Published: February 2020

Background: An issue of central importance for most neurological disorders is that of case definition. In the field of neuroepidemiology, case definition informs the design, conduct, and interpretation of research studies that range from observational to interventional studies, from case-control to cohort studies, and from descriptive to analytical studies. For essential tremor (ET), one of the most common neurological disorders, the issue of case definition is particularly important. Though traditionally viewed as a monochromatic disorder, recent years have seen an expansion of the clinical phenotype. In a recently proposed consensus statement on tremor, a proposal was made to separate from ET a new tentatively and uncertainly-defined entity characterized by the presence of additional neurological signs other than action tremor. This entity would be termed “ET-plus”. The aims of this invited paper are to discuss the impact of the proposed nomenclature on studies of ET neuroepidemiology. Summary: The proposed term “ET-plus” is based solely on clinical features and even these are not clearly defined. It is not based on differences in underlying etiology (e.g., genes) or pathology. As such, it is not grounded in underlying biological differences. The use of the term would have numerous research implications. As detailed here, it would greatly complicate or make impossible studies of the descriptive epidemiology of ET, association studies, cohort studies, and clinical trials in ET. Key Messages: The proposed designation has the potential to be very problematic for studies of the epidemiology of tremor. This, along with this questionable validity of the proposed nomenclature, calls its use into serious question.
Thinner Average Choroidal Thickness Is a Risk Factor for the Onset of Diabetic Retinopathy
Authors: Huang Xiaobo , Zhang Pei , Zou Xinrong , Xu Yi , Zhu Jianfeng , He Jiangnan , Zhang Bo , Lu Lina , Zou Haidong
Published: February 2020

Purpose: To analyze the relationships between choroidal thickness (CT) and diabetes mellitus (DM), diabetic retinopathy (DR), and DR severity in community residents diagnosed with type 2 DM, and to explore whether CT can improve the discriminatory ability of other risk factors to predict the incidence of DR. Methods: A total of 1,250 type 2 DM residents and 1,027 healthy controls in Xinjing community of Shanghai participated a cross-sectional survey of eye diseases in 2016. CT was measured using swept-source optical coherence tomography. DR was classified according to the 2002 international clinical classification of DR. A total of 537 subjects with type 2 DM without DR at the 2016 survey were followed up in 2018 to investigate the 2-year incidence of DR. Receiver operating characteristic curve analysis was used to test the accuracy of different indicators in predicting the onset of DR. Results: The central CT of the control, no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and PDR groups were 223.40, 216.22, 213.57, 211.91, 178.47, and 168.15 μm, respectively (p for trend <0.001), and the average CT (ACT) were 197.83, 186.94, 182.03, 178.00, 156.91, and 136.72 μm respectively (p for trend <0.001). Body mass index (BMI), DM duration, fasting blood glucose, glycosylated hemoglobin (HbA1C), and ACT were risk factors for 2-year DR incidence. For the onset of DR, as predicted by ACT, after tenfold cross validation the average area under the curve was 0.55 (p = 0.048). Addition of ACT did not improve the discriminatory ability of DM duration, BMI, glucose and HbA1C on the incidence of DR (Z = 0.48; p = 0.63). Conclusions: As the severity of DR increased, the CT of community type 2 DM patients showed a significant downward trend compared with the healthy controls. Thinner ACT was found to be a risk factor for DR incidence, but it did not improve the discriminatory ability of other risk factors to predict the incidence of DR.
Computed Tomography Angiography in Acute Stroke Patients Receiving Recombinant Tissue Plasminogen Activator: Outcome and Safety Evaluations in an Asian Population
Authors: Lin Chuan-Min , Wu Hsiu-Chuan , Wu Yi-Ming , Liu Chi-Hung , Chang Kuo-Hsuan , Chang Ting-Yu , Huang Kuo-Lun , Chang Yeu-Jhy , Lee Tsong-Hai , Tsay Pei-Kwei , Cheng Chih-Kuang , Chang Chien-Hung
Published: February 2020

Introduction: The multiphase computed tomography angiography (mCTA) is superior to the noncontrast computed tomography (NCCT) in selecting patients that would benefit from mechanical thrombectomy following an acute ischemic stroke (AIS). It remains unclear whether the longer examination time of mCTA worsens outcomes of intravenous recombinant tissue plasminogen activator (IV r-tPA) or increases the risk of hemorrhagic transformation (HT) compared to NCCT in Asian stroke patients. Methods: Between January 2011 and December 2017, 199 AIS patients receiving IV r-tPA with initial National Institute of Health Stroke Scale (NIHSS) scores between 6 and 25 were enrolled in a single medical center. Onset-to-needle time (ONT), door-to-needle time (DNT), and creatinine levels before and after thrombolysis were recorded. We evaluated NIHSS scores 2, 24 h after treatment, and at discharge, the modified Rankin Scale (mRS) at discharge, and mortality rate. The presence of HT was reviewed within 7 days after thrombolysis. Results: DNT, perithrombolysis creatinine levels, NIHSS, and mRS scores at the emergency room were similar between the NCCT and mCTA groups. ONT was shorter in the mCTA group. AIS patients got more significant neurologic improvement (NIHSS decrease ≥4) after thrombolysis and physically independent (mRS ≤2) at discharge in the mCTA group. Mortality rates, symptomatic, and total HT rates were similar between the NCCT and mCTA groups. Conclusion: Comparing to NCCT, mCTA-based IV r-tPA would not delay DNT nor worsen the outcome. Furthermore, mCTA provides more information for early identification of candidates for mechanical thrombectomy in Asian AIS patients.
Redo Hypospadias Repair: Comparison of Three Different Methods
Authors: Turkyilmaz Zafer , Karabulut Ramazan , Atan Ali , Sonmez Kaan
Published: February 2020

Purpose: To evaluate the clinical data and treatment outcomes of 3 different methods for redo hypospadias surgery. Patients and Methods: We retrospectively reviewed the data of 39 patients with redo hypospadias surgery between January 2010 and April 2019 at our clinic. A ventral preputial onlay flap, a preputial tubular flap, and a full thickness skin tubular graft were used in redo hypospadias surgery. We evaluated these methods regarding age, number, and type of previous repairs, catheter time, chordee, length of the urethral defect, operation time, complications, and follow-up results. T tests and Fisher’s exact tests were used to compare differences between groups. Results: The mean operation age of the patients was 5.23 years. Sixteen patients had a single, 21 had 2, and 2 patients had 3 previous repairs. The position of the urethral meatus was perineal in 2, penoscrotal in 6, mid penile in 21, and distal penile in 10 patients. The initial repairs comprised 19 tubularized incised plates (TIP), 12 Mathieu procedures, 5 tubularized preputial flaps, 2 full thickness skin tubular grafts, and 1 onlay island flap repair. Eight full thickness skin tubular grafts, 18 onlay preputial island flaps, and 13 preputial tubular flaps were used for redo surgery. The success rate was 79.1%. Eight wound infections, 6 glans dehiscences, 13 fistulas, 12 meatal stenoses, and 5 urethral diverticulas were seen in the patients. The rates of these complications, Cystofix requirement, and reoperation were higher in the skin tubular graft group but this was not statistically significant (p > 0.05). One patient with graft contracture required a redo skin graft urethroplasty. The mean follow-up duration was18 months. Conclusion: Preputial tissue should be preferred in the presence of redo hypospadias surgery. In the absence of preputial tissue other tissues such as oral or buccal mucosa should be preferred instead of skin grafts.
Psychotherapeutic Work in Palliative Care
Authors: Gramm Jan , Trachsel Manuel , Berthold Daniel
Published: February 2020

In palliative care, multi-professional teams work to improve and maintain the quality of life of terminally ill patients and their families. In this field, clinical psychologists and psychotherapists take on a broad variety of tasks that range from preventive and supportive to psychotherapeutic work. Even if the provision of palliative care frequently does not yet offer appropriate need-based care by psychologists and psychotherapists, developments to that effect are clearly noticeable. The aim of the present article is to give an overview of palliative care as an area of application for psychological and psychotherapeutic interventions. After depicting relevant features of palliative care, characteristic topics, strains, and mental disorders in palliative care will be briefly delineated. Finally, an overview of psychological and psychotherapeutic interventions for palliative care will be presented.
The Relationship between Feeding and Non-Nutritive Sucking Behaviours and Speech Sound Development: A Systematic Review
Authors: Burr Samantha , Harding Sam , Wren Yvonne , Deave Toity
Published: February 2020

Background: Children with and without speech sound disorders (SSDs) are exposed to different patterns of infant feeding (breast/bottle-feeding) and may or may not engage in non-nutritive sucking (NNS) (pacifier/digit-sucking). Sucking and speech use similar oral musculature and structures, therefore it is possible that early sucking patterns may impact early speech sound development. The objective of this review is to synthesise the current evidence on the influence of feeding and NNS on the speech sound development of healthy full-term children. Summary: Electronic databases (PubMed, NHS CRD, EMBASE, MEDLINE) were searched using terms specific to feeding, NNS and speech sound development. All methodologies were considered. Studies were assessed for inclusion and quality by 2 reviewers. Of 1,031 initial results, 751 records were screened, and 5 primary studies were assessed for eligibility, 4 of which were included in the review. Evidence from the available literature on the relationship between feeding, NNS and speech sound development was inconsistent and inconclusive. An association between NNS duration and SSDs was the most consistent finding, reported by 3 of the 4 studies. Quality appraisal was carried out using the Appraisal Tool for Cross-Sectional Studies (AXIS). The included studies were found to be of moderate quality. Key Messages: This review found there is currently limited evidence on the relationship between feeding, NNS and speech sound development. Exploring this unclear relationship is important because of the overlapping physical mechanisms for feeding, NNS and speech production, and therefore the possibility that feeding and/or sucking behaviours may have the potential to impact on speech sound development. Further high-quality research into specific types of SSD using coherent clinically relevant assessment measures is needed to clarify the nature of the association between feeding, NNS and speech sound development, in order to inform and support families and health care professionals.