bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Multi-directional Gas Drainage Technology in Goaf of Working Face
Authors: Qian Zhiliang
Published: July 2020

According to the abnormal gas overrun quadrant in the mined-out area during the initial mining and normal mining of a mine, the causes of some gas outbursts were analyzed, and the multi-directional extraction method for low-level drilling, middle-level drilling and high-level drilling was designed and constructed Successively connect and replace the mined-out gas, and the effect analysis shows that each borehole achieves and exceeds the expected effect, which improves the efficiency of gas extraction in the mined-out area and relieves the gas pressure during the normal mining of the working face.
Research on Online Shopping Return Mode in “New Retail” Era
Authors: Zhang Shubin , Zhong Fachun , Zhang Jingjun , Du Dandan , Zhao Yuhan , Yuan Miaomiao
Published: July 2020

Through B2C/C2C platform, online shopping has realized the simplified mode of factory—retailer—consumer. With the rapid development of online shopping and retail industry, consumers’ requirements for online shopping and retail services are gradually raising. At present, the size of the new retail market is only 38.94 billion yuan, while as the formation of user habits and the innovation of new retail mode, there is great potential for future growth. It is estimated that the total market size will reach 1.8 billion yuan in 2022. This article analyzes the reasons and existing problems of online shopping return in the “new retail” era, analyzes the logistics modes of online shopping return, self-run shopping return, the third-party return and the alliance return. This paper adopts the method of empirical research to analyze the return of online shopping.
Hazardous Materials Railway Transportation Train Selection Considering Environmental Risks
Authors: Liu Liping , Zhou Chao
Published: July 2020

Railway transportation of hazardous materials has the characteristics of large transportation volume, small risk probability but great harm consequence, which will not only cause important harm to population, but also cause great harm to the surrounding environment. In this paper, on the determination of the risk of railway transportation of hazardous materials, considering the dynamic environmental risk during transportation and the static risk waiting for transit point, this paper constructs a double-objective model of railway transportation train selection considering environmental and population risks based on the hazardous materials railway transportation model. Through the dimensionless processing, the trains with low risk and low transportation cost are selected. Furthermore, an illustrative example is designed for analysis and solved by CPLEX solver. The results show that the number of transfer points the train passes through will directly affect the selection about train and the relative weight of the decision-maker’s attention to the environment and population will also have a significant impact on train selection.
Elaboration of architecture of the enterprise of dairy animal breeding
Authors: Kochetkova O V , Shiryaeva E V , Arkov D P , Matveyev A S
Published: July 2020

The actual task of dairy enterprises is to increase the efficiency of resource use, optimize business processes, reduce water and energy consumption, deploy a reliable traceability system that improves transparency, safety and product quality, providing detailed information about the product for the consumer. The specific task for dairy farms is monitoring the behavior of cows and their maintenance in order to improve their well-being and prevent morbidity. In turn, it will lead to better enterprise management, increasing of productivity and quality of production. It is possible to solve the set of tasks only with the help of digital technologies, which are vital for achieving the competitive advantage of dairy farms. It requires the elaboration of enterprise architecture for optimizing many disparate processes in an integrated environment, which will achieve the right balance between IT efficiency and business innovation. Enterprise architecture provides a strategic context for the development of IT systems in response to the ever-changing needs of the dairy industry environment. The research presents the “As Is” model of the architecture of typical dairy farms, developed using the ArchiMate language. As a result of its analysis, the discrepancy between business and IT requirements was found. An insufficiently high level of application of digital technologies was noted, allowing only to identify animals, but not giving the opportunity to determine their condition, to signal about its change and the need for urgent measures. The insufficient level of application of digital technologies does not provide support for decision-making by employees and managing specialists, and also does not allow to monitor in real time the parameters of the conditions of the animals, the quality of the products, the preparation of balanced feed and their individual dosing, automatic milking, storage, sorting and packaging products. The conducted studies are the basis for the creation of the standard architecture “To be” of dairy farms using modern digital technology and sensor systems for providing high quality and efficiency of production of dairy products.
Transaction Costs in the New Age of Digital Economy
Authors: Shumakova O V
Published: July 2020

The present article is devoted to peculiarities in the formation of transaction costs in a period of increasing influence of digital technologies on economy and transaction practices. The integrated concept of transaction costs themselves is reported, while their classification is updated. The present article is meant for specialists in the fields of economy, education, science and technology transfer.
The impact of integrated modelling on the technical and economic indicators of the oil production process
Authors: Kutergina G V , Yapparov E N
Published: July 2020

The article outlines the findings of the reviewed list of tasks to be solved at different stages of oil fields development and operation with the use of integrated modelling technology. Operational and technological models are the most popular nowadays. However, there is no unified field model that would include all the elements of integrated planning. Systematisation of the solved problems and directions for reducing operating and investment costs at different stages of oil field development and operation remains relevant with the use of new modelling technology. Considering the possibilities of a series of integrated modelling programs (Mbal, Prosper, Gap) for optimising oil production process allows us to group the main problems using integrated modelling technology at the following stages: design and strategic decision-making, evaluation and optimising individual activities in the process of operational management, monitoring the development and oil field operation. Based on the analysis of open sources, we have concluded that the introduction of new ‘smart’ technologies significantly impacts technical and economic performance of oil and gas companies, including the level of oil recovery, reduction of drilling time, reduction of operating costs and profit growth, increasing the stability of design solutions and project efficiency in general.
Magnetic properties of polyurethane magnetorheological elastomer based on carbon nanotubes
Authors: Chen Lu , Liu Shaogang , Zhao Dan , Yang Song , Dong Na , Liu Yuxin
Published: July 2020

The paper has modified a magnetorheological elastomer (MRE), a sensitive component of a sensing device, by adding conductive particles of multi-wall carbon nanotubes (MWCNTs), to increase conductivity and reduce response time. After adding MWCNTs, the magnetoresistance calculation model is established based on the theories of effective medium and percolation. Also, MRE with different ratios of carbon nanotubes and carbonyl iron powder are prepared, and the test system for magnetoresistance is built. The test results show that when the ratio is 2:3, the resistivity reaches a minimum while the response time is the shortest. For the same 2:3 ratio and different conductive particle volume fractions, the relationship between electric resistance and magnetic induction is tested. The results show that the resistance decreases with the increase of the applied magnetic field strength, and the larger the volume fraction of the conductive particles, the more obvious the resistance drop. The resistance value as a function of applied magnetic field is predicted well by our model, which provides a new method for the calculation of the resistance value of MRE.
Study on the measurement and evaluation of cotton color using image analysis
Authors: Heng Chong , Chen Lijun , Shen Hua , Wang Fumei
Published: July 2020

Color is an important property to grade cotton. However, precise measurement and comprehensive evaluation of cotton color have not yet been carried out because of instrumental defect, colorful trash and less indicators. This work proposed an accurate method of color measurement and cotton grading. In order to remove the influence of trash on result, a novel trash detection method based on color features of defined three categories of trash and cotton was introduced. In order to improve the accuracy of trash detection, a method based on two-step threshold algorithm is proposed. The original images stored in sRGB format was transformed into binary images according to fixed thresholds and ‘Otsu’ algorithm. Compared to previous trash detection methods, the two-steps detection method was more suitable for cottons with different trash-content. Indicators expressed in Hunter color space were determined by the conversion referring to optical theory and light source. The feasibility of the proposed method was confirmed by comparing the present result with that obtained from standard instruments system. Furthermore, the grading indicators of cotton discussed in this paper suggested that the variation and distribution within a cotton sample should be considered in cotton grading, including a parameter redness or blueness (a). Our work would provide a much better approach to measure and evaluate color of cotton.
Challenges for practical applications of shape memory alloy actuators
Authors: Kumar Dileep , Daudpoto Jawaid , Chowdhry Bhawani Shankar
Published: July 2020

Shape memory alloy (SMA) actuators present opportunities for the development of novel actuating systems. High force-to-weight ratio, silent operation, muscle-like motion, biocompatibility, and simple design possibilities have attracted researchers to SMA actuators. Many SMA actuated systems in engineering and medical domains have been reported in the literature. Recently, SMAs have also being used to develop soft robotic systems. However, low absolute force and high cycle time have limited the widespread use of these actuators. Moreover, non-linear and unpredictable behaviour caused by hysteresis results in difficulties to accurately control it. Some work detailing the strategies to overcome these shortcomings has been reported in the literature, this paper presents an articulated brief review of the techniques to overcome low force, long cycle time, and material non-linearity issues.
Statistical Properties of Stepped Wedge Cluster-Randomized Trials in Infectious Disease Outbreaks
Authors: Kennedy-Shaffer Lee , Lipsitch Marc
Published: July 2020

Randomized controlled trials are crucial for the evaluation of interventions such as vaccinations, but the design and analysis of these studies during infectious disease outbreaks is complicated by statistical, ethical, and logistical factors. Attempts to resolve these complexities have led to the proposal of a variety of trial designs, including individual randomization and several types of cluster randomization designs: parallel-arm, ring vaccination, and stepped wedge designs. Because of the strong time trends present in infectious disease incidence, however, methods generally used to analyze stepped wedge trials might not perform well in these settings. Using simulated outbreaks, we evaluated various designs and analysis methods, including recently proposed methods for analyzing stepped wedge trials, to determine the statistical properties of these methods. While new methods for analyzing stepped wedge trials can provide some improvement over previous methods, we find that they still lag behind parallel-arm cluster-randomized trials and individually randomized trials in achieving adequate power to detect intervention effects. We also find that these methods are highly sensitive to the weighting of effect estimates across time periods. Despite the value of new methods, stepped wedge trials still have statistical disadvantages compared with other trial designs in epidemic settings.
Natural Transmission of Bat-like Severe Acute Respiratory Syndrome Coronavirus 2 Without Proline-Arginine-Arginine-Alanine Variants in Coronavirus Disease 2019 Patients
Authors: Wong Yik Chun , Lau Siu Ying , Wang To Kelvin Kai , Mok Bobo Wing Yee , Li Xin , Wang Pui , Deng Shaofeng , Woo Kin Fai , Du Zhenglong , Li Cun , Zhou Jie , Chan Jasper Fuk Woo , Yuen Kwok Yung , Chen Honglin , Chen Zhiwei
Published: July 2020

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contains the furin cleavage Proline-Arginine-Arginine-Alanine (PRRA) motif in the S1/S2 region, which enhances viral pathogenicity but is absent in closely related bat and pangolin coronaviruses. Whether bat-like coronaviral variants without PRRA (∆PRRA) can establish natural infections in humans is unknown.

Methods

Here, we developed a duplex digital polymerase chain reaction assay to examine ∆PRRA variants in Vero-E6-propagated isolates, human organoids, experimentally infected hamsters, and coronavirus disease 2019 (COVID-19) patients.

Results

We found that SARS-CoV-2, as currently transmitting in humans, contained a quasispecies of wild-type, ∆PRRA variants and variants that have mutations upstream of the PRRA motif. Moreover, the ∆PRRA variants were readily detected despite being at a low intra-host frequency in transmitted founder viruses in hamsters and in COVID-19 patients, including in acute cases and a family cluster, with a prevalence rate of 52.9%.

Conclusions

Our findings demonstrate that bat-like SARS-CoV-2ΔPRRA not only naturally exists but remains transmissible in COVID-19 patients, which has significant implications regarding the zoonotic origin and natural evolution of SARS-CoV-2.
COVID-19 in Civil or Commercial Disputes: First Responses from Chinese Courts
Authors: Liu Qiao
Published: July 2020

This comment highlights the major civil or commercial (mostly contract) law provisions in 24 judicial documents newly released by the Supreme People’s Court or High People’s Courts in China in response to the outbreak of COVID-19 and assesses the significance of key changes to the pre-pandemic law. It concludes by noting the increased role of the doctrine of the change of circumstances and the ‘contract purpose’ test, the emphasis placed on consensual solutions (by way of mediation and contract renegotiation), and the flexibility and relatively clearer guidance afforded to lower courts in their adjudication of disputes arising in connection with COVID-19.
99th Percentile Upper-Reference Limit of Cardiac Troponin and the Diagnosis of Acute Myocardial Infarction
Authors: Sandoval Yader , Apple Fred S , Saenger Amy K , Collinson Paul O , Wu Alan H B , Jaffe Allan S
Published: July 2020

Background

Concerns exist regarding how the 99th percentile upper reference limit (URL) of cardiac troponin (cTn) is determined and whether it should be derived from normal healthy individuals.

Content

The 99th percentile URL of cTn is an important criterion to standardize the diagnosis of myocardial infarction (MI) for clinical, research, and regulatory purposes. Statistical heterogeneity in its calculation exists but recommendations have been proposed. Some negativity has resulted from the fact that with some high-sensitivity (hs) cTn assays, a greater number of increases above the 99th percentile are observed when transitioning from a contemporary assay. Increases reflect acute or chronic myocardial injury and provide valuable diagnostic and prognostic information. The etiology of increases can sometimes be difficult to determine, making a specific treatment approach challenging. For those reasons, some advocate higher cutoff concentrations. This approach can contribute to missed diagnoses. Contrary to claims, neither clinical or laboratory guidelines have shifted away from the 99th percentile. To support the diagnosis of acute MI, the 99th percentile URL remains the best-established approach given the absence of cTn assay standardization. Importantly, risk stratification algorithms using hs-cTn assays predict the possibility of MI diagnoses established using the 99th percentile.

The 99th percentile of cTn remains the best-established criterion for the diagnosis of acute MI. While not perfect, it is analytically and clinically evidence-based. Until there are robust data to suggest some other approach, staying with the 99th percentile, a threshold that has served the field well for the past 20 years, appears prudent.
Impact of land use history on the arbuscular mycorrhizal fungal diversity in arid soils of Argentinean farming fields
Authors: Ontivero R Emanuel , Voyron Samuele , Allione Lucía V Risio , Bianco Paolo , Bianciotto Valeria , Iriarte Hebe J , Lugo Mónica A , Lumini Erica
Published: July 2020

Arbuscular mycorrhizal fungi (AMF) are a key soil functional group, with an important potential to increase crop productivity and sustainable agriculture including food security. However, there is clear evidence that land uses, crop rotations and soil features affect the AMF diversity and their community functioning in many agroecosystems. So far, the information related to AMF biodiversity in ecosystems like the Argentinean Puna, an arid high plateau where plants experience high abiotic stresses, is still scarce. In this work, we investigated morphological and molecular AMF diversity in soils of native corn, bean and native potato Andean crops, under a familiar land use, in Chaupi Rodeo (Jujuy, Argentina), without agrochemical supplements but with different histories of crop rotation. Our results showed that AMF morphological diversity was not only high and variable among the three different crop soils but also complemented by Illumina MiSeq data. The multivariate analyses highlighted that total fungal diversity is significantly affected by the preceding crop plants and the rotation histories, more than from the present crop species, while AMF communities are significantly affected by preceding crop only in combination with the effect of nitrogen and calcium soil concentration. This knowledge will give useful information on appropriate familiar farming.
Impairment of MET transcriptional activators, MET4 and MET31 induced lipid accumulation in Saccharomyces cerevisiae
Authors: Rajakumar Selvaraj , Suriyagandhi Vennila , Nachiappan Vasanthi
Published: July 2020

The genes involved in the methionine pathway are closely associated with phospholipid homeostasis in yeast. The impact of the deletion of methionine (MET) transcriptional activators (MET31, MET32 and MET4) in lipid homeostasis is studied. Our lipid profiling data showed that aberrant phospholipid and neutral lipid accumulation occurred in met31∆ and met4∆ strains with low Met. The expression pattern of phospholipid biosynthetic genes such as CHO2, OPI3 and triacylglycerol (TAG) biosynthetic gene, DGA1 were upregulated in met31∆, and met4∆ strains when compared to wild type (WT). The accumulation of triacylglycerol and sterol esters (SE) content supports the concomitant increase in lipid droplets in met31∆ and met4∆ strains. However, excessive supplies of methionine (1 mM) in the cells lacking the MET transcriptional activators MET31 and MET4 ameliorates the abnormal lipogenesis and causes aberrant lipid accumulation. These findings implicate the methionine accessibility plays a pivotal role in lipid metabolism in the yeast model.
Post-processing of the plane-wave approximation of Schrödinger equations. Part II: Kohn–Sham models
Authors: Dusson Geneviève
Published: July 2020

In this article, we provide a priori estimates for a perturbation-based post-processing method of the plane-wave approximation of nonlinear Kohn–Sham local density approximation (LDA) models with pseudopotentials, relying on Cancès et al. (2020, Post-processing of the plane-wave approximation of Schrödinger equations. Part I: linear operators. IMA Journal of Numerical Analysis, draa044) for the proofs of such estimates in the case of linear Schrödinger equations. As in Cancès et al. (2016, A perturbation-method-based post-processing for the plane-wave discretization of Kohn–Sham models. J. Comput. Phys., 307, 446–459), where these a priori results were announced and tested numerically, we use a periodic setting and the problem is discretized with plane waves (Fourier series). This post-processing method consists of performing a full computation in a coarse plane-wave basis and then to compute corrections based on the first-order perturbation theory in a fine basis, which numerically only requires the computation of the residuals of the ground-state orbitals in the fine basis. We show that this procedure asymptotically improves the accuracy of two quantities of interest: the ground-state density matrix, i.e. the orthogonal projector on the lowest $N$ eigenvectors, and the ground-state energy.
Pirfenidone reduces immune-suppressive capacity of cancer-associated fibroblasts through targeting CCL17 and TNF-beta
Authors: Aboulkheyr Es Hamidreza , Zhand Sareh , Thiery Jean Paul , Warkiani Majid Ebrahimi
Published: July 2020

Various factors in the tumor microenvironment (TME) regulate the expression of PD-L1 in carcinoma cells. The cancer-associated fibroblasts (CAFs) play a crucial role in regulating and rewiring TME to enhance their immune suppressive function and to favor the invasion of the malignant cells. Tumor progression may be retarded by targeting CAFs in the TME. Various studies highlighted the ability of targeting CAF with pirfenidone (PFD), leading to increased efficacy of chemotherapy. However, its potential for the reduction of immune-suppression capacity of CAFs remains to be elusive. Here, we assessed the effect of PFD on the expression of PD-L1 on CAF cells. Besides migration inhibitory effects of PFD on CAFs, the expression level of PD-L1 reduced in CAFs after treatment with PFD. The downstream analysis of released cytokines from CAFs showed that PFD significantly dropped the secretion of CCL17 and TNF-β, where a positive association between PFD-targeted proteins and PD-L1 was observed. These data suggest that the treatment of CAF within TME through the PFD may reduce the acquisition of CAF-mediated invasive and immune-suppressive capacity of breast carcinoma cells.
Sofosbuvir and daclatasvir compared with standard of care in the treatment of patients admitted to hospital with moderate or severe coronavirus infection (COVID-19): a randomized controlled trial
Authors: Sadeghi Anahita , Ali Asgari Ali , Norouzi Alireza , Kheiri Zahedin , Anushirvani Amir , Montazeri Mahnaz , Hosamirudsai Hadiseh , Afhami Shirin , Akbarpour Elham , Aliannejad Rasoul , Radmard Amir Reza , Davarpanah Amir H , Levi Jacob , Wentzel Hannah , Qavi Ambar , Garratt Anna , Simmons Bryony , Hill Andrew , Merat Shahin
Published: July 2020

Background

Currently no effective antiviral therapy has been found to treat COVID-19. The aim of this trial was to assess if the addition of sofosbuvir and daclatasvir improved clinical outcomes in patients with moderate or severe COVID-19.

Methods

This was an open-label, multicentre, randomized controlled clinical trial in adults with moderate or severe COVID-19 admitted to four university hospitals in Iran. Patients were randomized into a treatment arm receiving sofosbuvir and daclatasvir plus standard care, or a control arm receiving standard care alone. The primary endpoint was clinical recovery within 14 days of treatment. The study is registered with IRCT.ir under registration number IRCT20200128046294N2.

Results

Between 26 March and 26 April 2020, 66 patients were recruited and allocated to either the treatment arm (n = 33) or the control arm (n = 33). Clinical recovery within 14 days was achieved by 29/33 (88%) in the treatment arm and 22/33 (67%) in the control arm (P = 0.076). The treatment arm had a significantly shorter median duration of hospitalization [6 days (IQR 4–8)] than the control group [8 days (IQR 5–13)]; P = 0.029. Cumulative incidence of hospital discharge was significantly higher in the treatment arm versus the control (Gray’s P = 0.041). Three patients died in the treatment arm and five in the control arm. No serious adverse events were reported.

Conclusions

The addition of sofosbuvir and daclatasvir to standard care significantly reduced the duration of hospital stay compared with standard care alone. Although fewer deaths were observed in the treatment arm, this was not statistically significant. Conducting larger scale trials seems prudent.
Sideswipes and Backhanders: Abolition of the Reasonable Chastisement Defence in South Africa
Authors: Sloth-Nielsen Julia
Published: July 2020

This article reviews the abolition of the defence of reasonable chastisement by the South African Constitutional Court on the grounds that it infringes the Constitution. After detailing the history of the abolition of corporal punishment in a democracy with the Constitution as supreme law, the article dissects the reasoning of the Constitutional Court. It argues that judgment in Freedom of Religion South Africa v Minister of Justice and Constitutional Development (hereafter FORSA), whilst overall positive in its result, is probably a low water mark in the development of children’s rights jurisprudence in South Africa. There are a number of inadequacies and strangely deferential statements in the FORSA decision. Whilst inescapably coming to the constitutionally correct decision, the reluctance of the Court to reach this point, and its desire to accommodate the religious and cultural beliefs of the appellants, is evident. The way forward has, as a result, been left rather obscure.
Ruling out septic arthritis risk in a few minutes using mid-infrared spectroscopy in synovial fluids
Authors: Albert Jean-David , Le Corvec Maëna , Berthoud Olivia , David Claire , Guennoc Xavier , Hoppe Emmanuel , Jousse-Joulin Sandrine , Le Goff Benoît , Tariel Hugues , Sire Olivier , Jolivet-Gougeon Anne , Coiffier Guillaume , Loréal Olivier
Published: July 2020

Objectives

The aim of this study was to show the usefulness of a mid-infrared fibre evanescent wave spectroscopy point of care device in the identification of septic arthritis patients in a multicentre cohort, and to apply this technology to clinical practice among physicians.

Methods

SF samples from 402 patients enrolled in a multicentre cohort were frozen for analysis by mid-infrared fibre evanescent wave spectroscopy. The calibration cohort was divided into two groups of patients (septic arthritis and non-septic arthritis) and relevant spectral variables were used for logistic regression model. Model performances were tested on an independent set of 86 freshly obtained SF samples from patients enrolled in a single-centre acute arthritis cohort and spectroscopic analyses performed at the patient’s bedside.

Results

The model set-up, using frozen–thawed SFs, provided good performances, with area under the curve 0.95, sensitivity 0.90, specificity 0.90, positive predictive value 0.41 and negative predictive value 0.99. Performances obtained in the validation cohort were area under the curve 0.90, sensitivity 0.92, specificity 0.81, positive predictive value 0.46 and negative predictive value 0.98. The septic arthritis probability has been translated into a risk score from 0 to 4 according to septic risk. For a risk score of 0, the probability of identifying a septic patient is very low (negative predictive value of 1), whereas a risk score of 4 indicates very high risk of septic arthritis (positive predictive value of 1).

Conclusion

Mid-infrared fibre evanescent wave spectroscopy could distinguish septic from non-septic synovial arthritis fluids with good performances, and showed particular usefulness in ruling out septic arthritis. Our data supports the possibility of technology transfer.

Trial registration

ClinicalTrials.gov, http://clinicaltrials.gov, NCT02860871.
The Effect of Hearing Loss and Hearing Device Fitting on Fatigue in Adults: A Systematic Review
Authors: Holman Jack A. , Drummond Avril , Naylor Graham
Published: July 2020

Objectives:

To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on fatigue? It was hypothesized that hearing loss would increase fatigue (H1), and hearing device fitting would reduce fatigue (H2).

Design:

Systematic searches were undertaken of five bibliographic databases: Embase, MedLine, Web of Science, Psychinfo, and the Cochrane Library. English language peer-reviewed research articles were included from inception until present. Inclusion and exclusion criteria were formulated using the Population, Intervention, Comparison, Outcomes and Study design strategy.

Results:

Initial searches for both research questions produced 1,227 unique articles, after removal of duplicates. After screening, the full text of 61 studies was checked, resulting in 12 articles with content relevant to the research questions. The reference lists of these studies were examined, and a final updated search was conducted on October 16, 2019. This resulted in a final total of 20 studies being selected for the review. For each study, the information relating to the Population, Intervention, Comparison, Outcomes and Study design criteria and the statistical outcomes relating to both questions (Q1 and Q2) were extracted. Evidence relating to Q1 was provided by 15 studies, reporting 24 findings. Evidence relating to Q2 was provided by six studies, reporting eight findings. One study provided evidence for both. Using the Grading of Recommendations Assessment, Development and Evaluation guidelines, the quality of evidence on both research questions was deemed to be “very low.” It was impossible to perform a meta-analysis of the results due to a lack of homogeneity.

Conclusions:

As the studies were too heterogeneous to support a meta-analysis, it was not possible to provide statistically significant evidence to support the hypotheses that hearing loss results in increased fatigue (H1) or that hearing device fitting results in decreased fatigue (H2). Despite this, the comparative volume of positive results and the lack of any negative findings are promising for future research (particularly in respect of Q1). There was a very small number of studies deemed eligible for the review, and there was large variability between studies in terms of population, and quantification of hearing loss and fatigue. The review highlights the need for consistency when measuring fatigue, particularly when using self-report questionnaires, where the majority of the current evidence was generated.
PrEvention of Posttraumatic contractuRes with Ketotifen 1 (PERK 1): A Randomized Clinical Trial
Authors: Hildebrand Kevin A. , Schneider Prism S. , Mohtadi Nicholas G. H. , Ademola Ayoola , White Neil J. , Garven Alexandra , Walker Richard E. A. , Sajobi Tolulope T. ,   on behalf of the PERK 1 Investigators
Published: July 2020

Objective:

To assess the use of ketotifen fumarate (KF) to reduce posttraumatic contractures after elbow fractures and/or dislocations.

Design:

Randomized clinical trial.

Setting:

Three hospitals in Calgary, Canada, including one Level 1 trauma center.

Participants:

Adults (n = 151) sustaining operative or nonoperatively managed isolated distal humerus or proximal radius ± ulna fractures or elbow dislocations within 7 days of injury.

Interventions:

KF 5 mg (n = 74) or lactose placebo (PL, n = 77) orally twice daily for 6 weeks.

Main Outcomes:

Primary outcome elbow flexion–extension arc range of motion (ROM) at 12 weeks postrandomization. Safety measures including serious adverse events and radiographic fracture line disappearance from 2 to 52 weeks postrandomization.

Results:

The elbow ROM (mean, confidence interval) was not significantly different between KF (122 degrees, 118–127 degrees) and PL (124 degrees, 119–130 degrees) groups (P = 0.56). There was a significant difference in elbow ROM at 12 weeks postrandomization comparing operative (117 degrees, 112–122 degrees) versus nonoperative groups (128 degrees, 124–133 degrees) irrespective of intervention (P = 0.0011). There were 11 serious adverse events (KF = 6, PL = 5) that were those expected in an elbow fracture population potentially taking KF. There was no statistically significant difference in the rates of these events between the groups. The disappearance of fracture lines over the course of time was similar between groups. There was one nonunion in each group.

Conclusions:

In a population of operative and nonoperatively managed elbow fractures and/or dislocations KF did not reduce posttraumatic contractures. The administration of KF in this population was not found to result in a significantly higher number of major adverse events when compared with placebo.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Classification of Bone Defects: An Extension of the Orthopaedic Trauma Association Open Fracture Classification
Authors: Tetsworth Kevin D. , Burnand Henry G. , Hohmann Erik , Glatt Vaida
Published: July 2020

Objectives:

To develop a post-traumatic bone defect classification scheme and complete a preliminary assessment of its reliability.

Design:

Retrospective classification.

Setting:

Tertiary referral trauma center.

Patients/Participants:

Twenty open fractures with bone loss.

Intervention:

Assignment of a bone defect classification grade.

Main Outcome Measurements:

Open fractures were classified based on orthogonal radiographs, assessing the extent and local geometry of bone loss, including D1—incomplete defects, D2—minor/subcritical (complete) defects (<2 cm), and D3—segmental/critical-sized defects (≥2 cm). Incomplete defects (D1) include D1A—<25% cortical loss, D1B—25%–75% cortical loss, and D1C—>75% cortical loss. Minor/subcritical (complete) defects (<2 cm) (D2) include D2A—2 oblique ends allowing for possible overlap, D2B—one end oblique/one end transverse, and D2C—2 transverse ends. Segmental/critical-sized Defects (≥2 cm) include D3A—moderate defects, 2 to <4 cm; D3B—major defects, 4 to <8 cm; and D3C—massive defects, ≥8 cm. Reliability was assessed among 3 independent observers using Fleiss' kappa tests.

Results:

Interobserver reliability demonstrated the classification scheme has very good agreement, κ = 0.8371, P < 0.0005. Intraobserver reliability was excellent, κ = 1.000 (standard error 0.1478–0.1634), P < 0.00001. Interobserver reliability for the distinction between categories alone (D1, D2, or D3) was also excellent, κ = 1.000 (standard error 0.1421–0.1679), P < 0.00001.

Conclusions:

This classification scheme provides a robust guide to bone defect assessment that can potentially facilitate selection of the most appropriate treatment strategy to optimize clinical outcomes.
A demonstration project of Global Alliance against Chronic Respiratory Diseases: Prediction of interactions between air pollution and allergen exposure—the Mobile Airways Sentinel NetworK-Impact of air POLLution on Asthma and Rhinitis approach
Authors: Sofiev Mikhail , Palamarchuk Yuliia , Bédard Annabelle , Basagana Xavier , Anto Josep M. , Kouznetsov Rostislav , Urzua Rodrigo Delgado , Bergmann Karl Christian , Fonseca Joao A. , De Vries Govert , Van Erd Michiel , Annesi-Maesano Isabella , Laune Daniel , Pépin Jean Louis , Jullian-Desayes Ingrid , Zeng Stephane , Czarlewski Wienczyslawa , Bousquet Jean
Published: July 2020

This review analyzes the state and recent progress in the field of information support for pollen allergy sufferers. For decades, information available for the patients and allergologists consisted of pollen counts, which are vital but insufficient. New technology paves the way to substantial increase in amount and diversity of the data. This paper reviews old and newly suggested methods to predict pollen and air pollutant concentrations in the air and proposes an allergy risk concept, which combines the pollen and pollution information and transforms it into a qualitative risk index. This new index is available in an app (Mobile Airways Sentinel NetworK-air) that was developed in the frame of the European Union grant Impact of Air POLLution on sleep, Asthma and Rhinitis (a project of European Institute of Innovation and Technology-Health). On-going transformation of the pollen allergy information support is based on new technological solutions for pollen and air quality monitoring and predictions. The new information-technology and artificial-intelligence-based solutions help to convert this information into easy-to-use services for both medical practitioners and allergy sufferers.
Controversies on the Consequences of Iron Overload and Chelation in MDS
Authors: Vinchi Francesca , Hell Saskia , Platzbecker Uwe
Published: July 2020

Many patients with MDS are prone to develop systemic and tissue iron overload in part as a consequence of disease‐immanent ineffective erythropoiesis. However, chronic red blood cell transfusions, which are part of the supportive care regimen to correct anemia, are the major source of iron overload in MDS. Increased systemic iron levels eventually lead to the saturation of the physiological systemic iron carrier transferrin and the occurrence of non‐transferrin‐bound iron (NTBI) together with its reactive fraction, the labile plasma iron (LPI). NTBI/LPI‐mediated toxicity and tissue iron overload may exert multiple detrimental effects that contribute to the pathogenesis, complications and eventually evolution of MDS. Until recently, the evidence supporting the use of iron chelation in MDS was based on anecdotal reports, uncontrolled clinical trials or prospective registries. Despite not fully conclusive, these and more recent studies, including the TELESTO trial, unravel an overall adverse action of iron overload and therapeutic benefit of chelation, ranging from improved hematological outcome, reduced transfusion dependence and superior survival of iron‐loaded MDS patients. The still limited and somehow controversial experimental and clinical data available from preclinical studies and randomized trials highlight the need for further investigation to fully elucidate the mechanisms underlying the pathological impact of iron overload‐mediated toxicity as well as the effect of classic and novel iron restriction approaches in MDS. This review aims at providing an overview of the current clinical and translational debated landscape about the consequences of iron overload and chelation in the setting of MDS.
Corneal Crosslinking to Regress Pathologic Corneal Neovascularization Before High-Risk Keratoplasty
Authors: Schaub Friederike , Hou Yanhong , Zhang Wei , Bock Felix , Hos Deniz , Cursiefen Claus
Published: July 2020

Purpose:

Corneal neovascularization is the main risk factor for graft rejection after high-risk penetrating keratoplasty (PK). Corneal crosslinking (CXL) has been shown to regress pathological corneal blood and lymphatic vessels and to reduce the risk of graft rejection after high-risk PK experimentally in mice. The aim of this work was to analyze whether CXL is also able to regress corneal neovascularization in patients and is a safe procedure in the context of high-risk PK.

Methods:

This retrospective case series included 5 patients with progressive corneal neovascularization and the need for high-risk PK because of graft rejection and/or keratitis that received CXL and PK between April 2019 and January 2020. CXL was performed before or in combination with PK and the effect of CXL on corneal neovascularization was assessed morphometrically on slit-lamp images. Patients were followed up to determine the incidence of adverse effects and graft rejection.

Results:

In 1 case, peripheral corneal CXL was performed first as a single procedure, followed by an additional peripheral CXL procedure combined with PK. In all other cases, peripheral CXL was directly combined with PK. No intraoperative or postoperative complications were observed. Peripheral CXL resulted in a reduction of corneal neovascularization (mean reduction of 70.5% ± 22.7%). Revascularization was not observed. All transplants remained clear and without immune reactions (mean follow-up 16.4 ± 14.9 weeks, range 4–42 weeks).

Conclusions:

CXL is able to reduce pathological corneal neovascularization and might therefore be a novel treatment option to improve graft survival after high-risk PK.
Case Series: Novel Utilization of Rho-Kinase Inhibitor for the Treatment of Corneal Edema
Authors: Davies Emma
Published: July 2020

Purpose:

To describe 3 cases of corneal clearance after the use of topical rho-kinase inhibitor, netarsudil, in the setting of endothelial cell dysfunction in comparison to one case without corneal clearance after the use of netarsudil.

Methods:

Four patients presenting to a busy academic clinical corneal practice with visual complaints from corneal edema secondary to endothelial cell dysfunction were treated with topical netarsudil one drop daily in the affected eye.

Results:

Corneal clearance was observed in 1) a case of peripheral corneal edema in the setting of iridocorneal endothelial syndrome after 4 weeks on netarsudil, 2) a case of corneal edema in the setting of early penetrating keratoplasty graft failure after 2-week use of netarsudil, and 3) a case of corneal edema in the setting of chronic penetrating keratoplasty graft failure after 4-week use of netarsudil. Corneal clearance was not observed in a case of corneal edema in the setting of pseudophakic bullous keratopathy from previous complicated intraocular lens exchange surgery with placement of an anterior chamber intraocular lens after the use of netarsudil for 12 weeks.

Conclusions:

Addition of topical rho-kinase inhibitor in the form of netarsudil can result in corneal clearance in a variety of certain cases of endothelial cell dysfunction, not previously documented in the literature.
Uncovering the analgesic effects of a pH-dependent mu-opioid receptor agonist using a model of nonevoked ongoing pain
Authors: Massaly Nicolas , Temp Julia , Machelska Halina , Stein Christoph
Published: July 2020

Currently, opioids targeting mu-opioid receptors are the most potent drugs for acute and cancer pain. However, opioids produce adverse side effects such as constipation, respiratory depression, or addiction potential. We recently developed (±)-N-(3-fluoro-1-phenethylpiperidine-4-yl)-N-phenyl propionamide (NFEPP), a compound that does not evoke central or intestinal side effects due to its selective activation of mu-opioid receptors at low pH in peripheral injured tissues. Although we demonstrated that NFEPP effectively abolishes injury-induced pain, hyperalgesia, and allodynia in rodents, the efficacy of NFEPP in nonevoked ongoing pain remains to be established. Here, we examined reward, locomotor activity, and defecation in rats with complete Freund's adjuvant-induced paw inflammation to compare fentanyl's and NFEPP's potentials to induce side effects and to inhibit spontaneous pain. We demonstrate that low, but not higher, doses of NFEPP produce conditioned place preference but not constipation or motor disturbance, in contrast to fentanyl. Using a peripherally restricted antagonist, we provide evidence that NFEPP-induced place preference is mediated by peripheral opioid receptors. Our results indicate that a low dose of NFEPP produces reward by abolishing spontaneous inflammatory pain.
Pain trajectory defines knee osteoarthritis subgroups: a prospective observational study
Authors: Radojčić Maja R. , Arden Nigel K. , Yang Xiaotian , Strauss Victoria Y. , Birrell Fraser , Cooper Cyrus , Kluzek Stefan ,   the VIDEO Trial Investigators
Published: July 2020

Knee osteoarthritis (OA) is a heterogeneous disease, and identification of its subgroups/phenotypes can improve patient treatment and drug development. We aimed to identify homogeneous OA subgroups/phenotypes using pain development over time; to understand the interplay between pain and functional limitation in time course; and to investigate subgroups' responses to available pharmacological and surgical treatments. We used group-based trajectory modelling to identify pain trajectories in the phase-3 VIDEO trial (n = 474, 3-year follow-up) and also in the Osteoarthritis Initiative cohort study (n = 4796, 9-year follow-up). We extended trajectory models by (1) fitting dual trajectories to investigate the interplay between pain and functional limitation over time, and (2) including analgesic use as a time-varying covariate. Also, we investigated the relationship between trajectory groups and knee replacement in regression models. We identified 4 pain trajectory groups in the trial and 6 in the cohort. These overlapped and led us to define 4 OA phenotypes: low-fluctuating, mild-increasing, moderate-treatment-sensitive, and severe-treatment-insensitive pain. Over time, functional knee limitation followed the same trajectory as pain with almost complete concordance (94.3%) between pain and functional limitation trajectory groups. Notably, we identified a phenotype with severe pain that did not benefit from available treatments, and another one most likely to benefit from knee replacement. Thus, knee OA subgroups/phenotypes can be identified based on patients' pain experiences in studies with long and regular follow-up. We provided a robust approach, reproducible between different study designs, which informs clinicians about symptom development and delivery of treatment options and opens a new avenue toward personalized medicine in OA.
Using Data Analytics to Improve Hospital Quality Performance
Authors: Pitocco Christine , Sexton Thomas R. , Stickle Kelly
Published: July 2020

EXECUTIVE SUMMARY

The objective of this study was to build a unified quality performance model for hospitals using publicly available data. We obtained data from the New York State Department of Health’s Statewide Planning and Research Cooperative System database for our model, which had three outcome measures that we wished to make smaller (deaths, readmissions, average length of stay). Because this was a performance model rather than an economic efficiency model, we excluded costs, which are affected significantly by local economic conditions. We included four site characteristics. With our data envelopment analysis model structure, we used logistic regression to analyze the output. We extracted data for 2,233,214 discharges in 2014 from 183 hospitals in the state. We found that 20.8% of the facilities were on the quality performance frontier—20.6% of the not-for-profit facilities and 21.4% of the other facilities. Hospitals with more discharges performed better with respect to mortality, readmission, and average length of stay. We found no difference in performance between not-for-profit hospitals and others. We concluded that 79.2% of hospitals could improve their quality of care. As an upper bound, if all hospitals increased each quality factor performance to 100%, there would have been 11,722 (24.8%) fewer deaths, 17,840 (15.8%) fewer readmissions, and the statewide average length of stay would have been 0.71 days (13.5%) less.