bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of Sporangium Formation, Spore Dormancy, and Sporangium Dehiscence by a Hybrid Sensor Histidine Kinase inActinoplanes missouriensis: Relationship with the Global Transcriptional Regulator TcrA
Authors: Hashiguchi Yuichiro , Tezuka Takeaki , Mouri Yoshihiro , Konishi Kenji , Fujita Azusa , Hirata Aiko , Ohnishi Yasuo
Published: August 2020

The rare actinomyceteActinoplanes missouriensisforms terminal sporangia containing a few hundred flagellated spores. In response to water, the sporangia open and release the spores into external environments. The orphan response regulator TcrA functions as a global transcriptional activator during sporangium formation and dehiscence. Here, we report the characterization of an orphan hybrid histidine kinase, HhkA. Sporangia of anhhkAdeletion mutant contained many distorted or ectopically germinated spores and scarcely opened to release the spores under sporangium dehiscence-inducing conditions. These phenotypic changes are quite similar to those observed in atcrAdeletion mutant. Comparative RNA sequencing analysis showed that genes controlled by HhkA mostly overlap TcrA-regulated genes. The direct interaction between HhkA and TcrA was suggested by a bacterial two-hybrid assay, but this was not conclusive. The phosphorylation of TcrA using acetyl phosphate as a phosphate donor markedly enhanced its affinity for the TcrA box sequences in the electrophoretic mobility shift assay. Taking these observations together with other results, we proposed that HhkA and TcrA compose a cognate two-component regulatory system, which controls the transcription of the genes involved in many aspects of morphological development, including sporangium formation, spore dormancy, and sporangium dehiscence inA. missouriensis.

IMPORTANCEActinoplanes missouriensisgoes through complex morphological differentiation, including formation of flagellated spore-containing sporangia, sporangium dehiscence, swimming of zoospores, and germination of zoospores to filamentous growth. Although the orphan response regulator TcrA globally activates many genes required for sporangium formation, spore dormancy, and sporangium dehiscence, its partner histidine kinase remained unknown. Here, we analyzed the function of an orphan hybrid histidine kinase, HhkA, and proposed that HhkA constitutes a cognate two-component regulatory system with TcrA. That HhkA and TcrA homologues are highly conserved among the genusActinoplanesand several closely related rare actinomycetes indicates that this possible two-component regulatory system is employed for complex morphological development in sporangium- and/or zoospore-forming rare actinomycetes.
Additional Og-Typing PCR Techniques Targeting Escherichia coli-Novel and
Shigella
-Unique O-Antigen Biosynthesis Gene Clusters
Authors: Iguchi Atsushi , Nishii Hironobu , Seto Kazuko , Mitobe Jiro , Lee Kenichi , Konishi Noriko , Obata Hiromi , Kikuchi Taisei , Iyoda Sunao
Published: August 2020

The O-serogrouping of pathogenic
Escherichia coli
is a standard method for subtyping strains for epidemiological studies and controls. O-serogroup diversification shows a strong association with the genetic diversity in some O-antigen biosynthesis gene clusters. Through genomic studies, in addition to the types of O-antigen biosynthesis gene clusters (Og-types) from conventional O-serogroup strains, a number of novel Og-types have been found in
E. coli
isolates.
Broad Anti-coronavirus Activity of Food and Drug Administration-Approved Drugs against SARS-CoV-2
In Vitro
and SARS-CoV
In Vivo
Authors: Weston Stuart , Coleman Christopher M. , Haupt Robert , Logue James , Matthews Krystal , Li Yize , Reyes Hanako M. , Weiss Susan R. , Frieman Matthew B.
Published: August 2020

There are no FDA-approved antivirals for any coronavirus, including SARS-CoV-2. Numerous drugs are already approved for human use that may have antiviral activity and therefore could potentially be rapidly repurposed as antivirals. Here, we present data assessing the antiviral activity of 20 FDA-approved drugs against SARS-CoV-2 that also inhibit SARS-CoV and MERS-CoV
in vitro
. We found that 17 of these inhibit SARS-CoV-2, suggesting that they may have pan-anti-coronaviral activity. We directly followed up seven of these and found that they all inhibit infectious-SARS-CoV-2 production. Moreover, we evaluated chloroquine and chlorpromazine
in vivo
using mouse-adapted SARS-CoV. We found that neither drug inhibited viral replication in the lungs, but both protected against clinical disease.
SAFety, Effectiveness of care and Resource use among Australian Hospitals (SAFER Hospitals): a protocol for a population-wide cohort study of outcomes of hospital care
Authors: Ranasinghe Isuru , Hossain Sadia , Ali Anna , Horton Dennis , Adams Robert JT , Aliprandi-Costa Bernadette , Bertilone Christina , Carneiro Gustavo , Gallagher Martin , Guthridge Steven , Kaambwa Billingsley , Kotwal Sradha , O'Callaghan Gerry , Scott Ian A , Visvanathan Renuka , Woodman Richard J
Published: August 2020

Introduction

Despite global concerns about the safety and quality of health care, population-wide studies of hospital outcomes are uncommon. The SAFety, Effectiveness of care and Resource use among Australian Hospitals (SAFER Hospitals) study seeks to estimate the incidence of serious adverse events, mortality, unplanned rehospitalisations and direct costs following hospital encounters using nationwide data, and to assess the variation and trends in these outcomes.

Methods and analysis

SAFER Hospitals is a cohort study with retrospective and prospective components. The retrospective component uses data from 2012 to 2018 on all hospitalised patients age ≥18 years included in each State and Territories’ Admitted Patient Collections. These routinely collected datasets record every hospital encounter from all public and most private hospitals using a standardised set of variables including patient demographics, primary and secondary diagnoses, procedures and patient status at discharge. The study outcomes are deaths, adverse events, readmissions and emergency care visits. Hospitalisation data will be linked to subsequent hospitalisations and each region’s Emergency Department Data Collections and Death Registries to assess readmissions, emergency care encounters and deaths after discharge. Direct hospital costs associated with adverse outcomes will be estimated using data from the National Cost Data Collection. Variation in these outcomes among hospitals will be assessed adjusting for differences in hospitals’ case-mix. The prospective component of the study will evaluate the temporal change in outcomes every 4 years from 2019 until 2030.

Ethics and dissemination

Human Research Ethics Committees of the respective Australian states and territories provided ethical approval to conduct this study. A waiver of informed consent was granted for the use of de-identified patient data. Study findings will be disseminated via presentations at conferences and publications in peer-reviewed journals.
High-resolution spatiotemporal measurement of air and environmental noise pollution in Sub-Saharan African cities: Pathways to Equitable Health Cities Study protocol for Accra, Ghana
Authors: Clark Sierra N , Alli Abosede S , Brauer Michael , Ezzati Majid , Baumgartner Jill , Toledano Mireille B , Hughes Allison F , Nimo James , Bedford Moses Josephine , Terkpertey Solomon , Vallarino Jose , Agyei-Mensah Samuel , Agyemang Ernest , Nathvani Ricky , Muller Emily , Bennett James , Wang Jiayuan , Beddows Andrew , Kelly Frank , Barratt Benjamin , Beevers Sean , Arku Raphael E
Published: August 2020

Introduction

Air and noise pollution are emerging environmental health hazards in African cities, with potentially complex spatial and temporal patterns. Limited local data are a barrier to the formulation and evaluation of policies to reduce air and noise pollution.

Methods and analysis

We designed a year-long measurement campaign to characterise air and noise pollution and their sources at high-resolution within the Greater Accra Metropolitan Area (GAMA), Ghana. Our design uses a combination of fixed (year-long, n=10) and rotating (week-long, n =~130) sites, selected to represent a range of land uses and source influences (eg, background, road traffic, commercial, industrial and residential areas, and various neighbourhood socioeconomic classes). We will collect data on fine particulate matter (PM2.5), nitrogen oxides (NOx), weather variables, sound (noise level and audio) along with street-level time-lapse images. We deploy low-cost, low-power, lightweight monitoring devices that are robust, socially unobtrusive, and able to function in Sub-Saharan African (SSA) climate. We will use state-of-the-art methods, including spatial statistics, deep/machine learning, and processed-based emissions modelling, to capture highly resolved temporal and spatial variations in pollution levels across the GAMA and to identify their potential sources. This protocol can serve as a prototype for other SSA cities.

Ethics and dissemination

This environmental study was deemed exempt from full ethics review at Imperial College London and the University of Massachusetts Amherst; it was approved by the University of Ghana Ethics Committee (ECH 149/18-19). This protocol is designed to be implementable in SSA cities to map environmental pollution to inform urban planning decisions to reduce health harming exposures to air and noise pollution. It will be disseminated through local stakeholder engagement (public and private sectors), peer-reviewed publications, contribution to policy documents, media, and conference presentations.
Comparing two dry needling interventions for plantar heel pain: a randomised controlled trial
Authors: Al-Boloushi Zaid , Gómez-Trullén Eva Maria , Arian Mohammad , Fernández Daniel , Herrero Pablo , Bellosta-López Pablo
Published: August 2020

Objectives

To compare the effectiveness of dry needling (DN) versus percutaneous needle electrolysis (PNE) for improving the level of pain, function and quality of life (QoL) of patients suffering from plantar heel pain (PHP) provoked by myofascial trigger points.

Design

A prospective, parallel-group, randomised controlled trial with blinded outcome assessment.

Setting

A single treatment facility in the State of Kuwait.

Participants

118 participants were screened for eligibility. Of these, 102 participants were enrolled (30 men (49.5±8.9 years) and 72 women (48.1±8.8 years)) and 68 of them completed the trial.

Interventions

Two parallel groups, one study arm received DN and a stretching protocol whereas the other arm received percutaneous needling electrolysis with a stretching protocol.

Primary and secondary outcome measures

The primary outcome measure was the Foot Pain domain of the Foot Health Status Questionnaire, with 13 questions related to foot health-related domains. Secondary outcome measures included the 0–10 numerical rating scale pain visual analogue scale (VAS) scores, performed before and after each treatment session. In addition, QoL was measured using the EuroQoL-5 dimensions. All measurements were taken at baseline, at 4, 8, 12, 26 and 52 weeks.

Results

Foot Pain domain improved at all time points for DN group (p<0.001; 29.7 (17.8 to 41.5)) and percutaneous needling electrolysis group (p<0.001; 32.7 (18.3 to 47.0)), without significant differences between groups. Pain VAS scores decreased at all time points for both DN (p<0.001; −2.6 (−4.0 to −1.2)) and percutaneous needling electrolysis group (p<0.001; −3.0 (−4.5 to −1.6)). QoL improved at 4 weeks for both DN (p<0.01; 0.15 (0.5 to 0.25)) and percutaneous needling electrolysis group (p<0.01; 0.09 (0.01 to 0.17)) and at 8 and 52 weeks for the PNE group (p<0.01; 0.10 (0.02 to 0.18)), with significant differences between groups for the QoL at 52 weeks (p<0.05; 0.10 (0.01 to 0.18)). There were two small haematomas in the PNE group and one in the DN group. No serious adverse events were reported.

Conclusions

Both PNE and DN were effective for PHP management, reducing mean and maximum pain since the first treatment session, with long lasting effects (52 weeks) and significant differences between groups in the case of QoL at 52 weeks in favour of the PNE group.

Trial registration number

NCT03236779.
Multimorbidity and patient-reported diagnostic errors in the primary care setting: multicentre cross-sectional study in Japan
Authors: Aoki Takuya , Watanuki Satoshi
Published: August 2020

Objectives

There is lack of evidence for the association between multimorbidity and diagnostic errors. Information on diagnostic errors from patients’ perspectives is crucial to improve the diagnostic process. In this study, we aimed to investigate patient-reported diagnostic errors and to examine the relationship between multimorbidity and patient-reported diagnostic errors in the primary care setting.

Design

Multicentre cross-sectional study.

Setting

A primary care practice-based research network in Japan (25 primary care facilities).

Participants

Adult outpatients filled out a standardised questionnaire.

Primary outcome measure

Patient-reported diagnostic errors.

Results

Data collected from 1474 primary care outpatients were analysed. The number of participants who reported diagnostic errors was 57 (3.9%). Most of the missed diagnoses were common conditions in primary care, such as cancer, dermatitis and hypertension. After adjustment for possible confounders and clustering within facilities, multimorbidity was positively associated with patient-reported diagnostic errors (adjusted OR=1.83, 95% CI 1.01 to 3.31). The results of the sensitivity analysis were consistent with those of the primary analysis.

Conclusions

The present study showed a lower proportion of patients reporting experiences of diagnostic errors in primary care than those reported in previous studies in other countries. However, patients with multimorbidity are more likely to report diagnostic errors in primary care; thus, further research is necessary to improve the diagnostic process for patients with multimorbidity.
Identifying the effects of an upgraded ‘fever clinic’ on COVID-19 control and the workload of emergency department: retrospective study in a tertiary hospital in China
Authors: Wang Jiangshan , Zong Liang , Zhang Jinghong , Sun Han , Harold Walline Joseph , Sun Pengxia , Xu Shengyong , Li Yan , Wang Chunting , Liu Jihai , Li Fan , Xu Jun , Li Yi , Yu Xuezhong , Zhu Huadong
Published: August 2020

Objective

COVID-19 started spreading widely in China in January 2020. Outpatient fever clinics (FCs), instituted during the SARS epidemic in 2003, were upgraded to serve for COVID-19 screening and prevention of disease transmission in large tertiary hospitals in China. FCs were hoped to relieve some of the healthcare burden from emergency departments (EDs). We aimed to evaluate the effect of upgrading the FC system on rates of nosocomial COVID-19 infection and ED patient attendance at Peking Union Medical College Hospital (PUMCH).

Design

A retrospective cohort study.

Participants

A total of 6365 patients were screened in the FC.

Methods

The FC of PUMCH was upgraded on 20 January 2020. We performed a retrospective study of patients presenting to the FC between 12 December 2019 and 29 February 2020. The date when COVID-19 was declared an outbreak in Beijing was 20 January 2020. Two groups of data were collected and subsequently compared with each other: the first group of data was collected within 40 days before 20 January 2020; the second group of data was collected within 40 days after 20 January 2020. All necessary data, including patient baseline information, diagnosis, follow-up conditions and the transfer records between the FC and ED, were collected and analysed.

Results

6365 patients were screened in the FC, among whom 2912 patients were screened before 21 January 2020, while 3453 were screened afterward. Screening results showed that upper respiratory infection was the major disease associated with fever. After the outbreak of COVID-19, the number of patients who were transferred from the FC to the ED decreased significantly (39.21% vs 15.75%, p<0.001), and patients generally spent more time in the FC (55 vs 203 min, p<0.001), compared with before the outbreak. For critically ill patients waiting for their screening results, the total length of stay in the FC was 22 min before the outbreak, compared with 442 min after the outbreak (p<0.001). The number of in-hospital deaths of critically ill patients in the FC was 9 out of 29 patients before the outbreak and 21 out of 38 after the outbreak (p<0.05). Nineteen cases of COVID-19 were confirmed in the FC during the period of this study. However, no other patients nor any healthcare providers were cross-infected.

Conclusion

The workload of the FC increased significantly after the COVID-19 outbreak. New protocols regarding the use of FC likely helped prevent the spread of COVID-19 within the hospital. The upgraded FC also reduced the burden on the ED.
Supporting self-management of low back pain with an internet intervention in primary care: a protocol for a randomised controlled trial of clinical and cost-effectiveness (SupportBack 2)
Authors: Geraghty Adam W A , Roberts Lisa , Hill Jonathan , Foster Nadine E , Yardley Lucy , Hay Elaine , Stuart Beth , Turner David , Griffiths Gareth , Webley Frances , Durcan Lorraine , Morgan Alannah , Hughes Stephanie , Bathers Sarah , Butler-Walley Stephanie , Wathall Simon , Mansell Gemma , Leigh Linda , Little Paul
Published: August 2020

Introduction

Self-management and remaining physically active are first-line recommendations for the care of patients with low back pain (LBP). With a lifetime prevalence of up to 85%, novel approaches to support behavioural self-management are needed. Internet interventions may provide accessible support for self-management of LBP in primary care. The aim of this randomised controlled trial is to determine the clinical and cost-effectiveness of the ‘SupportBack’ internet intervention, with or without physiotherapist telephone support in reducing LBP-related disability in primary care patients.

Methods and analysis

A three-parallel arm, multicentre randomised controlled trial will compare three arms: (1) usual primary care for LBP; (2) usual primary care for LBP and an internet intervention; (3) usual primary care for LBP and an internet intervention with additional physiotherapist telephone support. Patients with current LBP and no indicators of serious spinal pathology are identified and invited via general practice list searches and mailouts or opportunistic recruitment following LBP consultations. Participants undergo a secondary screen for possible serious spinal pathology and are then asked to complete baseline measures online after which they are randomised to an intervention arm. Follow-ups occur at 6 weeks, 3, 6 and 12 months. The primary outcome is physical function (using the Roland and Morris Disability Questionnaire) over 12 months (repeated measures design). Secondary outcomes include pain intensity, troublesome days in pain over the last month, pain self-efficacy, catastrophising, kinesophobia, health-related quality of life and cost-related measures for a full health economic analysis. A full mixed-methods process evaluation will be conducted.

Ethics and dissemination

This trial has been approved by a National Health Service Research Ethics Committee (REC Ref: 18/SC/0388). Results will be disseminated through peer-reviewed journals, conferences, communication with practices and patient groups. Patient representatives will support the implementation of our full dissemination strategy.

Trial registration number

ISRCTN14736486.
Physicians’ views on the usefulness of practical tools for assessing the driving ability of older drivers: a cross-sectional study
Authors: Sebo Paul
Published: August 2020

Objective

We aimed to explore Swiss physicians’ views on the usefulness of a self-administered questionnaire completed by older drivers before the consultation and a reference guide summarising current Swiss guidelines on the fitness-to-drive assessment of older drivers. We also aimed to assess the frequency with which physicians used the information sources provided by the Swiss traffic medicine website.

Design

Questionnaire-based cross-sectional study.

Setting

The study was conducted in four cantons of Western Switzerland (Geneva, Vaud, Neuchâtel and Jura).

Participants

All physicians certified to carry out fitness-to-drive assessments in the canton of Geneva (medical assessors; n=69) and a random sample of 500 general practitioners practising in the cantons of Vaud, Neuchâtel and Jura were invited to participate. They were asked to report their estimated average number of fitness-to-drive assessments per week and to rate on a 5-point Likert scale the perceived usefulness of the preconsultation patient questionnaire and reference guide, and the frequency of use of the information sources provided by the traffic medicine website. We computed the proportion of physicians who found the assessment tools very/somewhat useful and the proportion of physicians who always/often used the traffic medicine website. We compared the responses according to medical specialty (medical assessors vs general practitioners) using design-basedFtests and weighted logistic regressions.

Results

268 physicians (47%) agreed to participate in the study. Their median number of assessments was 2 per week (IQR 2). Overall, the majority of physicians found the questionnaire (75%) and reference guide (89%) very/somewhat useful. Only 17% of the sample always/often used the traffic medicine website. There were no statistically significant associations in multivarible analysis between the medical specialty and the perceived usefulness of the questionnaire and reference guide and the frequency of use of the traffic medicine website.

Conclusion

Many physicians find the preconsultation patient questionnaire and reference guide useful to guide them for assessing the driving ability of older drivers, but only a minority regularly use the information sources provided by the traffic medicine website. Future studies should explore the reasons why many physicians do not use these available sources of information.
Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?
Authors: Stevenson Alex , Kirresh Ali , Conway Samuel , White Laura , Ahmad Mahmood , Little Callum
Published: August 2020

The outbreak of COVID-19 in Wuhan, China and its declaration as a global pandemic by WHO has left the medical community under significant pressure to rapidly identify effective therapeutic and preventative strategies. Chloroquine (CQ) and its analogue hydroxychloroquine (HCQ) were found to be efficacious against SARS-CoV-2 when investigated in preliminary in vitro experiments. Reports of success in early clinical studies were widely publicised by news outlets, politicians and on social media. These results led several countries to approve the use of these drugs for the treatment of patients with COVID-19. Despite having reasonable safety profiles in the treatment of malaria and certain autoimmune conditions, both drugs are known to have potential cardiotoxic side effects. There is a high incidence of myocardial injury and arrhythmia reported with COVID-19 infection, and as such this population may be more susceptible to this side-effect profile. Studies to date have now demonstrated that in patients with COVID-19, these drugs are associated with significant QTc prolongation, as well as reports of ventricular arrhythmias. Furthermore, subsequent studies have failed to demonstrate clinical benefit from either drug. Indeed, clinical trials have also been stopped early due to safety concerns over HCQ. There is an urgent need for credible solutions to the global pandemic, but we argue that in the absence of high-quality evidence, there needs to be greater caution over the routine use or authorisation of drugs for which efficacy and safety is unproven.
Clinical, CT and ultrasonographic features of renal secondary hyperparathyroidism in a juvenile dog
Authors: Barczak Elzbieta , O'Connell Erin , Mortier Jeremy R
Published: August 2020

A nine‐month‐old female entire Rottweiler was presented for further investigation of progressive, symmetric facial swelling over the maxilla of four weeks duration. Biochemistry revealed severe azotaemia with hyperphosphataemia. CT revealed poor mineralisation of the facial and calvarial bones. The maxillary and palatine bones were replaced by proliferative, heterogeneous tissue of mixed soft tissue and granular mineral attenuating material. On ultrasound, parathyroid glands were enlarged and renal lesions suggestive of juvenile nephropathy were observed. Due to poor long‐term prognosis, the owner elected euthanasia. Necropsy confirmed generalised osteopenia and chronic kidney disease. Renal secondary hyperparathyroidism was diagnosed and should be considered a differential for bilateral facial swelling in young dogs.
Inversion of magnetic and frequency-domain electromagnetic data for investigating lithologies associated with gold mineralization in the Canadian Malartic area, Québec, Canada
Authors: Darijani Mehrdad , Farquharson Colin G.
Published: August 2020

Canadian Malartic is an Archean low-grade bulk tonnage native gold deposit. The deposit is mostly located in altered clastic metasedimentary rocks, mafic–ultramafic dykes, and monzodioritic porphyry intrusions. Airborne magnetic and frequency-domain electromagnetic (EM) data were inverted to reconstruct the geological units associated with the mineralization, especially the intrusive masses. The 3-D inversion of magnetic data, which used a tetrahedral mesh to a depth of 2.4 km, shows that mafic volcanic rocks and iron formation rocks extend to depth in the area, more so than diabase dykes. The magnetic inversion also shows that the diorite and monzodiorite rocks of the Lac Fournière A pluton are dipping toward the south on its northern edge at the contact with the metasedimentary rocks. The 1-D inversion of the frequency-domain EM data, for both electrical conductivity and magnetic susceptibility, is able to reconstruct geological structures to a depth of approximately 100 m, providing more details and information about these features. The intrusive masses such as diabase dykes, diorite and monzodiorite rocks, and mafic volcanic rocks are reconstructed as electrically conductive structures in the inversion results. The metasedimentary rocks are resistive, and the overburden is conductive in most of the area. The geophysical data and inversion results suggest the presence of some features (such as diabase dykes and monzodiorite rocks) that are not yet present on some parts of the geology map. A comparison of the EM-derived susceptibility and the magnetic-derived susceptibility over the iron formations can reveal the effect of remanent magnetization.
Quasinormal modes and greybody factors of the novel four dimensional Gauss–Bonnet black holes in asymptotically de Sitter space time: scalar, electromagnetic and Dirac perturbations
Authors: Devi Saraswati , Roy Rittick , Chakrabarti Sayan
Published: August 2020

We find the low lying quasinormal mode frequencies of the recently proposed novel four dimensional Gauss–Bonnet de Sitter black holes for scalar, electromagnetic and Dirac field perturbations using the third order WKB approximation as well as Padé approximation, as an improvement over WKB. We figure out the effect of the Gauss–Bonnet coupling $$\alpha $$α and the cosmological constant $$\Lambda $$Λ on the real and imaginary parts of the QNM frequencies. We also study the greybody factors and eikonal limits in the above background for all three different types of perturbations.
A CROSS-CULTURAL ADAPTATION OF THE OXFORD ELBOW SCORE: THE ARABIC VERSION
Authors: Khaja Aliaa F , Hanna Sager Samir , Saleh Ali Adel , Alqasser Abdullah M , Alobaidi Salma A , Azeem Mokhtar Abdul
Published: August 2020

Background: Oxford Elbow Score, abbreviated OES, is a tool used for measurement of a patient’s experience post elbow surgery. The tool is formulated as a questionnaire. OES has three subscales: pain, elbow function and social-psychological effects. The patient may complete the questionnaire and the results used as an outcome measure post elbow surgery. Objectives: The study aims to develop and evaluate the Arabic version of the OES for reliability, validity concerning patients after elbow trauma and surgery. Material and Methods: Fifty two patients participated in this survey at the baseline (14 days after the operation) and follow-up (after 60 days). We calculated internal consistency using Cronbach’s alpha. Also, Pearson’s correlation was calculated for construct validity verification. Results: The values for Cronbach’s alpha for psychological, function and pain subscales were 0.701, 0.704 and 0.779, respectively. Cronbach’s alpha for the questionnaire had a value of 0.743. We confirmed construct validity using correlation coefficients of values [Formula: see text], [Formula: see text] and [Formula: see text] as compared to DASH. Conclusion: The Arabic OES is an internal consistent tool with good construct validity, which can be used to estimate the patient’s condition after the elbow surgery.
Ultimate complexity for numerical algorithms
Authors: van der Hoeven Joris , Lecerf Grégoire
Published: August 2020

Most numerical algorithms are designed for single or double precision floating point arithmetic, and their complexity is measured in terms of the total number of floating point operations. The resolution of problems with high condition numbers (e.g. when approaching a singularity or degeneracy) may require higher working precisions, in which case it is important to take the precision into account when doing complexity analyses. In this paper, we propose a new "ultimate complexity" model, which focuses on analyzing the cost of numerical algorithms for "sufficiently large" precisions. As an example application we will present an ultimately softly linear time algorithm for modular composition of univariate polynomials.
Quantification of left ventricular contribution to stroke work by longitudinal and radial force-length loops
Authors: Seemann Felicia , Berg Jonathan , Solem Kristian , Jablonowski Robert , Arheden Håkan , Carlsson Marcus , Heiberg Einar
Published: August 2020

A novel method for quantifying the contributions of longitudinal and radial pumping to stroke work using global left ventricular force-length loops was proposed and validated, which can be quantified noninvasively using cardiovascular magnetic resonance and brachial cuff pressure. We found that longitudinal and radial pumping contributes equally to stroke work in controls and 44/56% in heart failure patients, and that the longitudinal pumping is more energy efficient in delivering stroke volume than radial pumping.
The muscle reflex and chemoreflex interaction: ventilatory implications for the exercising human
Authors: Wan Hsuan-Yu , Weavil Joshua C. , Thurston Taylor S. , Georgescu Vincent P. , Bledsoe Amber D. , Jessop Jacob E. , Buys Michael J. , Richardson Russell S. , Amann Markus
Published: August 2020

Although the muscle reflex and the chemoreflex are recognized as independent feedback mechanisms regulating breathing during exercise, the ventilatory implications resulting from their interaction remain unclear. We quantified the individual and interactive effects of these reflexes during exercise and revealed differential modes of interaction. Importantly, the reflex interaction further amplifies the ventilatory response to exercise under hypoxemic conditions, highlighting a potential mechanism for optimizing arterial oxygenation in physically active humans at high altitude.
Motor memories in manipulation tasks are linked to contact goals between objects
Authors: McGarity-Shipley Michael R. , Heald James B. , Ingram James N. , Gallivan Jason P. , Wolpert Daniel M. , Flanagan J. Randall
Published: August 2020

Skilled manipulation requires forming memories of object dynamics, previously assumed to be associated with entire objects. However, we recently demonstrated that people can form multiple motor memories when explicitly instructed to move different locations on an object to different targets. Here, we show that separate motor memories can be learned for different contact goals, which involve a unique combination of a control point and target.
The Implementation of the Lesson Study Strategy in Teaching Mathematics: Teachers’ Perspectives
Authors: Alamri Naem M.
Published: August 2020

Lesson study is a form of classroom inquiry that can facilitate teachers’ continuing professional development. This study aims to explore primary school mathematics teachers’ perspectives about the implementation of the lesson study strategy in teaching mathematics. The sample of this study included 149 primary school mathematics teachers in Riyadh, Saudi Arabia, who were selected by using the purposive sampling. A quantitative questionnaire was sent to the teachers by e-mail or mobile. 149 mathematics teachers responded to the questionnaire; among them, fifteen teachers participated in a qualitative interview. The results indicated that most of the sample members carry out lesson study activities. The percentages of the teachers in the study sample who practice the activities and procedures of the lesson study ranged between 61.7% and 89.9%. The results also indicated that there is a high impact on the professional development of mathematics teachers as a result of their participation in the lesson study strategy as it helps enhance their mathematical and pedagogical knowledge, improve their knowledge of students’ learning process, and influence their views about the lesson study approach.
A New Method for Interindustry Linkage Analysis Based on Demand-Driven and Multisector Input-Output Model and Its Application in China’s Manufacturing and Producer Services
Authors: Liu Xiao , Shi Jinchuan
Published: August 2020

Interindustry linkage analysis is an important interdisciplinary research field of technical economic and complex systems, and the results can be used as critical bases for making strategies and policies of economic development. This study reviews the previous methods for measuring interindustry linkages and their disadvantages and puts forward a new method for interindustry linkage analysis in a complex economic system on the basis of demand-driven and multisector input-output model. Firstly, it makes a further decomposition of the Leontief inverse matrix in the economic sense and decomposes the gross output of one industrial sector or its sub-industries into three components. Then, it analyzes the structural features of output and measures the interindustry linkages between two industrial sectors with three indices: interindustry linkage effect, interindustry linkage contribution, and interindustry linkage coefficient. Compared with the previous measurements, the method in this study has three obvious advantages: it integrates the sectoral internal effect and external linkage effect at the same time; it can not only measure the interindustry linkage effects between two given industrial sectors but also clearly describe the composition ratio of the direct and indirect interindustry linkage effects; and it adopts, respectively, the absolute flow value, relative flow value, and unit relative value to measure the linkages comprehensively. Finally, this study takes China’s input and output in 2017 as an application case to analyze the structural features of output of its manufacturing and producer services and measure the interindustry linkages between them.
Endoscopic Esophageal Submucosal Tunnel Dissection for Cystic Lesions Originating from the Muscularis Propria of the Gastric Cardia
Authors: Liu Lu , Guo Hai-Mei , Miao Feng , Li Nuo , Jiao Shu-Hua , Cai Shuang , Liu Peng-Liang , Zhang Shan-Shan , Ma Jia , Weng Yang , Sun Ying , Tang Yin-Si , Zhao Feng , Zheng Yan , Zhang Shen , Yang Yan , Zhao Zhi-Feng
Published: August 2020

Objective. To analyze the types and properties of cystic lesions originating from the muscularis propria of the gastric cardia (CLMPGC), explore the growth pattern and anatomical characteristics, and evaluate the safety, feasibility, and clinical efficacy of endoscopic esophageal submucosal tunnel dissection (ESTD). Methods. From September 2013 to July 2018, we treated 6 patients with CLMPGC whom we had diagnosed using endoscopy, endoscopic ultrasound (EUS), and Computed Tomography (CT) before the operations. ESTD was the best option for treatment for all these patients. Postoperative observation and follow-ups were performed, and the operational, clinical data, and treatment results are analyzed. Results. The mean age of the patients was 50.67 ± 11.59 years (male : female = 1 : 1). The only clinical manifestations the patients exhibited were upper abdominal discomfort. The diameter of the masses was 2.05 ± 0.73 (1.1–3.0) cm. The duration of the ESTD operation was 93.5 (82–256) mins, and the length of hospital stay was 7.50 ± 1.38 days. Postoperative pathology showed 4 cases of an epithelioid cyst, and 2 cases of mucocele with xanthogranuloma. There were no complications, such as hemorrhage, pneumothorax, and pleural effusion during and after the operation. No recurrence during the follow-ups was observed. Conclusion. The CLMPGC were mainly mucocele and epidermoid cyst, in an expansive growth pattern, and these lesions had no distinct borders with the muscularis propria. The muscularis propria formed a complete wall of the lesion. There was no direct blood supply to the lesions from big blood vessels. Endoscopic esophageal submucosal tunnel dissection was a safe, feasible, and effective treatment for CLMPGC.
Reinforcement Effect of Inclined Prestressed Concrete Pipe Piles on an Inclined Soft Foundation
Authors: Zhou De-quan , Feng Chen-xi , Li Liu-xi , Zhou Yi , Zhu Qin
Published: August 2020

The embankment slope is vulnerable to slip and collapse, when prestressed concrete pipe (PCP) piles are used to reinforce the inclined soft foundation to bear the load of the embankment. Accordingly, this study puts forward new programs for strengthening embankment foundation with inclined, rather than vertical, PCP piles. Based on an actual engineering accident with embankment slope collapse, this study establishes a finite element model, accompanied by analysis of engineering characteristics and reinforcement effects of the foundation. The main conclusions are drawn as follows: (1) when a pile‐supported foundation is used to strengthen the inclined soft foundation, PCP piles in the lower part of the embankment are subjected to bending moments, with their maximum value appearing in the upper part of the PCP pile at the embankment slope foot. During the embankment filling, the maximum pile bending moment may reach the ultimate bending load, resulting in bending failure accompanied with large lateral displacement and even slope collapse. The maximum horizontal displacement of the foundation is located at the foot of the embankment slope. (2) Reinforcement using inclined PCP piles contributes to smaller maximum pile body bending moments than that using vertical PCP piles and loading berms, and such contribution is enhanced when the inclination angle of PCP piles in the lower part of the slope gets larger. Therefore, inclined PCP piles with high angles are optimum in improving the overall stability of the foundation. (3) Compared with vertical PCP piles, inclined PCP piles contribute to smaller horizontal displacement and vertical settlement in foundation reinforcement, which means better reinforcement effects. Moreover, as the inclination angle of PCP piles increases, the maximum displacement decreases rapidly, associated with greatly enhanced lateral stability.
Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications
Authors: Franke Mareike , Franke Jasper , Saager Christian , Barthel Sven , Riemann Randolf , Mueckner Kersten
Published: August 2020

Today, there are still no uniform guidelines for the treatment of epistaxis. Furthermore, it is widely debated whether embolization or surgical approaches should be the first choice of treatment for intractable posterior epistaxis after conservative measures have failed. In several meta-analyses, it is reported that endoscopic sphenopalatine artery ligation and embolization have similar success rates, but embolization was associated with more severe neurological complications. Regarding existing literature, there are many comparative analyses of surgical methods but none for embolization protocols. Against this backdrop of a lack of uniform standards in embolization techniques, we present a retrospective evaluation of what has emerged to be best procedural practice for endovascular treatment of epistaxis in our department using microsphere particles and microcoils, in particular regarding precaution measures to avoid neurological complications. In our retrospective data analysis of 141 procedures in 123 patients, performed between 2008 and 2019, we find success rates very similar to those reported in other studies (95.1% immediate-stop-of-bleeding success and 90.2% overall embolization success) but did not encounter any major neurological complication opposed to other reports. We suggest some aspects of our protocol as precaution measure to avoid neurological complications. More generally and perhaps even more importantly, we make a strong case for standardization for embolization techniques to the level of details in surgical procedure standardization to enable an apples to apples comparison of embolization techniques to each other and of intervention vs. surgery.
Fixed-Time Synchronization of Neural Networks with Discrete Delay
Authors: Liu Shuai , Chen Chuan , Peng Haipeng
Published: August 2020

In this paper, we establish a new fixed-time stability theorem, which provides a novel fixed-time stability criterion and a novel upper bound estimate formula for the settling time. Numerical simulations show that the upper bound estimate for the settling time in this paper is tighter than those given in the existing fixed-time stability theorems. By designing a simple feedback controller, the fixed-time synchronization of neural networks with discrete delay is investigated based on the fixed-time stability theorem established in this paper. A numerical example is included to validate the effectiveness of the obtained theoretical results.
A Compact High-Gain Coplanar Waveguide-Fed Antenna for Military RADAR Applications
Authors: Dayo Zaheer Ahmed , Cao Qunsheng , Wang Yi , Pirbhulal Sandeep , Sodhro Ali Hassan
Published: August 2020

This paper presents a new design of a compact, high-gain coplanar waveguide-fed antenna and proposes a multielement approach to attain enhanced characteristics. The proposed method overcomes the simulation and geometrical complexity and achieves optimal performance features. The antenna prototype is carefully designed, and simulation results have been analyzed. The proposed antenna was fabricated on a new WangLing TP-2 laminate with dimensions (0.195λ × 0.163λ × 0.0052λ) at the lowest resonance of 9.78 GHz. The results have been tested and experimentally verified. The antenna model achieved excellent performance including a peak realized gain better than 9.0 dBi, optimal radiation efficiency better than 87.6% over the operating band, and a good relative bandwidth of 11.48% at 10 dB return loss. Symmetrical stable far-field radiation pattern in orthogonal planes and strong distribution of current are observed. Moreover, a comparative analysis with state-of-the-artwork is presented. The measured and simulation result shows a good agreement. The high-performance antenna results reveal that the proposed model is a good contender of military airborne, land, and naval radar applications.
Philosophical Analysis of the Meaning and Nature of Entropy and Negative Entropy Theories
Authors: Wu Kun , Nan Qiong , Wu Tianqi
Published: August 2020

The interpretation of entropy and negative entropy theories on the nature of information is the first scientific paradigm on the interpretation of the nature of information at the beginning of the rise of contemporary information science. The information entropy or negative entropy theories are the relative measurement for the structuralization degree of the system at a specific level, which have certain characteristics of relativity, functionality, and quantification. Although the concepts of entropy, negative entropy, information, entropy increase, and entropy decrease often have very different specific meanings in different disciplines and for different scientists, the meanings of these concepts are unified in essence and the differences between them are generated when the same kind of concepts is applied to the study of different directions of the same kind of phenomena: either to the static structuralization degree of the system or to the change of the dynamic structuralization degree of the system. Since entropy and negative entropy theories only measure the relationship of structural differences at a specific level of the system from a formal aspect, they are not aimed at the information itself but rather they are aimed at only the structuralization characteristics of the information carrier itself at a specific level. Because of this, it is impossible to deduce the general nature of information directly from such theories.
Uterine Carcinosarcoma: A Case Report and Literature Review
Authors: Kord Ali , Rabiee Behnam , Elbaz Younes Ismail , Xie Karen L.
Published: August 2020

Uterine carcinosarcomas are rare and extremely aggressive undifferentiated carcinomas which include both carcinomatous and sarcomatous elements. A 52-year-old female presented with heavy irregular menstrual bleeding for several years and new right elbow pain and swelling. Ultrasound and computed tomography showed a large uterine mass with regional and distant metastatic lymphadenopathy and suspicious findings of osseous metastasis to the right elbow. A biopsy confirmed uterine carcinosarcoma, and the patient underwent chemotherapy and then surgical resection of the uterine mass with palliative radiotherapy of the right elbow. The postoperative imaging showed new metastasis, and the patient was scheduled to start on immunotherapy. Considering the highly invasive nature of uterine carcinosarcomas, timely detection of this cancer using characteristic imaging and pathology findings is of extreme importance to improve the patient’s survival.