bluuebunny/crossref_metadata_2025 huggingface dataset:
Automatic Judgment of Ultrasonic Detection for Solid Axle Inlaid Part
Authors: Yang Kai , Wu Dongdong , Xie Liming
Published: November 2020

Ultrasonic detection is the most effective nondestructive method for axle inlaid part, which has high efficiency and wide coverage. In the process of rail vehicle running, the influence of the external environment and the interaction between wheel and axle cause uneven distribution of stress concentration and with fretting corrosion, which lead to the generation of fatigue crack, otherwise, the waveform of ultrasonic detection is complex, because the energy of non-defect is too high to identify the defect. In view of this phenomenon, the ultrasonic echo data is analyzed by wavelet transform method to extract the defect characteristic, which is used for automatically judgment. The results show that the fatigue defect can be identified effectively by using the defect characteristic that extracted by wavelet transform method.
Support Vector Machine Based Feature Extraction For Gender Recognition From Objects Using Lasso Classifier
Authors: Galla Damodara Krishna Kishore , Mukamalla BabuReddy , Chegireddy Rama Prakasha Reddy
Published: November 2020

Object detection and gender recognition were two different categories to be classified in a single section is a complicated task and this approach helps in supporting the blind people for an artificial vision. In this paper, our method to the betters vision sensation of blind persons by conversion of visualized data to audio data. Therefore this artificial intelligence model helps in detecting the objects as well as human face recognition with gender classification based on face recognition approach. This model processed with feature extraction and classification models. The feature extraction was comprised with multi scale-invariant feature transform(MSIFT), with feature optimization with support vector machine algorithm then classified using LASSO classifier. For better performance identification, three different classification models were implemented and tested too. Feature selection helps in making tests early to detect the objects and recognizing human actions using image processing approach. This approach can be applied for both offline and online modes. But in this scenario, an offline mode was implemented and was tested with a combination of different databases. For this process of classification ridge regression (RR), elastic net (EN), lasso regression(LR) and LASSO regression were implemented. The final classification results with accuracy are as follows for RR- 89.6%, EN- 93.5%, LR-93.2% and proposed approach(LRGS) with 98.4% accurate detection rate with prediction name of classes.
Association between self-reported walking speed and calcaneal stiffness index in postmenopausal Japanese women
Authors: Tomita Yoshihito , Arima Kazuhiko , Mizukami Satoshi , Tsujimoto Ritsu , Kawashiri Shin-ya , Nishimura Takayuki , Okabe Takuhiro , Tanaka Natsumi , Honda Yuzo , Nakahara Kazumi , Yamamoto Naoko , Ohmachi Izumi , Goto Hisashi , Hasegawa Maiko , Sou Youko , Horiguchi Itsuko , Kanagae Mitsuo , Abe Yasuyo , Nonaka Fumiaki , Tamai Mami , Yamanashi Hirotomo , Nagata Yasuhiro , Kawakami Atsushi , Maeda Takahiro , Aoyagi Kiyoshi
Published: November 2020

Background; Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older.Design; Cross-sectional study.Setting and Participants; The survey population included 1008 postmenopausal women 50–92 years of age residing in rural communities.Methods; Self-reported walking speed was ascertained by asking the participants: “Is your walking speed faster than others of the same age and sex?” to which participants responded “yes (faster)” or “no (moderate/slower).” Calcaneal stiffness index was measured.Results; Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, BMI, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p < 0.001).Conclusions; Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.
Minimally Invasive Versus open AbdominoThoracic Esophagectomy for esophageal carcinoma (MIVATE) - study protocol for a randomized controlled trial DRKS00016773
Authors: Nickel Felix , Probst Pascal , Studier-Fischer Alexander , Nienhüser Henrik , Pauly Jana , Kowalewski Karl-Friedrich , Weiterer Sebastian , Knebel Philipp , Diener Markus K. , Weigand Markus A. , Büchler Markus W. , Schmidt Thomas , Müller-Stich Beat Peter
Published: November 2020

Background:The only curative treatment for most esophageal cancers is radical esophagectomy. Minimally invasive esophagectomy (MIE) aims to reduce postoperative morbidity, but is not yet widely established. Linear stapled anastomosis is a promising technique for MIE because it is quite feasible even without robotic assistance. Aim of the present study is to compare total MIE with linear stapled anastomosis to open esophagectomy (OE) with circular stapled anastomosis with special regard to postoperative morbidity in an expertise-based randomized controlled trial (RCT).Methods/design:This superiority RCT compares MIE with linear stapled anastomosis (intervention) to OE with circular stapled anastomosis (control) for Ivor-Lewis esophagectomy. It was initiated in February 2019 and recruitment is expected to last for 3 years. For inclusion, patients must be 18 years of age or more with a resectable primary malignancy in the distal esophagus. Participants with tumor localizations above the azygos vein, metastasis or infiltration into adjacent tissue will be excluded. In an expertise-based approach the allocated treatment will only be carried out by the single most experienced surgeon of the surgical center for each respective technique. The sample size was calculated with 20 participants per group for the primary endpoint postoperative morbidity according to comprehensive complication index (CCI) within 30 postoperative days. Secondary endpoints include anastomotic insufficiency, pulmonary complications, other intra- and postoperative outcome parameters such as estimated blood loss, operative time, length of stay, short-term oncologic endpoints, adherence to a standardized fast-track protocol, postoperative pain, and postoperative recovery (QoR-15). Quality of life (SF-36, CAT EORTC QLQ-C30, CAT EORTC QLQ-OES18) and oncological outcomes are evaluated with 60 months follow-up.Discussion:MIVATE is the first RCT to compare OE with circular stapled anastomosis to total MIE with linear stapled anastomosis exclusively for intrathoracic anastomosis. The expertise-based approach limits bias due to heterogeneity of surgical expertise. The use of a dedicated fast-track protocol in both OE and MIE will shed light on the role of the access strategy alone in this setting. The findings of this study will serve to define which approach has the best perioperative outcome for patients requiring esophagectomy.Trial registration: German Clinical Trials Register DRKS00016773. Registered on February 18th, 2019.
Determinants of Micro and Small Scale Enterprises’ financing preference in line with POH and Access to Credit: Empirical Evidence from Entrepreneurs in Ethiopia, Benishangul-Gumuz Regional State
Authors: Meressa Hayelom Abrha
Published: November 2020

The purpose of this study was to examine factors that determine micro and small scale enterprises’ financing preference in line with pecking order theory and access to credit in Benishangul-Gumuz Regional State of Ethiopia. The study used primary data collected using cross sectional survey questionnaire. The sample of this study was 296 enterprises selected using proportional stratified random sampling technique. The data was analyzed using descriptive and logistic regression analysis. Accordingly, the results of logistic regression revealed that business experience, collateral, gender, motivation and enterprises’ sectoral engagement affect financing preference of enterprises in line with pecking order hypothesis. To investigate access to credit determinants, only enterprises that need to raise capital through credit were considered. As a result, the logistic regression output revealed that business experience, size, sectoral engagement, collateral, interest rate, loan repayment period, financial reporting, preparation of business plan, location and educational background of entrepreneurs affect access to credit of enterprises. However, more evidence is needed on enterprises’ financing preference and access to credit determinants before any generalization of the results can be made for the fact that the empirical tests were conducted only on 296 entrepreneurs since 2019. Therefore, the findings are valid and practicable only for the entrepreneurs under the study and the results cannot be assumed to extend beyond this group of entrepreneurs to different study periods. Despite its limitations, the study makes an original contribution to the literature of small business finance by investigating determinants of micro and small scale enterprises’ financing preference in line with pecking order hypothesis and access to credit in Benishangul Gumuz regional state of Ethiopia as a developing country.
Overexpression of HNF4α enhances umbilical cord mesenchymal stem cell function to treat acute liver failure in mice through macrophage polarization
Authors: Yu Yeping , Zhang Qiqi , Wu Ning , Xia Lei , Cao Jie , Xia Qiang , Zhao Jie , Zhang Jianjun , Hang Hualian
Published: November 2020

Background and aim: Advances in research on stem cell therapy provide new feasible solutions for acute liver failure (ALF) treatment. Recent studies have demonstrated that the expression of hepatocyte nuclear factor 4α (HNF4α) reset within the damaged hepatocytes can restore normal physiological function. This study aimed to determine the role of human umbilical cord mesenchymal stem cells (HuMSCs) overexpressing HNF4α in ALF treatment. Method: HuMSCs in vitro were isolated, cultured, and reprogrammed by the lentiviral expression of HNF4α (hereinafter referred to as HuMSC-HNF4α). HuMSC-HNF4α was intraperitoneally administered into the mice immediately after exposed to D-galactosamine/lipopolysaccharide (D-galN/LPS). The liver histological and serum biochemical analyses were performed to investigate the effects of HuMSC-HNF4α in ALF. Macrophages differentiation and cytokines secretion by HuMSCs were evaluated to elucidate the underlying mechanisms. Results: HuMSC-HNF4α had more obvious therapeutic effects on ALF compared with negative control virus-transfected the HuMSCs (HuMSC-CON). In vitro, HuMSC-HNF4α promoted the polarization of liver macrophages (Kupffer cells) to the M2 phenotype, inhibited the inflammatory response of macrophages, and reduced the levels of inflammatory factors such as TNF-α and IL-1β to reduce liver damage. Conclusions: This study confirmed that the therapeutic effect of HuMSC-HNF4α on ALF was not the same as the previous passive support but as active intervention on excessive inflammation in the body. The findings provided new ideas for research and clinical practice in the future.
Emission factor, relative ozone formation potential and relative carcinogenic risk assessment of VOCs emitted from manufacturing industries
Authors: Yang Hsi-Hsien , Gupta Sunil Kumar , Dhital Narayan Babu
Published: November 2020

Manufacturing industries are one of the important emission sectors of anthropogenic volatile organic compounds (VOCs). In this study, VOC emission factors, relative ozone formation potential (ROFP) and relative carcinogenic risk (RCR) were estimated for manufacturing industries (n=13) located in central Taiwan. Emission samples were collected in stainless steel canisters and were analyzed with a system of gas chromatography-mass spectroscopy. Higher emission factors of total VOCs (∑VOCs) were observed for stencil printing (423 mg-VOC kg-1) compared to other emission industries. Alkanes constituted the most prominent group of VOCs for steel foundry (42%), aluminum foundry (25%) and synthetic resin industries (25%). Oxygenated VOCs were the most abundant group in the organic solvent (80%), polyester resin (80%) and polyurethane (75%) industries. Moreover, emissions from acrylic resin manufacturing had a major contribution from aromatic compounds (> 95%). Toluene was the topmost compound in terms of its contribution to ∑VOCs in plastic tape manufacturing (44%), aluminum foundry (40%), steel foundry (12%), plastic coating (64%) and stencil printing (35%). Analysis of ozone formation potentials showed that the metal product and machinery acrylic resin manufacturing and stencil printing had a higher normalized relative ozone formation potential (ROFP) index and belonged to Level-I emission sources. However, in terms of the relative carcinogenic risk (RCR), integrated iron and steel manufacturing had the highest normalized RCR index that belonged to level-I emission sources. Level-I represents the most important VOC emission sources. This study provides a reactivity- and carcinogenicity-based approach to identify high-priority VOC emission sources. The results of this study would help formulate emission reduction policies and strategies for manufacturing industries.
An individually randomised controlled multi-centre pragmatic trial with embedded economic and process evaluations of early vocational rehabilitation compared with usual care for stroke survivors: study protocol for the RETurn to work After stroKE (RETAKE) trial
Authors: Radford Kathryn , King Kristelle , McLellan Vicki , Sach Tracey , Brindle Richard , Holloway Ivana , Hartley Suzanne , Bowen Audrey , O'Connor Rory , Stevens Judith , Phillips Julie , Walker Marion , Holmes Jain , McEvitt Christopher , Murray John , Watkins Caroline , Powers Katie , Shone Angela , Farrin Amanda
Published: November 2020

Background: Return to work (RTW) is achieved by less than 50% of stroke survivors. The rising incidence of stroke among younger people, the UK economic forecast, and clinical drivers highlight the need for stroke survivors to receive support with RTW. However, evidence for this type of support is lacking. This randomised controlled trial (RCT) will investigate whether Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care (UC) (i.e., usual NHS rehabilitation) is more clinically and cost effective for supporting post-stroke RTW, than UC alone.Methods: 760 stroke survivors and their carers will be recruited from approximately 20 NHS stroke services. A 5:4 allocation ratio will be employed to randomise participants to receive ESSVR plus UC, or UC alone. The individually tailored ESSVR intervention will commence within 12 weeks of stroke onset and be delivered for up to 12 months as necessary by trained RETAKE occupational therapists in the community, participants’ homes or workplaces, outpatient/inpatient therapy settings, via telephone, email or SMS text message. Outcome data will be collected via self-report questionnaires administered by post or online at 3, 6, and 12 months follow-up. The primary outcome will be self-reported RTW and job retention at 12 months (minimum 2 hours/week). Secondary outcomes will include: mood; function; participation; health-related quality of life; confidence; intervention compliance; health and social care resource use; and mortality. An embedded economic evaluation will estimate cost-effectiveness and cost-utility analyses from National Health Service (NHS) and Personal Social Services (PSS) perspectives. An embedded process evaluation will employ a mixed methods approach to explore ESSVR implementation, contextual factors linked to outcome variation, and factors affecting NHS roll-out.Discussion: This article describes the protocol for a multi-centre RCT evaluating the clinical- and cost-effectiveness of an early vocational rehabilitation intervention aimed at supporting adults to return to work following a stroke. Evidence favouring the ESSVR intervention would support its roll-out in NHS settings.Trial registration: ISRCTN, ISRCTN12464275.Registered on 26th February 2018, http://www.isrctn.com/ISRCTN12464275.
Serum SP-A and KL-6 levels can predict the improvement and deterioration of patients with interstitial pneumonia with autoimmune features
Authors: Wang jingxian , Zheng Peiyan , Huang Zhifeng , Huang Huimin , Xue Mingshan , Liao Chenxi , Zhong Nanshan , Sun Baoqing
Published: November 2020

Background: Some patients with interstitial pneumonia with autoimmune features (IPAF) showed a progressive course despite therapy. This study aimed to evaluate whether serial changes in the serum levels of surfactant protein-A (SP-A) and Krebs von den Lungen-6 (KL-6) can predict disease progression. Methods: Sixty-four patients with IPAF and 41 patients with non-fibrotic lung disease (non-FLD) were examined. Based on long-term changes in lung function, 36 IPAF patients who were followed up for more than 3 months were divided into a progressive group (n=9), an improvement group (n=13), and a stable group (n=14). Serum KL-6 and SP-A levels were measured. The sensitivity, specificity, cut-off value, and area under the curve (AUC) value for each of the indices were determined using receiver operating characteristic (ROC) curve analysis. The expression differences in these biomarkers and their correlation with disease severity were analyzed. Results: Compared with non-FLD patients, serum SP-A and KL-6 levels in IPAF patients were increased significantly [SP-A: (p < 0.001); KL-6: (p < 0.001)] and negatively correlated with DLCO (SP-A: rS = -0.323, p = 0.018; KL-6: rS = -0.348, p = 0.0011). In patients with progressive disease, the posttreatment serum SP-A and KL-6 levels were increased significantly compared with pretreatment levels [SP-A: (p = 0.021); KL-6: (p = 0.008)]. In patients showing improvement, the levels were decreased significantly [SP-A (p = 0.007) and KL-6 (p = 0.002)]. Changes in serum biomarkers (Delta SP-A and Delta KL-6) were significantly negatively correlated with changes in lung function (Delta FVC, Delta DLCO and Delta FEV1) (rS = 0.482, p < 0.05). A significant positive correlation was found between Delta SP-A and Delta KL-6 (rS = 0.482, p < 0.001). Conclusions: Serum SP-A and KL-6 offer high sensitivity and specificity for the diagnosis of IPAF. The decrease in serum SP-A and/or KL-6 levels in patients with IPAF is related to the improvement in pulmonary function. SP-A and KL-6 may be important biomarkers for predicting disease progression in patients with IPAF.
The emotional and social burden of heart failure: integrating physicians’, patients’, and caregivers’ perspectives through Narrative Medicine.
Authors: Testa Marco , Cappuccio Antonietta , Latella Maura , Napolitano Silvia , Milli Massimo , Volpe Massimo , Marini Maria Giulia
Published: November 2020

Background: The TRUST (The Roadmap Using Story Telling) project used a Narrative Medicine (NM) framework to assess the perspectives of people with heart failure (HF), their informal caregivers and HF specialists of the impact of heart failure (HF) on the daily life of patients and their carers. Methods: Italian HF specialists participated on a voluntary basis, completing their own narratives, and inviting patients and their caregivers to write anonymously about their experiences, all on a dedicated online platform. The narratives were analyzed according to standard NM methodology. Results: 82 narratives were collected from patients, 61 from caregivers, and 104 from HF specialists. Analysis of the three points of view revealed the extent of the burden of illness on the entire family, particularly that of the caregiver. The impact was mainly experienced as emotional and social limitations in patients’ and their caregivers’ daily lives. The analysis of all three points of view highlighted a strong difference between how HF is perceived by patients, caregivers, and HF specialists. Conclusions: This NM project illustrates the complex issues of living with HF and gave insights to integrate three different perspectives into the HF pathway of care.
New insights in the reproducibility of visual and electronic tooth color assessment for dental practice
Authors: Ratzmann Anja , Welk Alexander , Hoppe Stephanie , Fanghaenel Jochen , Schwahn Christian
Published: November 2020

Background: The aim of the study was to compare a 2D and 3D color system concerning a variety of statistical and graphical methods to assess validity and reliability of color measurements, and provide guidance on when to use which system and how to interpret color distance measures, including ΔE and d(0M1).Methods: The color of teeth 14 to 24 of 35 patients undergoing regular bleaching treatment was visually assessed and electronically measured with the spectrophotometer Shade Inspector™. Tooth color was recorded before bleaching treatment, after 14 days, and again after 6 months. VITAPAN® Classical (2D) and VITA-3D-Master® (3D) served as reference systems.Results: Concerning repeated measurements, the 2D system was superior to the 3D system, both visually and electronically in terms of ΔE and d(0M1), for statistics of agreement and reliability. All four methods showed strong patterns in Bland-Altman plots. In the 3D system, hue was less reliable than lightness and chroma, which was more pronounced visually than electronically. The smallest detectable color difference varied among the four methods used, and was most favorable in the electronic 2D system. Comparing the methods, the agreement between the 2D and 3D system in terms of ΔE was not good. The reliability of the visual and electronic method was essentially the same in the 2D and 3D systems; this comparability is fair to good.Clinical Relevance: The 3D system may confuse human raters and even electronic devices. The 2D system is the simple and best choice.
Landscape disturbance impacts on Attalea butyracea palm distribution in central Panama
Authors: Mertzlufft Caitlin , Madden Marguerite , Gottdenker Nicole , Runk Julie Velasquez , Saldaña Azael , Tanner Susan , Calzada Jose , Yao Xiaobai
Published: November 2020

Background: Increased Attalea butyracea palm propagation, notable for its role as key habitat for the primary Chagas disease vector in Panama, has been linked to landscape disturbance in single-palm observations in this region. Close proximity of these palms to human dwellings is proposed to increase risk of Chagas disease transmission from sylvatic transmission cycles to domestic transmission involving human populations. This study examines the relationship between landscape disturbance and mature A. butyracea spatial distribution, density, and proximity to human populations and vector and reservoir species’ movement corridors at a regional scale in a 300-km2 heterogeneous tropical landscape in central Panama.Methods: We remotely identified the locations of over 50,000 mature A. butyracea palms using high-resolution WorldView2 satellite imagery. A local Getis-Ord Gi* spatial analysis identified significant clusters of aggregated palms. Associations between palm and cluster abundance and a landscape disturbance gradient, derived from official Panama land cover data, were tested using Chi-square tests for Homogeneity and Z-test for proportions. Kruskall-Wallis non-parametric analysis of variance tests were run to assess whether palm cluster area varied by disturbance level, or whether disturbance was associated with proximity of palms and palm clusters to susceptible populations or vector movement corridors.Results: Our findings indicate a regional relationship between landscape disturbance and A. butyracea occurrence. We observe a significant increase in both individual and clustered A. butyracea in secondary forest, but a reduction of palms in agricultural settings. We do not detect evidence of any reduction in abundance of palms in residential settings. The majority of residential and commercial buildings in our study area are within vector flight distance of potential vector habitat in palm crowns.Conclusions: We observe probable anthropogenic elimination of A. butyracea palms in agricultural, but not residential, settings. Even in heavily deforested regions, significant concentrations of mature palms remain in close proximity to human establishments.
Improved performances of lithium disilicate glass-ceramics by seeds induced crystallization
Authors: Zhao Ting , Lian Mei-Mei , Qin Yi , Zhu Jian-Feng , Kong Xin-Gang , Yang Jian-Feng
Published: November 2020

Self-reinforced lithium disilicate (Li2Si2O5, LD) glass-ceramics were hot pressing sintered by introducing 5 wt% Li2Si2O5 crystal seeds into two different glass compositions of SiO2-Li2O-P2O5-ZrO2-Al2O3-K2O-La2O3 (7C LD) and SiO2-Li2O-K2O-La2O3 (4C LD). The results show that the seeds play an important role in the crystallization inducement, microstructural and properties improvement of the glass, especially for the glass powder without the nucleating agent of P2O5. The microstructure features a wider bimodal grain size distribution with large rod-like crystals epitaxially grown along the seeds and small crystals nucleated from the glass powder itself, contributes to the improvement of the performance especially the fracture toughness. The specimen of 4C LD glass with the addition of 5 wt.% Li2Si2O5 seeds exhibited the best comprehensive properties with a good flexural strength (396 ± 7 MPa), improved fracture toughness (3.31 ± 0.19 MPa·m1/2) and comparable translucency as IPS e.max. This research will provide a new idea and method for the improvement of the fracture toughness of lithium disilicate glass-ceramics without affecting its aesthetic appearance, and lay the foundation for its clinical applications.
Risk factors for unplanned reintubation caused by acute airway compromise after general anesthesia: a case-control study
Authors: Chen Si , Zhang Yuelun , Che Lu , Shen Le , Huang Yuguang
Published: November 2020

Background: This study aimed to identify the risk factors and evaluate the prognosis of unplanned reintubation caused by acute airway compromise (AAC) after general anesthesia.Methods: This case-control study included surgical patients who underwent unplanned reintubation in the operating room and postanesthesia care unit after general anesthesia between January 1, 2014, and December 31, 2018. Cases due to AAC were matched 1:4 with randomly selected controls.Results: A total of 123,068 patients were included, and reintubation due to AAC was performed in 36 patients (approximate incidence 0.03%). Univariable analysis revealed that male sex, age >65, ASA physical status 3, sepsis, heart disease history, cerebral infarction history, Cormack Lehane grade, surgery type, fresh frozen plasma infusion, increased intubation duration, white blood cell count, and creatinine clearance rate were related to AAC-caused unplanned reintubation. Multivariable analysis revealed that age >65 (OR=7.50, 95% CI 2.47-22.81, P<0.001), ASA physical status 3 (OR=6.51, 95% CI 1.18-35.92, P=0.032), head-neck surgery (OR=4.94, 95% CI 1.33-18.36, P=0.017) or thoracic surgery (OR=12.56, 95% CI 2.93-53.90, P<0.001) and a high fluid load (OR=3.04, 95% CI 1.16-7.99, P=0.024) were associated with AAC-caused unplanned reintubation. AAC-caused unplanned reintubation patients had longer postoperative hospital (OR=5.26, 95% CI 1.57-8.95, P<0.001) and intensive care unit days (OR=3.94, 95% CI 1.69-6.18, P<0.001).Conclusions: Age>65, ASA physical status 3, head-neck or thoracic surgery and high fluid load were found to be associated with AAC-caused unplanned reintubation.
Grouping of genomic markers in populations with family structure
Authors: Wittenburg Dörte , Doschoris Michael , Klosa Jan
Published: November 2020

Background: Linkage and linkage disequilibrium (LD) between genome regions cause dependencies among genomic markers. Due to family stratification in populations with non-random mating in livestock or crop, the standard measures of population LD such as r 2 may be biased. Grouping of markers according to their interdependence needs to account for the actual population structure in order to allow proper inference in genome-based evaluations. Results: Given a matrix reflecting the strength of association between markers, groups are built successively using a greedy algorithm; largest groups are built at first. As an option, a representative marker is selected for each group. We provide an implementation of the grouping approach as a new function to the R package hscovar. This package enables the calculation of the theoretical covariance between biallelic markers for half- or full-sib families and the calculation of representative markers. In case studies, we have shown that the number of groups comprising dependent markers was smaller and representative SNPs were spread more uniformly over the investigated chromosome region when the family stratification was respected compared to a population-LD approach. In a simulation study, we observed that sensitivity and specificity of a genome-based association study improved if selection of representative markers took family structure into account. Conclusions: Chromosome segments which frequently recombine in the underlying population can be identified from the matrix of pairwise dependence between markers. Representative markers can be exploited, for instance, for dimension reduction prior to a genome-based association study or the grouping structure itself can be employed in a grouped penalization approach.
Exploring Mandarin Chinese teacher’s knowledge base in China and the US: A comparative case study
Authors: Lew Moi Mooi , Liu Liu
Published: November 2020

This study aimed to explore Mandarin Chinese teachers’ knowledge base in China and the United States. To address this research objective, a curriculum inquiry was conducted on graduate-level Teaching Chinese As a Foreign Language (TCFL) teacher education program curricula in both countries. We analyzed the program curricula based on three domains of knowledge, i.e., subject matter knowledge, procedural knowledge, and contextual knowledge. We conducted a document analysis on the program curricula and semi-structured interviews with four teacher educators. The results revealed that both countries focus on different domains of knowledge. China emphasis subject matters knowledge and the US focuses more on procedural knowledge. With different teacher domain knowledge focus in the program curricula, the results implied that Chinese teachers who were graduated from these programs could possess different knowledge base.
Evaluation of optimal fermentation conditions for volatile fatty acids production from artisanal fish waste
Authors: Cadavid-Rodríguez Luz Stella , Castro-López Viviana E. , PLACIDO JERSSON
Published: November 2020

In this research, operational parameters were assessed to optimise the production of volatile fatty acids (VFA) from artisanal fish waste (FW) using mixed-culture fermentation. The experiments were performed using a randomised block design with pH and Inoculum/Substrate (I/S) ratio as factors with three pH levels (5, 7 and 9) and five I/S ratios levels (0.20, 0.15, 0.10, 0.05, 0.00) with VFA production, total ammonia nitrogen (TAN), biogas and soluble chemical oxygen demand (sCOD) as response variables. The results indicated that pH and I/S ratio significantly influenced VFA production and the other variables evaluated. The highest VFA concentration (54.5 g/L) was obtained at pH 7 and with an I/S ratio of 0.05. These conditions were also optimal for TAN and sCOD. External pH control was proved as unnecessary as the highest VFA production (70.3 g VFA/L) was obtained without pH control. In these conditions, the fermentation broth was able to maintain its pH between 6.6 and 7.7. The VFA profile had acetic (35%) and butyric (32%) acids as the dominant species and propionic, iso-valeric and iso-butyric were minor species (< 10%). An economic assessment evaluating the establishment of a FW VFA biorefinery in Tumaco, Colombia was performed including capital, operational and labour cost, discounted payback period and cost curves. These results evidenced the potential of artisanal FW as a raw material for producing high concentrations of VFA and smooth the path for the establishment of a VFA and biogas biorefinery from FW.
Predicting Incidence of Long-term Care Insurance Certification in Japan with the Kihon Checklist for Frailty Screening Tool: Analysis of Local Government Survey Data
Authors: Ito Kumiko , Kawai Hisashi , Tsuruta Harukazu , Obuchi Shuichi
Published: November 2020

Background: Predicting incidence of long-term care insurance (LTCI) certification in the short term is of increasing importance in Japan. The present study examined whether the Kihon Checklist (KCL) can be used to predict incidence of LTCI certification (care level 1 or higher) in the short term among older Japanese persons.Methods: In 2015, the local government in Tokyo, Japan, distributed the KCL to all individuals older than 65 years who had not been certified as having a disability or who had already been certified as requiring support level 1–2 according to LTCI system. We also collected LTCI certification data within the 3 months after collecting the KCL data. The data of 17785 respondents were analyzed. First, we selected KCL items strongly associated with incidence of LTCI certification, using stepwise forward-selection multiple logistic regression. Second, we conducted receiver operating characteristic (ROC) analyses for three conditions (1: Selected KCL items, 2: The main 20 KCL items (nos. 1–20), 3: All 25 KCL items). Third, we estimated specificity and sensitivity for each condition.Results: During a 3-month follow-up, 81 (0.5%) individuals required new LTCI certification. Eight KCL items were selected by multiple logistic regression as predictive of certification. The area under the ROC curve in the three conditions was 0.92–0.93, and specificity and sensitivity for all conditions were greater than 80%.Conclusions: Three KCL conditions predicted short-term incidence of LTCI certification. This suggests that KCL items may be used to screen for the risk of incident LTCI certification.
Prevalence of readily detected amyloid blood clots in ‘unclotted’ Type 2 Diabetes Mellitus and COVID-19 plasma: A preliminary report
Authors: Pretorius Etheresia , Venter Chantelle , Laubscher Gert Jacobus , Lourens Petrus Johannes , Steenkamp Janami , Kell Douglas B
Published: November 2020

Background: Type 2 Diabetes Mellitus (T2DM) is a well-known comorbidity to COVID-19 and coagulopathies are a common accompaniment to both T2DM and COVID-19. In addition, patients with COVID-19 are known to develop micro-clots within the lungs. The rapid detection of COVID-19 uses genotypic testing for the presence of SARS-Cov-2 virus in nasopharyngeal swabs, but it can have a poor sensitivity. A rapid, host-based physiological test that indicated clotting severity and the extent of clotting pathologies in the individual who was infected or not would be highly desirable. Methods: Platelet poor plasma (PPP) was collected and frozen. On the day of analysis, PPP samples were thawed and analysed. We show here that microclots can be detected in the native plasma of twenty COVID-19, as well as ten T2DM patients, without the addition of any clotting agent, and in particular that such clots are amyloid in nature as judged by a standard fluorogenic stain. Results were compared to ten healthy age-matched individuals.Results: In COVID-19 plasma these microclots are significantly increased when compared to the levels in T2DM. Conclusions: This fluorogenic test may provide a rapid and convenient test with 100% sensitivity (P<0.0001) and is consistent with the recognition that the early detection and prevention of such clotting can have an important role in therapy.
Association between social capital and loneliness among older adults: A cross-sectional study in Anhui Province, China
Authors: Bai Zhongliang , Wang Zijing , Shao Tiantai , Qin Xia , Hu Zhi
Published: November 2020

Background: We aimed to examine the association between social capital and loneliness in Anhui Province, China. Methods: Data were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed to assess the association of social capital and loneliness. Results: Our results indicated that social capital in terms of lower level of social participation (AOR = 1.38; 95% CI: 1.10-1.74), social connection (AOR = 1.51; 95% CI: 1.18-1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13-1.90) were associated with higher odds of developing loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation. Conclusions: Our findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness in later life.
TNFα priming through its interaction with TNFR2 enhances Endothelial Progenitor Cell immunosuppressive effect: new hope for their widespread clinical application
Authors: BARKESTANI Mahsa NOURI , SHAMDANI Sara , BAKSHLOO Mazdak AFSHAR , AROUCHE Nassim , BAMBAI Bijan , UZAN Georges , NASERIAN Sina
Published: November 2020

Background: Bone marrow (BM) derived endothelial progenitor cells (EPCs) are immature endothelial cells (ECs) involved in neo-angiogenesis and endothelial homeostasis and are considered as a circulating reservoir for endothelial repair. Many studies showed that EPCs from patients with cardiovascular pathologies are impaired and insufficient; hence, allogenic sources of EPCs from adult or cord blood are considered as good choices for cell therapy applications. However, allogenic condition increases the chance of immune rejection, especially by T cells, before exerting the desired regenerative functions. TNFα is one of the main mediators of EPC activation that recognizes two distinct receptors, TNFR1 and TNFR2. We have recently reported that human EPCs are immunosuppressive and this effect was TNFα-TNFR2 dependent. Here, we aimed to investigate if an adequate TNFα pre-conditioning could increase TNFR2 expression and prime EPCs towards more immunoregulatory functions.Methods: EPCs were pre-treated with several doses of TNFα to find the proper dose to up-regulate TNFR2 while keeping the TNFR1 expression stable. Then, co-cultures of human EPCs and human T cells were performed to assess whether TNFα priming would increase EPC immunosuppressive and immunomodulatory effect.Results: Treating EPCs with 1 ng/ml TNFα significantly up-regulated TNFR2 expression without unrestrained increase of TNFR1 and other endothelial injury markers. Moreover, TNFα priming through its interaction with TNFR2 remarkably enhanced EPC immunosuppressive and anti-inflammatory effects. Conversely, blocking TNFR2 using anti-TNFR2 mAb followed by 1 ng/ml of TNFα treatment led to the TNFα-TNFR1 interaction and polarized EPCs towards pro-inflammatory and immunogenic functions.Conclusions: We report for the first time the crucial impact of inflammation notably the TNFα-TNFR signaling pathway on EPC immunological function. Our work unveils the pro-inflammatory role of the TNFα-TNFR1 axis and, inversely the anti-inflammatory implication of the TNFα-TNFR2 axis in EPC immunoregulatory functions. Priming EPCs with 1 ng/ml of TNFα prior to their administration could boost them toward a more immunosuppressive phenotype. This could potentially lead to EPCs’ longer presence in vivo after their allogenic administration resulting in their better contribution to angiogenesis and vascular regeneration.
Sex effects on clinical features in LRRK2 G2385R carriers and non-carriers in Parkinson's disease
Authors: Cui Shi-Shuang , Fu Rao , Du Juan-Juan , Lin Yi-Qi , Huang Pei , Gao Chao , Zhou Hai-Yan , chen sheng-di
Published: November 2020

Background
Differences between male and female have been studied for PD but limited data was focused on the comparison between sexes with LRRK2 G2385 variant.
Objective
This study was to explore sex effects in the same genetic subtype and role of leucine-rich repeat kinase 2 (LRRK2) G2385R variants in the same sex.
Methods
613 PD Patients were recruitment from Movement Disorders Clinic in Ruijin Hospital. Clinical data including demographic information, disease history, scales of motor and non-motor symptoms, midbrain transcranial sonography and DNA was collected. Binary logistic regression analysis was performed to evaluate the possible association between the clinical features and sex in LRRK2 G2385R carriers and non-carriers, and to evaluate the possible association between the clinical features and LRRK2 G2385R variants in male and female.
Results
Sex distribution is similar in LRRK2 G2385R carriers and non-carriers. In male sex, LRRK2 G2385R carriers showed lower risk in cognitive impairment compared with non-carriers (OR = 0.301, p = 0.003, 95%CI 0.135–0.668). In female sex, LRRK2 G2385R carriers showed lower risk in autonomic dysfunction compared with non-carrier (OR = 0.401, p = 0.040, 95%CI 0.167–0.960). In LRRK2 G2385R non-carriers, female showed lower risk of impairment in activity of daily living (OR = 0.610, P = 0.021, 95%CI 0.400-0.928), excessive daytime sleepiness (OR = 0.555, p = 0.007, 95%CI 0.361–0.853), substantia nigra hyperechogenicity (OR = 0.448, P = 0.019, 95%CI 0.228–0.878), autonomic dysfunction frequency (OR = 0.626, p = 0.016, 95%CI 0.428–0.917) and higher risk in mood disorders (OR = 1.691, p = 0.022, 95%CI (1.078–2.654) compared with male. In LRRK2 G2385R carriers, female showed a lower risk of autonomic dysfunction (OR = 0.294, p = 0.024, 95%CI 0.102–0.849) compared with male.
Conclusion
A more benign disease course was observed in female compared to male in both LRRK2 G2385R carriers and non-carriers. However, sex differences were less notable in PD with LRRK2 carriers.
Morbidity among Arab-Israeli and Palestinian Hajj Pilgrims - a Prospective study
Authors: Fteiha Bashar , Rub Tawfiq Abul , Schwartz Eli , Lachish Tamar
Published: November 2020

Background – Thousands of Palestinian and Arab-Israeli pilgrims travel to Mecca each year to complete their pilgrimage. We prospectively investigated the occurrence of healthproblems among these Hajjis who travelled to complete their Pilgrimage during 2019 Hajj season.Methods - A prospective observational questionnaire-based study, distributed to Hajj pilgrims at 3 occasions - before travel, inquiring on demographics, and medical comorbidities; 1 and 4 weeks after returning recording any health problem during or after travel.Results – Initial recruitment included 111 Hajjis. The mean age of responders was 49.5 (+9.137) years with a M:F ratio of 1.3:1. Mean travel-duration was 18.7 days (13-36d). Altogether, 66.3% of the pilgrims reported at least one health problem during and after the trip, of which 38.6% sought medical attention. Five (4.8%) hajjis were hospitalized including life-threatening conditions. Cough was the most common complaint (53.8%), 11.5% also reported fever. Pre-travel counselling was associated with reduced outpatient and Emergency Room visits.Conclusion - A high rate of morbidity was reported among this cohort of Hajj pilgrims with a morbidity spectrum similar to pilgrims from other countries. Pre-travel consultation with the purpose of educating on the health risks of Hajj may help reduce the morbidity for future Hajj seasons.
Impact of Modification to DSM-5 Criterion A for Hypomania/Mania in Newly Diagnosed/First Episode Bipolar Patients – Findings From the Prospective BIO Study
Authors: Fredskild Mette Ungermann , Stanislaus Sharleny , Coello Klara , Melbye Sigurd , Kjærstad Hanne Lie , Sletved Kimie Stefanie Ormstrup , Suppes Trisha , Vinberg Maj , Kessing Lars
Published: November 2020

Background: DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed / first episode bipolar disorder. Results: In this prospective cohort study, 373 patients were included (median age=32; IQR, 27-40). Women constituted 66% (n=245) of the cohort and 68% of the cohort (n=253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1-3) and median follow-up time was 3 years (IQR, 2-4). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR=1.51, CL [1.34, 1.71], p <.0001) and increased number of visits contributed (OR=1.86, CL [1.52, 2.29], p <.0001). Conclusion: Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing hypomanic/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Overall, fewer hypomanic/manic visits may be detected in newly diagnosed /first episode bipolar patients with applied DSM-5 criterion A. Consequently, with the DSM-5 criteria applied less severe bipolar disorders may be overlooked, especially early during the course of illness, and result in a diagnostic delay. Further studies are warranted on this issue.