bluuebunny/crossref_metadata_2025 huggingface dataset:
Strengthening Antenatal Care towards a Salutogenic Approach: A Meta-Ethnography
Authors: Heinonen Kristiina
Published: May 2021

The aim was to explore how midwives, public health nurses and nurses view caring in antenatal care (ANC) as provided for mothers and fathers/partners. Based on Noblit and Hare (1988), meta-ethnography was used to address meaning by synthesizing knowledge and understanding inductively through selected qualitative studies (n = 16). Four core themes were identified: (1) supporting the parents to awaken to parenthood and creating a firm foundation for early parenting and their new life situation; (2) guiding parents on the path to parenthood and new responsibility; (3) ensuring normality and the bond between baby and parents while protecting life; and (4) promoting the health and wellbeing of the family today and in the future. The overarching theme can be expressed as “helping the woman and her partner prepare for their new life with the child by providing individualized, shared care, firmly grounded and with a view of the future”. Caring in antenatal care (ANC) is being totally present, listening and using multidimensional professional competence but also being open-minded to new aspects and knowledge. The health promotion and positive health aspects should be considered an important part of supporting parents and the whole family now and in the future. A more conscious salutogenic approach to ANC would lead to more favorable results and could be a fruitful research topic in the future. There is a need to provide midwives/nurses with enough time to allow them to concentrate on specific needs and support for different kind of families in ANC but also training for midwives to make them more familiar with online and other options.
Role of the Epicardium in the Development of the Atrioventricular Valves and Its Relevance to the Pathogenesis of Myxomatous Valve Disease
Authors: Wolters Renélyn , Deepe Ray , Drummond Jenna , Harvey Andrew B. , Hiriart Emilye , Lockhart Marie M. , van den Hoff Maurice J. B. , Norris Russell A. , Wessels Andy
Published: May 2021

This paper is dedicated to the memory of Dr. Adriana “Adri” Gittenberger-de Groot and in appreciation of her work in the field of developmental cardiovascular biology and the legacy that she has left behind. During her impressive career, Dr. Gittenberger-de Groot studied many aspects of heart development, including aspects of cardiac valve formation and disease and the role of the epicardium in the formation of the heart. In this contribution, we review some of the work on the role of epicardially-derived cells (EPDCs) in the development of the atrioventricular valves and their potential involvement in the pathogenesis of myxomatous valve disease (MVD). We provide an overview of critical events in the development of the atrioventricular junction, discuss the role of the epicardium in these events, and illustrate how interfering with molecular mechanisms that are involved in the epicardial-dependent formation of the atrioventricular junction leads to a number of abnormalities. These abnormalities include defects of the AV valves that resemble those observed in humans that suffer from MVD. The studies demonstrate the importance of the epicardium for the proper formation and maturation of the AV valves and show that the possibility of epicardial-associated developmental defects should be taken into consideration when determining the genetic origin and pathogenesis of MVD.
Effect of Hydroxychloroquine on QTc in Patients Diagnosed with COVID-19: A Systematic Review and Meta-Analysis
Authors: Arfaras-Melainis Angelos , Tzoumas Andreas , Kokkinidis Damianos G. , Salgado Guerrero Maria , Varrias Dimitrios , Xu Xiaobo , Cerna Luis , Avendano Ricardo , Kemal Cameron , Palaiodimos Leonidas , Faillace Robert T.
Published: May 2021

Background: Hydroxychloroquine or chloroquine with or without the concomitant use of azithromycin have been widely used to treat patients with SARS-CoV-2 infection, based on early in vitro studies, despite their potential to prolong the QTc interval of patients. Objective: This is a systematic review and metanalysis designed to assess the effect of hydroxychloroquine with or without the addition of azithromycin on the QTc of hospitalized patients with COVID-19. Materials and methods: PubMed, Scopus, Cochrane and MedRxiv databases were reviewed. A random effect model meta-analysis was used, and I-square was used to assess the heterogeneity. The prespecified endpoints were ΔQTc, QTc prolongation > 500 ms and ΔQTc > 60 ms. Results: A total of 18 studies and 7179 patients met the inclusion criteria and were included in this systematic review and meta-analysis. The use of hydroxychloroquine with or without the addition of azithromycin was associated with increased QTc when used as part of the management of patients with SARS-CoV-2 infection. The combination therapy with hydroxychloroquine plus azithromycin was also associated with statistically significant increases in QTc. Moreover, the use of hydroxychloroquine alone, azithromycin alone, or the combination of the two was associated with increased numbers of patients that developed QTc prolongation > 500 ms. Conclusion: This systematic review and metanalysis revealed that the use of hydroxychloroquine alone or in conjunction with azithromycin was linked to an increase in the QTc interval of hospitalized patients with SARS-CoV-2 infection that received these agents.
Sepsis as a Pan-Endocrine Illness—Endocrine Disorders in Septic Patients
Authors: Wasyluk Weronika , Wasyluk Martyna , Zwolak Agnieszka
Published: May 2021

Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. One of the elements of dysregulated host response is an endocrine system disorder. Changes in its functioning in the course of sepsis affect almost all hormonal axes. In sepsis, a function disturbance of the hypothalamic–pituitary–adrenal axis has been described, in the range of which the most important seems to be hypercortisolemia in the acute phase. Imbalance in the hypothalamic–pituitary–thyroid axis is also described. The most typical manifestation is a triiodothyronine concentration decrease and reverse triiodothyronine concentration increase. In the somatotropic axis, a change in the secretion pattern of growth hormone and peripheral resistance to this hormone has been described. In the hypothalamic–pituitary–gonadal axis, the reduction in testosterone concentration in men and the stress-induced “hypothalamic amenorrhea” in women have been described. Catecholamine and β-adrenergic stimulation disorders have also been reported. Disorders in the endocrine system are part of the “dysregulated host response to infection”. They may also affect other components of this dysregulated response, such as metabolism. Hormonal changes occurring in the course of sepsis require further research, not only in order to explore their potential significance in therapy, but also due to their promising prognostic value.
Long-Term Effectiveness of Treating Dentin Hypersensitivity with Bifluorid 10 and Futurabond U: A Split-Mouth Randomized Double-Blind Clinical Trial
Authors: Mazur Marta , Jedliński Maciej , Ndokaj Artnora , Ardan Roman , Janiszewska-Olszowska Joanna , Nardi Gianna Maria , Ottolenghi Livia , Guerra Fabrizio
Published: May 2021

Background: The definition of dental hypersensitivity is “pain derived from exposed dentin in response to chemical, thermal tactile or osmotic stimuli which cannot be explained as arising from any other dental defect or disease”. One of the treatments proposed is tubular occlusion. The aim of this in vivo split-mouth randomized clinical trial was to evaluate the clinical efficacy of a in-office application of a fluoride varnish (Bifluorid 10) and a bonding resin (Futurabond U) in adults with dentin hypersensitivity. Material and methods: A total of 180 teeth were treated with Bifluorid 10 and 160 with Futurabond U. Outcome measurements were taken one or two weeks before treatment, at baseline at the application days, at 1 week and at 1–6 months after first treatment. Results: Both treatments reduced pain intensity. Bifluorid 10 and Futurabond U have similar efficacy in reducing SCHIFF-measured pain reduction, while Bifluorid 10 is significantly more efficient for VAS-measured pain reduction, mainly due to long-term pain reduction. Patient age has a significant negative influence on pain reduction, while the influence of patient gender and BEWE of the tooth is insignificant. Conclusions: Bifluorid 10 and Futurabond U are effective in the treatment of dental hypersensitivity. The RCT was registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04813848.
Effect of Cardiac Rehabilitation on Left Ventricular Diastolic Function in Patients with Acute Myocardial Infarction
Authors: Lee Jae-Hwan , Kim Jungai , Sun Byung Joo , Jee Sung Ju , Park Jae-Hyeong
Published: May 2021

Cardiac rehabilitation (CR) improves symptoms and survival in patients with acute myocardial infarction (AMI). We studied the change of diastolic function and its prognostic impact after CR. After reviewing all consecutive AMI patients from January 2012 to October 2015, we analyzed 405 patients (mean, 63.7 ± 11.7 years; 300 males) with baseline and follow-up echocardiographic examinations. We divided them into three groups according to their CR sessions: No-CR group (n = 225), insufficient-CR group (CR < 6 sessions, n = 117) and CR group (CR ≥ 6 sessions, n = 63). We compared echocardiographic parameters of diastolic dysfunction including E/e’ ratio > 14, septal e’ velocity < 7 cm/s, left atrial volume index (LAVI) > 34 mL/m2, and maximal TR velocity > 2.8 m/s. At baseline, there were no significant differences in all echocardiographic parameters among the three groups. At follow-up echocardiographic examination, mitral annular e’ and a’ velocities were higher in the CR group (p = 0.024, and p = 0.009, respectively), and mitral E/e’ ratio was significantly lower (p = 0.009) in the CR group. The total number of echocardiographic parameters of diastolic dysfunction at the baseline echocardiography was similar (1.29 vs. 1.41 vs. 1.52, p = 0.358). However, the CR group showed the lowest number of diastolic parameters at the follow-up echocardiography (1.05 vs. 1.32 vs. 1.50, p = 0.017). There was a significant difference between the No-CR group and CR group (p = 0.021). The presence of CR was a significant determinant of major adverse cardiovascular events in the univariate analysis (HR = 0.606, p = 0.049). However, the significance disappeared in the multivariate analysis (HR = 0.738, p = 0.249). In conclusion, the CR was significantly associated with favorable diastolic function, with the highest mitral e’ and a’ velocity, and the lowest mitral E/e’ ratio and total number of echocardiographic parameters of diastolic dysfunction at the follow-up echocardiographic examinations in AMI patients.
Clinical Relevance of Torque Teno Virus (TTV) in HIV/HCV Coinfected and HCV Monoinfected Patients Treated with Direct-Acting Antiviral Therapy
Authors: Lapa Daniele , Del Porto Paola , Minosse Claudia , D’Offizi Gianpiero , Antinori Andrea , Capobianchi Maria Rosaria , Visco-Comandini Ubaldo , McPhee Fiona , Garbuglia Anna Rosa , Zaccarelli Mauro
Published: May 2021

Torque Teno virus (TTV) is a ubiquitous virus that causes chronic infection in humans with unknown clinical consequences. Here, we investigated the influence of TTV infection on HCV direct-acting antiviral (DAA) efficacy in HIV/HCV coinfected and HCV monoinfected patients as controls. Of 92 study patients, 79.3% were TTV DNA positive; untreated patients exhibited a significantly higher proportion of TTV DNA-positivity vs. sustained virological response (SVR) patients (100.0% vs. 65.2%, p < 0.001), while TTV positivity was not significant in DAA failure patients vs. SVR patients despite HIV/HCV coinfection. TTV DNA viral load was higher among HCV monoinfected patients vs. HIV/HCV coinfected, although marginally significant (p = 0.074) and no significant viral load difference was detected between DAA failures and SVR patients, while untreated vs. SVR patients had a significantly higher viral load (19,884, IQR 5977–333,534, vs. 469, IQR 10–4124, p = 0.004). Alpha-genogroup 3 TTV was the most prevalent genetic group, and no specific strain or genogroup was observed in relapser patients. Among HIV/HCV patients with HCV RNA detectable at end of treatment (EOT), TTV DNA was detected in 9/17 treatment responder patients and 3/5 relapser patients, thus, TTV infection does not appear to influence the control HCV viremia after EOT. Levels of IL-6 IL-4, and CD14 were not significantly different between TTV PCR-positive and -negative patients. These results suggest no association between TTV DNA positivity or viral load and HCV DAA failure whether patients were HIV/HCV coinfected or HCV monoinfected.
Does Statin Therapy Reduce the Risks of Mortality and Major Adverse Cardiac and Cerebrovascular Events in Young Adults with End-Stage Renal Disease? Population-Based Cohort Study
Authors: Cheng Ya-Lien , Yang Huang-Yu , Wu Chao-Yi , Tsai Chung-Ying , Chen Chao-Yu , Hsiao Ching-Chung , Hsu Hsiang-Hao , Tian Ya-Chung , Yen Chieh-Li
Published: May 2021

Among hemodialysis patients aged more than 40 years old, previous large-scale studies showed statin treatment had no effect on reducing cardiovascular adverse events. However, young-adult-onset end-stage renal disease (ESRD) patients have different physicosocial factors compared to older ESRD patients. The benefit of statins in such a specific group has not been well evaluated. Through the use of Taiwan’s National Health Insurance Research Database (NHIRD), young adult patients aged 20–40 with incident ESRD requiring permanent dialysis between 1 January 2003 and 31 December 2015 were identified. The enrollees were further divided into two groups depending on whether they received statin therapy for more than 90 days (statin group) or never received any statin (nonstatin group) in the first year after initiation of dialysis. Propensity score weighting (PSW) was used to balance the baseline characteristics between the two groups. After PSW, the statin group (n = 771) exhibited a higher rate of major adverse cardiac and cerebrovascular events (MACCEs) (2.65% vs. 1.44%, hazard ratio (HR): 1.87, 95% confidence interval (CI): 1.43–2.45), and acute myocardial infarction (1.51% vs. 0.30%, HR: 5.34, 95% CI: 3.40–8.39) compared to the nonstatin group (n = 1709). The risk of all-cause mortality, cardiovascular (CV) death. and stroke did not significantly differ between the two groups. Similar to older patients, this study demonstrated that statin therapy cannot offer any protective effects in reducing CV outcomes among young adult ESRD patients undergoing dialysis.
Accuracy of a Novel SARS-CoV-2 Antigen-Detecting Rapid Diagnostic Test from Standardized Self-Collected Anterior Nasal Swabs
Authors: Osmanodja Bilgin , Budde Klemens , Zickler Daniel , Naik Marcel G. , Hofmann Jörg , Gertler Maximilian , Hülso Claudia , Rössig Heike , Horn Philipp , Seybold Joachim , Lunow Stephanie , Bothmann Melanie , Barrera-Pesek Astrid , Mayrdorfer Manuel
Published: May 2021

Background Antigen-detecting rapid diagnostic tests (Ag-RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) offer new opportunities for the quick and laboratory-independent identification of infected individuals for control of the SARS-CoV-2 pandemic. Despite the potential benefits, nasopharyngeal sample collection is frequently perceived as uncomfortable by patients and requires trained healthcare personnel with protective equipment. Therefore, anterior nasal self-sampling is increasingly recognized as a valuable alternative. Methods We performed a prospective, single-center, point of care validation of an Ag-RDT using a polypropylene absorbent collector for standardized self-collected anterior nasal swabs. Real-time polymerase chain reaction (RT-PCR) from combined oropharyngeal/nasopharyngeal swabs served as a comparator. Primary endpoint was sensitivity of the standardized Ag-RDT in symptomatic patients with medium or high viral concentration (≥1 million RNA copies on RT-PCR for SARS-CoV-2). Results Between 12 February and 22 March 2021, 388 participants were enrolled. After exclusion of 9 patients for which no PCR result could be obtained, the novel Ag-RDT was evaluated based on 379 participants, of whom 273 were symptomatic and 106 asymptomatic. In 61 samples from symptomatic patients with medium or high viral load (≥1 million RNA copies), the sensitivity of the standardized Ag-RDT was 96.7% (59/61; 95% confidence interval (CI): 88.7–99.6%) for the primary endpoint. In total, 62 positive Ag-RDT results were detected out of 70 RT-PCR positive individuals, yielding an overall sensitivity of 88.6% (95% CI: 78.7–94.9%). Specificity was 99.7% (95% CI: 98.2–100%) in 309 RT-PCR negative individuals. Conclusions Here, we present a validation of a novel Ag-RDT with a standardized sampling process for anterior nasal self-collection, which meets World Health Organisation (WHO) criteria of ≥80% sensitivity and ≥97% specificity. Although less sensitive than RT-PCR, this assay could be beneficial due to its rapid results, ease of use, and suitability for standardized self-testing.
The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study
Authors: Jacewicz-Święcka Małgorzata , Wołczyński Sławomir , Kowalska Irina
Published: May 2021

The knowledge of polycystic ovary syndrome (PCOS) natural history is limited. Our objective was to assess the effect of aging on clinical, hormonal and sonographic ovarian PCOS features and additionally to identify parameters that impact the course of PCOS. A secondary aim was to supply additional information on the reproductive outcome in women with previously diagnosed PCOS. A longitudinal cohort study with a median follow-up of 120.9 months was conducted, and 31 Caucasian women previously diagnosed with PCOS according to the Rotterdam criteria were re-examined at a median age of 35. Clinical examinations; transvaginal ultrasound scans; and lipid, E-selectin and sex hormone assessments were performed at the beginning and at the end of the follow-up. It was observed that menstrual cycles became regular and sonographic morphology of ovaries was normalized in 55% and 49% of the participants, respectively (all p < 0.05). At the final assessment, 55% of the women no longer met the criteria for PCOS (p < 0.05). The age, follicle-stimulating hormone (FSH) and E-selectin assessed at the baseline were the most important predictors of the PCOS persistence into later years (respectively, OR = 0.84, OR = 0.39, OR = 1.08, all p < 0.05). Ninety-five percent of the patients who had ever been trying to conceive became pregnant a minimum of once. The women with persistent PCOS had worse metabolic and reproductive parameters compared to the women with resolved PCOS. Positive correlations were found between the number of miscarriages and ovarian volume, LH, androstenedione, 17-hydroxyprogesterone and an increase in E-selectin during the follow-up (R = 0.46, R = 0.59, R = 0.54, R = 0.49, R = 0.47, all p < 0.05). In conclusion, progressing from the third to the fourth decade is connected with a reduction in PCOS features, which seems to have a great impact on fertility of women with a previous diagnosis of PCOS. FSH and E-selectin, as determined at the initial PCOS diagnosis, had an impact on the disappearance of the syndrome years after.
Antidiabetic and Other Therapies Used in Subjects with Diabetes and Chronic Kidney Disease in a Hospital-Based Clinic Population in Greece
Authors: Migdalis Ilias , Papanas Nikolaos , Ioannidis Ioannis , Sotiropoulos Alexios , Raptis Athanasios , Dimitriadis George ,   on behalf of the Hellenic Diabetic Nephropathy Study (HDNS)
Published: May 2021

(1) Background: Type 2 diabetes mellitus (T2DM) is the main cause of chronic kidney disease (CKD). In Greece, in a population from hospital-based diabetes clinics (n = 1759), the overall prevalence of diabetic chronic kidney disease (DCKD) was 45% including mild, moderate, and severe CKD. The aim of this study was to describe and analyze how T2DM patients with mild-to-severe CKD are managed by diabetologists in Greece and assess the achievement rates in glycemic, blood pressure and low-density lipoprotein-cholesterol (LDL-C) control. (2) Methods: This cross-sectional multicenter study took place from June 2015 to March 2016 and collected data from diabetes centers in public hospitals all over Greece. (3) Results: With regard to the anti-diabetes treatment, most participants were on metformin, DPP-4 (Dipeptidyl Peptidase-4 inhibitors) inhibitors and insulin. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers were the most prescribed medications for hypertension. For the management of dyslipidemia, most participants were on statins. For patients with DCKD, the levels of HbA1c, blood pressure and LDL-C were 7.2%, 137.7/76.9 mmHg and 95.9 mg/dL, respectively (mean values). (4) Conclusions: The outcomes of this study suggest that management of DCKD can be further improved and should be enhanced. These results may contribute to the whole health care system in Greece. In addition, the better understanding of therapeutic strategies used by diabetologists treating these patients offers educational benefits to primary care physicians, which can result in an overall more successful and efficient management of subjects with T2DM and DCKD.
Do Transgenerational Epigenetic Inheritance and Immune System Development Share Common Epigenetic Processes?
Authors: Sen Rwik , Barnes Christopher
Published: May 2021

Epigenetic modifications regulate gene expression for development, immune response, disease, and other processes. A major role of epigenetics is to control the dynamics of chromatin structure, i.e., the condensed packaging of DNA around histone proteins in eukaryotic nuclei. Key epigenetic factors include enzymes for histone modifications and DNA methylation, non-coding RNAs, and prions. Epigenetic modifications are heritable but during embryonic development, most parental epigenetic marks are erased and reset. Interestingly, some epigenetic modifications, that may be resulting from immune response to stimuli, can escape remodeling and transmit to subsequent generations who are not exposed to those stimuli. This phenomenon is called transgenerational epigenetic inheritance if the epigenetic phenotype persists beyond the third generation in female germlines and second generation in male germlines. Although its primary function is likely immune response for survival, its role in the development and functioning of the immune system is not extensively explored, despite studies reporting transgenerational inheritance of stress-induced epigenetic modifications resulting in immune disorders. Hence, this review draws from studies on transgenerational epigenetic inheritance, immune system development and function, high-throughput epigenetics tools to study those phenomena, and relevant clinical trials, to focus on their significance and deeper understanding for future research, therapeutic developments, and various applications.
A gm/ID-Based Design Strategy for IoT and Ultra-Low-Power OTAs with Fast-Settling and Large Capacitive Loads
Authors: Giustolisi Gianluca , Palumbo Gaetano
Published: May 2021

In this paper, a new strategy for the design of ultra-low-power CMOS operational transconductance amplifiers (OTAs), using the gm/ID approach, is proposed for the Internet-of-things (IoT) scenario. The strategy optimizes the speed/dissipation of the OTA in terms of settling time, including slew-rate effects. It was designed for large capacitive loads and for transistors biased in the sub-threshold region, but it is also suitable for low-capacitive loads or for transistors biased in the saturation region. To validate the proposed strategy, a well-known three-stage OTA was designed starting from capacitive load and settling time requirements. Simulations confirmed that the OTA satisfies the specifications (even under Monte Carlo analysis), thus proving the correctness of the proposed approach.
Enhanced Weight-Optimized Recurrent Neural Networks Based on Sine Cosine Algorithm for Wave Height Prediction
Authors: Alqushaibi Alawi , Abdulkadir Said Jadid , Rais Helmi Md , Al-Tashi Qasem , Ragab Mohammed G. , Alhussian Hitham
Published: May 2021

Constructing offshore and coastal structures with the highest level of stability and lowest cost, as well as the prevention of faulty risk, is the desired plan that stakeholders seek to obtain. The successful construction plans of such projects mostly rely on well-analyzed and modeled metocean data that yield high prediction accuracy for the ocean environmental conditions including waves and wind. Over the past decades, planning and designing coastal projects have been accomplished by traditional static analytic, which requires tremendous efforts and high-cost resources to validate the data and determine the transformation of metocean data conditions. Therefore, the wind plays an essential role in the oceanic atmosphere and contributes to the formation of waves. This paper proposes an enhanced weight-optimized neural network based on Sine Cosine Algorithm (SCA) to accurately predict the wave height. Three neural network models named: Long Short-Term Memory (LSTM), Vanilla Recurrent Neural Network (VRNN), and Gated Recurrent Network (GRU) are enhanced, instead of random weight initialization, SCA generates weight values that are adaptable to the nature of the data and model structure. Besides, a Grid Search (GS) is utilized to automatically find the best models’ configurations. To validate the performance of the proposed models, metocean datasets have been used. The original LSTM, VRNN, and GRU are implemented and used as benchmarking models. The results show that the optimized models outperform the original three benchmarking models in terms of mean squared error (MSE), root mean square error (RMSE), and mean absolute error (MAE).
On the Slope Stability of the Submerged Trench of the Immersed Tunnel Subjected to Solitary Wave
Authors: Chen Weiyun , Wang Dan , Xu Lingyu , Lv Zhenyu , Wang Zhihua , Gao Hongmei
Published: May 2021

Wave is a common environmental load that often causes serious damages to offshore structures. In addition, the stability for the submarine artificial slope is also affected by the wave loading. Although the landslide of submarine slopes induced by the waves received wide attention, the research on the influence of solitary wave is rare. In this study, a 2-D integrated numerical model was developed to investigate the stability of the foundation trench under the solitary wave loading. The Reynolds-averaged Stokes (RANS) equations were used to simulate the propagation of a solitary wave, while the current was realized by setting boundary inlet/outlet velocity. The pore pressure induced by the solitary wave was calculated by Darcy’s law, and the seabed was characterized by Mohr–Coulomb constitutive model. Firstly, the wave model was validated through the comparison between analytical solution and experimental data. The initial consolidation state of slope under hydrostatic pressure was achieved as the initial state. Then, the factor of stability (FOS) for the slope corresponding to different distances between wave crest and slope top was calculated with the strength reduction method. The minimum of FOS was defined as the stability index for the slope with specific slope ratio during the process of dynamic wave loading. The parametric study was conducted to examine the effects of soil strength parameters, slope ratio, and current direction. At last, the influence of upper slope ratio in a two-stage slope was also discussed.
Diabetic Macular Edema Treated with 577-nm Subthreshold Micropulse Laser: A Real-Life, Long-Term Study
Authors: Frizziero Luisa , Calciati Andrea , Torresin Tommaso , Midena Giulia , Parrozzani Raffaele , Pilotto Elisabetta , Midena Edoardo
Published: May 2021

The aim of this study was to evaluate the long-term efficacy and safety of 577-nm subthreshold micropulse laser (SMPL) treatment in a large population of patients affected by mild diabetic macular edema (DME) in a real-life setting. We retrospectively evaluated 134 eyes affected by previously untreated center-involving mild DME, and treated with 577-nm SMPL, using fixed parameters. Retreatment was performed at 3 months, in case of persistent retinal thickening. Optical coherence tomography (OCT), along with short and near-infrared fundus autofluorescence, were used to confirm long-term safety. At the end of at least one year follow-up, a significant improvement in visual acuity was documented, compared to baseline (77.3 ± 4.5 and 79.4 ± 4.4 ETDRS score at baseline and at final follow-up, respectively), as well as a reduction in the mean retinal thickness of the thickest ETDRS macular sector at baseline. A reduction in the central retinal thickness and the mean thickness of the nine ETDRS sectors was also found, without reaching statistical significance. No patients required intravitreal injections. No adverse effects were detected. This study suggests that 577-nm SMPL is a safe and repeatable treatment for mild DME that may be applied to real-life clinical settings using fixed parameters and protocols.
The Application of Graphic Methods and the DEA in Predicting the Risk of Bankruptcy
Authors: Štefko Róbert , Horváthová Jarmila , Mokrišová Martina
Published: May 2021

The paper deals with the issue of analyzing the financial failure of businesses. The aim was to select key performance indicators entering the DEA model. The research was carried out on a sample of 343 Slovak heat management companies. When addressing the research problem, we made use of multidimensional scaling (MDS) and principal component analysis (PCA), which pointed out the areas of financial health of companies that may predict their financial failure. The core of our interest and research was the data envelopment analysis (DEA) method, which represents a more exact approach to the assessment of financial health. The important finding is that the statistical graphical methods—PCA and MDS—are very helpful in identifying outliers and selecting key performance indicators entering the DEA model. The benefit of the paper is the identification of companies that are at risk of bankruptcy using the DEA method. The originality is the selection of key inputs and outputs to the DEA model by the PCA method.
Linking Urban Sprawl and Surface Urban Heat Island in the Teresina–Timon Conurbation Area in Brazil
Authors: Carneiro Eduilson , Lopes Wilza , Espindola Giovana
Published: May 2021

Negative consequences of urban growing disparities usually lead to impressive levels of segregation, marginalization, and injustices, particularly in the context of climate change. Understanding the relations between urban expansion and social vulnerability has become extremely necessary for municipality management and sustainable urban development. Although the study of urbanization in Latin America (LA) has been well discussed, little attention has been given to how the population is affected by urban expansion-oriented movement after the 2008 economic crisis. Massive investments in infrastructure displaced the population to peripheral zones without adequate urban planning, which reflected in alteration in land use and land cover (LULC), followed by environmental impacts and public health issues caused by thermal discomfort, notably in semiarid regions. This paper aims to evaluate the effects of urban sprawl on the Teresina–Timon conurbation (TTC) area’s local population, located in Brazil’s northeast. Descriptive metrics (Moran’s I statistic and social vulnerability index) and orbital products derived from remote sensing—LULC and Land surface temperature (LST) maps—were applied. The results indicated that the housing program ‘My House My Life’ (PMCMV) had increased the values of land consumption per capita since 2009 significantly, showing a clear expanding trend. The gradual replacement of green areas by residential settlements resulted in an increased LST. The PMCMV program contributed substantially to a change in land use and land cover, which increased the extent of urbanized areas and changed the local microclimate.
A Two-Stage Approach to the Estimation of High-Resolution Soil Organic Carbon Storage with Good Extension Capability
Authors: Wei Sunwei , Zhao Zhengyong , Yang Qi , Ding Xiaogang
Published: May 2021

Soil organic carbon storage (SOCS) estimation is a crucial branch of the atmospheric–vegetation–soil carbon cycle study under the background of global climate change. SOCS research has increased worldwide. The objective of this study is to develop a two-stage approach with good extension capability to estimate SOCS. In the first stage, an artificial neural network (ANN) model is adopted to estimate SOCS based on 255 soil samples with five soil layers (20 cm increments to 100 cm) in Luoding, Guangdong Province, China. This method is compared with three common methods: The soil type method (STM), ordinary kriging (OK), and radial basis function (RBF) interpolation. In the second stage, a linear model is introduced to capture the regional differences and further improve the estimation accuracy of the Luoding-based ANN model when extending it to Xinxing, Guangdong Province. This is done after assessing the generalizability of the above four methods with 120 soil samples from Xinxing. The results for the first stage show that the ANN model has much better estimation accuracy than STM, OK, and RBF, with the average root mean square error (RMSE) of the five soil layers decreasing by 0.62–0.90 kg·m−2, R2 increasing from 0.54 to 0.65, and the mean absolute error decreasing from 0.32 to 0.42. Moreover, the spatial distribution maps produced by the ANN model are more accurate than those of other methods for describing the overall and local SOCS in detail. The results of the second stage indicate that STM, OK, and RBF have poor generalizability (R2 < 0.1), and the R2 value obtained with ANN method is also 43–56% lower for the five soil layers compared with the estimation accuracy achieved in Luoding. However, the R2 of the linear models built with the 20% soil samples from Xinxing are 0.23–0.29 higher for the five soil layers. Thus, the ANN model is an effective method for accurately estimating SOCS on a regional scale with a small number of field samples. The linear model could easily extend the ANN model to outside areas where the ANN model was originally developed with a better level of accuracy.
Radiation Effect of Urban Agglomeration’s Transportation Network: Evidence from Chengdu–Chongqing Urban Agglomeration, China
Authors: Yao Zhangfeng , Ye Kunhui , Xiao Liang , Wang Xiaowei
Published: May 2021

Recent years have seen the global proliferation and integration of transportation systems in urban agglomeration (UA), suggesting that transportation networks have become more prominent in the sustainable development of UA. Core cities play a radiating and driving role in affecting their adjacent cities to formulate transportation networks. Such a phenomenon is called the radiation effect of transportation networks and can be imaged using a field strength model as proposed in the study. The field strength model was verified using the Chengdu–Chongqing urban agglomeration (CCUA) as a case. Case data concerning transportation routes and traffic volume were collected for the past 20 years. The data analyses results indicate a relatively stable pattern of transportation networks in the UA. UA cities’ radiation effects follow the same compactness trend. The core cities’ radiation spheres go beyond their territories, and they can envelop the surrounding cities, highlighting the core cities’ dominance in the entire transportation network. Moreover, two development stages of UA transportation—focus and spillover—are also identified. This study contributes to the literature by providing an innovative quantitative method to detect the interaction between a city’s transportation system and peripheral cities or regions. The radiation effect of cities’ transportation systems should be considered in the UA transportation development plan, so as to meet the needs of spatial structure planning and coordinated development of the UA.
Study on the Spatial Classification of Construction Land Types in Chinese Cities: A Case Study in Zhejiang Province
Authors: Dong Lin , Li Jiazi , Xu Yingjun , Yang Youtian , Li Xuemin , Zhang Hua
Published: May 2021

Identifying the land-use type and spatial distribution of urban construction land is the basis of studying the degree of exposure and the economic value of disaster-affected bodies, which are of great significance for disaster risk predictions, emergency disaster reductions, and asset allocations. Based on point of interest (POI) data, this study adopts POI spatialization and the density-based spatial clustering of applications with noise (DBSCAN) algorithm to accomplish the spatial classification of construction land. Zhejiang province is selected as a study area, and its construction land is divided into 11 land types using an accurate spatial classification method based on measuring the area of ground items. In the research, the POI dataset, which includes information, such as spatial locations and usage types, was constructed by big data cleaning and visual interpretation and approximately 620,000 pieces in total. The overall accuracy of the confusion matrix is 76.86%, which is greatly improved compared with that constructed with EULUC data (61.2%). In addition, compared with the official statistical data of 11 cities in Zhejiang Province, the differences between the calculated spatial proportions and statistics are not substantial. Meanwhile, the spatial characteristics of the studied land-use types are consistent with the urban planning data but with higher accuracy. The research shows that the construction land in Zhejiang Province has a high degree of land intensity, concentrated assets, and high economic exposure. The approach proposed in this study can provide a reference for city management including urbanization process, risk assessment, emergency management and asset allocation.
A Combined Energy Method for Flutter Instability Analysis of Weakly Damped Panels in Supersonic Airflow
Authors: Wang Xiaochen , Yang Zhichun , Zhang Guiwei , Xu Xinwei
Published: May 2021

A combined energy method is proposed to investigate the flutter instability characteristics of weakly damped panels in the supersonic airflow. Based on the small damping assumption, the motion governing partial differential equation (PDE) of the panel aeroelastic system, is built by adopting the first-order piston theory and von Karman large deflection plate theory. Then by applying the Galerkin procedure, the PDE is discretized into a set of coupled ordinary differential equations, and the system reduced order model (ROM) with two degrees of freedom is obtained. Considering that the panel aeroelastic system is non-conservative in the physical nature, and assuming that the panel exhibits a single period oscillation on the flutter occurrence, the non-conservative energy balance principle is applied to the linearized ROM within one single oscillation period. The obtained result shows that the ROM modal coordinate amplitudes ratio is regulated by the modal damping coefficients ratio, though each modal damping coefficient is small. Furthermore, as the total damping dissipation energy can be eliminated due to its smallness, the He’s energy balance method is applied to the undamped ROM, therefore the critical non-dimensional dynamic pressure on the flutter instability occurrence, and the oscillation circular frequency amplitude relationship (linear and nonlinear form) are derived. In addition, the damping destabilization paradoxical influence on the system flutter instability is investigated. The accuracy and efficiency of the proposed method are validated by comparing the results with that obtained by using Routh Hurwitz criteria.
Steady Fluid–Structure Coupling Interface of Circular Membrane under Liquid Weight Loading: Closed-Form Solution for Differential-Integral Equations
Authors: Li Xue , Sun Jun-Yi , Lu Xiao-Chen , Yang Zhi-Xin , He Xiao-Ting
Published: May 2021

In this paper, the problem of fluid–structure interaction of a circular membrane under liquid weight loading is formulated and is solved analytically. The circular membrane is initially flat and works as the bottom of a cylindrical cup or bucket. The initially flat circular membrane will undergo axisymmetric deformation and deflection after a certain amount of liquid is poured into the cylindrical cup. The amount of the liquid poured determines the deformation and deflection of the circular membrane, while in turn, the deformation and deflection of the circular membrane changes the shape and distribution of the liquid poured on the deformed and deflected circular membrane, resulting in the so-called fluid-structure interaction between liquid and membrane. For a given amount of liquid, the fluid-structure interaction will eventually reach a static equilibrium and the fluid-structure coupling interface is steady, resulting in a static problem of axisymmetric deformation and deflection of the circular membrane under the weight of given liquid. The established governing equations for the static problem contain both differential operation and integral operation and the power series method plays an irreplaceable role in solving the differential-integral equations. Finally, the closed-form solutions for stress and deflection are presented and are confirmed to be convergent by the numerical examples conducted.
Multi-Objective Optimization of Switched Reluctance Machine Design Using Jaya Algorithm (MO-Jaya)
Authors: Afifi Mohamed , Rezk Hegazy , Ibrahim Mohamed , El-Nemr Mohamed
Published: May 2021

The switched reluctance machine (SRM) design is different from the design of most of other machines. SRM has many design parameters that have non-linear relationships with the performance indices (i.e., average torque, efficiency, and so forth). Hence, it is difficult to design SRM using straight forward equations with iterative methods, which is common for other machines. Optimization techniques are used to overcome this challenge by searching for the best variables values within the search area. In this paper, the optimization of SRM design is achieved using multi-objective Jaya algorithm (MO-Jaya). In the Jaya algorithm, solutions are moved closer to the best solution and away from the worst solution. Hence, a good intensification of the search process is achieved. Moreover, the randomly changed parameters achieve good search diversity. In this paper, it is suggested to also randomly change best and worst solutions. Hence, better diversity is achieved, as indicated from results. The optimization with the MO-Jaya algorithm was made for 8/6 and 6/4 SRM. Objectives used are the average torque, efficiency, and iron weight. The results of MO-Jaya are compared with the results of the non-dominated sorting genetic algorithm (NSGA-II) for the same conditions and constraints. The optimization program is made in Lua programming language and executed by FEMM4.2 software. The results show the success of the approach to achieve better objective values, a broad search, and to introduce a variety of optimal solutions.
Effect of Elastic Abdominal Binder on Pain and Functional Recovery Following Gynecologic Cancer Surgery: A Randomized Controlled Trial
Authors: Chantawong Nopwaree , Charoenkwan Kittipat
Published: May 2021

Background and Objectives: Clinicians have been using elastic abdominal binder for stabilizing incision site after major abdominal surgery. However, the benefits of that practice have never been formally assessed. The aim of this study was to examine the effects of the use of elastic abdominal binder on postoperative pain and recovery of gynecologic cancer patients. Materials and Methods: One-hundred and nine women diagnosed with cervical, endometrial, or ovarian cancer, who underwent open abdominal surgery were assigned randomly into two groups: intervention (56 patients) and control (53 patients). The women in the intervention group applied abdominal binder from postoperative day 1. For the control group, the women did not wear the binder or similar devices. The primary outcomes were pain and functional recovery. Subgroup analysis on participants age ≥ 50 was also performed. Results: For the entire study cohort, the baseline, postoperative day 1, and postoperative day 2 pain scores in the intervention group were significantly lower than the control group. However, there was no significant difference between the groups for postoperative day 3 pain score and for the change in pain scores from the baseline value. Of note, the age ≥ 50 subgroup represented a more balanced cohort with comparable baseline pain scores between the study groups. For this population, the pain scores for postoperative day 1–3 were significantly lower in the intervention group. The intervention group had a longer six-minute walking distance on postoperative day 3 with a trend toward a smaller difference in the day 3 distance from the baseline. Conclusions: The potential benefits of abdominal binder use in reducing postoperative pain and improving functional recovery after open gynecologic cancer surgery could be demonstrated only in those age ≥ 50.
Comparison of Emotional Dysregulation Features in Cyclothymia and Adult ADHD
Authors: Brancati Giulio Emilio , Barbuti Margherita , Schiavi Elisa , Colombini Paola , Moriconi Martina , Pallucchini Alessandro , Maiello Marco , Menculini Giulia , Perugi Giulio
Published: May 2021

Background and Objectives: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. Materials and Methods: One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) and the 40-item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RI-PoSt-40) were administered. Results: Cyclothymic patients were more frequently female and older with respect to the ADHD groups. Both comorbid and non-comorbid ADHD patients showed significantly lower educational attainment and more frequently had substance use disorders. Panic disorder was common in non-comorbid cyclothymic patients, who showed significantly higher rates of familial panic disorder, major depressive disorder and suicide attempts in comparison with patients only diagnosed with ADHD. Cyclothymic patients without ADHD were also characterized by fewer hyperthymic temperamental traits, higher depressive and anxious dispositions, and a greater negative emotionality. No significant differences among groups were observed for cyclothymic temperament and overall negative emotional dysregulation, but comorbid patients with both conditions scored the highest in these subscales. This group also showed significantly higher affective instability with respect to ADHD patients without cyclothymia and was less frequently diagnosed with bipolar disorder type II than patients from both the other groups. Conclusions: ADHD and cyclothymia often co-occur and show similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality in clinical settings. Subjects with “sunny” cyclothymic features might escape the attention of clinicians unless ADHD is present.