bluuebunny/crossref_metadata_2025 huggingface dataset:
Low pH altered salt stress in antioxidant metabolism and nitrogen assimilation in ginger (Zingiber officinale) seedlings
Authors: Yin Fengman , Liu Xuena , Cao Bili , Xu Kun
Published: July 2019

The effects of low pH on antioxidant metabolism and nitrogen (N) assimilation in ginger seedlings under salt stress were investigated. A two‐way randomized block design was used: the main treatment consisted of two pH levels, normal and low pH (6.0 and 4.0, respectively), and the other treatment consisted of two salinity levels, 0 and 100 mmol l−1 Na+ (NaCl and Na2SO4). The results showed that low pH decreased the malondialdehyde (MDA) and hydrogen peroxide contents of ginger seedling leaves under salt stress. Moreover, low pH and salt stress significantly decreased the contents of non‐enzymatic antioxidants, including ascorbate (AsA) and glutathione (GSH), and increased the activities of antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), monodehydroascorbate reductase (MDHAR), dehydroascorbate reductase (DHAR) and glutathione reductase (GR). In addition, salt stress inhibited the N assimilation process in ginger seedling leaves, but low pH improved N assimilation under salt stress. Our finding was that low pH alleviated oxidative damage and promoted N assimilation under salt stress.
Indefinite cytomegalovirus prophylaxis with valganciclovir after lung transplantation
Authors: Hecker Matthias , Hecker Andreas , Askevold Ingolf , Kuhnert Stefan , Reichert Martin , Guth Stefan , Mayer Eckhard , Slanina Heiko , Schüttler Christian G. , Seeger Werner , Padberg Winfried , Mayer Konstantin
Published: July 2019

Human cytomegalovirus (HCMV) infections and reactivations are common after lung transplantation and are associated with the development of bronchiolitis obliterans syndrome. Against this background, temporary HCMV prophylaxis is an established standard regimen after lung transplantation in most centers. However, the optimal duration of prophylaxis is unclear. We conducted a retrospective two‐center study to determine the efficacy of indefinite lifelong HCMV prophylaxis with oral valganciclovir in a cohort of 133 lung transplant recipients with a mean follow‐up time of approximately 5 years. During the follow‐up period, HCMV DNA was detected in 22 recipients (16.5%). In one case, HCMV pneumonitis developed after prophylaxis had been terminated. We observed a beneficial safety profile and tolerability in our cohort, as the majority of patients still received valganciclovir after a 1‐ and 3‐year observation period, respectively. Compared to the literature, these data indicate a beneficial effect of extended valganciclovir prophylaxis with an acceptable safety profile.
Treatment for human visceral leishmaniasis: a cost‐effectiveness analysis for Brazil
Authors: de Carvalho Isis Polianna Silva Ferreira , Peixoto Henry Maia , Romero Gustavo Adolfo Sierra , de Oliveira Maria Regina Fernandes
Published: July 2019

Objective

To estimate the cost‐effectiveness of strategies for the treatment of VL in Brazil.

Methods

Cost‐effectiveness study comparing three therapeutic options: meglumine antimoniate (MA), liposomal amphotericin B (LAMB) and a combination of LAMB plus MA (LAMB plus MA), from public health system and societal perspectives. An analytical decision‐making model was used to compare strategies for the following outcomes: early therapeutic failure avoided at 30 days, days of hospitalisation avoided and VL cure at 180 days. The efficacy and safety parameters of the drugs came from a randomised, open‐label trial and the cost data came from a cost‐of‐illness study, both carried out in Brazil.

Results

For all outcomes analysed, the LAMB strategy was more effective. The MA strategy was inferior to the LAMB plus MA strategy for the outcomes early therapeutic failure avoided and cure. When only LAMB and MA were compared from a societal perspective, a cost of US$ 278.56 was estimated for each additional early therapeutic failure avoided, a cost of US$ 26.88 for each additional day of hospitalisation avoided and a cost of US$ 89.88 for each additional case of cured VL, for the LAMB strategy vs. MA.

Conclusion

In Brazil, the LAMB strategy proved to be cost‐effective for treating VL, considering a GDP per capita as the willingness‐to‐pay threshold, for all of the outcomes analysed in comparison to MA.
Roles of pepper bZIP transcription factor CaATBZ1 and its interacting partner RING‐type E3 ligase CaASRF1 in modulation of ABA signalling and drought tolerance
Authors: Joo Hyunhee , Lim Chae Woo , Lee Sung Chul
Published: July 2019

Ubiquitination is a eukaryotic protein modulation system for identifying and affecting proteins that are no longer needed in the cell. In a previous study, we elucidated the biological function of CaASRF1, which contains a RING finger domain and functions as an E3 ligase. We showed that CaASRF1 positively modulates abscisic acid (ABA) signalling and drought stress tolerance by modulating the stability of subgroup D bZIP transcription factor CaAIBZ1. We performed yeast two‐hybrid (Y2H) screening to identify an additional target protein of CaASRF1. In this study, we identified pepper CaATBZ1 (Capsicum annuum ASRF1 target bZIP transcription factor 1), which belongs to the subgroup A bZIP transcription factors. We investigated the biological function of this protein using virus‐induced gene silencing (VIGS) in pepper plants and by generating overexpressing transgenic Arabidopsis plants. Our loss‐of‐function and gain‐of‐function studies revealed that CaATBZ1 negatively modulates ABA signalling and drought stress response. Consistent with CaATBZ1‐silenced pepper plants, CaASRF1/CaATBZ1‐silenced pepper plants displayed drought‐tolerant phenotypes via ABA‐mediated signalling. Our results demonstrated that CaASRF1‐mediated ubiquitination plays a crucial role in regulating the stability of CaATBZ1. These findings provide valuable insight into the post‐translational regulation of transcriptional factors.
Hypoglycemia associated with disseminated metastatic tonsillar squamous cell carcinoma producing insulin‐like growth factor‐I in a Pomeranian dog
Authors: Azuma Kazushi , Asakawa Makoto , Konno Toshiaki , Fukuda Shoko , Goto Asakawa Midori
Published: July 2019

A 13‐year‐old spayed female Pomeranian dog was presented for persistent, severe hypoglycemia (37 mg/dL; reference interval [RI] 75‐128 mg/dL). Progressive nonregenerative anemia (hematocrit 23.3%‐15.9%; RI 37.0%‐55.0%) and severe thrombocytopenia (36 000/µL; RI 200‐500 000/µL) were also noted. The serum insulin concentration was low (0.24 ng/mL; RI 0.302‐1.277 ng/mL). Computed tomography revealed multiple splenic nodules (1‐6 mm in diameter) and several hepatic nodules (7.6, 12 mm in diameter). Ultrasound‐guided fine‐needle aspiration of the splenic and hepatic nodules revealed low numbers of epithelial cells with mild cellular atypia, suggestive of a metastatic epithelial tumor, but the primary site was unknown at that time. On careful oral examination under general anesthesia, an enlarged right tonsil was noted grossly, and histopathologic examination of the tonsil diagnosed squamous cell carcinoma. Bone marrow aspirates and biopsies of the splenic and hepatic nodules were performed; all samples were diagnosed as metastatic carcinoma on histopathologic examination. No nodules were present in the pancreas, despite careful palpation during exploratory laparotomy. On immunohistochemistry, the neoplastic cells were positive for cytokeratin AE1/3 and insulin‐like growth factor (IGF)‐I but were negative for chromogranin A, PGP9.5, insulin, and inconclusive for IGF‐II. This is the first report of a primary IGF‐I‐producing squamous cell carcinoma in the tonsil of a dog with metastases to bone marrow, liver, and spleen, resulting in hypoglycemia.
Evaluation of damage area on fibre epoxy composites using digital image processing
Authors: Arul Jose P. , Sasikumar T. , Arun Bose P. , Prabhu N.
Published: July 2019

In this paper, fibre epoxy composite specimens are prepared by hand lay-up method with stacking sequences (04/±452)s. Five specimens are prepared with the same dimensions and named as S1, S2, S3, S4, and S5. These specimens are tested for impact analysis using a drop-weight apparatus (DWA-Ceast9350) at energy levels of 25, 30, and 35 J, followed by tensile testing using a universal testing machine (Dak9103). The damaged areas of the impacted specimens are examined by digital image processing, numerically simulated ABAQUS software, and scanning electron microscopy, followed by tensile strength results. The results of the experiment reveal that when the impact energy increases, the damage area increases, the tensile strength decreases, and the cracks formed during impact are shown in scanning electron microscope imaging. The homogeneity and isotropy of the composite are identified by the Feret ratio and circular shape factor.
Current Status of Pearl Millet Downy Mildew Prevalence across Agroecological Zones of Senegal
Authors: Zoclanclounon Yedomon Ange Bovys , Kanfany Ghislain , Kane Aboubacry , Fonceka Daniel , Ehemba Georgina Lala , Ly Fatmata
Published: July 2019

Pearl millet is a dominant staple cereal crop for smallholder farmers in Senegal. However, the crop is constrained by various nonbiotic and biotic stresses such as downy mildew disease. To assess the prevalence of this disease in Senegal, a field survey was conducted during the rainy season of 2017 across eight main pearl millet production regions following latitudinal gradient with different climatic conditions. Results showed that downy mildew prevalence was higher in Kaolack (incidence = 68.19%), Kaffrine (incidence = 77.19%), Tambacounda (incidence = 97.03%), Sedhiou (incidence = 82.78%), and Kolda (incidence = 98.01%) than Thies (incidence = 28.21%), Diourbel (incidence = 24.46%), and Fatick (incidence = 37.75%) regions. The field survey revealed an incidence as high as 98% and 28% of infected area in surveyed fields. Significant correlations between geographic coordinates, disease incidence, and infected areas were also observed. This study provided information that could help to understand the prevalence of downy mildew in pearl millet in Senegal.
Maternal Body Mass Index and Risk of Congenital Heart Defects in Infants: A Dose-Response Meta-Analysis
Authors: Liu Xuezhen , Ding Guoyong , Yang Weili , Feng Xia , Li Yuejin , Liu Huamin , Zhang Qianqian , Ji Long , Li Dong
Published: July 2019

Objective. The exact shape of the dose-response relationship between maternal body mass index (BMI) and the risk of congenital heart defects (CHDs) in infants has not been clearly defined yet. This study aims to further clarify the relationship between maternal obesity and the risk of CHDs in infants by an overall and dose-response meta-analysis. Methods. PubMed, Embase, and Web of Science databases were searched to identify all related studies. The studies were limited to human cohort or case-control studies in English language. Random-effect models and dose-response meta-analysis were used to synthesize the results. Heterogeneity, subgroup analysis, sensitivity analysis, and publication bias were also assessed. Results. Nineteen studies with 2,416,546 participants were included in our meta-analysis. Compared with the mothers with normal weight, the pooled relative risks (RRs) of infants with CHDs were 1.08 (95% CI=1.03-1.13) in overweight and 1.23 (95% CI=1.17-1.29) in obese mothers. According to the findings from the linear meta-analysis, we observed an increased risk of infants with CHDs (RR=1.07, 95% CI=1.06-1.08) for each 5 kg/m2 increase in maternal BMI. A nonlinear relationship between maternal BMI and risk of infants with CHDs was also found (p=0.012). Conclusion. The results from our meta-analysis indicate that increased maternal BMI is related to increased risk of CHDs in infants.
Extensions and Applications of Power‐Type Aczél‐Vasić‐Pečarić’s Inequalities
Authors: Chen Kun , Yan Fei , Yue Hong-Ying
Published: July 2019

In this paper, we enrich and develop power‐type Aczél‐Vasić‐Pečarić’s inequalities. First of all, we give some new versions of theorems and corollaries about Aczél‐Vasić‐Pečarić’s inequalities by quoting some lemmas. Moreover, in combination with Hölder’s inequality, we give some applications of the new version of Aczél‐Vasić‐Pečarić’s inequality and give its proof process.
Consensus Problem for Linear Time‐Invariant Systems with Time‐Delay
Authors: Fragoso-Rubio V. , Velasco-Villa M. , Vallejo-Alarcón M. A. , Vásquez-Santacruz J. A. , Hernández-Pérez M. A.
Published: July 2019

This work deals with the consensus problem of networks of agents with linear time‐invariant dynamics and input time‐delay. A predictor‐observer scheme that estimates the future value of the system state is considered. The partitioned nature of the predictor allows dealing with larger time‐delays than those reported in the literature. The estimated future state of the system is later used in the consensus protocol with the aim of compensating the system input delay. The effectiveness of the solution is shown by means of numerical evaluations.
Transversus Thoracis Muscle Plane Block
Authors: Fujii Satoru , Bairagi Ranjana , Roche Matthew , Zhou Jian Ray
Published: July 2019

The transversus thoracis muscle plane block (TTP) block is a newly developed regional anesthesia technique which provides analgesia to the anterior chest wall. Since its introduction, this technique has been utilized for a wide range of surgical procedures as well as nonsurgical indications. Current evidence suggests that the TTP block provides effective analgesia for breast and cardiac surgeries, cardiac device implantation, pericardiocentesis, and acute and chronic pain management. To date, no major complications have been reported. Currently there is an urgent need to standardize the nomenclature of this technique to facilitate accurate communication amongst care providers, researchers, and authors. In this review, we describe the TTP block technique, review the indications and available evidence in clinical practice, and discuss alternative blocks and future prospects.
Free‐Decay Nonlinear System Identification via Mass‐Change Scheme
Authors: Anastasio Dario , Marchesiello Stefano
Published: July 2019

Methods for nonlinear system identification of structures generally require input‐output measured data to estimate the nonlinear model, as a consequence of the noninvariance of the FRFs in nonlinear systems. However, providing a continuous forcing input to the structure may be difficult or impracticable in some situations, while it may be much easier to only measure the output. This paper deals with the identification of nonlinear mechanical vibrations using output‐only free‐decay data. The presented method is based on the nonlinear subspace identification (NSI) technique combined with a mass‐change scheme, in order to extract both the nonlinear state‐space model and the underlying linear system. The technique is tested first on a numerical nonlinear system and subsequently on experimental measurements of a multi‐degree‐of‐freedom system comprising a localized nonlinearity.
Mechanical Stretch Promotes the Osteogenic Differentiation of Bone Mesenchymal Stem Cells Induced by Erythropoietin
Authors: He Yong-Bin , Liu Sheng-Yao , Deng Song-Yun , Kuang Li-Peng , Xu Shao-Yong , Li Zhe , Xu Lei , Liu Wei , Ni Guo-Xin
Published: July 2019

Introduction. The effects of erythropoietin (EPO) on the behaviors of bone marrow mesenchymal stem cells (BMSCs) subjected to mechanical stretch remain unclear. This study was therefore aimed at establishing the dose-response effect of EPO stimulation on rat BMSCs and investigating the effects of mechanical stretch combined with EPO on the proliferation and osteogenic differentiation of BMSCs. Material and Methods. The proliferation and osteogenic differentiation of rat BMSCs were examined and compared using EPO with different concentrations. Thereafter, BMSCs were subjected to 10% elongation using a Flexcell strain unit, combined with 20 IU/ml EPO. The proliferation of BMSCs was detected by Cell Counting Kit-8, colony formation assay, and cell cycle assay; meanwhile, the mRNA expression levels of Ets-1, C-myc, Ccnd1, and C-fos were detected by reverse transcription and real-time quantitative PCR (qPCR). The osteogenic differentiation of BMSCs was detected by alkaline phosphatase (ALP) staining, and the mRNA expression levels of ALP, OCN, COL, and Runx2 were detected by qPCR. The role of the extracellular signal-regulated kinases 1/2 (ERK1/2) in the osteogenesis of BMSCs stimulated by mechanical stretch combined with 20 IU/ml EPO was examined by Western blot. Results. Our results showed that effects of EPO on BMSCs included a dose-response relationship, with the 20 IU/ml EPO yielding the largest. Mechanical stretch combined with 20 IU/ml EPO promoted proliferation and osteogenic differentiation of BMSCs. The increase in ALP, mineral deposition, and osteoblastic genes induced by the mechanical stretch–EPO combination was inhibited by U0126, an ERK1/2 inhibitor. Conclusion. EPO was able to promote the proliferation and osteogenic differentiation of BMSCs, and these effects were enhanced when combined with mechanical stretch. The underlying mechanism may be related to the activation of the ERK1/2 signaling pathway.
Medullary Thyroid Carcinoma: An Update on Imaging
Authors: Kushchayev Sergiy V. , Kushchayeva Yevgeniya S. , Tella Sri Harsha , Glushko Tetiana , Pacak Karel , Teytelboym Oleg M.
Published: July 2019

Medullary thyroid carcinoma (MTC), arising from the parafollicular C cells of the thyroid, accounts for 1–2% of thyroid cancers. MTC is frequently aggressive and metastasizes to cervical and mediastinal lymph nodes, lungs, liver, and bones. Although a number of new imaging modalities for directing the management of oncologic patients evolved over the last two decades, the clinical application of these novel techniques is limited in MTC. In this article, we review the biology and molecular aspects of MTC as an important background for the use of current imaging modalities and approaches for this tumor. We discuss the modern and currently available imaging techniques—advanced magnetic resonance imaging (MRI)-based techniques such as whole-body MRI, dynamic contrast-enhanced (DCE) technique, diffusion-weighted imaging (DWI), positron emission tomography/computed tomography (PET/CT) with 18F-FDOPA and 18F-FDG, and integrated positron emission tomography/magnetic resonance (PET/MR) hybrid imaging—for primary as well as metastatic MTC tumor, including its metastatic spread to lymph nodes and the most common sites of distant metastases: lungs, liver, and bones.
A Fuzzy Comprehensive Assessment Approach and Application of Rock Mass Cavability in Block Caving Mining
Authors: He Rongxing , Liu Huan , Ren Fengyu , Li Guanghui , Zhang Jing
Published: July 2019

Cavability assessment is an important subject during the feasibility stages before determining whether to use block caving mining. This paper provides a fuzzy comprehensive assessment (FCA) approach based on the cavability assessment approaches and its influencing factors, which are all fuzzy. This approach combines the cavability influencing factors with engineering empirical approaches by fuzzy mathematics, which improves the applicability of the cavability assessment results. This approach is applied to assess the cavability via cores in the Luoboling copper molybdenum mine. The spatial distribution of the rock mass cavability at different depths of the borehole is obtained. The cavability ranks of various rocks are determined in different locations. These assessment results can provide a basis for demonstrating the feasibility of block caving mining in the Luoboling copper molybdenum mine. The study can also provide a basis for the design of mining engineering.
A SINS/BDS Integrated Navigation Method Based on Classified Weighted Adaptive Filtering
Authors: Kang Xuchao , He Guangjun , Li Xingge
Published: July 2019

Aiming at the problem that the accuracy and stability of SINS/BDS integrated navigation system decrease due to uncertain model and observation anomalies, a SINS/BDS integrated navigation method based on classified weighted adaptive filtering is proposed. Firstly, the innovation covariance matching technology is used to detect whether there is any abnormality in the system as a whole. Then the types of anomalies are distinguished by hypothesis test. Different types of anomalies have different effects on state estimation. Based on the dynamic changes of innovation, different adaptive weighting methods are adopted to correct navigation information. The simulation results show that this method can effectively improve the fault‐tolerant performance of integrated navigation system in complex environment with unknown anomaly types. When both model anomalies and observation anomalies exist, the speed and position accuracy are increased by 42% and 24% compared with the standard KF, 38% and 22% compared with the innovation orthogonal adaptive filtering, which has higher navigation accuracy.
Reasons for Women’s Choice of Elective Caesarian Section in Duayaw Nkwanta Hospital
Authors: Diema Konlan Kennedy , Baku Elizabeth Kpodotsi , Japiong Milipaak , Dodam Konlan Kennedy , Amoah Roberta Mensima
Published: July 2019

Background. Caesarean section is one of the most commonly performed major surgeries in obstetric practice intended to save the mother and child and in turn reduce maternal and perinatal mortality. The steadily increasing global rate of caesarean section has become one of the most debated topics in maternity care. This study identified the factors that influence women’s choice of elective cesarean sections in the Duayaw Nkwanta Hospital. Methodology. This study used descriptive cross-sectional survey method to collect data from 78 post-caesarean section women above age 18 years. A whole population sampling method was used to trace respondents to their homes to administer a pretested questionnaire. Data was double-entered into Microsoft Excel spreadsheet, compared, cleaned, and transported to Statistical Package for Social Sciences (SPSS) version 21. Data was analyzed using descriptive statistics with a Pearson correlation test. Results. Post-caesarean section women (37.2%) indicated CS is a pain-free method of birth while 57.1% reported CS is safe for both mother and baby. Others (28.2%) chose CS based on a friend’s advice and 19.2% on religious advice. The relationship between age of respondents and the number of times of having CS showed a weak positive correlation (r= .170, N= 78, p≤0.136, two-tailed test). There was a significant positive correlation between average monthly income of respondents and the number of times of having a CS birth (r= .320, N= 78, p≤ 0.004). Conclusion. It is imperative that there is heightened interest in educating mothers on associated benefit and risk of elective caesarean sections as a method of birthing by nurses and midwives in the antenatal clinics.
Characterization of T-Cell Receptor Repertoire in Patients with Rheumatoid Arthritis Receiving Biologic Therapies
Authors: Chang Che-Mai , Hsu Yu-Wen , Wong Henry Sung-Ching , Wei James Cheng-Chung , Liu Xiao , Liao Hsien-Tzung , Chang Wei-Chiao
Published: July 2019

Rheumatoid arthritis (RA) is a systematic autoimmune disease, predominantly causing chronic polyarticular inflammation and joint injury of patients. For the treatment of RA, biologic disease-modifying antirheumatic drugs (bDMARDs) have been used to reduce inflammation and to interfere with disease progression through targeting and mediating the immune system. Although the therapeutic effects of bDMARDs in RA patients have been widely reported, whether these drugs also play important roles in T-cell repertoire status is still unclear. We therefore designed the study to identify the role of T-cell repertoire profiles in RA patients with different types of bDMARD treatments. A high-throughput sequencing approach was applied to profile the T-cell receptor beta chain (TCRB) repertoire of circulating T lymphocytes in eight patients given adalimumab (anti-TNF-α) with/without the following use of either rituximab (anti-CD20) or tocilizumab (anti-IL6R). We subsequently analyzed discrepancies in the clonal diversity and CDR3 length distribution as well as usages of the V and J genes of TCRB repertoire and interrogated the association between repertoire diversity and disease activities followed by the treatment of bDMARDs in these RA patients. All groups of patients showed well-controlled DAS28 scores (<2.6) after different treatment regimens of drugs and displayed no significant statistical differences in repertoire diversity, distribution of CDR3 lengths, and usage of V and J genes of TCRB. Nonetheless, a trend between overall TCRB repertoire diversity and disease activity scores in all bDMARD-treated RA patients was observed. Additionally, age was found to be associated with repertoire diversity in RA patients treated with bDMARDs. Through the profiling of the TCR repertoire in RA patients receiving different biologic medications, our study indicated an inverse tendency between TCR repertoire diversity and disease activity after biologic treatment in RA patients.
Integration of CTA in the Diagnostic Workup of New Onset Chest Pain in Clinical Practice
Authors: Carrabba Nazario , Berteotti Martina , Taborchi Giulia , Ciatti Francesca , Acquafresca Manlio , Moroni Mario , Migliorini Angela , Miele Vittorio , Marchionni Niccolò , Valenti Renato
Published: July 2019

Background. Recently, NICE guidelines recommend the use of computed tomographic angiography (CTA) as the first line of investigation for new onset chest pain. We sought to evaluate the impact of the integration of CTA in the diagnostic workup, as either a first- or second-line of investigation, in the clinical practice for patients presenting with new onset chest pain, with suspicion that it may be due to coronary artery disease (CAD). Method and Results. From 2014 to 2016, 208 outpatients (mean age 63.8 ± 12.7, 37% female) with an unknown CAD diagnosis were evaluated. About half (n=106, 51%) received usual testing care plus CTA as a second-line investigation (group A), while the other half (n=102, 49%) received CTA as a first-line investigation (group B). Care decisions and test interpretations were made by the attending physician. Obstructive CAD (O-CAD) was defined as >50% stenosis in the principal branch. As determined by CTA, the rates of CAD in group A vs. group B were the following (P=0.001): 31.1% vs. 27.4% for normal/minimal CAD; 42.5% vs. 63.7% for no O-CAD; and 26.4% vs. 8.8% with O-CAD. Based on a diagnostic result of no O-CAD, invasive angiography was cancelled in 42.6% (n=45) of group A patients, and additional functional tests were cancelled for the same reason in 63.7% (n=65) of group B patients, without adverse events at median 3-year. The average diagnostic cost for patients in our study was lower in group B (206 vs. 324.42 euro; P<0.0001). Conclusions. In clinical practice, CTA, as a first- or second-line investigation, most commonly detected no O-CAD in new onset chest pain patients, leading us to safely avoid unnecessary ICA or additional functional tests. The use of CTA as a first-line investigation also appears to be cost saving, but its cost-effectiveness remains to be demonstrated in larger studies.
Cervical Subcutaneous Emphysema following Total Laryngectomy: An Unusual Complication of Nasogastric Intubation
Authors: Jama Guled M. , Barmayehvar Behrad , Vydianath Sanjay , Mathews John , Spinou Catherine
Published: July 2019

The nasogastric tube remains an important route of enteral feeding in the early postoperative period following total laryngectomy. Its insertion, however, is not without any risks of complications. In this article, we report an unusual case of inadvertent nasopharyngeal perforation secondary to intraoperative nasogastric tube insertion presenting as unilateral cervical subcutaneous emphysema in a patient who underwent total laryngectomy.
Beamforming for Rotated 3D Multipanel Array Structures for 5G NR MIMO Transmission
Authors: Lee Hyukjun , Ryu Wonjae , Sung Wonjin , Park Jonghyun
Published: July 2019

5G new radio (NR) provides enhanced transmission capabilities to transceivers by utilizing the massive multiple-input multiple-output (MIMO) technology with a significantly increased number of antenna elements. Such transmission requires massive arrays to perform accurate high-gain beamforming over the millimeter-wave frequency band. There is no fixed form of array structures for 5G NR base stations, but they are likely to include multiple subarrays or panels for practicality of implementation and are expected to cover the user equipment (UE) in various locations. In this paper, we propose an array structure to transmit signals over the three-dimensional (3D) space in an isotropic fashion for all types of UEs in ground, aerial, and high-rise building locations, by employing panels on surfaces of a polyhedron. We further derive exact beamforming equations for the proposed array and show the resulting beams provide improved receiver performance over the exiting conventional beamforming. The presented beamforming expressions can be applied to an arbitrary multipanel array with massive antenna elements.
The Minimum Data Set and Quality Indicators for National Healthcare-Associated Infection Surveillance in Mainland China: Towards Precision Management
Authors: Yao Hongwu , Suo Jijiang , Xing Yubin , Du Mingmei , Bai Yanling , Liu Bowei , Li Lu , Huo Rui , Lin Jian , Chen Chunping , Fu Qiang , Liu Yunxi
Published: July 2019

The magnitude and scope of the healthcare-associated infections (HCAIs) burden are underestimated worldwide, and have raised public concerns for their adverse effect on patient safety. In China, HCAIs still present an unneglected challenge and economic burden in recent decades. With the purpose of reducing the HCAI prevalence and enhancing precision management, China’s National Nosocomial Infection Management and Quality Control Center (NNIMQCC) had developed a Minimum Data Set (MDS) and corresponding Quality Indicators (QIs) for establishing national HCAI surveillance system, the data elements of which were repeatedly discussed, investigated, and confirmed by consensus of the expert team. The total number of data elements in MDS and QIs were 70 and 64, and they were both classified into seven categorical items. The NNIMQCC also had started two pilot projects to inspect the applicability, feasibility, and reliability of MDS. After years of hard work, more than 400 health facilities in 14 provinces have realized the importance of HCAI surveillance and contributed to developing an ability of exporting automatically standardized data to meet the requirement of MDS and participate in the regional surveillance system. Generally, the emergence of MDS and QIs in China indicates the beginning of the national HCAI surveillance based on information technology and computerized process data. The establishment of MDS aimed to use electronic health process data to ensure the data accuracy and comparability and to provide instructive and ongoing QIs to estimate and monitor the burden of HCAIs, and to evaluate the effects of interventions and direct health policy decision-making.
An Automatic Density Clustering Segmentation Method for Laser Scanning Point Cloud Data of Buildings
Authors: Zhao Jianghong , Dong Yan , Ma Siyu , Liu Huajun , Wei Shuangfeng , Zhang Ruiju , Chen Xi
Published: July 2019

Segmentation is an important step in point cloud data feature extraction and three‐dimensional modelling. Currently, it is also a challenging problem in point cloud processing. There are some disadvantages of the DBSCAN method, such as requiring the manual definition of parameters and low efficiency when it is used for large amounts of calculation. This paper proposes the AQ‐DBSCAN algorithm, which is a density clustering segmentation method combined with Gaussian mapping. The algorithm improves upon the DBSCAN algorithm by solving the problem of automatic estimation of the parameter neighborhood radius. The improved algorithm can carry out density clustering processing quickly by reducing the amount of computation required.
A Combined ESPRIT-MUSIC Method for FDA-MIMO Radar with Extended Range Ambiguity Using Staggered Frequency Increment
Authors: Song Yuwei , Zheng Guimei , Hu Guoping
Published: July 2019

For the problem of joint angle and range estimation with frequency diverse array (FDA), MIMO radar, staggered frequency increment is proposed to expand the range ambiguity and the joint algorithm of ESPRIT and MUSIC is proposed to reduce the computational complexity. The uniformly weighted beampattern of FDA is a SINC-like function. Therefore, the grating lobe of range estimation exists. In this paper, staggered frequency increment is proposed to increase the distance of adjacent grating lobes. The proposed joint estimation algorithm firstly estimates the angle by using ESPRIT algorithm. Then we get the range estimation by MUSIC one-dimensional range search using the above estimated angle. In simulation results section, it is indicated in simulation results that the proposed method improves the range grating lobe and reduces the complexity.
Automated Ventricular System Segmentation in Paediatric Patients Treated for Hydrocephalus Using Deep Learning Methods
Authors: Klimont Michał , Flieger Mateusz , Rzeszutek Jacek , Stachera Joanna , Zakrzewska Aleksandra , Jończyk-Potoczna Katarzyna
Published: July 2019

Hydrocephalus is a common neurological condition that can have traumatic ramifications and can be lethal without treatment. Nowadays, during therapy radiologists have to spend a vast amount of time assessing the volume of cerebrospinal fluid (CSF) by manual segmentation on Computed Tomography (CT) images. Further, some of the segmentations are prone to radiologist bias and high intraobserver variability. To improve this, researchers are exploring methods to automate the process, which would enable faster and more unbiased results. In this study, we propose the application of U-Net convolutional neural network in order to automatically segment CT brain scans for location of CSF. U-Net is a neural network that has proven to be successful for various interdisciplinary segmentation tasks. We optimised training using state of the art methods, including “1cycle” learning rate policy, transfer learning, generalized dice loss function, mixed float precision, self-attention, and data augmentation. Even though the study was performed using a limited amount of data (80 CT images), our experiment has shown near human-level performance. We managed to achieve a 0.917 mean dice score with 0.0352 standard deviation on cross validation across the training data and a 0.9506 mean dice score on a separate test set. To our knowledge, these results are better than any known method for CSF segmentation in hydrocephalic patients, and thus, it is promising for potential practical applications.
Multifunctionalized Microscale Ultrasound Contrast Agents for Precise Theranostics of Malignant Tumors
Authors: Fu Jia-Wei , Lin Yi-Sheng , Gan Sheng-Long , Li Yong-Rui , Wang Yao , Feng Shi-Ting , Li Hao , Zhou Guo-Fu
Published: July 2019

In ultrasonography, ultrasound contrast agents (UCAs) that possess high acoustic impedance mismatch with the bulk medium are frequently employed to highlight the borders between tissues by enhanced ultrasound scattering in a clinic. Typically, the most common UCA, microbubble, is generally close in size to a red blood cell (<∼10 μm). These microscale UCAs cannot be directly entrapped into the target cells but generate several orders of magnitude stronger echo signals than the nanoscale ones. And their large containment and high ultrasound responsiveness also greatly facilitate to perform combined treatments, e.g., drug delivery and other imaging techniques. So multifunctionalized microscale UCAs appear on this scene and keep growing toward a promising direction for precise theranostics. In this review, we systematically summarize the new advances in the principles and preparations of multifunctionalized microscale UCAs and their medical applications for malignant tumors.
Maternal Parvovirus B19 Infection Causing First-Trimester Increased Nuchal Translucency and Fetal Hydrops
Authors: Grubman Olivia , Hussain Farrah Naz , Nelson Zoe , Brustman Lois
Published: July 2019

This is a case report of a 31-year-old primigravida who was diagnosed with an asymptomatic acute parvovirus B19 infection in the second trimester of pregnancy and its suspected association with an increased nuchal translucency (NT) measurement. Parvovirus B19 is a single-stranded DNA virus that is cytotoxic to erythroid progenitor cells, causing inhibition of erythropoiesis. While maternal disease is usually mild, fetal infection can result in spontaneous abortion, aplastic anemia, nonimmune fetal hydrops, and fetal demise. This fetus had an increased NT of 3.2 mm at 11 weeks’ gestation with a normal male karyotype and microarray analysis on chorionic villi sampling, in addition to a normal fetal echocardiogram at 15 weeks’ gestation. The anatomy scan at 20 weeks’ and 1-day gestation revealed fetal ascites, pleural effusion, and increased middle cerebral artery peak systolic velocity suspicious for fetal anemia. At this time, maternal serology for parvovirus was positive for IgM and IgG. Amniocentesis, cordocentesis, and intrauterine transfusion were performed. The amniocentesis revealed elevated parvovirus B19 DNA, quantitative PCR (2,589,801 copies/mL, reference range <100 copies/mL). The patient delivered a viable male fetus at 37 weeks’ and 6-day gestation, without sequelae of the previously noted hydrops. Parvovirus B19 infection should be a consideration when evaluating increased NT and hydrops fetalis. It warrants close antepartum surveillance and possible intrauterine fetal transfusions. With prompt recognition, proper treatment, and surveillance, these patients can go on to achieve healthy term deliveries. Long-term outcomes of delivered infants require further study.
The Existence Result for a Class of p-Kirchhoff-Type Problem with a Multilinear Growth Nonlinearity
Authors: Yao Jiangyan , Han Wei
Published: July 2019

In this paper, we firstly discuss the existence of the least energy sign-changing solutions for a class of p-Kirchhoff-type problems with a (2p-1)-linear growth nonlinearity. The quantitative deformation lemma and Non-Nehari manifold method are used in the paper to prove the main results. Remarkably, we use a new method to verify that Mb≠∅. The main results of our paper are the existence of the least energy sign-changing solution and its corresponding energy doubling property. Moreover, we also give the convergence property of the least energy sign-changing solution as the parameter b↘0.
An Update on Clinicopathological and Molecular Features of Plexiform Fibromyxoma
Authors: Su Hsuan-An , Yen Hsu-Heng , Chen Chih-Jung
Published: July 2019

Plexiform fibromyxoma is a rare and newly described gastric mesenchymal tumor with only 121 reported cases in the literature. Our understanding of plexiform fibromyxoma requires updating since the first case has been reported by Takahashi et al. 12 years ago. The present review summarized reported cases in the literature, and both clinical and pathological aspects of plexiform fibromyxoma were comprehensively discussed. Plexiform fibromyxoma usually causes nonspecific or bleeding signs or symptoms, and therefore clinical recognition of the disease is challenging. Plexiform fibromyxoma is of benign nature without any metastasis or recurrence reported, and more conservative surgical treatment should be considered.
Research on Characteristic Stress and Constitutive Equation of Confined Sandstone during Damage Evolution Based on Energy Evolution Analysis
Authors: Yang Xiaobin , Cheng Hongming , Hou Xin , Nie Chaogang , Lv Jiaqi
Published: July 2019

This study implements the cyclic loading-unloading triaxial compression tests with confining pressures of 5, 10, 20, and 30 MPa for determining the characteristic stress and constitutive equation of sandstone during damage evolution. The energy evolution characteristics and transformations are analyzed, the energy proportion evolution law is defined and analyzed, and its process is divided into five stages according to the whole stress-strain curve. Then, the dissipation energy proportion method for determining the characteristic stress is proposed and compared with the lateral strain method and the volumetric strain method, and the differences of characteristic stress determined by the three methods are within the acceptable error range, i.e., the proportion of crack initiation stress and crack damage stress to peak stress are all about 40% and 70%, respectively, and least affected by the confining pressures. The new method has strong maneuverability, clearer response to the damage evolution, better coordination with the damage evolution, and less subjective initiative. In addition, the dissipation energy proportion behavior is captured by fitting function and established a relationship with elastic modulus of sandstone, and then the damage evolution constitutive equation of sandstone is established based on energy proportion. Finally, the theoretical curve and experimental curve of damage evolution are compared according to the five stages of dissipation energy proportion evolution, and the result shows that the damage evolution constitutive equation is reasonable.
Functional Inequalities for Generalized Complete Elliptic Integrals with Two Parameters
Authors: Dou Xiangkai , Yin Li , Lin Xiu-Li
Published: July 2019

In this paper, we establish some functional inequalities for generalized complete elliptic integrals with two parameters, such as estimation of bounds and mean inequalities. Our main results give(p,q)-analogues to the early results for classical complete elliptic integrals.
Prevalence and Genotyping of Echinococcus Species from Livestock in Kajiado County, Kenya
Authors: Nungari Lucy , Mbae Cecilia , Gikunju Joseph , Mulinge Erastus , Kaburu Timothy , Zeyhle Eberhard , Magambo Japhet
Published: July 2019

Cystic Echinococcosis (CE) is a widespread neglected zoonotic disease and is caused by the larval stage of the dog tapeworm Echinococcus granulosus sensu lato. CE is more frequent in livestock-rearing areas and where people live a nomadic or seminomadic lifestyle such as in Kajiado County, Kenya. There is limited data on CE disease situation in the county of Maasailand; the present study, therefore, reports on the prevalence of CE in cattle, sheep, and goats and their relative importance in CE transmission in Kajiado County. In total, 1,486 livestock (388 cattle, 625 sheep, and 473 goats) slaughtered in two abattoirs were examined for the presence of hydatid cysts in various organs. Cyst isolates were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the NADH dehydrogenase subunit 1 gene (nad1). The overall prevalence of CE was 14.8% (220/1486), while prevalence per livestock species was 15.2% (72/473) in goats, 14.9% (93/625) in sheep, and 14.2% (55/388) in cattle. Out of the 421 cysts isolated, 389 cysts were successfully characterized to be either E. granulosus sensu stricto (s. s.), 356/389 (91.5%), E. canadensis (G6/7), 26/389 (6.7%), or E. ortleppi, 7/389 (1.8%). This record confirms predominance of E. granulosus s. s. in Maasailand and other parts of Kenya, while the importance of E. ortleppi and E. canadensis (G6/7) to the general CE burden in Maasailand might be higher than previously thought. More so, a higher infection pressure for humans by E. granulosus s. s. based on its abundance could be speculated. The study sheds significant light on CE situation in livestock in the nomadic/seminomadic society of the Maasai in Kajiado County and provides good bases to investigate human CE in the area.
Estimating the Gerber-Shiu Function in a Compound Poisson Risk Model with Stochastic Premium Income
Authors: Wang Yunyun , Yu Wenguang , Huang Yujuan
Published: July 2019

In this paper, we consider the compound Poisson risk model with stochastic premium income. We propose a new estimation of Gerber-Shiu function by an efficient method: Fourier-cosine series expansion. We show that the estimator is easily computed and has a fast convergence rate. Some simulation examples are illustrated to show that the estimation has a good performance when the sample size is finite.
Exploring Douglas-Peucker Algorithm in the Detection of Epileptic Seizure from Multicategory EEG Signals
Authors: Zarei Roozbeh , He Jing , Siuly Siuly , Huang Guangyan , Zhang Yanchun
Published: July 2019

Discovering the concealed patterns of Electroencephalogram (EEG) signals is a crucial part in efficient detection of epileptic seizures. This study develops a new scheme based on Douglas-Peucker algorithm (DP) and principal component analysis (PCA) for extraction of representative and discriminatory information from epileptic EEG data. As the multichannel EEG signals are highly correlated and are in large volumes, the DP algorithm is applied to extract the most representative samples from EEG data. The PCA is utilised to produce uncorrelated variables and to reduce the dimensionality of the DP samples for better recognition. To verify the robustness of the proposed method, four machine learning techniques, random forest classifier (RF), k-nearest neighbour algorithm (k-NN), support vector machine (SVM), and decision tree classifier (DT), are employed on the obtained features. Furthermore, we assess the performance of the proposed methods by comparing it with some recently reported algorithms. The experimental results show that the DP technique effectively extracts the representative samples from EEG signals compressing up to over 47% sample points of EEG signals. The results also indicate that the proposed feature method with the RF classifier achieves the best performance and yields 99.85% of the overall classification accuracy (OCA). The proposed method outperforms the most recently reported methods in terms of OCA in the same epileptic EEG database.
The National Tuberculosis Control Programme of Liberia Laboratory Programme Performance
Authors: Desta Kassaye Tekie , Masango T. E. , Zethu Nkosi Zerish
Published: July 2019

Background. Tuberculosis (TB) is a major public health problem in Liberia. Little is known about the TB laboratory performance of Liberia and the challenges after the 14 years of civil war which ended in 2003. The purpose of the study was to evaluate the TB laboratory performance of Liberia. Methods. A cross-sectional study was conducted from 2014 to 2015. The study was conducted using quantitative data of TB case findings, sputum microscopy proficiency testing, and on-site assessment of sputum microscopy laboratories in Liberia. 80 laboratories participated in the proficiency testing. Besides, four years’ (2012–2015) TB case finding data obtained from the National Leprosy and Tuberculosis Control Programme (NLTCP) were used to complement the study. The data were analysed using descriptive statistics. Results. From the 80 TB sputum microscopy testing laboratories participating in proficiency testing, only 20 (25%) scored acceptable performance. 46 (58%) TB microscopy laboratories reported quantification errors for the proficiency panel slide 6 which was 3+. The national TB smear-positive cases notified were 4342 in 2012 but decreased to 3820 and 2448 in 2013 and 2014, respectively. The TB smear case detection rate showed an increase from 68% in 2010 to 78% in 2011 and a decrease to 60%, 57%, and 42% in 2012, 2013, and 2014, respectively. Conclusion. Between 2010 and 2013, the NLTCP succeeded in increasing the number of TB sputum microscopy laboratories. At most of the TB microscopy sites, the TB laboratory quality system was not implemented. The NLTCP of Liberia should develop strategies to overcome its challenges in TB laboratory testing.