bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive validity of PRISMA-7 as a screening instrument for frailty in a hospital setting
Authors: Hoffmann Sarah , Wiben Amalie , Kruse Marie , Jacobsen Katja Kemp , Lembeck Maurice A , Holm Ellen Astrid
Published: October 2020

Objectives

Frailty is a major clinical geriatric syndrome associated with serious adverse events including functional disability, falls, hospitalisation, increased morbidity and mortality. The aim of this study was to study the associations between frailty defined as Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA-7) score ≥3 and use of healthcare resources in hospital and in the municipality as well as association between frailty and mortality.

Design

Register-based retrospective study.

Setting

The target population consists of patients aged 75 years or above who, during hospital stay, were assessed by a physiotherapist, and at discharge from hospital were prescribed further physical training in the community.

Participants

973 individuals aged 75+ years were included.

Outcome measures

We examined associations between frailty and use of healthcare resources in hospital and in the municipality as well as the association between frailty and mortality.

Results

973 individuals aged 75+ years were included. Of these, 63.9% had a PRISMA-7 score ≥3 and were thus defined as frail. Frail individuals were older compared with non-frail with mean ages of 84.6 and 80.4 years, respectively, p>0.001. Age and gender-adjusted mortality after 1 year was higher among the frail (OR 2.46, 95% CI 1.53 to 3.97). Use of healthcare services in the municipality as well as hospital admissions was significantly higher among frail individuals.

Conclusions

Based on these findings we consider PRISMA-7 to be useful in an in-hospital setting as a screening tool to identify frail elderly patients who may profit from further geriatric assessment during hospital stay.

Trial registration number

ID REG-070-2017.
Feasibility of using an Early Warning Score for preterm or low birthweight infants in a low-resource setting: results of a mixed-methods study at a national referral hospital in Kenya
Authors: Mitchell Eleanor J , Qureshi Zahida P , Were Fredrick , Daniels Jane , Gwako George , Osoti Alfred , Opira Jacqueline , Bradshaw Lucy , Oliver Mary , Pallotti Phoebe , Ojha Shalini
Published: October 2020

Introduction

Fifteen million babies are born prematurely, before 37 weeks gestational age, globally. More than 80% of these are in sub-Saharan Africa and Asia. 35% of all deaths in the first month of life are due to prematurity and the neonatal mortality rate is eight times higher in low-income and middle-income countries (LMICs) than in Europe. Early Warning Scores (EWS) are a way of recording vital signs using standardised charts to easily identify adverse clinical signs and escalate care appropriately. A range of EWS have been developed for neonates, though none in LMICs. This paper reports the findings of early work to examine if the use of EWS is feasible in LMICs.

Methods

We conducted an observational study to understand current practices for monitoring of preterm infants at a large national referral hospital in Nairobi, Kenya. Using hospital records, data were collected over an 8-week period in 2019 on all live born infants born at <37 weeks and/or <2500 g (n=294, 255 mothers) in the first week of life. Using a chart adopted from the EWS developed by the British Association of Perinatal Medicine, we plotted infants’ vital signs. In addition, we held group discussions with stakeholders in Kenya to examine opinions on use of EWS.

Results

Recording of vital signs was variable; only 63% of infants had at least one temperature recorded and 53% had at least one heart rate and respiratory rate recorded. Stakeholders liked the traffic-light system and simplicity of the chart, though recognised challenges, such as staffing levels and ability to print in colour, to its adoption.

Conclusion

EWS may standardise documentation and identify infants who are at higher risk of an adverse outcome. However, human and non-human resource issues would need to be explored further before development of an EWS for LMICs.
Conditionally positive: a qualitative study of public perceptions about using health data for artificial intelligence research
Authors: McCradden Melissa D , Sarker Tasmie , Paprica P Alison
Published: October 2020

Objectives

Given widespread interest in applying artificial intelligence (AI) to health data to improve patient care and health system efficiency, there is a need to understand the perspectives of the general public regarding the use of health data in AI research.

Design

A qualitative study involving six focus groups with members of the public. Participants discussed their views about AI in general, then were asked to share their thoughts about three realistic health AI research scenarios. Data were analysed using qualitative description thematic analysis.

Settings

Two cities in Ontario, Canada: Sudbury (400 km north of Toronto) and Mississauga (part of the Greater Toronto Area).

Participants

Forty-one purposively sampled members of the public (21M:20F, 25–65 years, median age 40).

Results

Participants had low levels of prior knowledge of AI and mixed, mostly negative, perceptions of AI in general. Most endorsed using data for health AI research when there is strong potential for public benefit, providing that concerns about privacy, commercial motives and other risks were addressed. Inductive thematic analysis identified AI-specific hopes (eg, potential for faster and more accurate analyses, ability to use more data), fears (eg, loss of human touch, skill depreciation from over-reliance on machines) and conditions (eg, human verification of computer-aided decisions, transparency). There were mixed views about whether data subject consent is required for health AI research, with most participants wanting to know if, how and by whom their data were used. Though it was not an objective of the study, realistic health AI scenarios were found to have an educational effect.

Conclusions

Notwithstanding concerns and limited knowledge about AI in general, most members of the general public in six focus groups in Ontario, Canada perceived benefits from health AI and conditionally supported the use of health data for AI research.
Predicting pain recovery in patients with acute low back pain: a study protocol for a broad validation of a prognosis prediction model
Authors: Silva Fernanda Gonçalves , Mota da Silva Tatiane , Palomo Gabriele Alves , Hancock Mark Jonathan , Costa Lucíola da Cunha Menezes , Costa Leonardo Oliveira Pena
Published: October 2020

Background

The clinical course of acute low back pain (LBP) is generally favourable; however, there is significant variability in the prognosis of these patients. A clinical prediction model to predict the likelihood of pain recovery at three time points for patients with acute LBP has recently been developed. The aim of this study is to conduct a broad validation test of this clinical prediction model, by testing its performance in a new sample of patients and a different setting.

Methods

The validation study with a prospective cohort design will recruit 420 patients with recent onset non-specific acute LBP, with moderate pain intensity, seeking care in the emergency departments of hospitals in São Paulo, Brazil. The primary outcome measure will be days to recovery from pain. The predicted probability of pain recovery for each individual will be computed based on predictions of the development model and this will be used to test the performance (calibration and discrimination) in the validation dataset.

Discussion

The findings of this study will better inform about the performance of the clinical prediction model, helping both clinicians and patients. If the model’s performance is acceptable, then future research should evaluate the impact of the prediction model, assessing whether it produces a change in clinicians’ behaviour and/or an improvement in patient outcomes.

Ethics and dissemination

Ethics were granted by the Research Ethics Committee of the Universidade Cidade de São Paulo, #20310419.4.0000.0064. Study findings will be disseminated widely through peer-reviewed publications and conference presentations.
Autofluorescence of choroidal vessels in Bietti’s crystalline dystrophy
Authors: Ameri Hossein , Su Erin , Dowd-Schoeman Tyler J
Published: October 2020

Objective

To describe the pattern of fundus autofluorescence (FAF) in Bietti’s crystalline dystrophy (BCD).

Methods and analysis

From the National Institutes of Health EyeGene database of 2769 patients with known pathogenic mutations, 5 patients with BCD-causing CYP4V2 mutations who had FAF images were selected. Demographic and genetic information and imaging files were obtained. From the FAF imaging files, unique autofluorescence (AF) patterns and correlation with retinal structures were assessed by three investigators for clinical significance.

Results

Five patients (four males, one female; mean age 56 years, range 42–76 years) were included, all with different CYP4V2 mutations. All patients displayed varying degrees of hypo-AF in the posterior pole. In four out of five patients, there was a relative hyper-AF of choroidal vessels within the hypo-AF area; this feature was limited to sclerotic vessels only. A transitional zone of speckled AF was visible around the hypo-AF area. This zone corresponded to the area containing retinal crystals on colour fundus photography; however, retinal crystals did not demonstrate hyper or hypo-AF.

Conclusions

This study presents a previously unreported characteristic finding in patients with BCD with CYP4V2 mutations. AF of choroidal vessels may aid in differentiating BCD from other retinal dystrophies.
Effect of the Carer Support Needs Assessment Tool intervention (CSNAT-I) in the Danish specialised palliative care setting: a stepped-wedge cluster randomised controlled trial
Authors: Lund Line , Ross Lone , Petersen Morten Aagaard , Blach Annemette , Rosted Elizabeth , Bollig Georg , Juhl Gitte Irene , Farholt Hanne Bollerup , Winther Helen , Laursen Louise , Hasse Marianne , Weensgaard Signe , Guldin Mai-Britt , Ewing Gail , Grande Gunn , Groenvold Mogens
Published: October 2020

Background

The Carer Support Needs Assessment Tool intervention (CSNAT-I) has been shown to improve end-of-life care support for informal caregivers. This study investigated the impact of the CSNAT-I on caregivers of patients recently enrolled in specialised palliative care (SPC) at home in Denmark.

Methods

A stepped-wedge cluster randomised controlled trial with nine clusters (ie, SPC teams). Outcome measures were collected using caregiver questionnaires at baseline (T0) and 2-week (T1) and 4-week (T2) follow-up.

Results

A total of 437 caregivers were enrolled (control group, n=255; intervention group, n=182). No intervention effect was found on the primary outcome, caregiver strain at T1 (p=0.1865). However, positive effects were found at T1 and T2 on attention to caregivers’ well-being (p<0.0001), quality of information and communication (p<0.0001), amount of information (T1: p=0.0002; T2: p<0.0001), involvement (T1: p=0.0045; T2: p<0.0001), talking about greatest burdens (p<0.0001) and assistance in managing greatest burdens (p<0.0001). The effect sizes of these differences were medium or large and seemed to increase from T1 to T2. At T1, positive effects were found on distress (p=0.0178) and home care responsibility (p=0.0024). No effect was found on the remaining outcomes.

Conclusion

Although no effect was found on caregiver strain, the CSNAT-I showed positive effects on caregiver distress, home care responsibility and key outcomes regarding caregivers’ experience of the interaction with healthcare professionals.

Trial registration number

NCT03466580.
Modulating the Infarcted Ventricle'S Refractoriness with An Epicardial Biomaterial
Authors: Chinyere Ikeotunye Royal , Hutchinson Mathew , Moukabary Talal , Koevary Jen Watson , Juneman Elizabeth , Goldman Steven , Lancaster Jordan J
Published: October 2020

Patients diagnosed with heart failure with reduced ejection fraction (HFrEF) are at increased risk of monomorphic ventricular tachycardia (VT) and ventricular fibrillation. The presence of myocardial fibrosis provides both anatomical and functional barriers that promote arrhythmias in these patients. Propagation of VT in a reentrant circuit depends on the presence of excitable myocardium and the refractoriness of the circuit. We hypothesize that myocardial refractoriness can be modulated surgically in a model of HFrEF, leading to decreased susceptibility to VT.

Male Sprague-Dawley rats were infarcted via permanent left coronary artery ligation. At 3 weeks post-infarction, engineered grafts composed of human dermal fibroblasts cultured into a polyglactin-910 biomaterial were implanted onto the epicardium to cover the area of infarction. Three weeks post-graft treatment, all rats underwent a terminal electrophysiologic study to compare monophasic action potential electroanatomic maps and susceptibility to inducible monomorphic VT.

HFrEF rats (n=29) demonstrated a longer (p=0.0191) ventricular effective refractory period (ERP) and a greater (p=0.0394) VT inducibility compared with sham (n=7). HFrEF rats treated with the graft (n=12) exhibited no change in capture threshold (p=0.3220), but had a longer ventricular ERP (p=0.0029) compared with HFrEF. No statistically significant change in VT incidence was found between HFrEF rats treated with the graft and untreated HFrEF rats (p=0.0834).

Surgical deployment of a fibroblast-containing biomaterial in a rodent ischemic cardiomyopathy model prolonged ventricular ERP as measured by programmed electrical stimulation. This hypothesis-generating study warrants additional studies to further characterize the antiarrhythmic or proarrhythmic effects of this novel surgical therapy.
Intratumoral injection reduces toxicity and antibody-mediated neutralization of immunocytokine in a mouse melanoma model
Authors: Baniel Claire C , Sumiec Elizabeth G , Hank Jacqueline A , Bates Amber M , Erbe Amy K , Pieper Alexander A , Hoefges Anna G , Patel Ravi B , Rakhmilevich Alexander L , Morris Zachary S , Sondel Paul M
Published: October 2020

Background

Some patients with cancer treated with anticancer monoclonal antibodies (mAbs) develop antidrug antibodies (ADAs) that recognize and bind the therapeutic antibody. This response may neutralize the therapeutic mAb, interfere with mAb effector function or cause toxicities. We investigated the potential influence of ADA to modify the tumor-binding capability of a tumor-reactive ‘immunocytokine’ (IC), namely, a fusion protein (hu14.18-IL2) consisting of a humanized, tumor-reactive, anti-GD2 mAb genetically linked to interleukin 2. We characterize the role of treatment delivery of IC (intravenous vs intratumoral) on the impact of ADA on therapeutic outcome following IC treatments in an established antimelanoma (MEL) regimen involving radiotherapy (RT) +IC.

Methods

C57BL/6 mice were injected with human IgG or the hu14.18-IL2 IC to develop a mouse anti-human antibody (MAHA) response (MAHA+). In vitro assays were performed to assess ADA binding to IC using sera from MAHA+ and MAHA− mice. In vivo experiments assessed the levels of IC bound to tumor in MAHA+ and MAHA− mice, and the influence of IC route of delivery on its ability to bind to B78 (GD2+) MEL tumors.

Results

MAHA is inducible in C57BL/6 mice. In vitro assays show that MAHA is capable of inhibiting the binding of IC to GD2 antigen on B78 cells, resulting in impaired ADCC mediated by IC. When B78-bearing mice are injected intravenously with IC, less IC binds to B78-MEL tumors in MAHA+ mice than in MAHA− mice. In contrast, when IC is injected intratumorally in tumor-bearing mice, the presence of MAHA does not detectibly impact IC binding to the tumor. Combination therapy with RT+IT-IC showed improved tumor regression compared with RT alone in MAHA+ mice. If given intratumorally, IC could be safely readministered in tumor-bearing MAHA+ mice, while intravenous injections of IC in MAHA+ mice caused severe toxicity. Histamine levels were elevated in MAHA+ mice compared with MAHA− mice after reintroduction of IC.

Conclusions

Intratumoral injection may be a means of overcoming ADA neutralization of therapeutic activity of tumor-reactive mAbs or ICs and may reduce systemic toxicity, which could have significant translational relevance.
Genetically engineered macrophages persist in solid tumors and locally deliver therapeutic proteins to activate immune responses
Authors: Brempelis Katherine J , Cowan Courtney M , Kreuser Shannon A , Labadie Kevin P , Prieskorn Brooke M , Lieberman Nicole A P , Ene Chibawanye I , Moyes Kara W , Chinn Harrison , DeGolier Kole R , Matsumoto Lisa R , Daniel Sara K , Yokoyama Jason K , Davis Amira D , Hoglund Virginia J , Smythe Kimberly S , Balcaitis Stephanie D , Jensen Michael C , Ellenbogen Richard G , Campbell Jean S , Pierce Robert H , Holland Eric C , Pillarisetty Venu G , Crane Courtney A
Published: October 2020

Background

Though currently approved immunotherapies, including chimeric antigen receptor T cells and checkpoint blockade antibodies, have been successfully used to treat hematological and some solid tumor cancers, many solid tumors remain resistant to these modes of treatment. In solid tumors, the development of effective antitumor immune responses is hampered by restricted immune cell infiltration and an immunosuppressive tumor microenvironment (TME). An immunotherapy that infiltrates and persists in the solid TME, while providing local, stable levels of therapeutic to activate or reinvigorate antitumor immunity could overcome these challenges faced by current immunotherapies.

Methods

Using lentivirus-driven engineering, we programmed human and murine macrophages to express therapeutic payloads, including Interleukin (IL)-12. In vitro coculture studies were used to evaluate the effect of genetically engineered macrophages (GEMs) secreting IL-12 on T cells and on the GEMs themselves. The effects of IL-12 GEMs on gene expression profiles within the TME and tumor burden were evaluated in syngeneic mouse models of glioblastoma and melanoma and in human tumor slices isolated from patients with advanced gastrointestinal malignancies.

Results

Here, we present a cellular immunotherapy platform using lentivirus-driven genetic engineering of human and mouse macrophages to constitutively express proteins, including secreted cytokines and full-length checkpoint antibodies, as well as cytoplasmic and surface proteins that overcomes these barriers. GEMs traffic to, persist in, and express lentiviral payloads in xenograft mouse models of glioblastoma, and express a non-signaling truncated CD19 surface protein for elimination. IL-12-secreting GEMs activated T cells and induced interferon-gamma (IFNγ) in vitro and slowed tumor growth resulting in extended survival in vivo. In a syngeneic glioblastoma model, IFNγ signaling cascades were also observed in mice treated with mouse bone-marrow-derived GEMs secreting murine IL-12. These findings were reproduced in ex vivo tumor slices comprised of intact MEs. In this setting, IL-12 GEMs induced tumor cell death, chemokines and IFNγ-stimulated genes and proteins.

Conclusions

Our data demonstrate that GEMs can precisely deliver titratable doses of therapeutic proteins to the TME to improve safety, tissue penetrance, targeted delivery and pharmacokinetics.
Impact of hyperglycaemia on complications in patients who had a stroke after thrombolysis
Authors: Cheng Yani , Luo Ji , Lin Yanyan , Zeng Yifan , Yu Junru , Lin Yuanshao
Published: October 2020

Background

We sought to investigate whether admission hyperglycaemia is associated with complications in patients who had an acute ischaemic stroke (AIS) treated with intravenous recombinant tissue plasminogen activator and, if so, whether complications during hospitalisation modify the effect of hyperglycaemia on 3-month poor outcome after thrombolysis.

Methods

Patients who were diagnosed with AIS after thrombolysis between July 2016 and January 2019 were enrolled in this study. Five prespecified complications, including infections, brain oedema, deep vein thrombosis (DVT), haemorrhagic transformation (HT) and gastrointestinal bleeding, were recorded during hospitalisation.

Results

Of 388 patients, 143 (36.86%) presented with hyperglycaemia. Patients with hyperglycaemia were more likely to experience one or more complications than patients without hyperglycaemia. After adjustment for potential confounders, hyperglycaemia was associated with brain oedema (OR 2.39; 95% CI 1.08 to 5.30), HT (OR 2.16, 95% CI 1.06 to 4.41), symptomatic intracerebral haemorrhage (sICH) (OR 7.32, 95% CI 2.35 to 22.80) and gastrointestinal bleeding (OR 3.62; 95% CI 1.93 to 6.80), but was not linked to infections (OR 1.48, 95% CI 0.76 to 2.9) and DVT (OR 0.60, 95% CI 0.23 to 1.5). Additional adjustment for the complications in the clinical outcome analysis, done to assess these complications as an intermediate in the pathway from admission hyperglycaemia to clinical outcome, did not substantially change the model (all p for interaction >0.05).

Conclusion

Hyperglycaemia is an independent predictor of complications following stroke after thrombolysis, especially for brain oedema, gastrointestinal bleeding, HT and sICH. Complications during hospitalisation did not modify the effect of hyperglycaemia on the poor outcome at 3 months in ischaemic stroke.
Quantifying poor working equid welfare in Nepalese brick kilns using a welfare assessment tool
Authors: Rodrigues Joao Brandao , Sullivan Rebekah J E , Judge Andrew , Norris Stuart Lee , Burden Faith A
Published: October 2020

Background

Across Asia the brick‐kiln industry is expanding. In Nepal, urban dwelling has increased in recent years, raising requirement for low‐cost, mass produced bricks to meet the population needs. Working equids (WEs) play a key role in non‐mechanised kilns. Assessing the welfare of these equids is the starting point to addressing concerns. In line with One Welfare principles, the health and welfare of animals, people and the kiln environment are interlinked.

Materials and methods

In December 2019, 119 WEs were assessed in seven brick kilns in three districts of Nepal, using the Equid Assessment Research and Scoping tool, developed by The Donkey Sanctuary. The objective was to measure welfare at the start of the brick kiln season.

Results

Horses were the predominant species of WE. Hazardous housing and environments were seen in all kilns. Behaviour responses were mixed. Owner responses and animal examination indicated poor working conditions. Signs of harmful practice were evident in most animals. The majority were underweight, with poor general health, skin alterations and musculoskeletal issues.

Conclusion

The welfare of equids prior to starting brick kiln work is poor, posing significant concerns for the actual working period. Intervention to enhance health and welfare is required.
Electrical neutrality and $$\beta $$-equilibrium conditions in dense quark matter: generation of charged pion condensation by chiral imbalance
Authors: Khunjua T. G. , Klimenko K. G. , Zhokhov R. N.
Published: October 2020

The phase diagram of dense quark matter with chiral imbalance is considered with the conditions of electric neutrality and $$\beta $$
β
-equilibrium. It has been shown recently that chiral imbalance can generate charged pion condensation (PC) in dense quark matter. It was, therefore, interesting to verify that this phenomenon takes place in realistic physical scenarios such as electrically neutral quark matter in $$\beta $$
β
-equilibrium, because a window of charged PC at dense quark matter phase diagram (without chiral imbalance) predicted earlier was closed by the consideration of these conditions at the physical current quark mass. In this paper it has been shown that the charged PC phenomenon is generated by chiral imbalance in the dense electric neutral quark/baryonic matter in $$\beta $$
β
-equilibrium, i.e. matter in neutron stars. It has also been demonstrated that charged PC is an inevitable phenomenon in dense quark matter with chiral imbalance if there is nonzero chiral imbalance in two forms, chiral and chiral isospin one. It seems that in this case charged PC phase can be hardly avoided by any physical constraint on isospin imbalance and that this conclusion can be probably generalized from neutron star matter to the matter produced in heavy ion collisions or in neutron star mergers. The chiral limit and the physical point (physical pion mass) have both been considered and it was shown that the appearance of charged PC is not much affected by the consideration of nonzero current quark mass.
Thermodynamic properties of novel black hole solutions in the Einstein–Born–Infeld-dilaton gravity theory
Authors: Dehghani M.
Published: October 2020

The exact solutions of coupled scalar, electromagnetic and gravitational field equations have been obtained in the framework of Einstein-dilaton gravity theory which is coupled to the Born–Infeld nonlinear electrodynamics. The solutions show that Einstein–Born–Infeld-dilaton gravity theory admits three novel classes of nonlinearly charged black hole solutions with the non-flat and non-AdS asymptotic behavior. Some of the solutions, in addition to the naked singularity, extreme and two-horizon black holes, produce one- and multi-horizon black holes too. The electric charge, mass and other thermodynamic quantities of the black holes have been calculated and it has been proved that they satisfy the standard form of the thermodynamical first law. The black hole local stability has been investigated by use of the canonical ensemble method. Noting the black hole heat capacity the points of type-one and type-two phase transitions and the locally stable black holes have been identified exactly. By use of the thermodynamic geometry, and noting the divergent points of the thermodynamic metric proposed by HEPM, it has been shown that the results of this method are consistent with those of canonical ensemble method. Global stability and Hawking–Page phase transition points have been studied by use of the grand canonical ensemble method and regarding the Gibbs free energy of the black holes. By calculating the Gibbs free energies, we characterized the ranges of horizon radii in which the black holes remain globally stable or prefer the radiation phase.
SURFACE STRENGTHENING TECHNOLOGY FOR MECHANICAL PARTS
Authors: LIU WENBO , YANG XUEFENG , WAN ZHUANG , XIA GUOFENG , LI DAN , WANG SHOUREN
Published: October 2020

This paper has summarized five surface strengthening methods, and these methods could to improve the surface properties of materials. The selection of mechanical parts materials has determined according to their working conditions. The work-piece in using cannot avoid defects in the material. This paper has introduced surface deformation enhancement, surface phase transformation enhancement, ion implantation technology, surface diffusion and infiltration technology, chemical transformation technology and surface coating technology. And has also included the principle of every surface technology, various technologies, parameters, strengthening characteristics, as well as strengthening effect and matters needing attention. The hardness, residual stress and corrosion resistance off mechanical parts could be improved through these surface strengthening methods. It is convenient to find the strengthening method and parameters in this paper when strengthening mechanical parts.
Digital Innovation Ecosystems for Circular Economy: the Case of ICESP, the Italian Circular Economy Stakeholder Platform
Authors: Del Vecchio Pasquale , Passiante Giuseppina , Barberio Grazia , Innella Carolina
Published: October 2020

An important but unexplored research issue is understanding how digital innovation ecosystem and a quintuple helix model can support the promotion of Circular Economy. Circular Economy, however, is intrinsically linked to the innovation issue. It can occur in a productive and consumption system under the form of a new product, process, organizational or marketing model. In the meantime, the digital innovation ecosystem debate was enriched by the social and environmental sustainability perspectives that are the pillars of the Circular Economy theory. Despite this, the research has failed to achieve full comprehension of digital innovation ecosystems’ dynamics and processes for the Circular Economy, by highlighting the need for deeper understanding. Under the above assumptions, this paper presents the evidence of a single and extreme case study related to the Italian Circular Economy Stakeholder Platform (ICESP). This is shown as good practice of a digital platform for stakeholders’ engagement, supporting the creation of a digital innovation ecosystem focused on the Circular Economy. We conclude by deriving implications for researchers and policy makers’ agendas.
Research on Seismic Reduction and Isolation Measures for Urban Underground Station Structure
Authors: Wang Guobo , Ba Feng , Ma Xianfeng , Zhao Jielin , Yue Yifei
Published: October 2020

Based on a rectangle underground station structure, two-dimensional finite element models are established in this study to explore the effectiveness of different seismic reduction and isolation measures for underground structure, where Davidenkov model is adopted to consider the soil nonlinearity and the underground structure is considered elastic. The performances of the seismic reduction and isolation measures are evaluated by assessing the structure internal force and deformation responses. Depending on the ratio of wave impedance between the isolation layer and the structure, the isolation layers are divided into rigid and flexible types. The effects of the length and elastic modulus of rigid isolation layer as well as that of the thickness and shear modulus of flexible isolation layer are investigated. The results show that the seismic reduction effect of rigid isolation layer is better with the increase of stiffness, and the effect of flexible isolation layer is more obvious with the decrease of stiffness, which are consistent with the classical impedance theory. Furthermore, the middle column of subway station is usually the most vulnerable during seismic shakings, and one viable way to improve its seismic behavior is to reduce the column end constraints. Therefore, different column constraints consisting of swing, hinge, sliding connection and isolation bearing are considered. The numerical results suggest that among the different column end constraints considered, the sliding connection is comparatively more favorable, which can effectively limit the lateral deformation of column while imposing no horizontal reaction force.
Madness: Recursive Ethnography and the Critical Uses of Psychopathology
Authors: Pinto Sarah
Published: October 2020

From the late 1990s, a wave of writing in anthropology took up the idiom of madness to orient a critical approach. However, anthropology's use of madness as critique reflects a longer conversation between psychiatry and anthropology. As madness is used to point to and connect other things—afflictions, therapeutics, medicine, politics, colonialism, religion, and, especially, trauma as a social condition—it is noteworthy not only for its breadth, but also because it is often applied to contexts in which it already has purchase as critique. Thus, madness in anthropology is a mirror onto the discipline's recursive engagements with psychiatry and the worlds to which both turn their attention.
Expression of the regulated isoform of the electrogenic Na+/HCO3− cotransporter, NBCe1, is enriched in pacemaker interstitial cells of Cajal
Authors: Colmenares Aguilar Maria-Gabriela , Mazzone Amelia , Eisenman Seth T. , Strege Peter R. , Bernard Cheryl E. , Holmes Heather L. , Romero Michael F. , Farrugia Gianrico , Gibbons Simon J.
Published: October 2020

In this study, we show that the electrogenic Na+/HCO3− cotransporter, NBCe1/Slc4a4, is expressed in subtypes of interstitial cells of Cajal (ICCs) responsible for electrical slow wave generation throughout the mouse gastrointestinal tract and is absent in other types of ICCs. The transcripts of Slc4a4 expressed in mouse ICCs and human gastrointestinal smooth muscle are the regulated isoforms. This indicates a key role for HCO3- transport in generation of gastrointestinal motility patterns.
Lung CD103+dendritic cells and Clec9a signaling are required for neonatal hyperoxia-induced inflammatory responses to rhinovirus infection
Authors: Cui Tracy X. , Fulton Christina T. , Brady Alexander E. , Zhang Ying-Jian , Goldsmith Adam M. , Popova Antonia P.
Published: October 2020

Premature infants, especially those with bronchopulmonary dysplasia (BPD), develop recurrent severe respiratory viral illnesses. We have shown that hyperoxic exposure of immature mice, a model of BPD, increases lung IL-12-producing Clec9a+ CD103+ dendritic cells (DCs), pro-inflammatory responses, and airway hyperreactivity following rhinovirus (RV) infection. However, the requirement for CD103+ DCs and Clec9a, a DAMP receptor that binds necrotic cell cytoskeletal filamentous actin (F-actin), for RV-induced inflammatory responses has not been demonstrated. To test this, 2-day-old C57BL/6J, CD103+ DC-deficient Batf3−/− or Clec9agfp−/− mice were exposed to normoxia or hyperoxia for 14 days. Also, selected mice were treated with neutralizing antibody against CD103. Immediately after hyperoxia, the mice were inoculated with RV intranasally. We found that compared with wild-type mice, hyperoxia-exposed Batf3−/− mice showed reduced levels of IL-12p40, IFN-γ, and TNF-α, fewer IFN-γ-producing CD4+ T cells, and decreased airway responsiveness following RV infection. Similar effects were observed in anti-CD103-treated and Clec9agfp−/− mice. Furthermore, hyperoxia increased airway dead cell number and extracellular F-actin levels. Finally, studies in preterm infants with respiratory distress syndrome showed that tracheal aspirate CLEC9A expression positively correlated with IL12B expression, consistent with the notion that CLEC9A+ cells are responsible for IL-12 production in humans as well as mice. We conclude that CD103+ DCs and Clec9a are required for hyperoxia-induced pro-inflammatory responses to RV infection. In premature infants, Clec9a-mediated activation of CD103+ DCs may promote pro-inflammatory responses to viral infection, thereby driving respiratory morbidity.
Wrist proprioceptive acuity is linked to fine motor function in children undergoing piano training
Authors: Tseng Yu-Ting , Tsai Chia-Liang , Chen Fu-Chen
Published: October 2020

We document that improved proprioceptive acuity is a common feature in young pianists. This proprioceptive improvement is associated with both proprioceptive processing and proprioceptive-motor integration. Higher wrist proprioceptive acuity in young pianists is linked to enhanced manual dexterity, which suggests that intensive piano training may improve untrained fine motor skills.
Feasibility and reproducibility of electroencephalography-based corticokinematic coherence
Authors: Piitulainen Harri , Illman Mia , Jousmäki Veikko , Bourguignon Mathieu
Published: October 2020

The most important message in this report is that the corticokinematic coherence (CKC) method is a feasible and reproducible tool to quantify, map, and follow cortical proprioceptive (“the movement sense”) processing using EEG that is more widely available for CKC recordings than previously used magnetoencephalographic designs, in basic research, but especially in clinical environments. We provide useful recommendations for optimal EEG derivations for cost-effective experimental designs, allowing large sample size studies.
Methods for Identifying Truck Crash Hotspots
Authors: Qu Wenrui , Liu Shaojie , Zhao Qun , Qi Yi
Published: October 2020

The goal of this study was to develop a new method for identifying the actual risky spots by using the geographic information system (GIS). For this purpose, in this study, three different methods for detecting hotspots are developed, i.e., (1) the annual average daily traffic (AADT) normalization method, (2) AK crashes (A is the incapacitating crash, and K is the fatal crash) percentage method, and (3) distribution difference method. To evaluate the performances of these three hotspot detection methods along with a baseline method that only considered the frequency of crashes, we applied these three methods to identify the top 20 hotspots for truck crashes in two representative areas in Texas. The results indicated that (1) all three proposed methods produced more reasonable results than the baseline method, and (2) the “distribution difference” method outperformed the other methods.
CG8005 Mediates Transit-Amplifying Spermatogonial Divisions via Oxidative Stress in Drosophila Testes
Authors: Chen Wanyin , Luan Xiaojin , Yan Yidan , Wang Min , Zheng Qianwen , Chen Xia , Yu Jun , Fang Jie
Published: October 2020

The generation of reactive oxygen species (ROS) widely occurs in metabolic reactions and affects stem cell activity by participating in stem cell self-renewal. However, the mechanisms of transit-amplifying (TA) spermatogonial divisions mediated by oxidative stress are not fully understood. Through genetic manipulation of Drosophila testes, we demonstrated that CG8005 regulated TA spermatogonial divisions and redox homeostasis. Using in vitro approaches, we showed that the knockdown of CG8005 increased ROS levels in S2 cells; the induced ROS generation was inhibited by NAC and exacerbated by H2O2 pretreatments. Furthermore, the silencing of CG8005 increased the mRNA expression of oxidation-promoting factors Keap1, GstD1, and Mal-A6 and decreased the mRNA expression of antioxidant factors cnc, Gclm, maf-S, ND-42, and ND-75. We further investigated the functions of the antioxidant factor cnc, a key factor in the Keap1-cnc signaling pathway, and showed that cnc mimicked the phenotype of CG8005 in both Drosophila testes and S2 cells. Our results indicated that CG8005, together with cnc, controlled TA spermatogonial divisions by regulating oxidative stress in Drosophila.
Fixed Point of Almost Contraction inb-Metric Spaces
Authors: Iqbal Maryam , Batool Afshan , Ege Ozgur , Sen Manuel de la
Published: October 2020

In this paper, we introduce a generalized multivalued (α, L)-almost contraction in theb-metric space. Furthermore, we prove the existence and uniqueness of the fixed point for a specific mapping. The result presented in this paper extends some of the earlier results in the existing literature. Moreover, some examples are given to illuminate the usability of the obtained results.
Test on Compaction Reinforcement Effect of Sand
Authors: Zhang Lianzhen , Zhang Qingsong , Li Zhipeng , Wang Hongbo
Published: October 2020

In fracture or compaction grouting projects of sand layer, there exist many compacted sand regions on both sides of grout veins or around grout bulbs. It has an important effect on the final reinforcement effect of the sand layer that how much performance of the sand layer is improved after being compacted. Compression modulus, cohesion, and permeability coefficient are selected to be the performance indexes of the compaction reinforcement effect of sand. The relationship between the performance properties of sand and grouting pressure has been tested and analyzed. And influences of clay content and initial water ratio of sand on the compaction reinforcement effect have been studied. Results show that compaction can effectively improve the mechanical properties and impermeability properties of sand. Compression modulus of sand increases by 2∼18 times. The cohesion of sand increases from the scope of 9.4∼26 kPa to the scope of 40∼113.6 kPa. The permeability coefficient of sand decreases from the scope of 1.0 × 10−2∼ 8.33 × 10−4 cm/s to the scope of 2.19 × 10−4∼2.77 × 10−9 cm/s. When the clay content of sand is smaller than about 20%, sand cannot be reinforced effectively by compaction. Cohesion cannot be improved significantly and the permeability coefficient cannot be reduced markedly. A high initial water ratio of sand is beneficial to improve the compression modulus of compacted sand and goes against the improvement of cohesion of compacted sand. In addition, the initial water ratio has little effect on the permeability coefficient of compacted sand. In the end, fitting formulas have been developed to quantitatively describe the compaction reinforcement effect of sand by different grouting pressures.
Therapeutic Applications of Cannabinoids in Cardiomyopathy and Heart Failure
Authors: Garza-Cervantes J. A. , Ramos-González M. , Lozano O. , Jerjes-Sánchez C. , García-Rivas G.
Published: October 2020

A large number of cannabinoids have been discovered that could play a role in mitigating cardiac affections. However, none of them has been as widely studied as cannabidiol (CBD), most likely because, individually, the others offer only partial effects or can activate potential harmful pathways. In this regard, CBD has proven to be of great value as a cardioprotective agent since it is a potent antioxidant and anti-inflammatory molecule. Thus, we conducted a review to condensate the currently available knowledge on CBD as a therapy for different experimental models of cardiomyopathies and heart failure to detect the molecular pathways involved in cardiac protection. CBD therapy can greatly limit the production of oxygen/nitrogen reactive species, thereby limiting cellular damage, protecting mitochondria, avoiding caspase activation, and regulating ionic homeostasis. Hence, it can affect myocardial contraction by restricting the activation of inflammatory pathways and cytokine secretion, lowering tissular infiltration by immune cells, and reducing the area of infarct and fibrosis formation. These effects are mediated by the activation or inhibition of different receptors and target molecules of the endocannabinoid system. In the final part of this review, we explore the current state of CBD in clinical trials as a treatment for cardiovascular diseases and provide evidence of its potential benefits in humans.
Oral Administration of Quercetin or Its Derivatives Inhibit Bone Loss in Animal Model of Osteoporosis
Authors: Huang Yue-Yue , Wang Zi-Hao , Deng Li-Hui , Wang Hong , Zheng Qun
Published: October 2020

Objectives. Quercetin (Q) and its derivatives are the major members of the naturally occurring flavonoid family, which possess beneficial effects on disease prevention including osteoporosis. The present study is aimed at further investigating the efficacy of the Q and its derivatives on bone pathology, bone-related parameters under imageology, bone maximum load, and serum bone metabolism indexes in animal model of osteoporosis. Potential mechanisms of Q and its derivatives in the treatment of osteoporosis as well as the existing problems regarding the modeling method and limitations of researches in this area were also summarized. Eight databases were searched from their inception dates to February 2020. Nineteen eligible studies containing 21 comparisons were identified ultimately. The risk of bias and data on outcome measures were analyzed by the CAMARADES 10-item checklist and Rev-Man 5.3 software separately. The results displayed the number of criteria met varied from 3/10 to 7/10 with an average of 5.05. The present study provided the preliminary preclinical evidence that oral administration of Q or its derivatives was capable of improving bone pathology, bone-related parameters under imageology and bone maximum load, increasing serum osteocalcin, alkaline phosphatase, and estradiol, and reducing serum c-terminal cross-linked telopeptide of type I collagen (P<0.05). No statistical difference was seen in survival rate, index of liver, or kidney function (P>0.05). Q and its derivatives partially reverse osteopenia probably via antioxidant, anti-inflammatory, promoting osteogenesis, inhibiting osteoclasts, and its estrogen-like effect. The findings reveal the possibility of developing Q or its derivatives as a drug or an ingredient in diet for clinical treatment of osteoporosis.
Maintenance and Operation Optimization Algorithm of PV Plants under Multiconstraint Conditions
Authors: Hua Chi , Kuang Liang , Pi Dechang
Published: October 2020

With the rapid increase in the photovoltaic (PV) plants, the real-time operation and maintenance of photovoltaic power generation equipment is very important. The maintenance and dispatching of decentralized power stations is still one of the key issues affecting the operation safety of photovoltaic power stations. However, most of the photovoltaic power stations in China fail to rationally optimize the utilization of resources and time. The current study puts forward effort implementation via genetic algorithm-based multiconstrained optimization methodology. The proposed study optimally overrides the traditional PV plant operation and maintenance dispatching operations with automation and reliability. The proposed study is also applicable to multiple PV plants, multiple maintainers, multipoint departure, different dispatching conditions, and cost considerations. We propose an MOOA algorithm to solve this issue, and we strongly believe that, by defining a suitable fitness function, the convergence speed and optimization ability can be greatly improved, and this study puts a forward step.
Marchiafava–Bignami Disease Associated with Spinal Involvement
Authors: Perea Jhon , Luis María Belén , Lázaro Luciana Grimanesa , Scollo Sergio , Tamargo Agustina , Crespo José , Avalle Maira , Solarz Horacio , Fernández Liguori Nora , Alonso Ricardo
Published: October 2020

Marchiafava–Bignami disease (MBD) is a rare disorder of unknown etiology, strongly associated with alcoholism and malnutrition. MBD causes primary involvement of the corpus callosum, leading to confusion, dysarthria, seizures, and frequent death. We report the case of a 54-year-old male without a history of alcoholism or known malabsorption disease, who presented with altered consciousness and neurologic impairment. Complex B deficiency was addressed. Magnetic resonance imaging (MRI) showed typical corpus callosum lesions. The clinical features and radiologic images suggested spinal cord involvement. Brain histopathologic findings were consistent with MBD. Despite vitamin replacement therapy, he had a poor outcome.
An Extension Failure Criterion for Brittle Rock
Authors: Lu Aizhong , Zhang Ning , Zeng Guisen
Published: October 2020

Under the triaxial compressive state, the compressive strain is supposed to happen in the direction of the maximum principal stress, but tensile strain happens in the direction of the minimum principal stress. Moreover, as the intermediate principal stress is not too high, the corresponding strain can also be tensile. If the brittle rock is assumed as linear elastic in the prefailure stage, a new strength criterion based on the sum of the two tensile strains was presented. The new criterion considers the differences in mechanical parameters (i.e., elastic modulus and Poisson’s ratio) under tension and compression. The parameters of the criterion only include Poisson’s ratio and uniaxial strength. And the effect of the intermediate principal stress σ2 can be reflected. Certain featured failure phenomenon of rock material can be explained well by the proposed criterion. The results of conventional and true triaxial tests can verify the criterion well. Finally, the criterion is compared with the Mohr–Coulomb and Drucker–Prager criteria.