bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods of risk minimization in investment and construction projects
Authors: Sukhorukova I V , Maksimov D A , Fomin G P
Published: October 2020

The paper puts forward a hypothesis about the possible integration of risk assessment methods in order to minimize them in investment and construction projects, for that the problems of risk minimization in the management and implementation of construction projects are considered. A critical review of existing methods of risk analysis is carried out and a method of risk minimization is proposed based on the creation of a “Construction risk Informatoria” and methods for optimizing the reallocation of resources according to the minimum time criterion, which determines the risk of lost profits. The example of the use of risk minimization methods in the optimization procedure for network models of low-rise building construction is given, and the composition of the application of mathematical methods and models that contribute to increasing the economic effect in this area is described. As a result, effective recommendations were developed in the form of tools for monitoring the dynamics of construction work to prevent risk situations.
Plasters with wood processing waste additives
Authors: Drozdyuk T A , Sokolova Yu V , Makhova T A
Published: October 2020

The paper assesses the influence of additives based on wood processing industry waste on the physical and mechanical properties of plasters. As additives to the plaster, the bark and sawdust of Scots pine were used, previously crushed and purified from extractive and easily hydrolysable substances. Extraction of extractive substances from wood processing waste was performed by hot water extraction. The content of additives was in the range from 1.5 to 6 % by weight of cement. The average density, compressive strength, flexural tensile strength, water absorption, and thermal conductivity were monitored for the obtained samples of plasters. As a result of the carried out experiments, it was found that the quantitative increase of the additive in the mixture reduces the density of the mortar, water absorption increases slightly, the coefficient of thermal conductivity and the tensile strength during bending decreases. The compressive strength increases with the addition of sawdust 1.5 %, in other cases it decreases with the increase in the amount of the additive. It is shown that mortars with the addition of fine wood processing waste can be used as plasters with reduced thermal conductivity for interior work.
Properties of phosphogypsum as technogenic soil
Authors: Saenko Yu V , Shiranov A M , Nevzorov A L
Published: October 2020

Phosphogypsum (CaSO4·2H2O) is heavy tonnage waste generated by binding calcium in the process of sulfuric acid decomposition of phosphate raw materials when obtaining wet-process phosphoric acid in the production of phosphate fertilizers. In appearance, it is solid fine-crystalline substance of white or gray color with inclusions of large aggregates. The paper presents the results of laboratory studies of more than 390 samples of phosphogypsum neutralized with construction lime. The deformation and strength properties as well as the water permeability were determined on specially prepared samples with the relative compaction of 0.95, 0.90 and 0.80 by methods used in engineering and geological surveys. While the angle of internal friction, the cohesion and the coefficient of permeability of the phosphogypsum have the values typical for fine or silty sands, the compressibility characteristics are significantly worse due to the solubility of the particles. Phosphogypsum is characterized by subsidence and suffusion settling, which are proper for carbonate rocks (dolomite, limestone). The use of the phosphogypsum as ground is possible for subbase of roads with low traffic intensity with a gravel pavement, for dams at industrial solid waste storage facilities, as well as for engineering reclamation of those storage facilities, but only if implementing water protection measures.
The newly laboratory equipment for exploring of freezing and thawing soils
Authors: Korshunov A A , Churkin S V , Nevzorov A L
Published: October 2020

Frost heaving is a challenge for geotechnical engineers in cold climate. Frost heave depends on two factors: the freezing rate and the velocity of water migration from unfrozen to frozen soil. The article deals with the existing apparatus for exploring frost heave which are systematized according to their purpose (measured parameters), design features and experimental conditions. The authors proposed the ways for improving laboratory equipment and presented newly developed apparatus for studying both the frost heaving and its consequences. The article presents apparatuses that allow controlling the freezing rate of soils by step-by-step movement of the freezing cell along the sample and providing even movement of the frost front in center and edges of the soil sample. Control of water migration to the frost front is carried out by making a vacuum in a base plate or using a porous item with a given water permeability. To study the impact of cyclic freezing-thawing on water permeability both along and across the cryogenic texture the authors developed a special apparatus in which horizontal permeability test is performed through the perforated double walls of multi-ring cell, vertical test-through bottom and top porous discs.
A novel approach for coverings transformation to define a robot workspace
Authors: Rybak L A , Behera L , Averbukh M A , Sapryka A V
Published: October 2020

The article discusses the application of optimization algorithms to solve the problem of determining the workspace of robots. The development of a numerical method for approximating the set of solutions of a system of nonlinear inequalities that describe the restrictions on the geometric parameters of a robot based on the concept of non-uniform coverings is considered. An approach is proposed that allows you to reduce the number of boxes and numbers describing each of the boxes. Reducing the number of boxes is achieved by combining the boundary boxes of the covering set and the area between them along one of the axes. The dimensions along the other axes are equal for all boxes, which allows them to be described by one number. The transition to the integer space is described. Thus, converting non-uniform covering sets to a partially ordered set of integers reduces computational complexity. An algorithm for converting boxes of a covering set is presented. The approach has been tested for a 3-RPS robot.
Effects of Thermal Diffusivity Analysis after Irradiation
Authors: Willie Ahli K. D. , Zhao Hongtao , Svetlana Teplinskaya
Published: October 2020

The diffusion calculation gives a vivid understanding as to what happens in the SiC-cladded material. Molecular Dynamics (MD) and Molecular Statics are being employed to study the diffusion coefficient phenomena. The MD simulations in this study are been built on the ZBL potential. In this work we initially applied the MD simulation for minimization within the temperature range of 1000-3000 K. Then the MOX fuel is then used to perform assessment of radiation damage by ions at burnup temperatures as well. Various chemical states are developed depending on the condition of the fuel. Within the fuel lattice the O atoms break bonds with the U-Pu atoms at higher temperature. The very short diffusion lengths mechanisms results were obtained measured for uranium atom over the course of this 300ps simulation.
Application of Date Palm Ash to Improve Strength Characteristics of Sabkha Soil
Authors: Abbas Kazmi Zaheer
Published: October 2020

Surface layer of earth’s crust in Kingdom of Saudi Arabia is composed of loose sand with soluble salts, which is generally termed as Sabkha. Poor strength and durability characteristics of the Sabkha soil adversely challenge the safety and serviceability of infrastructure built on it. Therefore, improvement of its physical properties demands urgent attention of the engineering society. In this study, date palm ash (DPA), a local industrial waste, is utilized as an additive to improve strength characteristics of problematic Sabkha soil. A remarkable improvement in compaction characteristics and compressive strength is achieved. By investigating the effect of different proportions, the optimum quantity of additive is determined with respect to compressive strength.
Evaluation of the energy driving performance of a cooling system assembled with a Peltier module operated in hot climates at different electrical currents
Authors: Jimenez-Rodriguez David J. , Sanchez-Ramos Carlos A. , Palma-Ramirez Diana , Carlos Paredes-Rojas Juan , Flores-Vela Abelardo I. , Marquez-Rocha Facundo J.
Published: October 2020

Peltier devices have two sides with two different temperatures when an electrical current is applied through it. In the hot side, heat is dissipated and in the cool side, heat is absorbed, requiring additional electrical current to decrease heat absorption, primarily in hot climates. In this work, a block model was design with a Simulink tool of Matlab software to analyze thermal performance of a Peltier module in hot-imitate climate at different electric current levels. Through this model, it would be possible to evaluate the operating conditions of different control systems for Peltier applications, such as energy optimization in human thermal comfort devises, for sports, mobility, and medical care applications.
A screening strategy for hot forging combining high-throughput forging experiment and machine learning
Authors: Sun Zhiren , Wang Kaikun
Published: October 2020

In this study, we proposed a screening strategy of processing conditions for hot forging based on high-throughput experiment equipment, numerical simulation, and machine learning to obtain the optimal conditions for the forging process. Nikle based superalloy IN718 was selected as an application case. We designed high-throughput experiment equipment for hot forging. Numerical simulation of the forging process on the equipment was studied, and a database of 625 examples was obtained. Two BP NN models for average grain size and maximum principal stress predictions, respectively, were trained. These two BP NN models were used to search different processing conditions in searching space consisting of 1 206 000 processing conditions, and an algorithm was designed to screen the processing conditions comprehensively considering the average grain size and the maximum principal stress in the bulge zone. The optimal conditions for different forging displacements were obtained. Compared with the traditional high-cost and time-consuming trial-and-error methods, the method proposed in this paper to optimize the processing technology has significant advantages. This method can be applied to pre-screening for material design and process optimization.
Microstructure and mechanical properties of Sn–58Bi eutectic alloy with Cu/P addition
Authors: Li Mingmao , Tang Yingying , Li Zhaoxin , Zhu Mingbiao , Wang Wenjing
Published: October 2020

Sn–(58-x) Bi–x Cu/P ternary alloys were prepared by downward continuous casting, and the microstructure of the alloy was characterized using scanning electron microscopy (SEM), x-ray diffractometry (XRD) and differential scanning calorimetry (DSC). The results show that the addition of Cu and P can refine the eutectic structure and form rod-shaped Cu6Sn5 and P3Sn4 phases distributed in Sn matrix. The refined eutectic structure can be observed in Sn–(58-x) Bi–x Cu/P alloys, and this results in the elongation at break increases up. In addition, the wettability of Sn–58Bi alloy increases on Cu substrate with the addition of Cu and P elements. The improvement of the wettability of Sn–58Bi alloy by the addition of Cu element can be attributed to the increase of Cu-Sn IMC nucleation and growth rate. The addition of P element in Sn–58Bi alloy can improve its anti-oxidation performance, which is beneficial to the improvement of its wettability.
Disseminated Effects in Agent-Based Models: A Potential Outcomes Framework and Application to Inform Preexposure Prophylaxis Coverage Levels for HIV Prevention
Authors: Buchanan Ashley L , Bessey S , Goedel William C , King Maximilian , Murray Eleanor J , Friedman Samuel R , Halloran M Elizabeth , Marshall Brandon D L
Published: October 2020

Preexposure prophylaxis (PrEP) for prevention of human immunodeficiency virus (HIV) infection may benefit not only the person who uses it but also their uninfected sexual risk contacts. We developed an agent-based model using a novel trial emulation approach to quantify disseminated effects of PrEP use among men who have sex with men in Atlanta, Georgia, from 2015 to 2017. Model components (subsets of agents connected through partnerships in a sexual network but not sharing partnerships with any other agents) were first randomized to an intervention coverage level or the control group; then, within intervention components, eligible agents were randomized to receive or not receive PrEP. We calculated direct and disseminated (indirect) effects using randomization-based estimators and report corresponding 95% simulation intervals across scenarios ranging from 10% coverage in the intervention components to 90% coverage. A population of 11,245 agents was simulated, with an average of 1,551 components identified. When comparing agents randomized to no PrEP in 70% coverage components with control agents, there was a 15% disseminated risk reduction in HIV incidence (risk ratio = 0.85, 95% simulation interval: 0.65, 1.05). Persons not on PrEP may receive a protective benefit by being in a sexual network with higher PrEP coverage. Agent-based models are useful for evaluating possible direct and disseminated effects of HIV prevention modalities in sexual networks.
Comparing New-User Cohort Designs: The Example of Proton Pump Inhibitor Effectiveness in Idiopathic Pulmonary Fibrosis
Authors: Tran Tanja , Suissa Samy
Published: October 2020

The prevalent new-user cohort design is useful for assessing the effectiveness of a medication in the absence of an active comparator. Alternative approaches, particularly in the presence of informative censoring, include a variant of this design based on never users of the study drug and the marginal structural Cox model approach. We compared these approaches in assessing the effectiveness of proton pump inhibitors (PPIs) in reducing mortality among patients with idiopathic pulmonary fibrosis (IPF) using a cohort of IPF patients identified in the United Kingdom’s Clinical Practice Research Datalink and diagnosed between 2003 and 2016. The cohort included 2,944 IPF patients, 1,916 of whom initiated use of PPIs during follow-up. There were 2,136 deaths (mortality rate = 25.8 per 100 person-years). Using the conventional prevalent new-user design, we found a hazard ratio for death associated with PPI use compared with nonuse of 1.07 (95% confidence interval (CI): 0.94, 1.22). The variant of the prevalent new-user design comparing PPI users with never users found a hazard ratio of 0.82 (95% CI: 0.73, 0.91), while the marginal structural Cox model found a hazard ratio of 1.08 (95% CI: 0.85, 1.38). The marginal structural model and the conventional prevalent new-user design, both accounting for informative censoring, produced similar results. However, the prevalent new-user design variant based on never users introduced selection bias and should be avoided.
Development and Validation of a Pediatric Comorbidity Index
Authors: Sun Jenny W , Bourgeois Florence T , Haneuse Sebastien , Hernández-Díaz Sonia , Landon Joan E , Bateman Brian T , Huybrechts Krista F
Published: October 2020

Comorbidity scores are widely used to help address confounding bias in nonrandomized studies conducted within health-care databases, but existing scores were developed to predict all-cause mortality in adults and might not be appropriate for use in pediatric studies. We developed and validated a pediatric comorbidity index, using health-care utilization data from the tenth revision of the International Classification of Diseases. Within the MarketScan database of US commercial claims data, pediatric patients (aged ≤18 years) continuously enrolled between October 1, 2015, and September 30, 2017, were identified. Logistic regression was used to predict the 1-year risk of hospitalization based on 27 predefined conditions and empirically identified conditions derived from the most prevalent diagnoses among patients with the outcome. A single numerical index was created by assigning weights to each condition based on its β coefficient. We conducted internal validation of the index and compared its performance with existing adult scores. The pediatric comorbidity index consisted of 24 conditions and achieved a C statistic of 0.718 (95% confidence interval (CI): 0.714, 0.723). The index outperformed existing adult scores in a pediatric population (C statistics ranging from 0.522 to 0.640). The pediatric comorbidity index provides a summary measure of disease burden and can be used for risk adjustment in epidemiologic studies of pediatric patients.
Characteristics of US Adults Who Would Be Recommended for Lifestyle Modification Without Antihypertensive Medication to Manage Blood Pressure
Authors: Jackson Sandra L , Park Soyoun , Loustalot Fleetwood , Thompson-Paul Angela M , Hong Yuling , Ritchey Matthew D
Published: October 2020

Background

The 2017 American College of Cardiology / American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated BP or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their cardiovascular disease risk factors, barriers to lifestyle modification, and healthcare access.

METHODS

This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013–2016, on 10,205 US adults aged ≥18, among whom 2,081 had elevated BP or stage 1 hypertension and met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone.

RESULTS

An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low-quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%–60%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06–1.38), reduce sodium intake (2.33, 2.00–2.72), or exercise more (1.60, 1.32–1.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year.

Conclusions

One-fifth of US adults met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.
Chapter Two Didymus and lyric
Authors: Prodi Enrico Emanuele
Published: October 2020

Didymus worked extensively on archaic lyric poetry. The greatest amount of surviving material comes from the Pindar scholia and concerns Pindar’s Epinicians, but there are fragments and testimonies of his commentaries to other authors and a treatise On Lyric Poets. This chapter reviews the evidence for Didymus’ lyric scholarship, then discusses the contents of the On Lyric Poets—whose surviving fragments are concerned with the identification of lyric genres and the etymologies of their names—and the threads that run through his Pindaric exegesis: the compilation and evaluation of earlier scholarship, the use of historiographical evidence, textual criticism, a concern for the constitution of the Pindaric corpus and the contextualization of individual poems, and strategies of literary interpretation such as recourse to recurrent Pindaric themes and the train of thought of a passage.
ALeS: adaptive-length spaced-seed design
Authors: Mallik Arnab , Ilie Lucian
Published: October 2020

Motivation

Sequence similarity is the most frequently used procedure in biological research, as proved by the widely used BLAST program. The consecutive seed used by BLAST can be dramatically improved by considering multiple spaced seeds. Finding the best seeds is a hard problem and much effort went into developing heuristic algorithms and software for designing highly sensitive spaced seeds.

Results

We introduce a new algorithm and software, ALeS, that produces more sensitive seeds than the current state-of-the-art programs, as shown by extensive testing. We also accurately estimate the sensitivity of a seed, enabling its computation for arbitrary seeds.

Availabilityand implementation

The source code is freely available at github.com/lucian-ilie/ALeS.

Supplementary information

Supplementary data are available at Bioinformatics online.
Maximum likelihood estimation for semiparametric regression models with panel count data
Authors: Zeng Donglin , Lin D Y
Published: October 2020

Panel count data, in which the observation for each study subject consists of the number of recurrent events between successive examinations, are commonly encountered in industrial reliability testing, medical research and other scientific investigations. We formulate the effects of potentially time-dependent covariates on one or more types of recurrent events through nonhomogeneous Poisson processes with random effects. We employ nonparametric maximum likelihood estimation under arbitrary examination schemes, and develop a simple and stable EM algorithm. We show that the resulting estimators of the regression parameters are consistent and asymptotically normal, with a covariance matrix that achieves the semiparametric efficiency bound and can be estimated using profile likelihood. We evaluate the performance of the proposed methods through simulation studies and analysis of data from a skin cancer clinical trial.
A novel clinical nomogram for the evaluation of disorders of plasma osmolality
Authors: Voets Philip J G M , Vogtländer Nils P J , Kaasjager Karin A H
Published: October 2020

Disorders of water and sodium homeostasis in the human body—or dysnatraemias—are frequently encountered in clinical practice, but their analysis is often complex and their management is often troublesome. For many clinicians, it remains challenging to correctly interpret all relevant biochemical parameters involved in the analysis of dysnatraemia, especially when a rapid ‘bedside’ evaluation is required to initiate treatment. By mathematically deriving the relationship between plasma osmolality and urine osmolality under physiological circumstances, we were able to propose a novel and clinically useful nomogram for the rapid evaluation of disorders of plasma osmolality. We believe that the presented osmolality nomogram could be a transparent and clinically useful tool for the quick evaluation of disorders of the water and sodium balance in patients.
Gill slits provide a window into the respiratory physiology of sharks
Authors: VanderWright Wade J , Bigman Jennifer S , Elcombe Cayley F , Dulvy Nicholas K
Published: October 2020

Metabolically important traits, such as gill surface area and metabolic rate, underpin life histories, population dynamics and extinction risk, as they govern the availability of energy for growth, survival and reproduction. Estimating both gill surface area and metabolic rate can be challenging, especially when working with large-bodied, threatened species. Ideally, these traits, and respiratory physiology in general, could be inferred from external morphology using a faster, non-lethal method. Gill slit height is quick to measure on live organisms and is anatomically connected to the gill arch. Here, we relate gill slit height and gill surface area for five Carcharhiniform sharks. We compared both total and parabranchial gill surface area to mean and individual gill slit height in physical specimens. We also compared empirical measurements of relative gill slit height (i.e. in proportion to total length) to those estimated from field guide illustrations to examine the potential of using anatomical drawings to measure gill slit height. We find strong positive relationships between gill slit height and gill surface area at two scales: (i) for total gill surface area and mean gill slit height across species and (ii) for parabranchial gill surface area and individual gill slit height within and across species. We also find that gill slit height is a consistent proportion of the fork length of physical specimens. Consequently, relative gill slit height measured from field guide illustrations proved to be surprisingly comparable to those measured from physical specimens. While the generality of our findings needs to be evaluated across a wider range of taxonomy and ecological lifestyles, they offer the opportunity that we might only need to go to the library and measure field guide illustrations to yield a non-lethal, first-order approximation of the respiratory physiology of sharks.
Evaluating physiology of a human heart during ventricular tachycardia: new insights of mechanical alterations via beat to beat strain analysis—case report
Authors: Wedekind Georg , Schröder Stephen
Published: October 2020

Background

Ventricular tachycardia can be triggered by myocardial ischaemia. These often fatal events are nearly always accompanied by a significant circulatory depression. However, the exact mechanical alterations and mechanisms of adaption during such arrhythmia episodes are still unknown.

Case summary

We report on a 71-year-old male patient with a distinct cardiovascular risk profile, recurrent incidences of dizziness and palpitations. A Holter electrocardiogram was performed showing multiple episodes of ventricular tachycardia. He was immediately transferred to our hospital for further monitoring and diagnostics. During echocardiography, one of these episodes could be recorded with a four-dimensional (4D) probe in triplane acquisition mode and strain analysis was done. Afterwards, a heart catheter examination was performed. A one-vessel coronary heart disease was diagnosed and treated with three drug-eluting stents. The burden of non-sustained ventricular tachycardia (nsVT) significantly reduced post-procedure. During the follow-up, new episodes of nsVT occurred after 6 weeks, which were treated by electrophysiological examinations.

Discussion

Modern 4D echocardiography machines offer the possibility to visualize the entire heart simultaneously. Thus ventricular arrhythmias can be evaluated using off-line strain analysis. This technology allows new real-time insights into the human heart showing compensatory mechanisms to overcome stressful episodes, such as ventricular tachycardia.
Composition, structure, and function of heart teams: a joint position paper of the ACVC, EAPCI, EACTS, and EACTA focused on the management of patients with complex coronary artery disease requiring myocardial revascularization
Authors: Leonardi Sergio , Capodanno Davide , Sousa-Uva Miguel , Vrints Christiaan , Rex Steffen , Guarracino Fabio , Bueno Héctor , Lettino Maddalena , Price Susanna , Valgimigli Marco , Jeppsson Anders
Published: October 2020

Contemporary cardiovascular medicine is complex, dynamic, and interactive. Therefore, multidisciplinary dialogue between different specialists is required to deliver optimal and patient-centred care. This has led to the concept of explicit collaborations of different specialists caring for patients with complex cardiovascular diseases—that is ‘heart teams’. These teams are particularly valuable to minimize referral bias and improve guideline adherence as so to be responsive to patient preferences, needs, and values but may be challenging to coordinate, especially in the acute setting. This position paper—jointly developed by four cardiovascular associations—is intended to provide conceptual and practical considerations for the composition, structure, and function of multidisciplinary teams. It focuses on patients with complex coronary artery diseases in both elective and urgent setting and provide guidance on how to implement the heart team both in chronic and in acute coronary syndromes patients, including cases with mechanical complications and haemodynamic instability; it also discusses strategies for clear and transparent patient communication and provision of a patient-centric approach. Finally, gaps in evidence and research perspectives in this context are discussed.
External validation of six existing multivariable clinical prediction models for short-term mortality in patients undergoing lung resection
Authors: Taylor Marcus , Szafron Bartłomiej , Martin Glen P , Abah Udo , Smith Matthew , Shackcloth Michael , Granato Felice , Shah Rajesh , Grant Stuart W ,   the North West Thoracic Surgery Collaborative (NWTSC), Eadington Thomas , Argus Leah , Michael Sarah , Mason Sabrina , Bhullar Dilraj , Obale Emmanuel , Fritsch Nils Cristopher , Shah Rajesh , Krysiak Piotr , Rammohan Kandadai , Fontaine Eustace , Granato Felice , Page Richard , Woolley Steven , Shackcloth Michael , Assante-Siaw Julius , Mediratta Neeraj
Published: October 2020

OBJECTIVES

National guidelines advocate the use of clinical prediction models to estimate perioperative mortality for patients undergoing lung resection. Several models have been developed that may potentially be useful but contemporary external validation studies are lacking. The aim of this study was to validate existing models in a multicentre patient cohort.

METHODS

The Thoracoscore, Modified Thoracoscore, Eurolung, Modified Eurolung, European Society Objective Score and Brunelli models were validated using a database of 6600 patients who underwent lung resection between 2012 and 2018. Models were validated for in-hospital or 30-day mortality (depending on intended outcome of each model) and also for 90-day mortality. Model calibration (calibration intercept, calibration slope, observed to expected ratio and calibration plots) and discrimination (area under receiver operating characteristic curve) were assessed as measures of model performance.

RESULTS

Mean age was 66.8 years (±10.9 years) and 49.7% (n = 3281) of patients were male. In-hospital, 30-day, perioperative (in-hospital or 30-day) and 90-day mortality were 1.5% (n = 99), 1.4% (n = 93), 1.8% (n = 121) and 3.1% (n = 204), respectively. Model area under the receiver operating characteristic curves ranged from 0.67 to 0.73. Calibration was inadequate in five models and mortality was significantly overestimated in five models. No model was able to adequately predict 90-day mortality.

CONCLUSIONS

Five of the validated models were poorly calibrated and had inadequate discriminatory ability. The modified Eurolung model demonstrated adequate statistical performance but lacked clinical validity. Development of accurate models that can be used to estimate the contemporary risk of lung resection is required.
Impact of oral-health-related quality of life and self-esteem on patients with missing maxillary lateral incisor after orthodontic space closure: a single-blinded, randomized, controlled trial
Authors: Pithon Matheus Melo , Vargas Eduardo Otero Amaral , da Silva Coqueiro Raildo , Lacerda-Santos Rogério , Tanaka Orlando Motohiro , Maia Lucianne Cople
Published: October 2020

Background

The maxillary lateral incisor is one of the teeth most likely to suffer agenesis, resulting in spacing between the central incisor and the canine.

Objective

To compare maxillary lateral incisor agenesis with space closure treatment versus non-treatment based on measurements of the self-perceived oral-health-related quality of life (OHRQoL) and self-esteem of the participants.

Subjects and methods

A total of 44 people, aged 17–49 years, with missing lateral incisors were randomly assigned to two groups (n = 22 in each)—a treated group in which the space was orthodontically closed (TG) and a control group that remained untreated (CG). Randomization was performed by a researcher who was not involved in the clinical part of the study. The outcomes were assessed using the Oral Health Impact Profile and Rosenberg’s Self-Esteem Scale, which were applied before (phase 1) and after (phase 2) the orthodontic treatment in the TG, and at baseline (phase 1) and 12 months after (phase 2) in the CG. All the data were blindly evaluated, supporting the single-blinded design of the study.

Results

All participants finished the randomized controlled trial, and the demographic characteristics were similar between the groups. In phase 1, the levels of self-esteem and OHRQoL at baseline were similar (P = 0.079, P = 0.693, respectively). In phase 2, the self-esteem scores of the CG decreased and the OHRQoL increased (P = 0.005, P < 0.001, respectively), while self-esteem increased in the TG and the OHRQoL decreased (P < 0.001). The CG had lower scores than the TG for self-esteem, but the opposite was observed for OHRQoL (P < 0.001).

Limitations

Information bias may have occurred. Since the questionnaires could not have been applied at the same time in both groups, the time difference between the two assessments may have led to random and systematic error.

Conclusions

The spacing resulting from missing maxillary lateral incisors had a negative impact on the OHRQoL and self-esteem of the participants, while orthodontically closing those spaces had a positive impact on those aspects.

Clinical trial registration

This study was not registered.

Protocol

The protocol was not published before trial commencement.
Witnessing interparental violence in childhood and symptoms of depression in adulthood: data from the 2017 French Health Barometer
Authors: Roland Noemie , Leon Christophe , du Roscoat Enguerrand , Panjo Henri , Saurel-Cubizolles Marie-Josephe , Ringa Virginie
Published: October 2020

Background

Every year, it is estimated that 143 000 French children are exposed to interparental violence (IPV). This exposure may have deleterious lifelong impact on mental health.

Objective

To investigate the associations between exposure to IPV in childhood and, as adults, the presence of depressive symptoms during the past year, suicidal thoughts and lifetime suicide attempt.

Methods

Our study is based on data from the 2017 French Health Barometer, a general population cross-sectional phone survey. 25 319 adults living in Metropolitan France responded. Data were weighted to obtain a representative sample of the French population. Associations between childhood exposure to IPV and each of three outcomes in adulthood—symptoms of depression, suicidal ideation in the past year and lifetime suicide attempt—were studied by calculating odds ratios (ORs) and their 95% confidence intervals (CIs), stratifying by sex and using multivariate models (logistic regression).

Results

After adjustment for age, social variables, negative life events in childhood and lifetime history of sexual violence, reporting witnessed IPV is significantly associated with the presence of symptoms of depression during the past 12 months (aORmen = 1.88, 95% CI = 1.49–2.38, and aORwomen = 2.00, 1.72–2.32), suicidal thoughts in the past 12 months (aORmen = 1.97, 1.48–2.64, and aORwomen = 2.35, 1.89–2.93), and at least one lifetime suicide attempt (aORmen =2.39, 1.83–3.11 and aORwomen = 2.66, 2.25–3.16).

Conclusion

Associations shown between a history of exposure to IPV and three mental health indicators in adulthood underline the need to study the lifelong impact of IPV.
The Impact of Intestinal Complications on Health Care Costs Among Patients With Inflammatory Bowel Disease Treated With Anti-Tumor Necrosis Factor Therapies
Authors: Rubin David T , Griffith Jenny , Zhang Qisu , Hepp Zsolt , Keshishian Allison
Published: October 2020

Background

Although there is evidence that anti-tumor necrosis factor (TNF) utilization earlier in the inflammatory bowel disease (IBD) course and before the onset of disease-related complications leads to improved patient outcomes, the health care costs and utilization impact have not been well defined. This study assessed differences in health care utilization and costs among patients with IBD treated with anti-TNFs.

Methods

Patients with a diagnosis of ulcerative colitis (UC) or Crohn disease (CD) between January 1, 2001, and December 31, 2014, were identified from a claims database. Patients were required to have ≥1 claim for a 5-aminosalicylic acid, corticosteroid, or immunomodulator after the IBD diagnosis and ≥1 anti-TNF drug claim after the first IBD treatment. Complication and noncomplication cohorts were identified based on disease-related complications and IBD-related hospitalizations or emergency department visits for 6 months before anti-TNF initiation. Generalized linear models were used to compare health care costs and utilization for the 12 months after anti-TNF initiation (follow-up).

Results

The study included 6329 patients with CD and 4451 patients with UC. In patients with CD with complications, >33.7% had intestinal strictures and 6% had enteroenteric fistula before anti-TNF treatment. Patients with CD with complications incurred significantly higher IBD-related and all-cause health care costs during follow-up, and patients with UC experienced the same trends.

Conclusions

These results suggest that anti-TNF treatment after, rather than before, a patient develops complications leads to a higher economic burden. However, these findings could also result from patients with more severe disease having early complications that are more difficult to treat.
Patient-specific computational fluid dynamics analysis of transcatheter aortic root replacement with chimney coronary grafts
Authors: Conti Michele , Romarowski Rodrigo M , Ferrarini Anna , Stochino Matteo , Auricchio Ferdinando , Morganti Simone , Segesser Ludwig Karl von , Ferrari Enrico
Published: October 2020

OBJECTIVES

Transcatheter aortic root repair (TARR) consists of the simultaneous endovascular replacement of the aortic valve, the root and the proximal ascending aorta. The aim of the study is to set-up a computational model of TARR to explore the impact of the endovascular procedure on the coronary circulation supported by chimney grafts.

METHODS

Computed tomography of a patient with dilated ascending aorta was segmented to obtain a 3-dimensional representation of the proximal thoracic aorta, including aortic root and supra-aortic branches. Computed assisted design tools were used to modify the geometry to create the post-procedural TARR configuration featuring the main aortic endograft integrated with 2 chimney grafts for coronary circulation. Computational Fluid Dynamics simulations were run in both pre- and post-procedural configurations using a pulsatile inflow and lumped parameter models at the outflows to simulate peripheral aortic and coronary circulation. Differences in coronary flow and pressure along the cardiac cycle were evaluated.

RESULTS

After the virtual implant of the TARR device with coronary grafts, the flow became more organized and less recirculation was seen in the ascending aorta. Coronary perfusion was guaranteed with negligible flow differences between pre- and post-procedural configurations. However, despite being well perfused by chimney grafts, the procedure induces an increase of the pressure drop between the coronary ostia and the ascending aorta of 8 mmHg.

CONCLUSIONS

The proposed numerical simulations, in the specific case under investigation, suggest that the TARR technique maintains coronary perfusion through the chimney grafts. This study calls for experimental validation and further analyses of the impact of TARR on cardiac afterload, decrease of aortic compliance and local pressure drop induced by the coronary chimney grafts.
A Tale of Two Countries: The Effectiveness of List Experiments to Measure Drug Consumption in Opposite Contexts
Authors: García-Sánchez Miguel , Queirolo Rosario
Published: October 2020

The utility of list experiments in overcoming social desirability bias in surveys may be conditioned on social contexts. Sensitive issues in some countries may be less delicate in others, as with the case of drug use. We test this argument using a list experiment to measure marijuana use in two countries that differ in terms of social progressiveness: Colombia and Uruguay. Using nationally representative samples, we find no differences between the direct and indirect measures of marijuana use in liberal Uruguay, whereas in Colombia, the list experiment failed to produce an estimate of marijuana use. Therefore, social contexts affect the capacity of list experiments to elicit valid estimates.
Optimizing preventive maintenance over a finite planning horizon in a semi-Markov framework
Authors: Sánchez Herguedas Antonio , Crespo Márquez Adolfo , Rodrigo Muñoz Francisco
Published: October 2020

This paper describes the optimization of preventive maintenance (PM) over a finite planning horizon in a semi-Markov framework. In this framework, the asset may be operating, and providing income for the asset owner, or not operating and undergoing PM, or not operating and undergoing corrective maintenance following failure. PM is triggered when the asset has been operating for τ time units. A number m of transitions specifies the finite horizon. This system is described with a set of recurrence relations, and their z-transform is used to determine the value of τ that maximizes the average accumulated reward over the horizon. We study under what conditions a solution can be found, and for those specific cases the solution τ* is calculated. Despite the complexity of the mathematical solution, the result obtained allows the analyst to provide a quick and easy-to-use tool for practical application in many real-world cases. To demonstrate this, the method has been implemented for a case study, and its accuracy and practical implementation were tested using Monte Carlo simulation and direct calculation.
Changing Prevalence of Potential Mediators of Aminoquinoline, Antifolate, and Artemisinin Resistance Across Uganda
Authors: Asua Victor , Conrad Melissa D , Aydemir Ozkan , Duvalsaint Marvin , Legac Jennifer , Duarte Elias , Tumwebaze Patrick , Chin Deborah M , Cooper Roland A , Yeka Adoke , Kamya Moses R , Dorsey Grant , Nsobya Sam L , Bailey Jeffrey , Rosenthal Philip J
Published: October 2020

Background

In Uganda, artemether-lumefantrine is recommended for malaria treatment and sulfadoxine-pyrimethamine for chemoprevention during pregnancy, but drug resistance may limit efficacies.

Methods

Genetic polymorphisms associated with sensitivities to key drugs were characterized in samples collected from 16 sites across Uganda in 2018 and 2019 by ligase detection reaction fluorescent microsphere, molecular inversion probe, dideoxy sequencing, and quantitative polymerase chain reaction assays.

Results

Considering transporter polymorphisms associated with resistance to aminoquinolines, the prevalence of Plasmodium falciparum chloroquine resistance transporter (PfCRT) 76T decreased, but varied markedly between sites (0–46% in 2018; 0–23% in 2019); additional PfCRT polymorphisms and plasmepsin-2/3 amplifications associated elsewhere with resistance to piperaquine were not seen. For P. falciparum multidrug resistance protein 1, in 2019 the 86Y mutation was absent at all sites, the 1246Y mutation had prevalence ≤20% at 14 of 16 sites, and gene amplification was not seen. Considering mutations associated with high-level sulfadoxine-pyrimethamine resistance, prevalences of P. falciparum dihydrofolate reductase 164L (up to 80%) and dihydropteroate synthase 581G (up to 67%) were high at multiple sites. Considering P. falciparum kelch protein propeller domain mutations associated with artemisinin delayed clearance, prevalence of the 469Y and 675V mutations has increased at multiple sites in northern Uganda (up to 23% and 41%, respectively).

Conclusions

We demonstrate concerning spread of mutations that may limit efficacies of key antimalarial drugs.
Current Capabilities of Gut Microbiome–Based Diagnostics and the Promise of Clinical Application
Authors: Damhorst Gregory L , Adelman Max W , Woodworth Michael H , Kraft Colleen S
Published: October 2020

There is increasing evidence for the importance of the gut microbiome in human health and disease. Traditional and modern technologies - from cell culture to next generation sequencing - have facilitated these advances in knowledge. Each of the tools employed in measuring the microbiome exhibits unique capabilities that may be leveraged for clinical diagnostics. However, much still needs to be done to standardize the language and metrics by which a microbiome is characterized. Here we review the capabilities of gut microbiome-based diagnostics, review selected examples, and discuss the outlook towards clinical application.
The Cognitive Science of Religion and Islamic Theology: An Analysis Based on the Works of al-Ghazālī
Authors: Nakissa Aria
Published: October 2020

Specialists in Islamic studies have taken virtually no interest in the influential emerging field of cognitive science of religion (CSR). The present article addresses this problem by considering how insights from CSR can be used to reconceptualize classical Islamic theology. The article analyzes a number of theological topics, including predestination and the uncreated Qurʾān. However, it focuses on five key Islamic theological claims, namely (1) God is a single first cause who brings the universe into being; (2) God lacks an anthropomorphic body; (3) it is possible to arrive at some knowledge of God independently of scripture through human nature (fiṭra) and reason; (4) God is a bringer of benefit and harm, thereby rewarding, punishing, testing, and blessing human beings; and (5) prophethood exists and it is proven through miracles. In analyzing the preceding theological issues, the article utilizes the Arabic writings of the renowned medieval theologian Abū Ḥāmid al-Ghazālī.
Using indication embeddings to represent patient health for drug safety studies
Authors: Melamed Rachel D
Published: October 2020

Objective

The electronic health record is a rising resource for quantifying medical practice, discovering the adverse effects of drugs, and studying comparative effectiveness. One of the challenges of applying these methods to health care data is the high dimensionality of the health record. Methods to discover the effects of drugs in health data must account for tens of thousands of potentially relevant confounders. Our goal in this work is to reduce the dimensionality of the health data with the aim of accelerating the application of retrospective cohort studies to this data.

Materials and methods

Here, we develop indication embeddings, a way to reduce the dimensionality of health data while capturing information relevant to treatment decisions. We evaluate these embeddings using external data on drug indications. Then, we use the embeddings as a substitute for medical history to match patients and develop evaluation metrics for these matches.

Results

We demonstrate that these embeddings recover the therapeutic uses of drugs. We use embeddings as an informative representation of relationships between drugs, between health history events and drug prescriptions, and between patients at a particular time in their health history. We show that using embeddings to match cohorts improves the balance of the cohorts, even in terms of poorly measured risk factors like smoking.

Discussion and conclusion

Unlike other embeddings inspired by word2vec, indication embeddings are specifically designed to capture the medical history leading to the prescription of a new drug. For retrospective cohort studies, our low-dimensional representation helps in finding comparator drugs and constructing comparator cohorts.