bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of acute exacerbation of chronic obstructive pulmonary disease (COPD) recording in electronic health records: a systematic review protocol
Authors: Stone Philip , Sood Nikhil , Feary Johanna , Roberts C Michael , Quint Jennifer K
Published: February 2020

Introduction

Many patients with chronic obstructive pulmonary disease (COPD) experience a sustained worsening in symptoms termed an acute exacerbation (AECOPD). AECOPDs impact on patients’ quality of life and lung function, are costly to health services and are an important topic for research. Electronic health records (EHR) are increasingly being used to study AECOPD, requiring accurate detection of AECOPD in EHRs to ensure generalisable results. The aim of this protocol is to provide an overview of studies that validate AECOPD definitions used in EHRs and administrative claims databases.

Methods and analysis

Medline and Embase will be searched for terms related to COPD exacerbation, EHRs and validation. All studies published between 1 January 1990 and 30 September 2019 written in English that validate AECOPD in EHRs and administrative claims databases will be considered. Inclusion criteria: EHR data must be routinely collected; the AECOPD detection algorithm must be compared against a reference standard; and a measure of validity must be calculable. Two independent reviewers will screen articles for inclusion, extract study details and assess risk of bias using QUADAS-2. Disagreements will be resolved by consensus or arbitration by a third reviewer. This protocol has been developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist.

Ethics and dissemination

This will be a review of previously published literature therefore no ethical approval is required. Results from this review will be published in a peer-reviewed journal. The results can be used in future research to identify occurrences of AECOPD.

PROSPERO registration number

CRD42019130863.
Identifying challenges to implementation of clinical practice guidelines for sentinel lymph node biopsy in patients with melanoma in Australia: protocol paper for a mixed methods study
Authors: Rapport Frances , Smith Andrea L , Cust Anne E , Mann Graham J , Watts Caroline G , Gyorki David E , Henderson Michael , Hong Angela M , Kelly John W , Long Georgina V , Mar Victoria J , Morton Rachael L , Saw Robyn PM , Scolyer Richard A , Spillane Andrew J , Thompson John F , Braithwaite Jeffrey
Published: February 2020

Introduction

Sentinel lymph node biopsy (SLNB) is a diagnostic procedure developed in the 1990s. It is currently used to stage patients with primary cutaneous melanoma, provide prognostic information and guide management. The Australian Clinical Practice Guidelines state that SLNB should be considered for patients with cutaneous melanoma >1 mm in thickness (or >0.8 mm with high-risk pathology features). Until recently, sentinel lymph node (SLN) status was used to identify patients who might benefit from a completion lymph node dissection, a procedure that is no longer routinely recommended. SLN status is now also being used to identify patients who might benefit from systemic adjuvant therapies such as anti-programmed cell death 1 (PD1) checkpoint inhibitor immunotherapy or BRAF-directed molecular targeted therapy, treatments that have significantly improved relapse-free survival for patients with resected stage III melanoma and improved overall survival of patients with unresectable stage III and stage IV melanoma. Australian and international data indicate that approximately half of eligible patients receive an SLNB.

Methods and analysis

This mixed-methods study seeks to understand the structural, contextual and cultural factors affecting implementation of the SLNB guidelines. Data collection will include: (1) cross-sectional questionnaires and semistructured interviews with general practitioners and dermatologists; (2) semistructured interviews with other healthcare professionals involved in the diagnosis and early definitive care of melanoma patients and key stakeholders including researchers, representatives of professional colleges, training organisations and consumer melanoma groups; and (3) documentary analysis of documents from government, health services and non-government organisations. Descriptive analyses and multivariable regression models will be used to examine factors related to SLNB practices and attitudes. Qualitative data will be analysed using thematic analysis.

Ethics and dissemination

Ethics approval has been granted by the University of Sydney. Results will be disseminated through publications and presentations to clinicians, patients, policymakers and researchers and will inform the development of strategies for implementing SLNB guidelines in Australia.
Magnitude and determinants of road traffic accidents in Northern Ethiopia: a cross-sectional study
Authors: Woldu Awtachew Berhe , Desta Abraham Aregay , Woldearegay Tewolde Wubayehu
Published: February 2020

Objective

This study aimed to assess the magnitude and determinants of road traffic accidents (RTAs) in Mekelle city, Northern Ethiopia.

Methods

A cross-sectional study was done using a simple random sampling technique.

Setting

The study was done in Mekelle city from February to June 2015.

Participants

The study was done among drivers settled in Mekelle city.

Main outcome measures

The main outcome measure was occurrence of RTA within 2 years. A binary logistic regression was used to identify factors associated with RTA.

Results

The magnitude of RTA was found to be 23.17%. According to the drivers’ perceived cause of the accident, 22 (38.60%) of the accident was due to violation of traffic rules and regulations. The majority of the victims were pedestrians, 19 (33.33%). Drivers who were driving a governmental vehicle were 4.16 (adjusted OR (AOR) 4.16; 95% CI 1.48 to 11.70) times more likely to have RTA compared with those who drive private vehicles. Drivers who used alcohol were 2.29 (AOR 2.29; 95% CI 1.08 to 4.85) times more likely to have RTA compared with those drivers who did not consume alcohol.

Conclusion

Magnitude of reported road traffic accident was high. Violation of traffic laws, lack of vehicle maintenance and lack of general safety awareness on pedestrians were the dominant reported causes of RTAs. Driving a governmental vehicle and alcohol consumption were the factors associated with RTA. Monitoring blood alcohol level of drivers and regular awareness to the drivers should be in place. Holistic study should be done to identify the causes of RTAs.
Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis
Authors: Namasivayam Amrita , Lovell Sarah , Namutamba Sarah , Schluter Philip J
Published: February 2020

Objective(s)

Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.

Study design

A nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).

Setting

Uganda.

Participants

All women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.

Primary outcome measures

Modern contraceptive use.

Results

Overall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).

Conclusion(s)

Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.
Tunnelled peritoneal drainage catheter placement for the palliative management of refractory ascites in patients with liver cirrhosis
Authors: Corrigan Margaret , Thomas Rhodri , McDonagh Joanne , Speakman John , Abbas Nadir , Bardell Sara , Thompson Fiona , Holt Andrew , Jones Robert , Willis Andrew , Karkhanis Salil , Rajoriya Neil
Published: February 2020

Objective

Refractory ascites is an established indication for liver transplantation. While transplantation is regarded as the definitive therapy for this condition, many patients are unsuitable due to comorbidity or frailty. Alternatives such as transjugular intrahepatic portosystemic shunt (TIPSS) and large-volume paracentesis can lead to complications, including encephalopathy, circulatory and renal dysfunction, and protein–calorie deficiency that may accelerate sarcopenia. Cost and complication rates limit therapies such as alfapump. While there are data to support the use of indwelling catheters in the management of patients with malignant ascites, there is limited evidence to support their routine use in the context of end-stage liver cirrhosis. Here we describe our centres’ experience using indwelling tunnelled ascitic drains over a 6-year period.

Methods

A retrospective review of data (January 2012–May 2018) was undertaken for all patients with refractory ascites who underwent a tunnelled ascitic drain. Demographics, disease aetiology, procedure data and follow-up data were obtained through interrogation of electronic records and reports.

Results

Twenty-five drains were placed. All procedures were technically successful with no immediate complications. Six patients were readmitted following their index admission with abdominal pain and suspected infected ascites (although only two had a positive ascitic fluid culture). There were three cases of abdominal wall cellulitis and three of leakage around the tunnel site; all managed conservatively.

Conclusion

Indwelling drains appear an effective strategy for palliative management of select patients with liver cirrhosis complicated by refractory ascites who are not amenable to undergo TIPSS or transplantation. While complications can occur, these are most usually minor and can be managed on an outpatient basis.
Big data in IBD: big progress for clinical practice
Authors: Seyed Tabib Nasim Sadat , Madgwick Matthew , Sudhakar Padhmanand , Verstockt Bram , Korcsmaros Tamas , Vermeire Séverine
Published: February 2020

IBD is a complex multifactorial inflammatory disease of the gut driven by extrinsic and intrinsic factors, including host genetics, the immune system, environmental factors and the gut microbiome. Technological advancements such as next-generation sequencing, high-throughput omics data generation and molecular networks have catalysed IBD research. The advent of artificial intelligence, in particular, machine learning, and systems biology has opened the avenue for the efficient integration and interpretation of big datasets for discovering clinically translatable knowledge. In this narrative review, we discuss how big data integration and machine learning have been applied to translational IBD research. Approaches such as machine learning may enable patient stratification, prediction of disease progression and therapy responses for fine-tuning treatment options with positive impacts on cost, health and safety. We also outline the challenges and opportunities presented by machine learning and big data in clinical IBD research.
Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017
Authors: Haagsma Juanita A , Olij Branko F , Majdan Marek , van Beeck Ed F , Vos Theo , Castle Chris D , Dingels Zachary V , Fox Jack T , Hamilton Erin B , Liu Zichen , Roberts Nicholas L S , Sylte Dillon O , Aremu Olatunde , Bärnighausen Till Winfried , Borzì Antonio M , Briggs Andrew M , Carrero Juan J , Cooper Cyrus , El-Khatib Ziad , Ellingsen Christian Lycke , Fereshtehnejad Seyed-Mohammad , Filip Irina , Fischer Florian , Haro Josep Maria , Jonas Jost B , Kiadaliri Aliasghar A , Koyanagi Ai , Lunevicius Raimundas , Meretoja Tuomo J , Mohammed Shafiu , Pathak Ashish , Radfar Amir , Rawaf Salman , Rawaf David Laith , Riera Lidia Sanchez , Shiue Ivy , Vasankari Tommi Juhani , James Spencer L , Polinder Suzanne
Published: February 2020

Introduction

Falls in older aged adults are an important public health problem. Insight into differences in fall-related injury rates between countries can serve as important input for identifying and evaluating prevention strategies. The objectives of this study were to compare Global Burden of Disease (GBD) 2017 estimates on incidence, mortality and disability-adjusted life years (DALYs) due to fall-related injury in older adults across 22 countries in the Western European region and to examine changes over a 28-year period.

Methods

We performed a secondary database descriptive study using the GBD 2017 results on age-standardised fall-related injury in older adults aged 70 years and older in 22 countries from 1990 to 2017.

Results

In 2017, in the Western European region, 13 840 per 100 000 (uncertainty interval (UI) 11 837–16 113) older adults sought medical treatment for fall-related injury, ranging from 7594 per 100 000 (UI 6326–9032) in Greece to 19 796 per 100 000 (UI 15 536–24 233) in Norway. Since 1990, fall-related injury DALY rates showed little change for the whole region, but patterns varied widely between countries. Some countries (eg, Belgium and Netherlands) have lost their favourable positions due to an increasing fall-related injury burden of disease since 1990.

Conclusions

From 1990 to 2017, there was considerable variation in fall-related injury incidence, mortality, DALY rates and its composites in the 22 countries in the Western European region. It may be useful to assess which fall prevention measures have been taken in countries that showed continuous low or decreasing incidence, death and DALY rates despite ageing of the population.
Defining the medical coverage of ballistic protection to the pelvis and thigh
Authors: Lewis Eluned , Fryer R N , Breeze J
Published: February 2020

Introduction

Pelvis, lower limb and associated genital injury caused by explosive devices was responsible for mortality and considerable long-term morbidity for the UK Armed Forces during combat operations in Afghanistan, resulting in the issue of a pelvic protection system in 2010. The aim of this current research was to determine the medical coverage of the pelvis and thigh and to define the vertical dimensions of ballistic protective material for future pelvic protection (PP).

Method

CT scans from 120 male UK Armed Forces personnel were analysed to identify the anthropometric landmarks and vertical boundaries of coverage for the pelvis and thigh. Pelvic height was the vertical distance between the upper border of the iliac crest in the midaxillary plane to the most inferior point of the ischial tuberosity of the pelvis. Upper thigh height was proposed as a 100 mm fixed distance below the ischial tuberosities, enabling a tourniquet to be reproducibly applied. These distances were compared with the ballistic component of the five sizes of tier 1 PP using a paired t-test.

Results

The vertical components of coverage measured using CT scans were all significantly less (p<0.01) compared with all five sizes of tier 1 PP; for example, the ballistic component of the smallest size of tier 1 PP measured 410 mm, which was larger than the 99th percentile male, which measured 346 mm on CT scans.

Conclusions

While all sizes of tier 1 PP provide coverage to the pelvis and upper thigh structures, there is an opportunity to optimise future PP. For example, comparing the large size of tier 1 PP to the 50th percentile male demonstrated an opportunity to reduce the ballistic protective component by 31%. Reducing the quantity of material used will improve heat dissipation and user comfort and reduce material mass and acquisition costs.
Canine central nervous system neosporosis: clinical, laboratory and diagnostic imaging findings in six dogs
Authors: Didiano Alessandro , Monti Paola , Taeymans Olivier , Cherubini Giunio Bruto
Published: February 2020

This report describes the clinical, neurological, laboratory and imaging findings in six dogs affected by CNS neosporosis and reviews previous publications. All dogs were born in England and never travelled outside the UK. Cerebellar and proprioceptive ataxia were the most common presenting neurological deficits. Markedly elevated creatine kinase in the serum was detected in four of the six dogs. Increased cerebrospinal fluid (CSF) protein concentration and mixed pleocytosis were present in five of the six dogs. Abnormal MRI findings were detected in five of the six dogs. The diagnosis was based on positive antibody titres on serum (1:800 or above) and positive PCR on CSF. All patients were treated with a combination of clindamycin and trimethoprim/sulfamethoxazole. The clinical signs improved in all six cases. One dog developed hypothyroidism and another one died due to liver disease of unknown causes, respectively six and eight months after initial presentation.
Cosmological evolution of two-scalar fields cosmology in the Jordan frame
Authors: Giacomini Alex , Leon Genly , Paliathanasis Andronikos , Pan Supriya
Published: February 2020

In the present article we study the cosmological evolution of a two-scalar field gravitational theory defined in the Jordan frame. Specifically, we assume one of the scalar fields to be minimally coupled to gravity, while the second field which is the Brans-Dicke scalar field is nonminimally coupled to gravity and also coupled to the other scalar field. In the Einstein frame this theory reduces to a two-scalar field theory where the two fields can interact only in the potential term, which means that the quintom theory is recovered. The cosmological evolution is studied by analyzing the equilibrium points of the field equations in the Jordan frame. We find that the theory can describe the cosmological evolution in large scales, while inflationary solutions are also provided.
The light CP-even MSSM Higgs mass including N$$^\mathbf {3}$$LO+N$$^\mathbf {3}$$LL QCD corrections
Authors: Harlander R. V. , Klappert J. , Voigt A.
Published: February 2020

We present a calculation of the light neutral CP-even Higgs boson pole mass in the real $$\text {MSSM}$$MSSM which combines state-of-the-art EFT and fixed-order results, including the three-loop fixed-order QCD corrections as well as the resummation of logarithmic terms in the ratio of the weak to the SUSY scale up to fourth logarithmic order. This hybrid calculation should be valid for arbitrary SUSY scales above the weak scale. Comparison to the pure fixed-order and EFT results provides an estimate of their individual validity range.
Drug-target Interaction Prediction by Metapath2vec Node Embedding in Heterogeneous Network of Interactions
Authors: Samizadeh Mina , Minaei-Bidgoli Behrouz
Published: February 2020

Drug discovery is a complicated, time-consuming and expensive process. The cost for each new molecular entity (NME) is estimated at $1.8 billion. Furthermore, for a new drug to be FDA approved it often takes nearly a decade and approximately 20 new drugs being approved by the US Food and Drug Administration (FDA) each year. Accurately predicting drug-target interactions (DTIs) by computational methods is an important area of drug research, which brings about a broad prospect for fast and low-risk drug development. By accurate prediction of drugs and targets interactions scientists can scale-down huge experimental space and reduce the costs and help to faster drug development as well as predicting the side effects and potential function of new drugs. Many approaches have been taken by researchers to solve DTI problem and enhance the accuracy of methods. State-of-the-art approaches are based on various techniques, such as deep learning methods-like stacked auto-encoder-, matrix factorization, network inference, and ensemble methods. In this work, we have taken a new approach based on node embedding in a heterogeneous interaction network to obtain the representation of each node in the interaction network and then use a binary classifier such as logistic regression to solve this prominent problem in the pharmaceutical industry. Most introduced network-based methods use a homogeneous network of interactions as their input data whereas in the real word problem there exist other informative networks to help to enhance the prediction and by considering the homogeneous networks we lose some precious network information. Hence, in this work, we have tried to work on the heterogeneous network and have improved the accuracy of methods in comparison to baseline methods.
Impact of Environmental Conditions on Frost Crystal Structure
Authors: Zhang Tongxin , O’Neal Dennis L. , McClain Stephen T.
Published: February 2020

Frost crystal type and distribution were characterized in the initial periods of frost growth on an aluminum surface. Experiments were carried out for a range of wall temperatures from [Formula: see text]C to [Formula: see text]C, air temperatures from [Formula: see text]C to [Formula: see text]C, relative humidities from 15% to 85%, and air velocities from 0.5 to 5.0[Formula: see text]m/s. The results showed that frost crystal type was strongly dependent on the wall temperature and humidity. Changing the air temperature shifted the region of some frost crystal types. Decreasing the air temperature from 22 down to either [Formula: see text]C or [Formula: see text]C led to the decrease of feather crystals but increased the region of scroll crystals. Air velocity had smaller impacts on frost crystal type but had a strong influence on the distance between the crystals, particularly at lower air velocities. The results were compared to prior researchers. The results should provide a better understanding of frost morphology during the early stages of frost growth on metal surfaces.
Distributed Subtrajectory Join on Massive Datasets
Authors: Tampakis Panagiotis , Doulkeridis Christos , Pelekis Nikos , Theodoridis Yannis
Published: February 2020

Joining trajectory datasets is a significant operation in mobility data analytics and the cornerstone of various methods that aim to extract knowledge out of them. In the era of Big Data, the production of mobility data has become massive and, consequently, performing such an operation in a centralized way is not feasible. In this article, we address the problem of
Distributed Subtrajectory Join
processing by utilizing the MapReduce programming model. Compared to traditional trajectory join queries, this problem is even more challenging since the goal is to retrieve all the “maximal” portions of trajectories that are “similar.” We propose three solutions: (i) a well-designed basic solution, coined
DTJb
; (ii) a solution that uses a preprocessing step that repartitions the data, labeled
DTJr
; and (iii) a solution that, additionally, employs an indexing scheme, named
DTJi
. In our experimental study, we utilize a 56GB dataset of real trajectories from the maritime domain, which, to the best of our knowledge, is the largest real dataset used for experimentation in the literature of trajectory data management. The results show that
DTJi
performs up to 16× faster compared with
DTJb
, 10× faster than
DTJr
, and 3× faster than the closest related state-of-the-art algorithm.
Understanding the Operational Dynamics of Mobility Service Providers
Authors: Qian Xinwu , Kumar Dheeraj , Zhang Wenbo , Ukkusuri Satish V.
Published: February 2020

The rise of mobility service providers (MSPs) is reforming the traditional taxi service (TTS) market. MSPs differ from TTS with the core idea of using technology to optimally match riders with drivers, features like ride-sharing and surge pricing, and are not entry-regulated. It is of great significance to understand how MSPs operate and how we can integrate them with TTS for efficient urban mobility. Unfortunately, little is known about MSPs due to limited data revealed by them. In this study, we collect and mine the trajectory data of online drivers who serve Uber (one of the largest MSP) to demystify how Uber drives their drivers. We analyze the trip patterns of different Uber services and reveal their market share, trip metrics, and the spatial distributions of trip origins and destinations. We explore how MSPs improve the driver-rider matching efficiency and empirically validate the enormous efficiency gap between TTS and MSPs. In the end, we debunk the surge price as an instrument to restore driver-rider balance theory and show that drivers choose to chase or avoid the high surge areas depending on various other factors such as traffic congestion, time and location, and availability of alternate travel options as well. The results of this article provide insightful knowledge about the supply side of MSPs and contribute to new ideas on improving TTS and regulating MSPs.
Reuse Distance-based Victim Cache for Effective Utilisation of Hybrid Main Memory System
Authors: Nath Arijit , Agarwal Sukarn , Kapoor Hemangee K.
Published: February 2020

Hybrid main memories comprising DRAM and Non-volatile memories (NVM) are projected as potential replacements of the traditional DRAM-based memories. However, traditional cache management policies designed for improving the hit rate lack awareness of the comparative latency of read-write for NVM blocks where the write latency is more than the read latency. Therefore, developing cache management techniques that reduce costly write-backs of the NVM blocks, yet maintain a fair hit rate in the cache, is of paramount importance.

We propose two techniques based on the use of a small victim cache associated with the last-level cache that helps in retaining on the chip critical DRAM and NVM blocks. Victim cache being a scarce resource, we intend to keep only performance-critical blocks in the victim cache by exploiting the idea of reuse distance. The first technique, Victim Cache Replacement Policy, works on the replacement policy of the victim cache by preferential eviction of DRAM blocks over NVM blocks. However, the second technique, Prioritized Partitioning of victim cache, logically partitions the victim cache, giving a smaller share to the DRAM blocks and a relatively larger share to the NVM blocks. Experimental evaluation on full-system simulator shows significant improvement in system performance and reduction in the number of write-backs to the NVM partition of the main memory compared to the baseline and existing technique. Additionally, NVM reads and DRAM miss rate are also improved, leading to further performance enhancement.
Sulforaphane prevents right ventricular injury and reduces pulmonary vascular remodeling in pulmonary arterial hypertension
Authors: Kang Yin , Zhang Guangyan , Huang Emma C. , Huang Jiapeng , Cai Jun , Cai Lu , Wang Sheng , Keller Bradley B.
Published: February 2020

Right ventricular (RV) dysfunction is the main determinant of mortality in patients with pulmonary arterial hypertension (PAH) and while inflammation is pathogenic in PAH, there is limited information on the role of RV inflammation in PAH. Sulforaphane (SFN), a potent Nrf2 activator, has significant anti-inflammatory effects and facilitates cardiac protection in preclinical diabetic models. Therefore, we hypothesized that SFN might play a comparable role in reducing RV and pulmonary inflammation and injury in a murine PAH model. We induced PAH using SU5416 and 10% hypoxia (SuHx) for 4 wk in male mice randomized to SFN at a daily dose of 0.5 mg/kg 5 days per week for 4 wk or to vehicle control. Transthoracic echocardiography was performed to characterize chamber-specific ventricular function during PAH induction. At 4 wk, we measured RV pressure and relevant measures of histology and protein and gene expression. SuHx induced progressive RV, but not LV, diastolic and systolic dysfunction, and RV and pulmonary remodeling, fibrosis, and inflammation. SFN prevented SuHx-induced RV dysfunction and remodeling, reduced RV inflammation and fibrosis, upregulated Nrf2 expression and its downstream gene NQO1, and reduced the inflammatory mediator leucine-rich repeat and pyrin domain-containing 3 (NLRP3). SFN also reduced SuHx-induced pulmonary vascular remodeling, inflammation, and fibrosis. SFN alone had no effect on the heart or lungs. Thus, SuHx-induced RV and pulmonary dysfunction, inflammation, and fibrosis can be attenuated or prevented by SFN, supporting the rationale for further studies to investigate SFN and the role of Nrf2 and NLRP3 pathways in preclinical and clinical PAH studies.

NEW & NOTEWORTHY Pulmonary arterial hypertension (PAH) in this murine model (SU5416 + hypoxia) is associated with early changes in right ventricular (RV) diastolic and systolic function. RV and lung injury in the SU5416 + hypoxia model are associated with markers for fibrosis, inflammation, and oxidative stress. Sulforaphane (SFN) alone for 4 wk has no effect on the murine heart or lungs. Sulforaphane (SFN) attenuates or prevents the RV and lung injury in the SUF5416 + hypoxia model of PAH, suggesting that Nrf2 may be a candidate target for strategies to prevent or reverse PAH.
Systemic and regional hemodynamic response to activation of the exercise pressor reflex in patients with peripheral artery disease
Authors: Kim Danielle Jin-Kwang , Kuroki Marcos , Cui Jian , Gao Zhaohui , Luck J. Carter , Pai Sam , Miller Amanda , Sinoway Lawrence
Published: February 2020

Patients with peripheral artery disease (PAD) have an accentuated exercise pressor reflex (EPR) during exercise of the affected limb. The underlying hemodynamic changes responsible for this, and its effect on blood flow to the exercising extremity, are unclear. We tested the hypothesis that the exaggerated EPR in PAD is mediated by an increase in total peripheral resistance (TPR), which augments redistribution of blood flow to the exercising limb. Twelve patients with PAD and 12 age- and sex-matched subjects without PAD performed dynamic plantar flexion (PF) using the most symptomatic leg at progressive workloads of 2–12 kg (increased by 1 kg/min until onset of fatigue). We measured heart rate, beat-by-beat blood pressure, femoral blood flow velocity (FBV), and muscle oxygen saturation ([Formula: see text]) continuously during the exercise. Femoral blood flow (FBF) was calculated from FBV and baseline femoral artery diameter. Stroke volume (SV), cardiac output (CO), and TPR were derived from the blood pressure tracings. Mean arterial blood pressure and TPR were significantly augmented in PAD compared with control during PF. FBF increased during exercise to an equal extent in both groups. However, [Formula: see text] of the exercising limb remained significantly lower in PAD compared with control. We conclude that the exaggerated pressor response in PAD is mediated by an abnormal TPR response, which augments redistribution of blood flow to the exercising extremity, leading to an equal rise in FBF compared with controls. However, this increase in FBF is not sufficient to normalize the SmO2 response during exercise in patients with PAD.

NEW & NOTEWORTHY In this study, peripheral artery disease (PAD) patients and healthy control subjects performed graded, dynamic plantar flexion exercise. Data from this study suggest that previously reported exaggerated exercise pressor reflex in patients with PAD is driven by greater vasoconstriction in nonexercising vascular territories which also results in a redistribution of blood flow to the exercising extremity. However, this rise in femoral blood flow does not fully correct the oxygen deficit due to changes in other mechanisms that require further investigation.
Heart failure in single right ventricle congenital heart disease: physiological and molecular considerations
Authors: Garcia Anastacia M. , Beatty Jonathan-Thomas , Nakano Stephanie J.
Published: February 2020

Because of remarkable surgical and medical advances over the past several decades, there are growing numbers of infants and children living with single ventricle congenital heart disease (SV), where there is only one functional cardiac pumping chamber. Nevertheless, cardiac dysfunction (and ultimately heart failure) is a common complication in the SV population, and pharmacological heart failure therapies have largely been ineffective in mitigating the need for heart transplantation. Given that there are several inherent risk factors for ventricular dysfunction in the setting of SV in addition to probable differences in molecular adaptations to heart failure between children and adults, it is perhaps not surprising that extrapolated adult heart failure medications have had limited benefit in children with SV heart failure. Further investigations into the molecular mechanisms involved in pediatric SV heart failure may assist with risk stratification as well as development of targeted, efficacious therapies specific to this patient population. In this review, we present a brief overview of SV anatomy and physiology, with a focus on patients with a single morphological right ventricle requiring staged surgical palliation. Additionally, we discuss outcomes in the current era, risk factors associated with the progression to heart failure, present state of knowledge regarding molecular alterations in end-stage SV heart failure, and current therapeutic interventions. Potential avenues for improving SV outcomes, including identification of biomarkers of heart failure progression, implications of personalized medicine and stem cell-derived therapies, and applications of novel models of SV disease, are proposed as future directions.
Hepatic Cyst: An Unusual Suspect of Syncope
Authors: Choudhry Mohammad K. , Xiong Bei , Anandaraj Antony , Trillo John
Published: February 2020

The patient is a 75-year-old man with history of diabetes and hypertension who presented with syncope after experiencing sharp, 10/10 right flank and abdominal pain worsening over three weeks associated with decreased appetite. Physical examination revealed hepatomegaly and right lower quadrant (RUQ) tenderness, negative for peritoneal signs. Bloodwork showed leukocytosis (13 K/mcl), alkaline phosphatase (141 U/L), total bilirubin (2.0 mg/dL), and gamma-glutamyl transferase (172 U/L). Computed Tomography (CT) revealed multiple hepatic cysts with the largest measuring 17 × 14 × 18 cm (Figure 1). Parenteral opiates provided minimal relief. Cardiac and neurologic etiologies of syncope were ruled out. The patient’s course was complicated by opioid-induced delirium as his abdominal pain progressively worsened despite escalating doses of parenteral and oral analgesics. Gastroenterology and interventional radiology consulted to evaluate for Glisson’s capsular stretch. Therapeutic aspiration yielded 2.5 L of serous fluid, which alleviated the patient’s pain. Cytology was negative for malignancy. Opiates were titrated down. Repeat CT (Figure 2) showed cysts that were significantly reduced in size. The patient showed complete resolution of symptoms and was subsequently discharged. We present a rare case of a large hepatic cyst causing syncope. In the appropriate clinical setting, syncope with RUQ tenderness and hepatomegaly should raise the index of suspicion for hepatic cysts.
Effect of DEHP on SCFA Production by Anaerobic Fermentation of Waste Activated Sludge
Authors: Gong Rui , Tang Xiang , Fan Changzheng , Zhang Baowei , Zhou Man
Published: February 2020

Diethylhexyl phthalate (DEHP) is a common plasticizer in industrial production. Recently, environmental problems caused by microplastics have drawn wide attention. As the microplastics have a large specific surface area, the release rate of the plasticizer from the microplastics to the environment is accelerated. The DEHP in the wastewater enters the wastewater treatment plants (WWTPs) along with the urban pipeline. After DEHP enters the WWTPs, it may affect the anaerobic fermentation with waste activated sludge (WAS) as raw material. So far, there has been no study on the effect of DEHP on anaerobic fermentation of WAS. Our study focused on the impact of exogenous DEHP on WAS anaerobic fermentation, and the results showed that DEHP mainly affects the solubilization stage of sludge anaerobic digestion, but has no significant effect on other stages. It does not affect the total yield and composition of short-chain fatty acids (SCFA). However, DEHP inhibited the solubilization process of WAS anaerobic fermentation, which was mainly manifested by the changes of soluble protein and soluble polysaccharide in the system. The results of the analysis of microbial communities revealed that the addition of DEHP did not change the diversity of microbial communities, but caused a change in the abundance of microbial organisms. DEHP reduced the abundance of acetogen bacteria and increased the abundance of methanogens. This work provides some insights into WAS fermentation systems in the presence of DEHP and helps to gain a better understanding of the potential environmental hazards of microplastics.
Differential Transform Algorithm for Functional Differential Equations with Time-Dependent Delays
Authors: Rebenda Josef , Pátíková Zuzana
Published: February 2020

An algorithm using the differential transformation which is convenient for finding numerical solutions to initial value problems for functional differential equations is proposed in this paper. We focus on retarded equations with delays which in general are functions of the independent variable. The delayed differential equation is turned into an ordinary differential equation using the method of steps. The ordinary differential equation is transformed into a recurrence relation in one variable using the differential transformation. Approximate solution has the form of a Taylor polynomial whose coefficients are determined by solving the recurrence relation. Practical implementation of the presented algorithm is demonstrated in an example of the initial value problem for a differential equation with nonlinear nonconstant delay. A two-dimensional neutral system of higher complexity with constant, nonconstant, and proportional delays has been chosen to show numerical performance of the algorithm. Results are compared against Matlab function DDENSD.
Application of Low-Cost Sensors for the Development of a Methodology to Design Front-End Loaders for Tractors
Authors: Malon H. , Ayuda A. , Garcia-Ramos F. J. , Vidal M. , Cuartero J.
Published: February 2020

Tractor front-end loaders are an essential part of the equipment used on farms. At present, there are an important number of small- and medium-sized companies involved in the manufacturing of this equipment. These companies rely heavily on experience for innovative designs, as in the vast majority of cases they lack access to adequate methodology for the optimal design of new front-end loaders. The study conducted has developed a methodology to design tractor front-end loaders with a view of obtaining their accurate design during the bucket loading process. The methodology comprises two phases: the first phase involves a numerical analysis of the structural behaviour of the front-end loader components by means of the Finite Element Method; the second phase, the experimental phase, makes use of low-cost sensors, in particular, strain gauges, to analyse existing strains at selected points in the front-end loader structure. The experimental results obtained by means of low-cost sensors fitted onto the front-end loader allow analysing the existing strains at the points measured, as well as validate the numerical model developed. This methodology is validated by applying it to a commercial front-end loader, more specifically to model 430E2 of the company Maquinaria Agrícola El León S.A (Spain).
Antiatherosclerosis Properties of Total Saponins of Garlic in Rats
Authors: Miao Qing , Wang Ruihai , Bai Dong , Xue Xin , Xu Jing , Sun Xiaoxin , Liu Limei
Published: February 2020

Garlic has been proven effective in the prevention and treatment of atherosclerosis (AS), which is widely used as a food and medicine by people in daily life. Garlic saponins are the main active nonsulfur compounds of garlic, which have a variety of pharmacological activities against cardiovascular diseases. In this study, the antiatherosclerosis properties and mechanism of total saponins of garlic (TSG) in rats were explored. The AS animal model was established by a combination of high‐fat feeding, intraperitoneal injection of vitamin D3, and ovalbumin‐induced inflammation in SD rats. Then, the atherosclerotic rats were gavaged daily by TSG for 4 weeks. Administration of TSG markedly decreased atherosclerotic lesions in the aorta of atherosclerotic rats. TSG restored the serum lipid profile by significantly decreasing the lipid levels and had effective antioxidation by inhibiting the content of malondialdehyde (MDA) and restoring the reduced activity of superoxide dismutase (SOD). Additionally, the ratio of thromboxane B2 (TXB2) and 6‐keto‐prostaglandin F1α (6‐keto‐PGF1α) could be maintained in a relatively stable dynamic balance after administration of TSG to maintain the vascular homeostasis. In summary, TSG had therapeutic effects on AS, which are promising as functional foods or nutraceuticals for the prevention and treatment of AS.
Determination of the Levels of Heavy Metals and Formaldehyde in Baby Clothes in South Africa: A Case Study of Stores in the Greater Cape Town Region
Authors: Nyamukamba P. , Bantom C. , Mququ Z. , Ngcobo T. , Isaacs S.
Published: February 2020

Herein, we report on the determination of formaldehyde, pH, and heavy metals (Pb, As, Co, Cr, Ni, and Cd) in various baby apparel (cotton, polyester, nylon, elastane, and polyethylene) of different colours (light, medium, and dark) purchased from both high-end and low-end market stores. The concentrations of the heavy metals were determined by inductively coupled plasma (ICP) after wet digestion and also after extraction using artificial sweat for a selected range of skin-contact baby apparel. The relative standard deviation for the determination of all heavy metals was less than 5% except for nickel which was 10.49%. The concentrations of the heavy metals in wet digested samples were found to be in the following range: Pb (0.02–23.662 mg/kg), As (0.009–0.033 mg/kg), Co (0.001–1.053 mg/kg), Cr (0.053–6.373 mg/kg), Ni (0.039–36.715 mg/kg), and Cd (0.001–0.914 mg/kg), whereas the concentrations in artificial sweat extracted samples were in the following range: Pb (0.006–1.658 mg/kg), As (not detected), Co (0.001–1.05 mg/kg), Cr (0.112–0.371 mg/kg), Ni (0.062–0.121 mg/kg), and Cd (0.001–0.018 mg/kg). The highest concentrations of Pb, Cr, and Co after wet digestion were found in baby apparel purchased from low-end market stores, whereas for As, Ni, and Cd were from high-end market stores. All the samples had a formaldehyde concentration within the acceptable limits recommended by Oeko-Tex. Out of the thirty-four samples analysed, fifteen samples were found to have a pH higher than Oeko-Tex limits. The pH values for the samples that exceeded the Oeko-Tex limits were in the alkali region, and the highest was 11.31 which exceeded by 3.81.
On a Thermoelastic Laminated Timoshenko Beam: Well Posedness and Stability
Authors: Feng Baowei
Published: February 2020

In this paper, we are concerned with a linear thermoelastic laminated Timoshenko beam, where the heat conduction is given by Cattaneo’s law. We firstly prove the global well posedness of the system. For stability results, we establish exponential and polynomial stabilities by introducing a stability number χ.
Pancreatoduodenectomy for Periampullary Tumors Presenting with Acute Pancreatitis
Authors: Cao Xuefeng , Wang Xixiu , Xu Xiaoliang , Lu Yanmin , Zhao Baolei , Zhang Xingyuan , Chen Qiangpu
Published: February 2020

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.