bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship Between Level of Care Dependency and Quality of Life of Family Caregivers of Care-Dependent Patients
Authors: Tavares Marcus L. O. , Pimenta Adriano M. , García-Vivar Cristina , Beinner Mark A. , Montenegro Lívia C.
Published: November 2019

A cross-sectional study was conducted with 139 family caregivers in two community health center areas in the city of Belo Horizonte, located in the southeastern state of Minas Gerais, Brazil. The purpose of the study was to analyze the relationship between level of care dependency and quality of life (QOL) of family caregivers. A socio-demographic questionnaire, the Barthel Index for assessing patients’ care dependency level, and the World Health Organization’s Quality of Life–BREF (WHOQOL-BREF) for evaluating family caregivers’ QOL were used. Patients’ care dependency level was not significantly associated with family caregivers’ QOL. However, the QOL decreased when family caregivers had chronic disease and were dependent on public health care services, and increased when they received caregiver education and practiced a leisure activity. These factors are modifiable or controllable; therefore, family health nurses have an important role in formulating strategies to support family caregivers, especially those related to health education aimed at health care, health promotion, control, and prevention of diseases.
The Green Light for Green Dot: A Qualitative Study of Factors Influencing Adoption of an Efficacious Violence Prevention Program in High School Settings
Authors: Davidov Danielle M. , Hill Kaitlyn , Bush Heather M. , Coker Ann L.
Published: November 2019

The purpose of this qualitative study was to investigate factors influencing the adoption of an effective bystander-based sexual violence prevention intervention. High schools participating in a cluster-randomized controlled trial that found significant declines in sexual violence over time and with full implementation were invited to adopt this program (Green Dot) at no cost. Three emergent themes arose from interviews with 10 intervention implementers. These findings have implications for researchers, practitioners, and high school administrators and may facilitate future program marketing efforts and the development and testing of strategies for targeted dissemination of this and other bystander programs for violence.
Educational Revolution: Integrating Concept-Based Curriculum and Active Learning for Mental Health Nursing Students
Authors: Romanowski Alison , Allen Patricia , Martin April
Published: November 2019

OBJECTIVE: To disseminate knowledge to mental health nurse educators regarding a course that is successfully preparing registered nurse (RN) students to pass the psychosocial integrity portion of the National Council Licensing Exam for Registered Nurses (NCLEX-RN). METHOD: Following the implementation of a new concept-based nursing program curricular design, faculty teaching in a psychiatric mental health nursing course embarked on converting lecture-based, content-saturated teaching strategies into active learning strategies. In this article, the overall conceptual framework for the course and specific examples of active learning teaching strategies related to nursing concepts in mental health are described. Information on objectives, clinical placements, testing, class organization, and curricular content are provided. Outcomes are shared revealing success in helping students pass the psychosocial integrity section of the NCLEX-RN. RESULTS: Predictive scores on the HESI RN Psychiatric Mental Health Specialty Exam have been consistently higher than the national average for the United States, and the NCLEX-RN pass rate for the cohort of 90 students was 97%. The majority of student evaluations of the course were positive. CONCLUSIONS: Results suggest that the integration of conceptual and active learning in a psychiatric mental health nursing course may increase the likelihood of student success.
Is There an Association Between Oxytocin Levels in Plasma and Pregnant Women’s Mental Health?
Authors: Serati Marta , Grassi Silvia , Redaelli Marta , Pergoli Laura , Cantone Laura , La Vecchia Adriano , Barkin Jennifer L. , Colombo Elisa , Tiso Giulia , Abbiati Cristina , Bollati Valentina , Buoli Massimiliano
Published: November 2019

BACKGROUND: Mood and anxiety disorders are prevalent in women during peripartum. AIMS: Purpose of the present article was to study the relationship between oxytocin (OT) plasma levels and affective symptoms in women during the third trimester of pregnancy. METHODS: Thirty-four pregnant women (13 with an affective disorder, 9 with preeclampsia, and 12 controls) were evaluated through the Edinburgh Postnatal Depression Scale (EPDS), the State/Trait Anxiety Inventory Form Y (STAI-Y), and the Prenatal Attachment Inventory (PAI). A blood sample was collected from all participants, and OT plasma levels have been compared between diagnostic groups. The total sample has been divided into two groups, according to OT median plasma levels, and compared using (a) χ2 tests for qualitative variables and (b) a multivariate analysis of covariance for quantitative ones. RESULTS: No statistically significant difference was found among the diagnostic groups in terms of OT plasma levels ( F = 0.49, p = .62). Women with lower OT plasma levels, independent from the presence of preeclampsia or an affective disorder, showed worse EPDS and STAI-S total scores than individuals with higher hormone levels ( F = 5.93, p = .02 and F = 7.57, p = .01, respectively). CONCLUSIONS: OT may play a role in the etiology of anxious/depressive symptoms during perinatal period independent from a medical or psychiatric diagnosis. This result has a clear effect on the quality of the relationship of patients with mental health professionals, including nurses, and higher levels of this hormone, in the light of its anxiolytic and antidepressive effect, may make easier medical and nursing procedures.
Effect of Cognitive Engagement on the Development of Brand Love in a Hotel Context
Authors: Shin Minjung , Back Ki-Joon
Published: November 2019

With growing number of hotel brands in the market, the lodging industry is facing intense competition more than ever, and managers are realizing the importance of developing strong customer–brand relationship. As a result, the concept of brand love is gaining increased attention in hospitality literature and academics are examining various antecedents of this concept. However, among prior studies’ exploration of its antecedents, the relationship between engagement process and brand love has been relatively neglected. Hence, the present study explores the relationship among customer–brand engagement, cognitive brand loyalty, and brand love. Specifically, this study focuses on the role of cognitive engagement on the development of brand love, as the advent of online environment and social networking service has significantly changed customer’s pre- and post-purchase decision-making process. The conceptual model illustrates that cognitive engagement, which is operationalized as a second-order construct of attention and absorption, has a significant positive effect on brand love directly and indirectly via the mediation of cognitive brand loyalty. Consequently, the findings indicate that “how” customers process brand information (cognitive engagement) is equally important as “what” they process (content, e.g., quality) to evoke cognitive brand loyalty and ultimately brand love among hotel guests.
Ultrasound-guided removal of organized thrombi using biopsy forceps in dialysis patients with arterio-venous access occlusion
Authors: Wakabayashi Masanori
Published: November 2019

Introduction:

As a countermeasure against the organized thrombi frequently observed in vascular access occlusion, we devised a percutaneous excision method for organized thrombi under superficial ultrasound guidance using biopsy forceps. The Radial JawTM 3 (2 mm) biopsy forceps of Boston Scientific Corporation was used. The usefulness of this method was investigated.

Method:

The following protocol, which is suitable for endovascular treatment, was prepared and used: (1) all procedures were performed under ultrasound guidance and (2) use of the forceps was assisted via a long sheath in cases involving a complicated bloodstream.

Subjects:

Among 564 cases of arterio-venous access occlusion that received treatment at this hospital between May 2014 and April 2017, the subjects of this study were 468 cases who could be followed up. Thrombectomy of an organized thrombus using the biopsy forceps was performed 194 times in 138 cases. Biopsy forceps were used in the initial treatment in a total of 115 cases, including 71 cases of acute occlusion of an autologous vein, 3 cases of chronic occlusion of an autologous vein, and 41 cases of acute occlusion of a prosthetic vessel.

Results:

The initial success rate for all cases of occlusion was 97.2%. The initial success rate for cases in which biopsy forceps were used was 98.2%. For cases using biopsy forceps, the primary patency rates were 47.1% at 3 months, and the secondary patency rates (until occlusion) were 89.1% at 3 months.

Conclusion:

This method was considered to be a valuable choice as a countermeasure against organized thrombi.
Effect of sliding speed and hardness on wear behavior and mechanism of AISI H13 steel
Authors: Jiang Wei , Zhu Shouxing , Wang Shuqi
Published: November 2019

Dry sliding tests were performed under various sliding speeds and loads in air for AISI H13 steel with different hardness values. Through investigating morphologies, compositions and phases of worn surfaces, the wear behaviors and mechanisms of AISI H13 steel as a function of sliding speed and hardness were explored, and especially, the effects of friction-oxide layers and their stability were disclosed. Sliding speed and the hardness of the steel significantly affected the wear behavior and mechanism due to the evolution of friction-oxide layers. With an increase of sliding speed, more oxides were produced by the process of friction oxidation. The stability of friction-oxide layers became a key factor in determining wear rate, which was closely related with the hardness of the steel. Those friction-oxide layers formed on the quenched and tempered steel with lower hardness remained stable, providing more protection from wear. Three types of wear mechanisms were found to prevail. Adhesive and abrasive wear were dominant accompanied with oxidation mild wear at relatively low sliding speeds, where the wear resistance was proportional to the hardness of the steel. As sliding speed increased, oxidation mild wear became dominating, where the wear resistance was not related to the hardness of the steel. As the sliding speed further increased, the wear fell in oxidation mild-to-severe wear transition region, in which the wear resistance was inversely proportional to the hardness of the steel.
Audit and evaluation: Working collaboratively to support accountability
Authors: Naidoo Indran
Published: November 2019

Audit and evaluation play crucial roles in the oversight function of organizations. Both professions share commonalities that have led some to call for “enhanced oversight” through stronger collaboration of the two functions. Our experience suggests that joint assessments can help promote a holistic three-dimensional view of performance, which looks both inside and outside organizations to see whether inputs matched with outputs and outcomes. However, tangible differences in paradigm and approach need discussion before further convergence of the functions is countenanced. The separation of the two functions ensures their independence, which is a guarantee of the credibility of the auditors and evaluators’ work.
The effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder: A systematic review
Authors: Ruggeri Anneliese , Dancel Alina , Johnson Robert , Sargent Barbara
Published: November 2019

Difficulty performing age-appropriate motor skills affects up to 83% of children with autism spectrum disorder. This systematic review examined the effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder and the effect of motor learning strategies on motor skill acquisition, retention, and transfer. Six databases were searched from 2000 to 2019. Forty-one studies were included: 34 intervention studies and 7 motor learning studies. The overall quality of the evidence was low. Participants included 1173 children with autism spectrum disorder ranging from 3 to 19 years. Results from level II and III intervention studies supported that participation outcomes improved with a physical education intervention; activity outcomes improved with aquatic, motor activity, motor skill, and simulated horse riding interventions; and body structure and function outcomes improved with aquatic, exergaming, motor activity, motor skill, and simulated horse riding interventions. Results from level II and III motor learning studies supported that motor skill acquisition improved with visual, versus verbal, instructions but was not influenced by differences in instructional personnel. More rigorous research on motor intervention is needed with well-controlled study designs, adequate sample sizes, and manualized protocols. In addition, research on motor learning strategies is warranted as it generalizes across motor interventions.
Prescription Value-Based Automatic Optimization of Importance Factors in Inverse Planning
Authors: Guo Caiping , Zhang Pengcheng , Gui Zhiguo , Shu Huazhong , Zhai Lihong , Xu Jinrong
Published: November 2019

Objective:

An automatic method for the optimization of importance factors was proposed to improve the efficiency of inverse planning.

Methods:

The automatic method consists of 3 steps: (1) First, the importance factors are automatically and iteratively adjusted based on our proposed penalty strategies. (2) Then, plan evaluation is performed to determine whether the obtained plan is acceptable. (3) If not, a higher penalty is assigned to the unsatisfied objective by multiplying it by a compensation coefficient. The optimization processes are performed alternately until an acceptable plan is obtained or the maximum iteration N max of step (3) is reached.

Results:

Tested on 2 kinds of clinical cases and compared with manual method, the results showed that the quality of the proposed automatic plan was comparable to, or even better than, the manual plan in terms of the dose–volume histogram and dose distributions.

Conclusions:

The proposed algorithm has potential to significantly improve the efficiency of the existing manual adjustment methods for importance factors and contributes to the development of fully automated planning. Especially, the more the subobjective functions, the more obvious the advantage of our algorithm.
“Repeated Hierarchies”: Uneven Participation in Research of Ethical Spaces in Hospitals
Authors: Bogaert Brenda , Dekeuwer Catherine , Eggert Nadja , Harpet Claire
Published: November 2019

We present a case study of uneven participation in a focus group discussion with health care professionals involved in local ethical committees. We conclude that the status of the different participants did not give adequate space for full participation of the members involved. Two commentators were invited to comment on the case study to enable further reflection on the methodology used for the target group. The first reviewer investigated whether research should address power relations and hierarchies of knowledge encountered in the study process. She also discussed whether researchers should be held ethically and politically responsible for the consequences of producing relations and hierarchies. The second reviewer looked at what focus groups say about professional practices in hospitals, what participants are willing (or unwilling) to invest, and what are the conditions for setting up ethical reflection.
Proteomic Analysis of Radiation-Induced Acute Liver Damage in a Rabbit Model
Authors: Jiang Lingong , Jia Huimin , Tang Zhicheng , Zhu Xiaofei , Cao Yangsen , Tang Yin , Yu Haiyan , Cao Jianping , Zhang Huojun , Zhang Shuyu
Published: November 2019

Radiation-induced liver damage (RILD) has become a limitation in radiotherapy for hepatocellular carcinoma. We established a rabbit model of RILD by CyberKnife. Electron microscopy analysis revealed obvious nuclear atrophy and disposition of fat in the nucleus after irradiation. We then utilized a mass spectrometry-based label-free relative quantitative proteomics approach to compare global proteomic changes of rabbit liver in response to radiation. In total, 2365 proteins were identified, including 338 proteins that were significantly dysregulated between irradiated and nonirradiated liver tissues. These differentially expressed proteins included USP47, POLR2A, CSTB, MCFD2, and CSNK2A1. Real-time polymerase chain reaction confirmed that USP47 and CABLES1 transcripts were significantly higher in irradiated liver tissues, whereas MCFD2 and CSNK2A1 expressions were significantly reduced. In Clusters of Orthologous Groups of proteins analysis, differentially expressed proteins were annotated and divided into 24 categories, including posttranslational modification, protein turnover, and chaperones. Kyoto Encyclopedia of Genes and Genomes analysis revealed that the enriched pathways in dysregulated proteins included the vascular endothelial growth factors (VEGF) signaling pathway, the mitogen-activated protein kinase (MAPK) signaling pathway, and the adipocytokine signaling pathway. The identification of proteins and pathways is crucial toward elucidating the radiation response process of the liver, which may facilitate the discovery of novel therapeutic targets.
Centroid variability model–based control of HITUWV for automatic underwater welding with enhanced stability and accuracy
Authors: Luo Yang , Tao Jianguo , Hao Zhuang , Sun Hao , Li Zhandong , Gao Haibo , Ding Liang , Deng Zongquan
Published: November 2019

This article presents a centroid variability model–based controller of HITUWV (Underwater Welding Vehicle by Harbin Institute of Technology), an underwater welding vehicle, for automatic welding with high stability and accuracy. First, an accurate centroid variability model, which considers the coefficient changes of the HITUWV caused by the movements of a 3-degree-of-freedom manipulator, is presented to perform the dynamic characteristics of the HITUWV precisely. Second, a centroid variability model–based adaptive sliding model controller is developed for the HITUWV to complete centroid variability compensation. Experimental results indicate that the proposed centroid variability model–based adaptive sliding model controller demonstrates better performances in stability and accuracy than the conventional proportional–integral–derivative controller and the model-based proportional–integral–derivative controller. As a result, the centroid variability model–based adaptive sliding model controller holds great practicality and utility on the control of underwater operation with high stability and accuracy.
The Impact of Infusion Center Layout on Workflow and Satisfactions in Two Cancer Infusion Centers: A Case Study on Staff and Patients
Authors: Jalalianhosseini Mahshid , Freihoefer Kara , Doyle Nancy , Simpson Amanda
Published: November 2019

Objective:

The objective of this empirical research is to compare nurses’ operational workflow and nurses’ and patients’ satisfactions of two different infusion center designs. One center has a traditional open bay design and the other has semi-private bays. This study also intends to gather baseline data to compare to a future post-occupancy evaluation of a new infusion center where the two existing centers will be combined.

Background:

The increasing number of patients with cancer diagnosis who refer to infusion centers highlights the importance of design of these centers.

Method:

The mixed-method approach of this study involves shadowing nurses and surveying nurses and patients. Data collection captured nurses’ activities, activity durations, and nurses’ and patients’ satisfaction with the design of clinics.

Results:

Comparison of shadowing data indicated that although the infusion centers have different layouts, there are no significant differences in the activities or time spent by nurses in different areas among the centers. Staff, however, have different satisfaction levels with visual and speech privacy, ability to concentrate without distraction, collaboration with other staff, and the process of medication delivery. Patients also had slightly different satisfaction levels with their ability to communicate with staff and design of bays.

Conclusion:

This research sheds light on operational workflows and satisfaction of staff and patients in two different infusion center design. Considering the limited studies on these settings, this study serves as baseline data to compare to other studies on cancer infusion centers and addresses issues of benchmarking and staff and patient satisfaction.
Too Hot to Handle—Quantifying Temperature Variations in the Nasal Endoscope Ocular Assembly and Light Post
Authors: Lewis Trevor , Levin Marc , Sommer Doron D.
Published: November 2019

Background

Nasal endoscopes have transformed and improved the safety of intranasal and transnasal surgery. The heat they can produce may, however, reach dangerous levels for surgeons. Studies have not previously assessed the temperature of the nasal endoscope light post/ocular assembly (LP/OA)—where the surgeon usually holds the endoscope.

Objective

This study aims to understand the effect of different nasal endoscopes, light sources, and light cords on the LP/OA temperature.

Methods

We measured the temperature at the LP/OA of various rigid nasal endoscopes at multiple time intervals over 30 minutes, as well as after turning off the light source and irrigating the LP/OA with 10 mL of saline.

Results

The highest temperature recorded was 67.37°C at the LP/OA at 30 minutes, using a new light cord, older endoscope, and 184-hour xenon light bulb. In every trial, the temperature of the LP/OA continually increased until 30 minutes when the light source was turned off. Statistically significant ( P < .001) temperature differences were seen in trials using the older xenon light sources. The light-emitting diode light source was significantly cooler with an older light cord regardless of the age of the scope ( P = .003).

Conclusion

Endoscope temperatures during sinus surgery may reach potentially dangerous levels at the LP/OA region. These temperatures may be sufficient to cause second-degree burns during normal usage. Factors associated with higher endoscope temperatures include longer times with the light source on and xenon light bulbs.
Examination of Lower Level Motion Mechanisms That Provide Information to Object Tracking: An Examination Using Dichoptic Stimulation
Authors: Kanaya Hidetoshi K. , Morita Marie M. , Sato Takao
Published: November 2019

In this study, we examined the operation of first- and second-order motion mechanisms with respect to object tracking using dichoptic presentation. A bistable apparent motion stimulus composed of four rectangles arranged in square- and diamond-shapes in every other frame was presented binocularly, monocularly, or dichoptically using a stereoscope. Since past motion studies showed that the first-order motion mechanism cannot function under dichoptic stimulation, we evaluated the upper temporal frequency limits of object tracking with dichoptic presentation and compared these results with those obtained with ordinary binocular or monocular (nondichoptic) presentation. We found that the temporal limits were 4 -5 Hz, regardless of the viewing conditions. These limits are similar to those for within-attribute (first- and second-order) object tracking (4 -5 Hz) obtained in our previous study. Thus, this putative mechanism may be responsible for object tracking, based only on second-order components, even in the case of first-order stimuli.
A Survey of Provider Attitudes, Beliefs, and Perceived Barriers Regarding a Centralized Direct-Mail Colorectal Cancer Screening Approach at Community Health Centers
Authors: Thompson Jamie H. , Schneider Jennifer L. , Rivelli Jennifer S. , Petrik Amanda F. , Vollmer William M. , Fuoco Morgan J. , Coronado Gloria D.
Published: November 2019

Background: Colorectal cancer screening (CRC) rates are low, particularly among individuals with low socioeconomic status. Organized CRC screening programs have demonstrated success in increasing screening rates. Little is known about provider attitudes, beliefs, and practices related to CRC screening or how they are influenced by an organized CRC screening program. Methods: In 2014 and 2016, providers from 26 safety net clinics in Oregon and Northern California were invited to complete baseline and follow-up online surveys for the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) study. The provider survey link was sent electronically to primary care providers serving adult patients. Providers were sent reminders every 2 weeks via email to complete the survey, up to 3 reminders total. In this article, we describe learnings about provider attitudes, beliefs, and practices related to CRC screening after implementation of the STOP CRC program. Results: A total of 166 unique providers completed baseline and/or follow-up surveys, representing 228 responses. Main themes included (1) favorable shifts in attitude toward fecal immunochemical test (FIT) and direct-mail cancer screening programs, (2) changes in provider perception of key barriers, and (3) growing interest in centralized automated systems for identifying patients due for CRC screening and eligible for population-based outreach. Discussion: Providers are interested in improved information systems for identifying patients due for CRC screening and delivering population-based outreach (ie, to distribute FIT kits outside of the clinic visit) to help reduce health system- and patient-level barriers to screening. Trial Registration: National Clinical Trial (NCT) Identifier NCT01742065.
Trade and traders: An exploration into trading communities and their activities in early medieval Odisha
Authors: Sahu Bhairabi Prasad
Published: November 2019

The article makes an effort to locate the emergence of merchant groups in the context of agrarian growth, availability of a marketable surplus, the rise of different types of exchange centres and political enterprises, which must have created their own requirements and facilitated the movement of goods and commodities. It also tries to factor in the transport and communication routes because coastal Odisha had a large hinterland moving up to the Chhattisgarh plains, as also access to southern Bengal and Jharkhand and beyond through the eastern littoral, especially Dandabhukti, among other routes. The rise of transregional states under the Somavaṁśīs and Later Eastern Gangas must have widened the orbit of activity for the regional mercantile groups. Practices and customs followed by the trading communities and their social competence are also investigated. The idea is to situate the developments in the region in the larger context of the issues and debates in the field of ancient and early medieval India. This essay is largely based on inscriptional sources and charts developments up to the fifteenth century.
Modulus reductions of dam embankment materials based on downhole array time series
Authors: Kishida Tadahiro , Park DongSoon , Sousa Rita L. , Armstrong Richard , Byon Young-Ji
Published: November 2019

A database of three-component acceleration time series recorded at downhole arrays in earthen dam cores was published by the Japan Commission on Large Dams. This study reviews the acceleration time series in nine earthfill and rockfill dams in Japan. The apparent shear wave velocities between downhole sensors in each dam during strong shakes are determined by calculating the wave travel time between the recorded time series. Transient shear strains are calculated from the differences in the displacement time series between sensors through the double integration of filtered acceleration time series. The modulus reduction curves of the in situ core materials are constructed by combining the apparent shear wave velocities and shear strains. The modulus reduction data are then compared with empirical models. Observations show considerable uncertainties and dam-dependent characteristics in the extracted in situ shear modulus. Accordingly, this study proposes a methodology to update the empirical modulus reduction model for dam core materials on the basis of observed data on downhole time series.
The 2018 update of the US National Seismic Hazard Model: Overview of model and implications
Authors: Petersen Mark D. , Shumway Allison M. , Powers Peter M. , Mueller Charles S. , Moschetti Morgan P. , Frankel Arthur D. , Rezaeian Sanaz , McNamara Daniel E. , Luco Nico , Boyd Oliver S. , Rukstales Kenneth S. , Jaiswal Kishor S. , Thompson Eric M. , Hoover Susan M. , Clayton Brandon S. , Field Edward H. , Zeng Yuehua
Published: November 2019

During 2017–2018, the National Seismic Hazard Model for the conterminous United States was updated as follows: (1) an updated seismicity catalog was incorporated, which includes new earthquakes that occurred from 2013 to 2017; (2) in the central and eastern United States (CEUS), new ground motion models were updated that incorporate updated median estimates, modified assessments of the associated epistemic uncertainties and aleatory variabilities, and new soil amplification factors; (3) in the western United States (WUS), amplified shaking estimates of long-period ground motions at sites overlying deep sedimentary basins in the Los Angeles, San Francisco, Seattle, and Salt Lake City areas were incorporated; and (4) in the conterminous United States, seismic hazard is calculated for 22 periods (from 0.01 to 10 s) and 8 uniform VS30 maps (ranging from 1500 to 150 m/s). We also include a description of updated computer codes and modeling details. Results show increased ground shaking in many (but not all) locations across the CEUS (up to ~30%), as well as near the four urban areas overlying deep sedimentary basins in the WUS (up to ~50%). Due to population growth and these increased hazard estimates, more people live or work in areas of high or moderate seismic hazard than ever before, leading to higher risk of undesirable consequences from forecasted future ground shaking.
Ultrasonic Welding of Magnesium–Titanium Dissimilar Metals: A Study on Thermo-mechanical Analyses of Welding Process by Experimentation and Finite Element Method
Authors: Zhao Dewang , Ren Daxin , Zhao Kunmin , Sun Pan , Guo Xinglin , Liu Liming
Published: November 2019

Ultrasonic welding is an effective ways to achieve a non-reactive/immiscible heterogeneous metal connection, such as the connection of magnesium alloy and titanium alloy. But the thermal mechanism of magnesium alloy/titanium alloy ultrasonic welding has not been defined clearly. In this paper, the experimental and the finite element analysis were adopted to study the thermal mechanism during welding. Through the test, the temperature variation law during the welding process is obtained, and the accuracy of the finite element model is verified. The microscopic analysis indicates that at the welding time of 0.5 s, the magnesium alloy in the center of the solder joint is partially melted and generates the liquid phase. Through the finite element analysis, the friction coefficient of the magnesium–titanium ultrasonic welding interface can be considered as an average constant value of 0.28. The maximum temperature at the interface can exceed 600 °C to reach the melting point temperature of the magnesium alloy. The plastic deformation begins after 0.35 s and occurs at the magnesium side at the center of the interface.
Shape Stability of Metallic Nanoplates: A Molecular Dynamics Study
Authors: Chen Xiwen , Huang Rao , Shih Tien-Mo , Wen Yu-Hua
Published: November 2019

Metallic nanoplates have attracted widespread interests owing to their functional versatility, which relies heavily on their morphologies. In this study, the shape stability of several metallic nanoplates with body-centered-cubic (bcc) lattices is investigated by employing molecular dynamics simulations. It is found that the nanoplate with (110) surface planes is the most stable compared to the ones with (111) and (001) surfaces, and their shapes evolve with different patterns as the temperature increases. The formation of differently orientated facets is observed in the (001) nanoplates, which leads to the accumulation of shear stress and thus results in the subsequent formation of saddle shape. The associated shape evolution is quantitatively characterized. Further simulations suggest that the shape stability could be tuned by facet orientations, nanoplate sizes (including diameter and thickness), and components.
Comparative genomics of Mycoplasma pneumoniae isolated from children with pneumonia: South Korea, 2010–2016
Authors: Lee Joon Kee , Seong Moon-Woo , Shin Dongjin , Kim Jong-Il , Han Mi Seon , Yeon Youbin , Cho Sung Im , Park Sung Sup , Choi Eun Hwa
Published: November 2019

Background

Mycoplasma pneumoniae is a common cause of respiratory tract infections in children and adults. This study applied high-throughput whole genome sequencing (WGS) technologies to analyze the genomes of 30 M. pneumoniae strains isolated from children with pneumonia in South Korea during the two epidemics from 2010 to 2016 in comparison with a global collection of 48 M. pneumoniae strains which includes seven countries ranging from 1944 to 2017.

Results

The 30 Korean strains had approximately 40% GC content and ranged from 815,686 to 818,669 base pairs, coding for a total of 809 to 828 genes. Overall, BRIG revealed 99% to > 99% similarity among strains. The genomic similarity dropped to approximately 95% in the P1 type 2 strains when aligned to the reference M129 genome, which corresponded to the region of the p1 gene. MAUVE detected four subtype-specific insertions (three in P1 type 1 and one in P1 type 2), of which were all hypothetical proteins except one tRNA insertion in all P1 type 1 strains. The phylogenetic associations of 30 strains were generally consistent with the multilocus sequence typing results. The phylogenetic tree constructed with 78 genomes including 30 genomes from Korea formed two clusters and further divided into two sub-clusters. eBURST analysis revealed two clonal complexes according to P1 typing results showing higher diversity among P1 type 2 strains.

Conclusions

The comparative whole genome approach was able to define high genetic identity, unique structural diversity, and phylogenetic associations among the 78 M. pneumoniae strains isolated worldwide.
Overexpression of OsPUB41, a Rice E3 ubiquitin ligase induced by cell wall degrading enzymes, enhances immune responses in Rice and Arabidopsis
Authors: Kachewar Neha Rajendra , Gupta Vishal , Ranjan Ashish , Patel Hitendra Kumar , Sonti Ramesh V.
Published: November 2019

Background

Cell wall degrading enzymes (CWDEs) induce plant immune responses and E3 ubiquitin ligases are known to play important roles in regulating plant defenses. Expression of the rice E3 ubiquitin ligase, OsPUB41, is enhanced upon treatment of leaves with Xanthomonas oryzae pv. oryzae (Xoo) secreted CWDEs such as Cellulase and Lipase/Esterase. However, it is not reported to have a role in elicitation of immune responses.

Results

Expression of the rice E3 ubiquitin ligase, OsPUB41, is induced when rice leaves are treated with either CWDEs, pathogen associated molecular patterns (PAMPs), damage associated molecular patterns (DAMPs) or pathogens. Overexpression of OsPUB41 leads to induction of callose deposition, enhanced tolerance to Xoo and Rhizoctonia solani infection in rice and Arabidopsis respectively. In rice, transient overexpression of OsPUB41 leads to enhanced expression of PR genes and SA as well as JA biosynthetic and response genes. However, in Arabidopsis, ectopic expression of OsPUB41 results in upregulation of only JA biosynthetic and response genes. Transient overexpression of either of the two biochemically inactive mutants (OsPUB41C40A and OsPUB41V51R) of OsPUB41 in rice and stable transgenics in Arabidopsis ectopically expressing OsPUB41C40A failed to elicit immune responses. This indicates that the E3 ligase activity of OsPUB41 protein is essential for induction of plant defense responses.

Conclusion

The results presented here suggest that OsPUB41 is possibly involved in elicitation of CWDE triggered immune responses in rice.
Factors associated with the rates of coronary artery bypass graft and percutaneous coronary intervention
Authors: Kim Agnus M. , Park Jong Heon , Cho Seongcheol , Kang Sungchan , Yoon Tae Ho , Kim Yoon
Published: November 2019

Background

Korea has seen a rapid increase in the use of percutaneous coronary intervention (PCI) with the ratio of PCI to coronary artery bypass graft (CABG) the highest in the world. This study was performed to examine the factors associated with the rates of CABG and PCI.

Methods

The data were acquired from the National Health Insurance database in Korea in 2013. We calculated the age-sex standardized rates of CABG and PCI. We examined the factors associated with the CABG and PCI rates by performing a regression analysis.

Results

The rate of CABG showed a negative association with the deprivation index score, and other factors, such as the number of providers or hospital beds, did not show any significant association with the CABG rate. The rate of PCI had a strong negative association with the number of cardiothoracic surgeons and a strong positive association with the number of hospital beds.

Conclusions

The positive association between the PCI rate and the number of hospital beds suggests that the use of PCI may be driven by the supply of beds, and the inverse association between the PCI rate and the number of cardiothoracic surgeons indicates the overuse of PCI due to lack of the providers of CABG. Policy measures should be taken to optimize the use of revascularization procedures, the choice of which should primarily be based on the patient’s need.
The magnitude and correlates of esophageal Varices among newly diagnosed cirrhotic patients undergoing screening fibre optic endoscope before incident bleeding in North-Western Tanzania; a cross-sectional study
Authors: Gunda Daniel W. , Kilonzo Semvua B. , Mamballah Zakhia , Manyiri Paulina M. , Majinge David C. , Jaka Hyasinta , Kidenya Benson R. , Mazigo Humphrey D.
Published: November 2019

Background

Bleeding esophageal varices is a deadly complication of liver cirrhosis. Guidelines recommend an early diagnosis of esophageal varices before incident bleeding by screening all patients diagnosed with liver cirrhosis. Though it has been reported elsewhere that the presence of esophageal varices varies widely among cirrhotic patients this has not been assessed in Tanzania since endoscopy is not readily available for routine use in our setting. This study was designed to determine the prevalence of esophageal varices and assess the utility of clinical parameters in predicting the presence of varices among cirrhotic patients in northwestern Tanzania.

Methods

A cross-sectional analysis of adult patients with liver cirrhosis was done at Bugando Medical Centre. Demographic, clinical, laboratory and endoscopic data were collected and analyzed using STATA 13. The presence of esophageal varices was detected using endoscopic examination and associated factors were assessed by logistic regression. The predictive value of clinical predictors was also assessed by calculating sensitivity and specificity.

Results

A total of 223 patients were enrolled, where 88 (39.5%; 95%CI: 33.0–45.9) had esophageal varices. The varices were independently associated with increased age (OR: 1.02; 95%CI: 1.0–1.04; p = 0.030); increased splenic diameter (OR:1.3; 95%CI:1.2–1.5; p <  0.001), increased portal vein diameter (OR:1.2; 95%CI: 1.07–1.4; p = 0.003), having ascites (OR: 3.0; 95%CI: 1.01–8.7; p = 0.046), and advanced liver disease (OR: 2.9; 95%CI: 1.3–6.7; p = 0.008). PSDR least performed in predicting varices, (AUC: 0.382; 95%CI: 0.304–0.459; cutoff: < 640; Sensitivity: 58.0%; 95%CI: 46.9–68.4; specificity: 57.0%; 95%CI: 48.2–65.5). SPD had better prediction; (AUC: 0.713; 95%CI: 0.646–0.781; cut off: > 15.2 cm; sensitivity: 65.9%; (95% CI: 55–75.7 and specificity:65.2%; 95%CI: 56.5–73.2), followed by PVD, (AUC: 0.6392; 95%CI: 0.566–0.712;cutoff: > 1.45 cm; sensitivity: 62.5%; 95CI: 51.5–72.6; specificity: 61.5%; 95%CI: 52.7–69.7).

Conclusion

Esophageal varices were prevalent among cirrhotic patients, most of which were at risk of bleeding. The non-invasive prediction of varices was not strong enough to replace endoscopic diagnosis. However, the predictors in this study can potentially assist in the selection of patients at high risk of having varices and prioritize them for endoscopic screening and appropriate management.
Characteristics of febrile urinary tract infections in older male adults
Authors: Smithson Alex , Ramos Javier , Niño Esther , Culla Alex , Pertierra Ubaldo , Friscia Michele , Bastida Maria Teresa
Published: November 2019

Background

Urinary tract infections (UTI) are among the most frequent bacterial infections in older adults. The aim of the study was to analyse the existence of differences in clinical features, microbiological data and risk of infection by multidrug-resistant organisms (MDRO) between older and non-older men with febrile UTI (FUTI).

Methods

This was an ambispective observational study involving older males with a FUTI attended in the Emergency Department. Variables collected included age, comorbidity, diagnostic of healthcare-associated (HCA)-FUTI, clinical manifestations, hospitalization, mortality, and microbiological data.

Results

Five hundred fifty-two males with a FUTI, 329 (59.6%) of whom were older adults, were included. Older males had a higher frequency of HCA-FUTI (p <  0.001), increased Charlson scores (p <  0.001), had received previous antimicrobial treatment more frequently (p <  0.001) and had less lower urinary tract symptoms (p <  0.001). Older patients showed a lower frequency of FUTI caused byE. coli(p <  0.001) and a higher rate of those due toEnterobacter spp.(p = 0.003) andP. aeruginosa(p = 0.033). Resistance rates to cefuroxime (p = 0.038), gentamicin (p = 0.043), and fluoroquinolones (p <  0.001)inE. coliisolates and the prevalence of extended-spectrum beta-lactamase and AmpC producingE. coliandKlebsiella spp.strains (p = 0.041) and MDRO (p <  0.001) were increased in older males. Inadequate empirical antimicrobial treatment (p = 0.004), frequency of hospitalization (p <  0.001), and all cause in-hospital mortality (p = 0.007) were higher among older patients. In the multivariate analysis, being admitted from an long term care facility (OR 2.4; 95% CI: 1.06–5.9), having a urinary tract abnormality (OR 2.2; 95% CI: 1.2–3.8) and previous antimicrobial treatment (OR 3.2; 95% CI: 1.9–5.4) were associated to FUTI caused by MDRO.

Conclusions

Older male adults with a FUTI have different clinical characteristics, present specific microbiological features, and antimicrobial resistance rates. In the multivariate analysis being an older male was not associated with an increased risk of FUTI caused by MDRO.
Mathematical modelling for antibiotic resistance control policy: do we know enough?
Authors: Knight Gwenan M. , Davies Nicholas G. , Colijn Caroline , Coll Francesc , Donker Tjibbe , Gifford Danna R. , Glover Rebecca E. , Jit Mark , Klemm Elizabeth , Lehtinen Sonja , Lindsay Jodi A. , Lipsitch Marc , Llewelyn Martin J. , Mateus Ana L. P. , Robotham Julie V. , Sharland Mike , Stekel Dov , Yakob Laith , Atkins Katherine E.
Published: November 2019

Background

Antibiotics remain the cornerstone of modern medicine. Yet there exists an inherent dilemma in their use: we are able to prevent harm by administering antibiotic treatment as necessary to both humans and animals, but we must be mindful of limiting the spread of resistance and safeguarding the efficacy of antibiotics for current and future generations. Policies that strike the right balance must be informed by a transparent rationale that relies on a robust evidence base.

Main text

One way to generate the evidence base needed to inform policies for managing antibiotic resistance is by using mathematical models. These models can distil the key drivers of the dynamics of resistance transmission from complex infection and evolutionary processes, as well as predict likely responses to policy change in silico. Here, we ask whether we know enough about antibiotic resistance for mathematical modelling to robustly and effectively inform policy. We consider in turn the challenges associated with capturing antibiotic resistance evolution using mathematical models, and with translating mathematical modelling evidence into policy.

Conclusions

We suggest that in spite of promising advances, we lack a complete understanding of key principles. From this we advocate for priority areas of future empirical and theoretical research.
Characteristics and outcome of influenza-associated encephalopathy/encephalitis among children in a tertiary pediatric hospital in Italy, 2017–2019
Authors: Mastrolia Maria Vincenza , Rubino Chiara , Resti Massimo , Trapani Sandra , Galli Luisa
Published: November 2019

Background

Influenza is the most frequent cause of acute upper respiratory tract infections during winter season. Although rare, neurological manifestations are known to occur during influenza infection and approximatively three-quarters of cases are in children. In this study, we aimed to characterize the burden and clinical spectrum of influenza-associated encephalopathy and encephalitis in children admitted at a tertiary pediatric hospital in Italy over two influenza seasons (2017–2019).

Methods

We retrospectively analyzed clinical, laboratory, instrumental data and outcome of patients discharged with ICD9-CM 487.0 code.

Results

Fifteen children (13.1% of those discharged with a diagnosis of influenza infection in the study period), had influenza-associated central nervous system (CNS) manifestations. Eight patients (53.3%) were diagnosed as influenza encephalitis, 7 (46.7%) as influenza encephalopathy. Median age was 27 months. In children under 2 years of age (40% of all cases) altered consciousness was the most frequent neurological manifestation while respiratory symptoms were present at admission in all cases. Younger children also required intensive care support more frequently. Five subjects (33.3%) presented comorbidity. None of the patients had received seasonal influenza vaccination. The median time from onset of respiratory signs to onset of neurological manifestations was 24 h. Cerebrospinal fluid (CSF) analysis was normal in most patients and polymerase chain reaction for influenza virus RNA on CSF, when performed, was negative in all samples. Neuroradiological investigations, performed in 5 children, reported cortical and subcortical white matter signal alterations. Oseltamivir was administered only in 2 cases. Fourteen patients recovered without sequelae, and only a 2-year-old girl had minimal impairment in fine motor skills at discharge.

Conclusions

All children presenting acute neurological features during influenza season should be evaluated for influenza-associated CNS complications even if the respiratory involvement is mild. Absence of underlying diseases or other risk factors are not protective factors against CNS influenza-associated complications. The lack of CSF pleocytosis does not exclude CNS involvement. Children under 2 years of age are at higher risk of requiring intensive care support.