bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated Fluxes in Magneto-Hydrodynamic Mixed Convection in a Cavity Sustained by Conjugate Heat Transfer
Authors: Mookherjee Orkodip , Pramanik Shantanu
Published: August 2019

A numerical study of magneto-hydrodynamic mixed convection in a cavity has been conducted to investigate the influence of magnetic field on integrated flux of thermal energy, linear momentum, and kinetic energy. Shear force through lid motion establishes the forced convection effect and buoyancy force due to differential heating of the moving lid and the stationary interface ensures the natural convection phenomenon. Additionally, conduction through the solid slab with prescribed temperature at the outer surface attached to the cavity induces conjugate heat transfer. Further, the top and bottom walls throughout the domain are kept insulated and a uniform horizontal magnetic field is applied on the interface toward left. Fluid flow and heat transfer characteristics are examined for a range of Hartmann number (Ha): 0, 10, 50, and 120 at fixed values of Reynolds number, Grashof number, and Prandtl number of 300, 9 × 104 and 0.71, respectively. The result shows that the transport of heat in the near wall regions of the fluid domain is primarily governed by diffusion, whereas advection appears stronger in the central region of the cavity. Increase in magnetic field strength from Ha = 0 to 120 gradually suppresses the recirculating structure of the flow signifying a reduction in advective strength as depicted by the decrease in the value of total integrated heat flux from 25.15×10-3 to 6.0×10-3. The reduction in heat flux, momentum fluxes, and kinetic energy fluxes with increase in magnetic field has been well correlated in the range of 0≤Ha≤120.
Combined Effects of Variable Thermal Conductivity and Electrical Conductivity on Peristaltic Flow of Pseudoplastic Nanofluid in an Inclined Non-Uniform Asymmetric Channel: Applications to Solar Collectors
Authors: Hasona W. M. , Almalki N. H. , ElShekhipy A. A. , Ibrahim M. G.
Published: August 2019

As conduction, convection, and radiation are fundamental modes of heat emitter and transfer, this paper looks at the influences of temperature-dependent thermal conductivity and thermal radiation on peristaltic flow of pseudoplastic nanofluids in an inclined non-uniform asymmetric channel. Inclined magnetic field is taken into consideration. As the Wiedemann–Franz law in metals, electrical conductivity has identical behavior as that of thermal conductivity; as freely animated evenness, electrons transfer not only electric current but also heat energy. Consequently, electrical conductivity should be depending on the temperature of nanoparticles. The related equations of momentum, mass, and concentration are reformulated using lubrication approximations (i.e., tiny or zero Reynolds number and long wavelength). The resulting system of nonlinear equations is solved semi-numerically with the aid of the parametric ND solve package using mathematica version 11. Results of velocity, temperature, and concentration distributions are obtained in the analytical three-dimensional forms. The streamline graphs are offered in the terminus, which elucidate the trapping bolus phenomenon. As a special case, a comparison is made and signified with the recently published results by Hayat et al. (2016, Soret and Dufour Effects in MHD Peristalsis of Pseudoplastic Nanofluid With Chemical Reaction,” J. Mol. Liq., 220, pp. 693–706). It's found that, the increases in thermal conductivity and electrical conductivity cause an increase in the temperature of nanofluid and the heat transfer rate gets induced so a better absorption of solar energy is gained.
Design of a High-Concentration Microtracking Photovoltaic System
Authors: Brulo Gregory S. , Grede Alex J. , Ren Andrew J. , Rahn Christopher D. , Giebink Noel C.
Published: August 2019

High-concentration photovoltaic systems can provide power conversion efficiency that is nearly double that of conventional solar panels. Concentrating photovoltaics (CPV) cannot compete with fixed silicon panels for rooftop installations due to the complexity and cost of CPV two-axis pedestal tracking systems. Fixed optic designs have recently been proposed to have a transparent middle sheet with small, widely spaced, and highly efficient solar cells sandwiched between a fixed lenslet array on the top and a fixed reflector array on the bottom. Precision actuators position the middle sheet at the focal points of the lenslet/reflector array to microtrack the sun throughout the day. This paper discusses the kinematic design and control of shape memory alloy (SMA) actuators used for the first time in this solar microtracking application. SMA actuators have the potential to be less expensive, easier to integrate, and lower power than electric motors. The kinematic design maintains upper and lower bounds on wire tension to prevent failure and ensure reversible actuation, respectively. The SMA actuators under quasi-linearized proportional integral directive (PID) control can position the middle sheet with ± 7 mm of range in the vertical and horizontal directions while ensuring less than 1.9 µm of steady-state error in SMA actuator stroke. The middle sheet position and orientation errors, however, exceed 1 mm and 0.5 deg, respectively. These relatively large errors are due to flexibility in the suspension system, friction at wire supports, and large kinematic gains at extreme positions and indicate the need for middle sheet error measurement and feedback control.
A greener path for the EU Common Agricultural Policy
Authors: Pe'er Guy , Zinngrebe Yves , Moreira Francisco , Sirami Clélia , Schindler Stefan , Müller Robert , Bontzorlos Vasileios , Clough Dagmar , Bezák Peter , Bonn Aletta , Hansjürgens Bernd , Lomba Angela , Möckel Stefan , Passoni Gioele , Schleyer Christian , Schmidt Jenny , Lakner Sebastian
Published: August 2019

It's time for sustainable, environmental performance
How diatoms harvest light
Authors: Büchel Claudia
Published: August 2019

Light-harvesting systems in a group of microalgae differ from those in plants
Interleukin-21 (IL-21) Downregulates Dendritic Cell Cytokine Responses to Helicobacter pylori and Modulates T Lymphocyte IL-17A Expression in Peyer’s Patches during Infection
Authors: Yasmin Sharia , Dixon Beverly R. E. A. , Olivares-Villagómez Danyvid , Algood Holly M. Scott
Published: August 2019

Interleukin-21 (IL-21), a cytokine produced by many subsets of activated immune cells, is critical for driving inflammation in several models. Using
Helicobacter pylori
infection as a model for chronic mucosal infection, we previously published that IL-21 is required for the development of gastritis in response to infection. Concomitant with protection from chronic inflammation,
H. pylori
-infected IL-21
−/−
mice exhibited limited Th1 and Th17 responses in their gastric mucosa.
Clinical examination remains crucial to the correct diagnosis: a case of severe peripheral oedema referred for investigation of heart failure
Authors: Mengi Siddhartha , Phelps Lyndsey , Silva Tiago Silva Carvalho da , Ludman Andrew
Published: August 2019

Hepatocellular carcinoma (HCC) uncommonly metastasises to the heart. We present a case of new onset bilateral leg swelling and suspected right heart failure in a previously fit and healthy man, which on further investigation revealed a new diagnosis of HCC with extension into the inferior vena cava and right atrium. This case highlights the importance of considering alternative possibilities when physical examination does not match the initial clinical diagnosis. The management approach was for best supportive care in view of extensive metastatic disease.
Deceitful red-flag: angina secondary to iron deficiency anaemia as a presenting complaint for underlying malignancy
Authors: Perera Chanaka Aravinda , Biggers Richard Peter , Robertson Alan
Published: August 2019

A 73-year-old man with an 8-week history of angina underwent an exercise tolerance test at the rapid access clinic, which indicated inducible ischaemia and he was subsequently referred for angiogram. His angiogram demonstrated no coronary pathology. It was later discovered that bloods taken on the day of the procedure showed a haemoglobin of 54 g/L (130–180 g/L). His haemoglobin used to book the angiogram 3 months before was 143 g/L. Following angiogram, a mass was identified in the right iliac fossa and CT scan confirmed a caecal tumour. The patient ultimately underwent a curative right hemicolectomy as an outpatient. The case is a reminder of the importance of basic preangiogram investigations, in particularly a full blood count, to rule-out angina secondary to anaemia through a low haemoglobin. Most importantly, it also questions when the appropriate time is for these investigations to be carried out, prior to coronary angiography.
Malignant melanoma arising from an end ileostomy
Authors: Gilbert Richard William Donald , Harvey Harry Myles , Nessim Carolyn
Published: August 2019

A 65-year-old woman with a history of proctocolectomy and end ileostomy for ulcerative colitis was referred to our clinic with a slowly growing mass around her ileostomy. She did not report any systemic symptoms. On examination, an exophytic mass was observed around her ileostomy and hard lymph nodes palpated in her groins bilaterally. Punch biopsy of the lesion established a diagnosis of invasive melanoma. Positron emission tomography revealed regional metastatic lymphadenopathy in the right axilla and both groins. There was no evidence of distant metastatic disease. The patient then underwent wide local excision of her ileostomy with bowel resection and ileostomy re-siting, bilateral complete ilioinguinal lymphadenectomy and a right Level III axillary dissection. She is doing well postoperatively and receiving adjuvant systemic therapy with BRAF and MEK inhibitors, now 17 months later with no signs of recurrent disease.
Retrospective observational study of the impact on emergency admission of telehealth at scale delivered in community care in Liverpool, UK
Authors: van Berkel Cees , Almond Peter , Hughes Carol , Smith Maurice , Horsfield Dave , Duckworth Helen
Published: August 2019

Objective

To assess the effect of a real world, ongoing telehealth service on the use of secondary healthcare.

Design

A retrospective observational study with anonymous matched controls.

Setting

Primary and community healthcare. Patients were recruited over 4 years in 89 general practices in Liverpool, UK and remotely managed by a dedicated clinical team in Liverpool Community Health.

Participants

5154 patients with chronic obstructive pulmonary disease, heart failure or diabetes were enrolled in the programme, of whom 3562 satisfied the inclusion criteria of this study.

Intervention

At least 9 weeks of telehealth including vital sign collection, questionnaires, education, support and informal coaching by clinical staff.

Primary outcome

Reduction in the number of emergency admissions in the 12 months after start, compared with the year before start. Secondary subgroup analysis to improve future targeting and personalisation of the service.

Result

The average number of emergency admissions for the intervention group at baseline is 0.35, 95% CI 0.32 to 0.38. The differential decrease in emergency admissions in the intervention group in comparison with the control group, the average treatment effect, is 0.08, 95 CI 0.05 to 0.11, corresponding to an average percentage decrease of 22.7%. In subgroup analysis, a score is calculated that can be used prospectively to predict individual benefit from the intervention. Patients with an above median score (37%) are predicted average reduction in emergency admissions of 0.15, 95% CI 0.09 to 0.2, corresponding to a percentage decrease in admissions of 25.3%.

Conclusion

The telehealth intervention has a positive impact across a wide cohort of patients with different diseases. Prospective scoring of patients and allocation to targeted telehealth interventions is likely to improve the effectiveness and efficiency of the service.
Rationale and tutorial for analysing and reporting sex differences in cardiovascular associations
Authors: Woodward Mark
Published: August 2019

Cardiovascular disease (CVD) is the leading cause of death in women and men. Yet biological and social factors differ between the sexes, while the importance of CVD in women may be underestimated due to the higher age-specific rates in men and the historical bias towards the male model of CVD. Consequently, sex differences in risk factor associations with CVD occur, but these are not always recognised. This article argues that sex disaggregation should be the norm in CVD research, for both humanitarian and clinical reasons. A tutorial on how to design and analyse sex comparisons is provided, including ways of reducing bias and increasing efficiency. This is presented both in the context of analysing individual participant data from a single study and a meta-analysis of sex-specific summary data. Worked examples are provided for both types of research. Fifteen key recommendations are included, which should be considered when undertaking sex comparisons of CVD associations. Paramount among these is the need to estimate sex differences, as ratios of relative risks or differences in risk differences, rather than merely test them for statistical significance. Conversely, when there is no evidence of statistical or clinical significance of a sex difference, the conclusions from the research should not be sex-specific.
Ability of fitness testing to predict injury risk during initial tactical training: a systematic review and meta-analysis
Authors: Tomes Colin D , Sawyer Sally , Orr Robin , Schram Ben
Published: August 2019

Objective

Tactical personnel (Military, Law Enforcement, Emergency Responders) require physical fitness levels sufficient for training and occupational duty. Physical conditioning aimed at increasing fitness levels during training presents an injury risk, but unfit trainees may struggle to meet occupational performance standards, further increasing injury risk to themselvesor others. Therefore, the aim of this review was to determine if fitness, asquantified by tactical fitness tests, effectively predicts injury risk during training.

Methods

Literature databases were search and relevant articles extracted. 27 Publications were included for qualitative review and seven studies reporting a timed run were included in meta-analysis.

Results

The combined risk ratio was 2.34 (95% CI 2.02 to2.70). Muscular endurance tests were less conclusive in their predictive abilities. Functional strength or power tests were effective predictors, but few studies reported on strength or power, indicating a need for further study inthis area.

Conclusions

The meta-analysis results are supported by the occupational relevance of run tests; tactical trainees are required to perform frequent bouts of distance weight bearing activity. However, given the diverse physical requirements of tactical personnel, measures of strength and power should alsobe evaluated, especially given their effectiveness in the studies that included these measures.
Genes and genetics in hyperhomocysteinemia and the “1-carbon metabolism”: implications for retinal structure and eye functions
Authors: George Akash K. , Majumder Avisek , Ice Hayley , Homme Rubens P. , Eyob Wintana , Tyagi Suresh C. , Singh Mahavir
Published: August 2019

Homocysteine (Hcy), a sulfur-containing nonproteinogenic amino acid, is generated as a metabolic intermediate. Hcy constitutes an important part of the “1-carbon metabolism” during methionine turnover. Elevated levels of Hcy known as hyperhomocysteinemia (HHcy) results from vitamin B deficiency, lack of exercise, smoking, excessive alcohol intake, high-fat and methionine-rich diet, and the underlying genetic defects. These factors directly affect the “1-carbon metabolism (methionine–Hcy–folate)” of a given cell. In fact, the Hcy levels are determined primarily by dietary intake, vitamin status, and the genetic blueprint of the susceptible individual. Although Hcy performs an important role in cellular functions, genetic alterations in any of the key enzymes responsible for the “1-carbon metabolism” could potentially upset the metabolic cycle, thus causing HHcy environment in susceptible people. As such, HHcy relates to several clinical conditions like atherosclerosis, myocardial infarction, stroke, cognitive impairment, dementia, Parkinson’s disease, multiple sclerosis, epilepsy, and ocular disorders, among others. This article summarizes the findings from our laboratory and public database regarding genetics of HHcy and its effects on ocular disorders, their respective management during dysregulation of the 1-carbon metabolism.
Lycopene improves methotrexate-induced functional alterations of the Madin–Darby kidney cells in a concentration-dependent manner
Authors: Stojiljković Nenad , Ilić Sonja , Stojanović Nikola , Stojanović Sanja , Stoiljković Milan
Published: August 2019

Lycopene is one of the most potent antioxidants among carotenoids due to its ability to quench singlet oxygen and react with free radicals to reduce DNA damage. Methotrexate is widely used in the treatment of several types of cancers and autoimmune diseases. One of the most common side effects of a high-dose of methotrexate is kidney injury. In this study, we evaluated effects of lycopene on the Madin–Darby canine kidney cells (MDCK) treated with methotrexate through the estimation of their mitochondrial and lysosomal functions ((4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide reduction assay and neutral red uptake assay) and changes in cell oxidative status (determination of advanced oxidized proteins concentrations and reduced glutathione levels) and lysosomal enzymes activity (β-N-acetyl glucosaminidase activity). Results of our study showed that lycopene applied in high concentration caused significant impairment of the MDCK function leading to cell death. Contrarily, in relatively low concentrations lycopene moderately ameliorated methotrexate-induced MDCK cell death estimated by both biochemical and microscopic analyses. It also prevented a significant decline in the MDCK cell lysosomal function estimated by neutral red accumulation ability and activity of the lysosomal enzyme β-N-acetyl glucosaminidase.
Elastic Parallel Systems for High Performance Cloud Computing: State-of-the-Art and Future Directions
Authors: Kehrer Stefan , Blochinger Wolfgang
Published: August 2019

With on-demand access to compute resources, pay-per-use, and elasticity, the cloud evolved into an attractive execution environment for High Performance Computing (HPC). Whereas elasticity, which is often referred to as the most beneficial cloud-specific property, has been heavily used in the context of interactive (multi-tier) applications, elasticity-related research in the HPC domain is still in its infancy. Existing parallel computing theory as well as traditional metrics to analytically evaluate parallel systems do not comprehensively consider elasticity, i.e., the ability to control the number of processing units at runtime. To address these issues, we introduce a conceptual framework to understand elasticity in the context of parallel systems, define the term elastic parallel system, and discuss novel metrics for both elasticity control at runtime as well as the ex-post performance evaluation of elastic parallel systems. Based on the conceptual framework, we provide an in-depth analysis of existing research in the field to describe the state-of-the-art and compile our findings into a research agenda for future research on elastic parallel systems.
Solving Arithmetic Word Problems by Object Oriented Modeling and Query-Based Information Processing
Authors: Mandal Sourav , Naskar Sudip Kumar
Published: August 2019

The paper presents an Object Oriented Analysis and Design (OOAD) approach to modeling, reasoning and a database query based approach to processing and solving addition-subtraction (Add-Sub) type arithmetic Mathematical Word Problems (MWP) of elementary school level. The system identifies and extracts the key entities in a word problem like owners, items and their attributes and quantities, verbs, from all the input sentences, using a rule based Information Extraction (IE) approach based on Semantic Role Labeling (SRL) technique. These information are then stored in predefined templates which are further modeled to represent an MWP in the object-oriented paradigm and processed using query based approach to generate the answer. These kind of applications are based on Natural Language Processing (NLP), Natural Language Understanding (NLU) and Artificial Intelligence (AI), and can be used as intelligent dynamic mathematical tutoring tools as part of E-Learning systems, Learning Management Systems, on-line education, etc. The proposed object oriented mathematical word problem solver can solve arithmetic MWPs involving only addition-subtraction operations and it has produced an accuracy of 94.35% on a subset of the AI2 arithmetic questions dataset.
MACE: Mobile Artificial Conversational Entity for Adapting Domain Knowledge and Generating Personalized Advice
Authors: Troussas Christos , Krouska Akrivi , Virvou Maria
Published: August 2019

Mobile learning offers, with the help of handheld devices, a continuous access to the learning process. With the advent of mobile learning, educational systems are changing, offering the possibility of distance education without the restrictions of place and time. As such, new technological advancements are employed by mobile learning. This paper presents the design, development and evaluation of a novel artificial conversational entity, incorporated in a mobile learning system for personalized English language instruction. More specifically, it offers amelioration of the domain knowledge model by adapting it to the students’ needs and to the pace that they prefer to receive learning. Moreover, it creates personalized tutoring advice in order to support students in the educational process. Finally, it can assist the procedure of assessments since it automatically generates questions to assess the knowledge level of students. The evaluation of the mobile tutoring system presents promising results regarding the incorporation of this new technology in digital education with the aim of creating a student-centric learning experience.
If you write it better, you will say it better
Authors: Yaffe Philip
Published: August 2019

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.

Preparing a good text for reading and preparing a good text for speaking are often considered to be unrelated activities. This is incorrect. A good text for reading and a good text for speaking are distinct, but they are not alien. They are complementary.
The complexities of nasal airflow: theory and practice
Authors: O’Neill Graham , Tolley Neil Samuel
Published: August 2019

The objective of this study was to investigate the effects of nasal valve area, valve stiffness, and turbinate region cross-sectional area on airflow rate, nasal resistance, flow limitation, and inspiratory “hysteresis” by the use of a mathematical model of nasal airflow. The model of O’Neill and Tolley ( Clin Otolaryngol Allied Sci 13: 273–277, 1988) describing the effects of valve area and stiffness on the nasal pressure-flow relationship was improved by the incorporation of additional terms involving 1) airflow through the turbinate region, 2) the dependence of the flow coefficients for the valve and turbinate region on the Reynolds number, and 3) effects of unsteady flow. The model was found to provide a good fit for normal values for nasal resistance and for pressure-flow curves reported in the literature for both congested and decongested states. Also, by showing the relative contribution of the nasal valve and turbinate region to nasal resistance, the model sheds light in explaining the generally poor correlation between nasal resistance measurements and the results from acoustic rhinometry. Furthermore, by proposing different flow conditions for the acceleration and deceleration phases of inspiration, the model produces an inspiratory loop (commonly referred to as hysteresis) consistent with those reported in the literature. With simulation of nasal flaring, the magnitude of the loop, the nasal resistance, and flow limitation all show change similar to that observed in the experimental results.

NEW & NOTEWORTHY The present model provides considerable insight into some difficult conundrums in both clinical and technical aspects of nasal airflow. Also, the description of nasal airflow mechanics based on the Hagen–Poiseuille equation and Reynolds laminar-turbulent transition in long straight tubes, which has figured prominently in medical textbooks and journal articles for many years, is shown to be seriously in error at a fundamental level.
A Service User Perspective Informing the Role of Occupational Therapy in School Transition Practice for High School Learners with TBI: An African Perspective
Authors: Jacobs-Nzuzi Khuabi Lee-Ann , Swart Estelle , Soeker Mogammad Shaheed
Published: August 2019

Background. In the South African context, there are no specific guidelines regarding how to prepare and support adolescents for the transition from a health care to a high school setting post TBI. This raises questions about the relevance and responsiveness of the current transition practices in occupational therapy in terms of adequately preparing and supporting these adolescents to participate in school and hence exercise their right to a quality education.Method. This study explored adolescents and other key role players’ perspectives on and experiences of the high school transition (i.e., school reentry and continued school participation) post TBI. It was anticipated that this would provide an increased understanding of the enablers and barriers to high school reentry and participation post TBI. This served as a basis to explore the main aim of this study which was to help occupational therapists identify where efforts in terms of service delivery are needed. This study was situated in the interpretivist qualitative paradigm and used a multicase study design, which included semistructured interviews with eight adolescent learners with TBI, their primary caregivers, teachers, and principals as well as observations and documentation review.Results. This paper will focus on a central theme in the research, namely, the nature and extent of support needed to facilitate the high school transition of adolescents with TBI within a developing context. Similar to the findings of studies conducted in developed contexts, participants highlighted that they felt that adolescents need support at various stages of the school transition. Participants further alluded to support that should be collaborative, coordinated, flexible, and monitored to ensure it is relevant and responsive to these adolescents’ changing needs.Conclusion. The study findings conclude that occupational therapists have a crucial role in fostering an enabling environment (directly and indirectly) through fulfilling various roles including that of a facilitator, intermediary, coach, collaborator, supporter, and advocator.
Stable Electrochemical Measurements of Platinum Screen-Printed Electrodes Modified with Vertical ZnO Nanorods for Bacterial Detection
Authors: Nguyen Thi Hong Phuoc , Tonezzer Matteo , Dang Thi Thanh Le , Vu Quang Khue , Tran Quang Huy , Nguyen Duc Hoa , Nguyen Van Hieu
Published: August 2019

The study is aimed at investigating the stability of electrochemical and biosensing properties of ZnO nanorod-based platinum screen-printed electrodes (SPEs) applied for detection of bacterial pathogens. The platinum SPEs were designed and patterned according to standard photolithography and lift-off process on a silicon wafer. ZnO nanorods (NRs) were grown on the platinum working electrode by the hydrothermal method, whereas Salmonella polyclonal antibodies were selected and immobilized onto ZnO NR surface via a crosslinking process. Morphological and structural characteristics of ZnO NRs were investigated by scanning electron microscopy (SEM), transmission electron microscopy (TEM), and X-ray diffraction (XRD). The results showed that the ZnO NRs were grown vertically on platinum electrodes with a diameter around 20-200 nm and a length of 5-7 μm. These modified electrodes were applied for detection of Salmonella enteritidis at a concentration of 103 cfu/mL by electrochemical measurements including cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The ZnO NR-modified platinum electrodes could detect Salmonella bacteria well with stable measurements, and the signal to noise ratio was much higher than that of 3 : 1. This study indicated that ZnO NR-modified platinum SPEs could be potential for the development of biochips for electrochemical detection of bacterial pathogens.
Antibiotic Use and Resistance Pattern in Ethiopia: Systematic Review and Meta-Analysis
Authors: Muhie Oumer Abdu
Published: August 2019

Background. In the last decades, medicines have had an unprecedented positive effect on health, leading to reduced mortality and disease burden and consequently to an improved quality of life. The rapid and ongoing spread of antimicrobial-resistant organisms threatens our ability to successfully treat a growing number of infectious diseases. In the absence of the development of new generations of antibiotic drugs, appropriate use of existing antibiotics is needed to ensure the long-term availability of effective treatment for bacterial infections. Irrational use of antibiotics is an ongoing global public health problem that deserves more attention. This review is conducted to evaluate the prevalence of inappropriate antibiotic utilization and resistance to antibiotics in Ethiopia. Methods. Electronic search in PubMed/MEDLINE and Google was used to find published literature with reference lists of relevant articles searched manually. Titles and abstracts were initially screened for eligibility. The full texts of articles judged to be eligible were reviewed if they meet the inclusion criteria. Data were extracted on important variables like the sample size, region of the study, the inappropriate antibiotic use, bacterial detection rate, multidrug resistance pattern, and more other variables. Microsoft Excel was used for data extraction. Quantitative analysis was performed using STATA version 11. Results. The electronic searches identified 193 articles of which 33 were found eligible. The random-effects model was used to provide point estimates (with 95% confidence interval (CI)) of bacterial detection rate, inappropriate antibiotic use, and multidrug resistance rate to account for heterogeneity. The pooled bacteria detection rate was 29.1 with 95% CI (16.6–41.7). The pooled prevalence of multidrug resistant strains identified was 59.7% (95% CI: 43.5–75.9). The pooled estimate of inappropriate antibiotic use was 49.2% (95% CI: 32.2–66.2). The pooled proportion of self-antibiotic prescription was 43.3% (95% CI: 15.7–70.9). Other reasons for inappropriate antibiotic use included a wrong indication, wrong duration, improper route of administration, use of leftover antibiotics from a family member, and immature discontinuation of antibiotics. Conclusion and Recommendations. Inappropriate antibiotic use is a huge problem in Ethiopia, and many bacteria were resistant to commonly used antibiotics and similarly, multidrug-resistant bacterial strains are numerous. Appropriate antibiotic use should be ensured by prohibiting over-the-counter sale of antibiotics and strengthening antimicrobial stewardship.
Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo
Authors: Egbohou Pilakimwe , Mouzou Tabana , Tchetike Pikabalo , Sama Hamza Doles , Assenouwe Sarakawabalo , Akala-Yoba Gnimdou , Randolph Lonlongnon , Tomta Kadjika
Published: August 2019

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.
The Effect of Extraction Conditions on Chemical and Thermal Characteristics of Kappa-Carrageenan Extracted fromHypnea bryoides
Authors: Al-Nahdi Zainab Mohammed , Al-Alawi Ahmed , Al-Marhobi Insaaf
Published: August 2019

Hypnea bryoidescollected from the Arabian Sea on the southern coast of Oman was investigated forκ-carrageenan optimal extraction conditions. The effects of different conditions of alkali treatment (4, 6, and 8% w/v NaOH), temperatures (70, 75, and 80°C), and time (2, 2.75, 3.5 hours) on carrageenan yield and chemical and thermal properties were evaluated. Yield was significantly affected by alkaline concentration and temperature, with highest value of 26.74 ± 5.01%. Molecular weights of the extracted carrageenan were significantly reduced by increased temperatures and ranged from 5.95 ± 0.49 × 105 Da to 13.90 ± 0.14 × 105. FTIR showed that samples under all extraction conditions were similar and confirmed the presence ofκ-carrageenan with no traces ofμ-precursor. Sulfate content was also significantly reduced by alkaline concentration (from 4% to 6%) and ranged from 7.62 ± 5.52% to 17.02 ± 0.14. Thermal properties showed more sensitivity towards temperature and alkaline strength parameter than time. In addition, melting and gelling temperatures were significantly correlated with the molecular weight, but not sulfate content. In conclusion, mild extraction conditions were found to be more efficient in introducing the intended structural modification while getting the highest yield and quality.
The Analysis of In Vivo Aging in Human Bone Marrow Mesenchymal Stromal Cells Using Colony-Forming Unit-Fibroblast Assay and the CD45lowCD271+ Phenotype
Authors: Ganguly Payal , El-Jawhari Jehan J. , Burska Agata N. , Ponchel Frederique , Giannoudis Peter V. , Jones Elena A.
Published: August 2019

Uncultured mesenchymal stromal cells (MSCs) are increasingly used in therapies; however, the effects of donor age on their biological characteristics and gene expression remain unclear. The aim of this study was to investigate age-related changes in bone marrow (BM) MSCs following minimal or no culture manipulation. Iliac crest BM was aspirated from 67 healthy donors (19-89 years old) and directly used for the colony-forming unit-fibroblast (CFU-F) assay or CD45lowCD271+ cell enumeration. The colonies were analysed for colony area and integrated density (ID) when grown in standard MSC media or media supplemented with human serum from young (YS) or old (OS) donors. There was a notable age-related decline in the number of MSCs per millilitre of BM aspirate revealed by the CFU-F assay (r=−0.527, p<0.0001) or flow cytometry (r=−0.307, p=0.0116). Compared to young donors (19-40 years old), colony IDs were significantly lower in older donors (61-89 years old), particularly for smaller-sized colonies (42% lower, p<0.01). When cultured in media supplemented with OS, young and old donor MSCs formed colonies with lower IDs, by 21%, p<0.0001, and 27%, p<0.05, respectively, indicating the formation of smaller sparser colonies. No significant differences in the expression of selected adipogenic, osteogenic, stromal, and bone remodelling genes as well as CD295, CD146, CD106, and connexin 43 surface molecules were found in sorted CD45lowCD271+ MSCs from young and old donors (n=8 donors each). Altogether, these results show similar trends for age-related decline in BM MSC numbers measured by the CFU-F assay and flow cytometry and reveal age-related effects of human serum on MSC colony formation. No significant differences in selected gene expression in uncultured CD45lowCD271+ MSCs suggest that old donor MSCs may not be inferior in regard to their multipotential functions. Due to large donor-to-donor variation in all donor groups, our data indicate that an individual’s chronological age is not a reliable predictor of their MSC number or potency.
Straight-Parallel Electrodes and Variable Gap for Hydrogen and Oxygen Evolution Reactions
Authors: Lavorante María J. , Reynoso Carla Y. , Franco Juan I.
Published: August 2019

The challenges to be overtaken with alkaline water electrolysis are the reduction of energy consumption, the maintenance, and the cost as well as the increase of durability, reliability, and safety. Having these challenges in mind, this work focused on the reduction of the electrical resistance of the electrolyte which directly affects energy consumption. According to the definition of electrical resistance of an object, the reduction of the space between electrodes could lower the electrical resistance but, in this process, the formation of bubbles could modify this affirmation. In this work, the performance analyses of nine different spaces between stainless steel 316L electrodes were carried out, although the spaces proposed are not the same as those from the positive electrode (anode) to the separator and from the separator to the negative electrode (cathode). The reason why this is studied is that stoichiometry of the reaction states that two moles of hydrogen and one mole of oxygen can be obtained per every two moles of water. The proposed spaces were 10.65, 9.20, 8.25, 7.25, 6.30, 6.05, 4.35, 4.15, and 3.40 millimetres. From the nine different analysed distances between electrodes, it can be said that the best performance was reached by one of the smallest distances proposed, 4.15 mm. When the same distance between electrodes was compared (the same and different distance between electrodes and separator), the one that had almost twice the distance (negative compartment) presented an increase in current density of approximately 33% with respect to that where both distances (from electrodes to separator) are the same. That indicates that the stichometry of the electrolysis reaction influenced the performance.
Safety and Tolerability of Initiating Maximum-Dose Sacubitril-Valsartan in Patients on Target Dose Renin-Angiotensin System Inhibitors
Authors: Norberg Helena , Bergdahl Ellinor , Lindmark Krister
Published: August 2019

Aim. Sacubitril-valsartan has proven beneficial in heart failure with reduced ejection fraction. Guidelines recommend initiating half-dose sacubitril-valsartan before up-titration even to patients already on target dose angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB). To reduce the number of titration steps needed in order to simplify for the patient as well as the clinic, we aimed to investigate the safety and tolerability of switching patients on target dose ACE inhibitors or ARBs directly to maximum-dose sacubitril-valsartan. Methods. This prospective cohort study was conducted between April 2016 and November 2017. A total of 66 patients with heart failure and reduced ejection fraction already on guideline-recommended target dose ACE inhibitors or ARBs (equivalent to enalapril 10 mg twice daily) were switched to maximum-dose sacubitril-valsartan (200 mg twice daily). The patients were followed for twelve months. Results. Patients had a mean age of 72 ± 10 years, mean systolic blood pressure of 121 ± 17 mmHg, and 92% were male. At 12-month follow-up, nine patients (14%) had discontinued sacubitril-valsartan, four patients (6%) had a dose reduction, and 17 patients (26%) had developed symptomatic hypotension. No angioedema occurred within the 12-month follow-up and there were no hospitalizations or emergency room visits within the first 14 days. Conclusions. Switching directly from target dose ACE inhibitors or ARBs to maximum-dose sacubitril-valsartan was safe and generally well tolerated.
On the Probabilistic Proof of the Convergence of the Collatz Conjecture
Authors: Barghout Kamal
Published: August 2019

A new approach towards probabilistic proof of the convergence of the Collatz conjecture is described via identifying a sequential correlation of even natural numbers by divisions by 2 that follows a recurrent pattern of the form x,1,x,1…, where x represents divisions by 2 more than once. The sequence presents a probability of 50:50 of division by 2 more than once as opposed to division by 2 once over the even natural numbers. The sequence also gives the same 50:50 probability of consecutive Collatz even elements when counted for division by 2 more than once as opposed to division by 2 once and a ratio of 3:1. Considering Collatz function producing random numbers and over sufficient number of iterations, this probability distribution produces numbers in descending order that lead to the convergence of the Collatz function to 1, assuming that the only cycle of the function is 1-4-2-1.
A Retrospective Case Series of Synovial Sarcoma of the Upper Extremity
Authors: Post J. , Houdek M. , Folpe A. L. , Kakar S. K. , Wilke B. K.
Published: August 2019

Purpose. Previous studies have grouped the treatment of axial and appendicular synovial sarcomas. The purpose of this study was to assess the prognostic variables of upper extremity synovial sarcomas (UESS) and compare the outcomes of those who underwent a nononcologic or inadvertent excision prior to definitive resection to those who underwent an initial oncologic resection. Methods. We reviewed the records of 23 UESS treated with definitive surgery at our institution between 1990 and 2014. There were 13 women and 10 men with a median age of 30 years (6–60) and median follow-up of 63 months (15–248). Prognostic variables, recurrence-free survival (RFS), and overall survival (OS) were then assessed. Results. Fifteen patients (65%) had a prior unplanned excision. Five patients required an amputation to obtain local control of disease. There were 3 observed local recurrences and 2 distant metastases at a median of 45 months from presentation. We found no difference in need for amputation, RFS, or OS between those who had undergone a planned excision and those who had an unplanned excision. Conclusion. While we were unable to find a significant difference in outcomes or amputation rates between those who underwent reexcision of a previously unplanned excision and those who underwent an initial planned resection, the high rate of unplanned excision is troubling and should remind practitioners to consider sarcoma in the differential of all upper extremity masses.
Deep Learning for Automatic Recognition of Magnetic Type in Sunspot Groups
Authors: Fang Yuanhui , Cui Yanmei , Ao Xianzhi
Published: August 2019

Sunspots are darker areas on the Sun’s photosphere and most of solar eruptions occur in complex sunspot groups. The Mount Wilson classification scheme describes the spatial distribution of magnetic polarities in sunspot groups, which plays an important role in forecasting solar flares. With the rapid accumulation of solar observation data, automatic recognition of magnetic type in sunspot groups is imperative for prompt solar eruption forecast. We present in this study, based on the SDO/HMI SHARP data taken during the time interval 2010-2017, an automatic procedure for the recognition of the predefined magnetic types in sunspot groups utilizing a convolutional neural network (CNN) method. Three different models (A, B, and C) take magnetograms, continuum images, and the two-channel pictures as input, respectively. The results show that CNN has a productive performance in identification of the magnetic types in solar active regions (ARs). The best recognition result emerges when continuum images are used as input data solely, and the total accuracy exceeds 95%, for which the recognition accuracy of Alpha type reaches 98% while the accuracy for Beta type is slightly lower but maintains above 88%.
Internal Jugular Vein as Alternative Access for Implantation of a Wireless Pulmonary Artery Pressure Sensor
Authors: Abraham Jacob , McCann Patrick , Wang Lian , Schnell Heringer Amanda , Paulsen Jeff , Chappell Jay , Remick Joshua , Westerdahl Daniel , Lewis Rebecca , Callis Katherine , Spinelli Kateri J. , Klein Liviu
Published: August 2019

Background:

A wireless pulmonary artery pressure sensor (CardioMEMS) is approved for implantation via the femoral vein. The internal jugular vein (IJ) is an attractive alternative access route commonly used in pulmonary artery catheterization.

Methods and Results:

Retrospective chart review was performed for all sensor implants from 10 providers at 4 centers from September 2016 to June 2018. To compare procedural outcomes and discharge efficiency between groups, multivariate analyses incorporating potential confounders were performed. Seventy-three (28%) patients had femoral access, and 189 (72%) had IJ access; demographics were similar between the groups. Complications, including one case of hematoma and 4 cases of mild hemoptysis, and 30-day mortality (2%–3%) did not differ between groups. Provider preference for IJ access substantially increased over time, with IJ accounting for 90% of cases in 2018. After risk-adjustment, IJ cases had 20% (5%–33%) shorter fluoroscopy time (
P
=0.01) and 24% (7%–38%) lower contrast volume (
P
=0.008). Compared with outpatient femoral cases, outpatient IJ cases had 62% (52%–69%) faster needle-to-door time and were 34 times (6–235) more likely to have same-day discharge (
P
<0.001 for both).

Conclusions:

IJ access for CardioMEMS implant is a safe alternative associated with superior procedural and discharge outcomes. Implanters at 4 high-volume centers adopted IJ access as the preferred implant approach.
Development of EST-SSR markers and genetic diversity analysis among three Artemia species from different geographic populations
Authors: Han Xuekai , Xu Ruyi , Zheng Yuyu , Gao Meirong , Sui Liying
Published: August 2019

Artemia is one of the most important live food items used in larviculture. In order to study the genetic diversity of Artemia in China, 170 novel simple sequence repeats (SSR) markers were identified from expressed sequence tags (ESTs) of the transcriptome library of Artemia parthenogenetica. Of these, 8 microsatellite loci were developed to characterize three geographical populations of Artemia. The results showed the expected and observed heterozygosity varied from 0.43 to 0.50 and from 0.59 to 0.64, respectively. The PIC (polymorphic information content) ranged from 0.37 to 0.45. These observations indicated that the Yuncheng population has the highest genetic diversity, whereas the Shuanghu population has the lowest. The Fst value (genetic differentiation coefficient) indicated that the three populations are highly differentiated. Genetic identity analyses revealed that the Yuncheng and Shuanghu populations have the closest relationship. The SSR markers described here will serve as a valuable tool for further studies in population and conservation genetics on Artemia.