bluuebunny/crossref_metadata_2025 huggingface dataset:
The silent epidemic of obesity in The Gambia: evidence from a nationwide, population-based, cross-sectional health examination survey
Authors: Cham Bai , Scholes Shaun , Ng Fat Linda , Badjie Omar , Groce Nora Ellen , Mindell Jennifer S
Published: June 2020

Objectives

Non-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia.

Design

Nationwide cross-sectional health examination survey using the WHO STEPwise survey methods.

Setting

The Gambia.

Participants

This study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25–64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533).

Primary and secondary outcome measures

The primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans).

Results

Two-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women.

Conclusion

There is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.
Chinese physicians’ attitudes toward eco-directed sustainable prescribing from the perspective of ecopharmacovigilance: a cross-sectional study
Authors: Wang Jun , Li Shulan , He Bingshu
Published: June 2020

Introduction

Eco-directed sustainable prescribing (EDSP) is an effective upstream way to reduce the environmental footprints of active pharmaceutical ingredients (APIs), a kind of emerging contaminants, from the patients’ excretion. EDSP is one of the key steps in the programme of ecopharmacovigilance (EPV), a drug administration route on API pollution.

Objective

To assess the attitudes of physicians prescribing medicines regarding EDSP from the perspective of EPV.

Design

A cross-sectional study conducted from March 2019 to June 2019.

Setting

5 government general hospitals in Hubei province, China.

Participants

405 physicians were randomly selected and 262 valid questionnaires were obtained.

Outcome measures

A self-developed questionnaire, which inquired about the participant characteristics, perceptions and attitudes toward API pollution, EPV and EDSP from an EPV perspective, was emailed to collect data from physicians.

Results

Most physicians agreed the existence of APIs in environment, worried about the potential environmental and ecological risks of API residues, supported the effectiveness and necessity of EDSP under an EPV perspective in decreasing environmental exposure of excreted APIs, and showed their willingness to participate in the EDSP practices. Nevertheless, no respondent identified the environmental impacts as the aspects regarding medicines affecting his(her) prescription decision, none was satisfied with knowledge on EDSP and showed confidence toward EDSP. The most important barrier to the effective implementation of EDSP was identified as ‘poor awareness of EDSP and EPV‘. Most responding physicians (97%) reported that they held the wait-and-see or conservative attitudes towards EDSP practice. The biggest concerns in low-dose prescribing and prescribing of drugs possessing environment-friendly excretion profiles, two EDSP approaches, were the possible negative impact on therapeutic outcomes and too complicated and professional drug evaluation process, respectively.

Conclusions

Chinese physicians had positive attitudes towards EDSP from the perspective of EPV. However, their environmental consciousness during prescribing and the related education were insufficient.
Questionnaire validation practice within a theoretical framework: a systematic descriptive literature review of health literacy assessments
Authors: Hawkins Melanie , Elsworth Gerald R , Hoban Elizabeth , Osborne Richard H
Published: June 2020

Objective

Validity refers to the extent to which evidence and theory support the adequacy and appropriateness of inferences based on score interpretations. The health sector is lacking a theoretically-driven framework for the development, testing and use of health assessments. This study used the Standards for Educational and Psychological Testing framework of five sources of validity evidence to assess the types of evidence reported for health literacy assessments, and to identify studies that referred to a theoretical validity testing framework.

Methods

A systematic descriptive literature review investigated methods and results in health literacy assessment development, application and validity testing studies. Electronic searches were conducted in EBSCOhost, Embase, Open Access Theses and Dissertations and ProQuest Dissertations. Data were coded to the Standards’ five sources of validity evidence, and for reference to a validity testing framework.

Results

Coding on 46 studies resulted in 195 instances of validity evidence across the five sources. Only nine studies directly or indirectly referenced a validity testing framework. Evidence based on relations to other variables is most frequently reported.

Conclusions

The health and health equity of individuals and populations are increasingly dependent on decisions based on data collected through health assessments. An evidence-based theoretical framework provides structure and coherence to existing evidence and stipulates where further evidence is required to evaluate the extent to which data are valid for an intended purpose. This review demonstrates the use of the Standards’ theoretical validity testing framework to evaluate sources of evidence reported for health literacy assessments. Findings indicate that theoretical validity testing frameworks are rarely used to collate and evaluate evidence in validation practice for health literacy assessments. Use of the Standards’ theoretical validity testing framework would improve evaluation of the evidence for inferences derived from health assessment data on which public health and health equity decisions are based.
Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review
Authors: Braithwaite Jeffrey , Ludlow Kristiana , Testa Luke , Herkes Jessica , Augustsson Hanna , Lamprell Gina , McPherson Elise , Zurynski Yvonne
Published: June 2020

Introduction

The sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented at the front lines of care to increase effectiveness and efficiency; however, little is known about how sustainability is conceptualised and measured in programme evaluations.

Objectives

We aimed to describe theoretical frameworks, definitions and measures of sustainability, as applied in published evaluations of healthcare improvement programmes and interventions.

Design

Systematic integrative review.

Methods

We searched six academic databases, CINAHL, Embase, Ovid MEDLINE, Emerald Management, Scopus and Web of Science, for peer-reviewed English journal articles (July 2011–March 2018). Articles were included if they assessed programme sustainability or sustained outcomes of a programme at the healthcare system level. Six reviewers conducted the abstract and full-text review. Data were extracted on study characteristics, definitions, terminology, theoretical frameworks, methods and tools. Hawker’s Quality Assessment Tool was applied to included studies.

Results

Of the 92 included studies, 75.0% were classified as high quality. Twenty-seven (29.3%) studies provided 32 different definitions of sustainability. Terms used interchangeably for sustainability included continuation, maintenance, follow-up or long term. Eighty studies (87.0%) clearly reported the timepoints at which sustainability was evaluated: 43.0% at 1–2 years and 11.3% at <12 months. Eighteen studies (19.6%) used a theoretical framework to conceptualise or assess programme sustainability, including frameworks that were not specifically designed to assess sustainability.

Conclusions

The body of literature is limited by the use of inconsistent definitions and measures of programme sustainability. Evaluations of service improvement programmes and interventions seldom used theoretical frameworks. Embedding implementation science and healthcare service researchers into the healthcare system is a promising strategy to improve the rigour of programme sustainability evaluations.
Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey
Authors: Assebe Lelisa Fekadu , Negussie Eyerusalem Kebede , Jbaily Abdulrahman , Tolla Mieraf Taddesse Taddesse , Johansson Kjell Arne
Published: June 2020

Objectives

HIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia.

Design

A cross-sectional survey.

Setting

27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV.

Participants

A total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively.

Outcome measures

The economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold.

Results

The mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p<0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p<0.001). This figure was higher for drug-resistant TB (62%).

Conclusions

HIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.
Neuralgic amyotrophy: a paradigm shift in diagnosis and treatment
Authors: Gstoettner Clemens , Mayer Johannes A , Rassam Stephanie , Hruby Laura A , Salminger Stefan , Sturma Agnes , Aman Martin , Harhaus Leila , Platzgummer Hannes , Aszmann Oskar C
Published: June 2020

Neuralgic amyotrophy (NA), also known as Parsonage-Turner syndrome, is characterised by sudden pain attacks, followed by patchy muscle paresis in the upper extremity. Recent reports have shown that incidence is much higher than previously assumed and that the majority of patients never achieve full recovery. Traditionally, the diagnosis was mainly based on clinical observations and treatment options were confined to application of corticosteroids and symptomatic management, without proven positive effects on long-term outcomes. These views, however, have been challenged in the last years. Improved imaging methods in MRI and high-resolution ultrasound have led to the identification of structural peripheral nerve pathologies in NA, most notably hourglass-like constrictions. These pathognomonic findings have paved the way for more accurate diagnosis through high-resolution imaging. Furthermore, surgery has shown to improve clinical outcomes in such cases, indicating the viability of peripheral nerve surgery as a valuable treatment option in NA. In this review, we present an update on the current knowledge on this disease, including pathophysiology and clinical presentation, moving on to diagnostic and treatment paradigms with a focus on recent radiological findings and surgical reports. Finally, we present a surgical treatment algorithm to support clinical decision making, with the aim to encourage translation into day-to-day practice.
Structuring mental health support for frontline caregivers during COVID-19: lessons from organisational scholarship on unit-aligned support
Authors: DiBenigno Julia , Kerrissey Michaela
Published: June 2020

Background

Although the COVID-19 pandemic exposes frontline caregivers to severe prolonged stresses and trauma, there has been little clarity on how healthcare organisations can structure support to address these mental health needs. This article translates organisational scholarship on professionals working in organisations to elucidate why traditional approaches to supporting employee mental health, which often ask employees to seek assistance from centralised resources that separate mental health personnel from frontline units, may be insufficient under crisis conditions. We identify a critical but often overlooked aspect of employee mental health support: how frontline professionals respond to mental health services. In high-risk, high-pressure fields, frontline professionals may perceive mental health support as coming at the expense of urgent frontline work goals (ie, patient care) and as clashing with their central professional identities (ie, as expert, self-reliant ironmen/women).

Findings

To address these pervasive goal and identity conflicts in professional organisations, we translate the results of a multiyear research study examining the US Army’s efforts to transform its mental health support during the wars in Iraq and Afghanistan. We highlight parallels between providing support to frontline military units and frontline healthcare units during COVID-19 and surface implications for structuring mental health supports during a crisis. We describe how an intentional organisational design used by the US Army that assigned specific mental health personnel to frontline units helped to mitigate professional goal and identity conflicts by creating personalised relationships and contextualising mental health offerings.

Conclusion

Addressing frontline caregivers’ mental health needs is a vital part of health delivery organisations’ response to COVID-19, but without thoughtful organisational design, well-intentioned efforts may fall short. An approach that assigns individual mental health personnel to support specific frontline units may be particularly promising.
Promoting endothelialization of flow-diverting stents: a review
Authors: Panchendrabose Kapilan , Muram Sandeep , Mitha Alim P
Published: June 2020

Intracranial flow-diverting (FD) stents have revolutionized the treatment of intracranial aneurysms in recent years, but complications resulting from failed endothelialization can still occur. Approaches to promote endothelialization are understudied, but hold promise in mitigating both short- and long-term complications associated with FD stent insertion. The aim of this review is to highlight the various features of and modifications that have been made to FD stents in order to expedite endothelialization. More specifically, we focus on how endothelialization can be influenced by the stent design, wall apposition, surface modifications, and the inclusion of biological agents.
Leukoaraiosis and acute ischemic stroke: 90-day clinical outcome following endovascular recanalization, with proposed “L-ASPECTS”
Authors: Benson John C , Seyedsaadat Seyed Mohammad , Mark Ian , Nasr Deena M , Rabinstein Alejandro A , Kallmes David F , Brinjikji Waleed
Published: June 2020

Background

To assess if leukoaraiosis severity is associated with outcome in patients with acute ischemic stroke (AIS) following endovascular thrombectomy, and to propose a leukoaraiosis-related modification to the ASPECTS score.

Methods

A retrospective review was completed of AIS patients that underwent mechanical thrombectomy for anterior circulation large vessel occlusion. The primary outcome measure was 90-day mRS. A proposed Leukoaraiosis-ASPECTS (“L-ASPECTS”) was calculated by subtracting from the traditional ASPECT based on leukoaraiosis severity (1 point subtracted if mild, 2 if moderate, 3 if severe). L-ASEPCTS score performance was validated using a consecutive cohort of 75 AIS LVO patients.

Results

174 patients were included in this retrospective analysis: average age: 68.0±9.1. 28 (16.1%) had no leukoaraiosis, 66 (37.9%) had mild, 62 (35.6%) had moderate, and 18 (10.3%) had severe. Leukoaraiosis severity was associated with worse 90-day mRS among all patients (P=0.0005). Both L-ASPECTS and ASPECTS were associated with poor outcomes, but the area under the curve (AUC) was higher with L-ASPECTS (P<0.0001 and AUC=0.7 for L-ASPECTS; P=0.04 and AUC=0.59 for ASPECTS). In the validation cohort, the AUC for L-ASPECTS was 0.79 while the AUC for ASPECTS was 0.70. Of patients that had successful reperfusion (mTICI 2b/3), the AUC for traditional ASPECTS in predicting good functional outcome was 0.80: AUC for L-ASPECTS was 0.89.

Conclusions

Leukoaraiosis severity on pre-mechanical thrombectomy NCCT is associated with worse 90-day outcome in patients with AIS following endovascular recanalization, and is an independent risk factor for worse outcomes. A proposed L-ASPECTS score had stronger association with outcome than the traditional ASPECTS score.
Preclinical safety and efficacy evaluation of the Pipeline Vantage Embolization Device with Shield Technology
Authors: Starke Robert M , Thompson John , Pagani Ariana , Choubey Animesh , Wainwright John M , Wolf Michael F , Jahanbekam Reza , Girdhar Gaurav
Published: June 2020

Background

The Pipeline Vantage Embolization Device with Shield Technology is a next generation flow diverter developed to improve aneurysm occlusion and implant endothelialization in addition to lowering thrombogenicity. We report here the in vivo biocompatibility and in vitro hemocompatibility performance of the Pipeline Vantage Embolization Device with Shield Technology (Vantage) compared with the Pipeline Flex Embolization Device (Flex).

Methods

Biocompatibility (via histology), aneurysm occlusion and vessel patency (via angiography), and endothelial coverage (via scanning electron microscopy (SEM)) for the Vantage and Flex devices were assessed in the rabbit elastase aneurysm model at 90 days (n=29) and 180 days (n=27). In vitro thrombogenicity for Flex and Vantage (n=16) was assessed using a human blood flow loop model at low heparin concentration (0.6 U/mL) with thrombin generation, platelet activation and thrombus visualization as outputs.

Results

Raymond Roy Occlusion Classification grade 1 was higher for Vantage (61%) compared with Flex (46%), but was not statistically significant (p>0.05). All branch vessels were patent. Histological measures for both devices were similar (p>0.05). Endothelial coverage of the implant was significantly better for Vantage compared with Flex (p<0.05). In vitro measurements of thrombin generation (thrombin-antithrombin complex (µg/mL): Vantage 0.49±0.45; Flex 10.57±9.84) and platelet activation (β-thromboglobulin (IU/µl): Vantage 0.41±0.19; Flex 4.14±2.38) were both statistically lower (p<0.05) for Vantage compared with Flex. High resolution microscopy showed less accumulation of thrombus on Vantage as compared with Flex.

Conclusion

Vantage improved aneurysm occlusion and implant endothelialization and had significantly lower thrombogenicity as compared with Flex, while preserving the biocompatibility safety profile of Flex.
Electrochemistry and transport properties of electrolytes modified with ferrocene redox-active ionic liquid additives
Authors: Gélinas Bruno , Bibienne Thomas , Dollé Mickaël , Rochefort Dominic
Published: June 2020

Used in their pure, undiluted form, ionic liquids usually result in Li-ion battery electrolytes with inadequate performance due low Li+ transport numbers (tLi+). Alternatively, they can be used as additives dissolved in carbonates to maintain a high tLi+ while providing the electrolyte with additional properties such as resistance to combustion, current collector passivation, and decreased Li dendritic growth. Additional properties can be imparted to the ionic liquid via the modification of their structure. Ionic liquids modified with electroactive moieties such as ferrocene (Fc-IL) can be used as an additive in Li-ion battery (LiB) electrolytes to prevent cathode over-oxidation via the redox shuttle mechanism. The aim of the present work is to evaluate the properties of LiB electrolytes modified with such Fc-IL at different concentrations. At low concentrations (0.3–0.5 mol/L), the redox-active ionic liquid behaves as expected for a redox shuttle. We show that at 1 mol/L, however, the redox ionic liquid yields a different discharge behavior after the overcharging step, providing an increase in discharge capacity. This behavior is linked to the deposition of the ferrocenium-IL at the positive electrode. Such electrolyte is non-flammable and is highly efficient to achieve shuttling of excess charge. Based on this principle, it is expected that novel ionic liquids can be designed for development of other types of additives and contribute to developing safer battery electrolytes. As a part of this commemorative issue, this contribution highlights the type of collaborative research currently being done on energy storage devices at the Department of Chemistry at the Université de Montréal.
Gravity, dual gravity and A1+++
Authors: Glennon Keith , West Peter
Published: June 2020

We construct the nonlinear realisation of the semidirect product of the very extended algebra [Formula: see text] and its vector representation. This theory has an infinite number of fields that depend on a space–time with an infinite number of coordinates. Discarding all except the lowest level field and coordinates the dynamics is just Einstein’s equation for the graviton field. We show that the gravity field is related to the dual graviton field by a duality relation and we also derive the equation of motion for the dual gravity field.
Representative Sets and Irrelevant Vertices
Authors: Kratsch Stefan , WahlströM Magnus
Published: June 2020

We continue the development of matroid-based techniques for kernelization, initiated by the present authors [47]. We significantly extend the usefulness of matroid theory in kernelization by showing applications of a result on
representative sets
due to Lovász [51] and Marx [53]. As a first result, we show how representative sets can be used to derive a polynomial kernel for the elusive
ALMOST
2-
SAT
problem (where the task is to remove at most
k
clauses to make a 2-
CNF
formula satisfiable), solving a major open problem in kernelization. This result also yields a new O(√log OPT)-approximation for the problem, improving on the O(√log n)-approximation of Agarwal et al. [3] and an implicit O(log OPT)-approximation due to Even et al. [24].

We further apply the representative sets tool to the problem of finding
irrelevant vertices
in graph cut problems, that is, vertices that can be made undeletable without affecting the answer to the problem. This gives the first significant progress towards a polynomial kernel for the
MULTIWAY CUT
problem; in particular, we get a kernel of O(
k
s+1
) vertices for
MULTIWAY CUT
instances with at most
s
terminals. Both these kernelization results have significant spin-off effects, producing the first polynomial kernels for a range of related problems.

More generally, the irrelevant vertex results have implications for covering min cuts in graphs. For a directed graph
G=(V,E)
and sets
S, T
⊆
V
, let
r
be the size of a minimum (
S,T
)-vertex cut (which may intersect
S
and
T
). We can find a set
Z
⊆
V
of size O(|S| . |T| . r) that contains a minimum (
A,B
)-vertex cut for every
A
⊆
S
,
B
⊆
T
. Similarly, for an undirected graph
G=(V,E)
, a set of terminals
X
⊆
V
, and a constant
s
, we can find a set
Z
⊆
V
of size O(|X|
s+1
) that contains a minimum multiway cut for every partition of
X
into at most
s
pairwise disjoint subsets. Both results are polynomial time. We expect this to have further applications; in particular, we get direct, reduction rule-based kernelizations for all problems above, in contrast to the indirect compression-based kernel previously given for
ODD CYCLE TRANSVERSAL
[47].

All our results are randomized, with failure probabilities that can be made exponentially small in
n
, due to needing a
representation
of a matroid to apply the representative sets tool.
Soil Microbiomes Under Climate Change and Implications for Carbon Cycling
Authors: Naylor Dan , Sadler Natalie , Bhattacharjee Arunima , Graham Emily B. , Anderton Christopher R. , McClure Ryan , Lipton Mary , Hofmockel Kirsten S. , Jansson Janet K.
Published: June 2020

Communities of soil microorganisms (soil microbiomes) play a major role in biogeochemical cycles and support of plant growth. Here we focus primarily on the roles that the soil microbiome plays in cycling soil organic carbon and the impact of climate change on the soil carbon cycle. We first discuss current challenges in understanding the roles carried out by highly diverse and heterogeneous soil microbiomes and review existing knowledge gaps in understanding how climate change will impact soil carbon cycling by the soil microbiome. Because soil microbiome stability is a key metric to understand as the climate changes, we discuss different aspects of stability, including resistance, resilience, and functional redundancy.We then review recent research pertaining to the impact of major climate perturbations on the soil microbiome and the functions that they carry out. Finally, we review new experimental methodologies and modeling approaches under development that should facilitate our understanding of the complex nature of the soil microbiome to better predict its future responses to climate change.
The Shortage of Technetium-99m and Possible Solutions
Authors: Ruth Thomas J.
Published: June 2020

Following a major shortage of 99Mo in the 2009–2010 period, concern grew that the aging reactor production facilities needed to be replaced. Most producers were using highly enriched 235U (HEU) as the target material. The Organisation for Economic Co-operation and Development and the International Atomic Energy Agency sought to remedy these issues by removing HEU from medical isotope production and implementing full cost recovery to enable new production entities to compete with the existing multipurpose reactor facilities, which were heavily subsidized by their respective governments. This review examines the various approaches to producing 99Mo and/or 99mTc with a critical eye toward their potential success in ( a) producing the medical isotopes and ( b) being able to successfully enter and compete in the market. Because many of the new approaches are adapting existing technologies for commercial businesses, some of the details are of a proprietary nature and not available for in-depth technical review.
Theoretical Prediction of Presupernova Neutrinos and Their Detection
Authors: Kato C. , Ishidoshiro K. , Yoshida T.
Published: June 2020

More than 30 years have passed since the successful detection of supernova (SN) neutrinos from SN 1987A. In the last few decades, remarkable progress has been made in neutrino detection techniques, through which it may be possible to detect neutrinos from a new source, presupernova (pre-SN) neutrinos. They are emitted from a massive star prior to core bounce. Because neutrinos escape from the core freely, they carry information about the stellar physics directly. Pre-SN neutrinos may play an important role in verifying our understanding of stellar evolution for massive stars. Observation of pre-SN neutrinos, moreover, may serve as an alarm regarding an SN explosion a few days in advance if the progenitor is located in our vicinity, enabling us to observe the next galactic SN. In this review, we summarize the current status of pre-SN neutrino studies from both the theoretical and observational points of view.
Covariant Density Functional Theory in Nuclear Physics and Astrophysics
Authors: Yang Junjie , Piekarewicz J.
Published: June 2020

How does subatomic matter organize itself? Neutron stars are cosmic laboratories uniquely poised to answer this fundamental question that lies at the heart of nuclear science. Newly commissioned rare isotope facilities, telescopes operating across the entire electromagnetic spectrum, and ever more sensitive gravitational wave detectors will probe the properties of neutron-rich matter with unprecedented precision over an enormous range of densities. A coordinated effort between observation, experiment, and theoretical research is of paramount importance for realizing the full potential of these investments. Theoretical nuclear physics provides valuable insights into the properties of neutron-rich matter in regimes that are not presently accessible to experiment or observation. In particular, nuclear density functional theory is likely the only tractable framework that can bridge the entire nuclear landscape by connecting finite nuclei to neutron stars. This compelling connection is the main scope of the present review.
Enhancement of the Anti‐Skin Wrinkling Effects of Aloe arborescens Miller Extracts Associated with Lactic Acid Fermentation
Authors: Ro Hyang Seon , Jang Hyun Jun , Kim Gyu Rae , Park Sang Jin , Lee Hyeon Yong
Published: June 2020

This work clearly shows that Aloe arborescens but not gels from Aloe vera, a common juice‐type product of Aloe, exerted anti‐skin wrinkling effects, and these effects were greatly enhanced by lactic acid fermentation with Lactobacillus plantarum. Treatment with the extract from the fermentation process (FE) at a dose of 0.5% highly activated human fibroblast cells by up to 175%, whereas 140% activation and 105% activation were observed with the extract obtained using conventional water extraction (WE) and the gel from A. vera (GE), respectively. The treatment of human fibroblasts with FE at a dose of 0.5% increased collagen production by up to 170% and inhibited MMP‐1 synthesis to 48%, which is likely due to its high antioxidant activity because the WE and GE showed markedly lower effects compared with those of the FE. Interestingly, the FE exhibited a profile dominated by relatively low‐molecular‐weight (MW) polysaccharides: 20% of the total polysaccharides in the FE were in the MW weight range of 600 to 900, whereas 95% of the total polysaccharides in the GE were in the MW range of 200,000 to 300,000. This result suggests that the larger polysaccharide molecules in the extract might be broken down during lactic acid fermentation, and the easy penetration of the small molecules in the extract into fibroblast cells thus results in improved anti‐skin wrinkling effects. This conclusion is also supported by the finding that the FE and WE, but not the GE, contained similar amounts of barbaloin, a strong antioxidant eluted from A. arborescens through the fermentation process. Therefore, this study strongly indicates that the enhanced anti‐skin wrinkling effects of the FE are most likely due to synergistic effects between the barbaloin and the low‐MW polysaccharides retained after the fermentation process.
Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial
Authors: Wang Li , Zhou Yi , Zhang Tiejun , Huang Lili , Peng Wei
Published: June 2020

Dexmedetomidine refers to an α2‐adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Patients’ duration of analgesia after surgery, surgeon and patient degrees of satisfaction, Observer’s Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, visual analogue scale (VAS) pain scores, and vital signs were recorded variables. Patients administered dexmedetomidine had significantly lower OAAS scores than those administered midazolam (p < 0.05). Patients administrated dexmedetomidine had a significantly longer analgesia duration after the surgical procedure than those administered midazolam, and the difference was statistically significant (p < 0.05). Dexmedetomidine had a significantly larger number of surgeons satisfied with the level of sedation/analgesia than midazolam (p < 0.05). Accordingly, it is considered that dexmedetomidine can achieve better postoperative analgesia, surgeon satisfaction, and sedation than midazolam.
Multiple Positive Solutions for a System of Caputo Fractionalp-Laplacian Boundary Value Problems
Authors: Lv Zhi-Wei , Liu Jie , Xu Jiafa
Published: June 2020

In this work, we are pleased to investigate multiple positive solutions for a system of Caputo fractionalp-Laplacian boundary value problems, and we also provide an example for illustrating our main results.
Greetings from the New Chief Editor
Authors: Sayama Hiroki
Published: June 2020

Complexity is pleased to announce the installment of Prof Hiroki Sayama as its new Chief Editor. In this Editorial, Prof Sayama describes his feelings about his recent appointment, discusses some of the journal’s journey and relevance to current issues, and shares his vision and aspirations for its future.
The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait
Authors: Al-Ozairi Ebaa , Al Ozairi Abdulla , Blythe Clare , Taghadom Etab , Ismail Khalida
Published: June 2020

This study is aimed at describing the prevalence of and risk factors for depression and diabetes distress in people with type 2 diabetes and whether depression and distress are independently associated with worse biomedical outcomes. The study was of cross-sectional design. The setting was the Dasman Diabetes Institute, Kuwait. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression, defined as a score≥10 (depression caseness). The Problem Areas in Diabetes (PAID) was used to measure diabetes-related distress. Data on biomedical outcomes, lifestyle factors, and sociodemographic information were collected. The prevalence of depression and diabetes distress caseness was 29% and 14%, respectively. Depression caseness patients were more likely to be female (60%; p=0.001), have Kuwaiti nationality (68%, p=0.121), were on insulin (67%, p=0.001), have higher body mass index (p=0.047), were less physically active (78%; p=0.034), have a higher PAID score (p<0.001), and have hypertension (74%, p=0.047). After adjustment of sociodemographics (age, gender, and marital status) and body mass index, the prevalence of depression was associated with higher HbA1c (B=0.04, 95% confidence interval 0.01 to 0.60), while diabetes distress had a weak association with HbA1c (B=0.13, 95% confidence interval 0.04 to 0.22). In conclusion, people with type 2 diabetes in Kuwait have a high prevalence of depression but lower diabetes distress and this was associated with worse glycaemic control.
Traffic Equilibrium for Mixed Traffic Flows of Human-Driven Vehicles and Connected and Autonomous Vehicles in Transportation Networks under Tradable Credit Scheme
Authors: Zhang Fang , Lu Jian , Hu Xiaojian
Published: June 2020

In this paper, the traffic equilibriums for mixed traffic flows of human-driven vehicles (HDV) and connected and autonomous vehicles (CAV) under a tradable credit scheme (TCS) are established and formulated as two variational inequality (VI) problems with exogenous and endogenous CAV penetration rate, respectively. A modified Lagrangian dual (MLD) method embedded with a revised Smith’s route-swapping (RSRS) algorithm is proposed to solve the problems. Based on the numerical analysis, the impacts of CAV penetration and the extra expense of using a CAV on network performance are investigated. A novel driveway management, autonomous vehicle/credit charge (AVCC) link, is put forward to improve the efficiency of TCS. Under the TCS with exogenous CAV penetration rate, a logit-based model is applied to describe the stochastic user equilibrium for mixed traffic flow. It is found that the penetration of CAV gives rise to a better network performance and it can be further improved by the deployment of AVCC link. Under the TCS with endogenous penetration rate, a nested-logit model is applied to describe travelers’ choices of vehicle types and routes. It is found that the deployment of AVCC links can slow down the decline rate of CAV penetration with increasing expense and thus ensure a lower average travel time for CAVs. In both cases, the deployment of AVCC links can stimulate credit trading and drop down its unit price.
Stability Optimization of Trapezoidal Frame with Rigid Members and Flexible Joints
Authors: Wu Chao , Li Ya-Nan , Tam Lik-Ho , He Li
Published: June 2020

Stability has been an important subject in the design of a portal frame structure. Conventional stability analysis of the portal frame is normally conducted assuming that all the joints are rigid. However, the joints of a portal frame in real applications are not always rigid and semirigid connections often exist. AISC design code requires that the effect of the joint flexibility on the behavior and buckling capacity of the portal frame should be taken into account in the analysis and design procedures. To address this issue, a portal frame with flexible joints and rigid members was theoretically analyzed in the literature and closed form solution was derived for its global buckling load. However, when more parameters are involved, e.g., different leg lengths, asymmetric frame shape, and moving load, the solution to the governing equation of the stability of the frame becomes impossible. This paper presents a comprehensive parametric study on the stability of an asymmetric portal frame with flexible joints and rigid members through finite element (FE) analysis. The FE model was first validated by the existing theoretical solution in the literature. Parameters including the position of the moving load, the lengths of the two frame legs, and the span of the frame were analyzed. Design curves were developed based on the parametric study, from which the stable, unstable, and catastrophically unstable states of the portal frame were characterized. This paper contributes benchmark results for the stability optimization in the design of the portable frame of a general shape.
Advanced Driver‐Assistance System (ADAS) for Intelligent Transportation Based on the Recognition of Traffic Cones
Authors: Wang Liyong , Sun Peng , Xie Min , Ma Shaobo , Li Boxiong , Shi Yuchen , Su Qinghua
Published: June 2020

Great changes have taken place in automation and machine vision technology in recent years. Meanwhile, the demands for driving safety, efficiency, and intelligence have also increased significantly. More and more attention has been paid to the research on advanced driver‐assistance system (ADAS) as one of the most important functions in intelligent transportation. Compared with traditional transportation, ADAS is superior in ensuring passenger safety, optimizing path planning, and improving driving control, especially in an autopilot mode. However, level 3 and above of the autopilot are still unavailable due to the complexity of traffic situations, for example, detection of a temporary road created by traffic cones. In this paper, an analysis of traffic‐cone detection is conducted to assist with path planning under special traffic conditions. A special machine vision system with two monochrome cameras and two color cameras was used to recognize the color and position of the traffic cones. The result indicates that this novel method could recognize the red, blue, and yellow traffic cones with 85%, 100%, and 100% success rate, respectively, while maintaining 90% accuracy in traffic‐cone distance sensing. Additionally, a successful autopilot road experiment was conducted, proving that combining color and depth information for recognition of temporary road conditions is a promising development for intelligent transportation of the future.
Characterization of Ancestral Origin of Cystic Fibrosis of Patients with New Reported Mutations in CFTR
Authors: Paz-y-Miño César , Zambrano Ana Karina , Ruiz-Cabezas Juan Carlos , Armendáriz-Castillo Isaac , García-Cárdenas Jennyfer M. , Guerrero Santiago , López-Cortés Andrés , Pérez-Villa Andy , Guevara-Ramírez Patricia , Yumiceba Verónica , Leone Paola E.
Published: June 2020

The incidence of cystic fibrosis (CF) and the frequency of the variants reported for CFTR depend on the population; furthermore, CF symptomatology is characterized by obstructive lung disease and pancreatic insufficiency among other symptoms, which are reliant on the individual′s genotype. The Ecuadorian population is a mixture of Native Americans, Europeans, and Africans. That population admixture could be the reason for the new mutations reported in a previous study by Ruiz et al. (2019). A panel of 46 Ancestry Informative Markers was used to estimate the ancestral proportions of each available sample (12 samples in total). As a result, the Native American ancestry proportion was the most prevalent in almost all individuals, except for three patients from Guayaquil with the mutation [c.757G>A:p.Gly253Arg; c.1352G>T:p.Gly451Val] who had the highest European composition.
Prevalence and Associated Factors of Thinness among Adolescent Students in Finote Selam Town, Northwest Ethiopia
Authors: Mengesha Damitie Kebede , Prasad Reddy P. C. J. , Asres Degnet Teferi
Published: June 2020

Even if adolescence is a window of opportunity to break the intergenerational cycle of malnutrition, adolescents are the neglected age groups. Hence, information regarding the nutritional status of adolescents is lacking, making creating and implementing intervention programs difficult. This study aimed to assess the prevalence and determinants of thinness among school adolescents in Finote Selam Town, Northwest Ethiopia. A school-based cross-sectional study among adolescent students aged 10–19 in public primary and secondary schools was carried out in Finote Selam Town from February 05 to March 27, 2018. Stratified and simple random sampling techniques were employed to select study subjects. A total of 397 adolescent students were included in the study. Pretested structured questionnaires were used to collect the data. Data were entered using Epi Info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable binary logistic regression analysis was employed to identify factors associated with thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared atpvalue less than 0.05. The prevalence of thinness among adolescents was 14.9%. Early adolescent stage (AOR = 4.81; 95% CI : 1.23, 18.51), being male adolescent students (AOR = 2.33; 95% CI : 1.60, 3.40), having less than 1000 birr family monthly income (AOR = 6.54; 95% CI : 3 : 82, 14.89), having 1000–2000 birr family monthly income (AOR = 3.47; 95% CI : 1.15, 7.45), and using well water (AOR = 3.82; 95% CI : 1.46, 10.04) were significantly associated with thinness at 95% confidence interval. The study revealed that prevalence of thinness was high in the study area. Sex, place of residence, and family monthly income were found to be important factors associated with thinness among the respondents.
On Solutions of a Parabolic Equation with Nonstandard Growth Condition
Authors: Zhan Huashui
Published: June 2020

A parabolic equation with nonstandard growth condition is considered. A kind of weak solution and a kind of strong solution are introduced, respectively; the existence of solutions is proved by a parabolically regularized method. The stability of weak solutions is based on a natural partial boundary value condition. Two novelty elements of the paper are both the dependence of diffusion coefficient bx,t on the time variable t, and the partial boundary value condition based on a submanifold of ∂Ω×0,T. How to overcome the difficulties arising from the nonstandard growth conditions is another technological novelty of this paper.
Moving beyond PARP Inhibition in ATM-Deficient Prostate Cancer
Authors: Setton Jeremy S. , Powell Simon N.
Published: June 2020

DNA repair defects are found in primary and metastatic prostate cancer. Alterations in the ATM gene are the second most common defect after BRCA2, but their sensitivity to PARP inhibitors has been questioned by recent clinical literature. The work by Rafiei and colleagues in this issue of Cancer Research now supports this observation with genetically engineered cells and quantitative responses. ATR inhibitors have not yet found a clear role in the clinic, but the new work suggests that ATM-deficient cancers may be more vulnerable to ATR inhibition rather than PARP inhibitors, which is a testable hypothesis for clinical trials.

See related article by Rafiei et al., p. 2094
PD-1 Blockade in Chinese versus Western Patients with Melanoma
Authors: Shoushtari Alexander N. , Bao Riyue , Luke Jason J.
Published: June 2020

In this trial of programmed cell death-1 (PD-1) blockade with toripalimab in previously treated Chinese patients with melanoma, unique histologic and molecular features may explain why the objective response rate is lower than those defined in Western populations. This work suggests future avenues for investigating mechanisms of melanoma formation and resistance to PD-1 blockade.

See related article by Tang et al., p. 4250