bluuebunny/crossref_metadata_2025 huggingface dataset:
Delphi developed syllabus for the medical specialty of sport and exercise medicine: part 2
Authors: Humphries David , Jaques Rod , Dijkstra H Paul , Asif Irfan , Batt Mark E , Borjesson Mats , Ergen Emin , Geertsema Celeste , Gojanovic Boris , Ionescu Anca , Janse van Rensburg Dina Christina , Lebrun Constance , Mohamed Nahar Azmi , Mountjoy Margo , Parikh Tvisha , Robinson Diana , Sallis Robert , Schwellnus Martin , Sheeran Padraig
Published: September 2020

Training in the medical specialty of sport and exercise medicine (SEM) is available in many, but not all countries. In 2015, an independent Delphi group, the International Syllabus in Sport and Exercise Medicine Group (ISSEMG), was formed to create a basic syllabus for this medical specialty. The group provided the first part of this syllabus, by identifying 11 domains and a total of 80 general learning areas for the specialty, in December 2017. The next step in this process, and the aim of this paper was to determine the specific learning areas for each of the 80 general learning areas. A group of 26 physicians with a range of primary medical specialty qualifications including, Sport and Exercise Medicine, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. SEM, Family Medicine, Internal Medicine, Cardiology, Rheumatology and Anaesthetics were invited to participate in a multiple round online Delphi study to develop specific learning areas for each of the previously published general learning areas. All invitees have extensive clinical experience in the broader sports medicine field, and in one or more components of sports medicine governance at national and/or international level. The hierarchical syllabus developed by the ISSEMG provides a useful resource in the planning, development and delivery of specialist training programmes in the medical specialty of SEM.
Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men
Authors: Deischinger Carola , Dervic Elma , Leutner Michael , Kosi-Trebotic Lana , Klimek Peter , Kautzky Alexander , Kautzky-Willer Alexandra
Published: September 2020

Introduction

Both diabetes mellitus and being female significantly increase the risk of being diagnosed with major depressive disorder (MDD). The diagnosis of MDD, combined with diabetes mellitus, can be detrimental in terms of mortality and morbidity. We aimed at investigating the impact of diabetes mellitus on the gender gap in MDD over the course of a human lifetime.

Research design and methods

In a cross-sectional study over the course of 17 years, medical claims data of the general Austrian population (n=8 996 916) between 1997 and 2014 was analyzed. Of these, 123 232 patients with diabetes mellitus were extracted and compared with non-diabetic controls.

Results

In a cohort of 123 232 patients with diabetes mellitus and 1 933 218 controls (52% females, 48% males), women with diabetes had 2.55 times increased ORs to be diagnosed with MDD compared with women without diabetes (95% CI 2.48 to 2.62, p<0.001) between the age of 30 and 69 years. The effect of diabetes mellitus on the prevalence of MDD was significantly smaller in men (OR=1.85, 95% CI 1.80 to 1.91, p<0.001). Between 0 and 30 years and after age 70 years, the gender gap of MDD was not different between patients with and without diabetes mellitus. The peak of the gender gap in MDD in patients with diabetes mellitus was around the age of 40–49 years. A sensitivity analysis identified overweight, obesity and alcohol dependence as the most potent influencing factors of the widening of the gender gap among patients with diabetes mellitus.

Conclusions

Diabetes mellitus is a stronger risk factor for MDD in women than in men, with the greatest width of the gender gap between 40 and 49 years. High-risk patients for MDD, such as overweight female patients with diabetes, should be more carefully assessed and monitored.
Psychiatric care use among migrants to Sweden compared with Swedish-born residents: a longitudinal cohort study of 5 150 753 people
Authors: Hollander Anna-Clara , Mackay Euan , Sjöqvist Hugo , Kirkbride James B , Bäärnhielm Sofie , Dalman Christina
Published: September 2020

Background

To investigate differences in psychiatric care use over time between Swedish born and those born abroad who migrate to Sweden.

Methods

Population-based cohort study analysing linked population and health registers, following individuals born 1944–1990 from 1 January 2005 to 31 December 2016. Time-stratified survival analysis using Cox regression estimated time to psychiatric care use. Population included 5 150 753 individuals with 78.1% Swedish born. Migrant status was coded as Swedish born or migrant. Migrants were grouped by year of immigration and region of origin. The main outcome: psychiatric care use, defined as any psychiatric care; psychiatric inpatient or outpatient care; or use of psychotropics.

Results

Migrants arriving before 2005 had a higher use of any psychiatric care relative to Swedish born but migrants arriving 2005 onwards had lower use. Migrants from sub-Saharan Africa and Asia had a lower use of any psychiatric care during the first decade in Sweden whereas migrants from Middle East and North Africa had a higher use, driven by use of psychotropics.

Conclusions

The lower use of psychiatric care during the first decade contrasts with higher use among migrants with a longer duration of stay. Psychiatric care use among migrants should be analysed multi-dimensionally, taking duration of stay, region of origin and type of care into account.
Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study
Authors: Scheepers Renée , Silkens Milou , van den Berg Joost , Lombarts Kiki
Published: September 2020

Objectives

To investigate associations of job demands and resources with patient-related burnout among physicians.

Design

Multicentre observational study.

Setting

Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands.

Participants

Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents.

Main outcome measures

Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader’s inspiration, relationships with colleagues and patients)—measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey—and patient-related burnout, measured using the validated Copenhagen Burnout Inventory.

Results

Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=–0.18; 95% CI, –0.27 to –0.08; p<0.001) and relationships with patients (b=–0.12; 95% CI, –0.22 to –0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=–0.15; 95% CI, –0.27 to –0.04; p=0.01).

Conclusions

Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician–patient relationships may be supported to reduce the likelihood of physicians’ patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings.
Analysis of medical services provided to patients with ankle sprains in Korea between 2015 and 2017: a cross-sectional study of the health insurance review and assessment service national patient sample database
Authors: Ryu Ho-sun , Jung Boyoung , Yeo Jiyoon , Kim Jae-Hong , Nam Dongwoo , Ha In-Hyuk
Published: September 2020

Objectives

To provide useful information for policy-makers and clinicians by analysing the medical service use—divided into Western medicine (WM) and Korean medicine (KM)—of patients with ankle sprains in South Korea between 2015 and 2017.

Design

Cross-sectional, retrospective, observational study.

Setting

Tertiary hospitals, WM hospitals, WM clinics, KM hospitals, KM clinics and others in South Korea.

Participants

We analysed claim data and patient information from the 2015 to 2017 Health Insurance Review and Assessment National Patient Sample (HIRA-NPS) dataset, including 151 415 patients diagnosed with a ‘dislocation, sprain and strain of joints and ligaments at ankle and foot level’ (10th revision of the International Statistical Classification of Diseases code S93) who used medical services at least once in 3 years between January 2015 and December 2017 in South Korea.

Primary and secondary outcome measures

Cost of medical care, number of consultations, type of institution visited, types of treatment.

Results

There were 160 200 consultations and 53 044 patients in 2015, 149 956 consultations and 50 830 patients in 2016 and 140 651 consultations and 47 541 patients in 2017. The total treatment costs were US$3 355 044.21, US$3 245 827.70 and US$3 128 938.46 in 2015, 2016 and 2017, respectively. The most common age was 10–19 years. The most frequent type of visit was KM outpatient visit (56%). Physiotherapy was most common in WM outpatient visits, while acupuncture was most common in KM visits. Most patients used one institution, rather than alternating between WM and KM.

Conclusions

By identifying the trends and costs of treatment methods used for ankle sprains and comparing WM and KM, our data provide basic information for future health policy-making. In addition, the duality of the Korean medical system is highlighted as a possible cause of increased costs.
Validating e-norms methodology in ophthalmic biometry
Authors: Shammas H John , Jabre Joe F
Published: September 2020

Objective

To validate the extrapolated norms or e-norms methodology in establishing a reference range for the biometric data used for intraocular lens power calculation.

Methods and Analysis

All measurements were performed with an optical low-coherence reflectometer. A novel technique, the e-norms methodology, was used to determine the normative values of measurements.

Results

Eyes (n=500) were measured to evaluate the axial length (AL), K readings (Ks), anterior chamber depth (ACD) and lens thickness (LT). Using the e-norms methodology, the normal AL ranged from 22.50 to 24.50 mm (mean=23.50 mm), with medium-long eyes between 24.51 and 24.99 mm and the long eyes measuring 25.00 mm and longer; the medium-short eyes ranged from 22.01 and 22.49 mm, with the short eyes measuring 22.00 mm and shorter. Normal values ranged from 2.50 to 3.50 mm for ACD (mean=3.00 mm), from 4.40 to 5.44 mm for LT (mean=4.92 mm), and from 42.50 to 44.82 dioptres for Ks (mean=43.66 dioptres).

Conclusion

Measurements of the biometric mean values compared favourably with published data. The e-norms methodology assisted in establishing a biometric reference range. Furthermore, it allowed us to cluster patients into groups based on AL differences.
Critical thresholds: key to unlocking the door to the prevention and specific treatments for acute pancreatitis
Authors: Barreto Savio George , Habtezion Aida , Gukovskaya Anna , Lugea Aurelia , Jeon Christie , Yadav Dhiraj , Hegyi Peter , Venglovecz Viktória , Sutton Robert , Pandol Stephen J
Published: September 2020

Acute pancreatitis (AP), an acute inflammatory disorder of the exocrine pancreas, is one of the most common gastrointestinal diseases encountered in emergency departments with no specific treatments. Laboratory-based research has formed the cornerstone of endeavours to decipher the pathophysiology of AP, because of the limitations of such study in human beings. While this has provided us with substantial understanding, we cannot answer several pressing questions. These are: (a) Why is it that only a minority of individuals with gallstones, or who drink alcohol excessively, or are exposed to other causative factors develop AP? (b) Why do only some develop more severe manifestations of AP with necrosis and/or organ failure? (c) Why have we been unable to find an effective therapeutic for AP? This manuscript provides a state-of-the-art review of our current understanding of the pathophysiology of AP providing insights into the unanswered clinical questions. We describe multiple protective factors operating in most people, and multiple stressors that in a minority induce AP, independently or together, via amplification loops. We present testable hypotheses aimed at halting progression of severity for the development of effective treatments for this common unpredictable disease.
High levels of anatomical and physiological leaf plasticity of Ocotea odorifera (Lauraceae) in response to different radiation intensities
Authors: Leme Gabriele Marques , Ramos Flavio Nunes , Pereira Fabricio José , Polo Marcelo
Published: September 2020

We investigated morpho-physiological plasticity in the leaves of Ocotea odorifera trees growing under different environmental conditions in a fragmented forest. Microclimatic data were collected in a pasture matrix, forest edge, and forest interior in three Atlantic Forest fragments. Leaf gas exchange, as well as leaf anatomy in paradermal and transversal sections, were evaluated in individuals in these environments. Radiation intensity and temperature had higher effects in the pasture matrix compared with the forest interior and forest edge. However, internal portions of the canopy did not exhibit significant variation in radiation or temperature. External canopy leaves exhibited higher net photosynthesis in plants from the pasture matrix, but there was higher net photosynthesis for internal leaves from the shaded forest interior. Variation in net photosynthesis and other gas-exchange parameters were related to thinner shade leaves in forest interior individuals, and internal leaves with lower stomatal density. Although the pasture matrix, forest edge, and forest interior experienced differences in light and temperature, leaf position in the canopy produced microclimatic variations, which modified gas exchange and anatomy. Thus, O. odorifera shows the potential for reforestation programs because of its high leaf plasticity, which will enable it to overcome variations in light and temperature.
The various ways that anadromous salmonids use lake habitats to complete their life history
Authors: Lennox Robert J. , Pulg Ulrich , Malley Brendan , Gabrielsen Sven-Erik , Hanssen Erlend M. , Cooke Steven J. , Birnie-Gauvin Kim , Barlaup Bjørn T. , Vollset Knut Wiik
Published: September 2020

Despite the preponderance of exorheic lakes in rivers home to anadromous salmonids, little research has focused on how salmon, trout, and char use lakes as part of their anadromous life histories. The literature on this subject has so far revealed that some parr move into lakes to feed and grow before smoltification but that smolts moving through lakes tend to have high mortality in disproportion to what is observed in other habitats they migrate in or through. Adults have been observed using lakes for behavioural thermoregulation prior to spawning, and kelts of iteroparous species often exploit lakes to overwinter before returning to sea to recondition. We summarized knowledge on lakes as salmonid habitat and identified knowledge gaps about the use of lakes by anadromous salmonids related to whether lakes are barriers that structure genetics of populations, whether mortality in lakes is compensatory or additive, and whether systems with lakes have higher rates of repeat spawning among iteroparous salmonids. Human activities that alter lakes require further study to understand how changes in temperature, oxygen, ice, or circulation affect navigation and fate.
Graded-division algebras over arbitrary fields
Authors: Bahturin Yuri , Elduque Alberto , Kochetov Mikhail
Published: September 2020

A graded-division algebra is an algebra graded by a group such that all nonzero homogeneous elements are invertible. This includes division algebras equipped with an arbitrary group grading (including the trivial grading). We show that a classification of finite-dimensional graded-central graded-division algebras over an arbitrary field [Formula: see text] can be reduced to the following three classifications, for each finite Galois extension [Formula: see text] of [Formula: see text]: (1) finite-dimensional central division algebras over [Formula: see text], up to isomorphism; (2) twisted group algebras of finite groups over [Formula: see text], up to graded-isomorphism; (3) [Formula: see text]-forms of certain graded matrix algebras with coefficients in [Formula: see text] where [Formula: see text] is as in (1) and [Formula: see text] is as in (2). As an application, we classify, up to graded-isomorphism, the finite-dimensional graded-division algebras over the field of real numbers (or any real closed field) with an abelian grading group. We also discuss group gradings on fields.
Coefficient-based regularization network with variance loss for error
Authors: Su Baoqi , Sun Hong-Wei
Published: September 2020

Loss function is the key element of a learning algorithm. Based on the regression learning algorithm with an offset, the coefficient-based regularization network with variance loss is proposed. The variance loss is different from the usual least quare loss, hinge loss and pinball loss, it induces a kind of samples cross empirical risk. Also, our coefficient-based regularization only relies on general kernel, i.e. the kernel is required to possess continuity, boundedness and satisfy some mild differentiability condition. These two characteristics bring essential difficulties to the theoretical analysis of this learning scheme. By the hypothesis space strategy and the error decomposition technique in [L. Shi, Learning theory estimates for coefficient-based regularized regression, Appl. Comput. Harmon. Anal. 34 (2013) 252–265], a capacity-dependent error analysis is completed, satisfactory error bound and learning rates are then derived under a very mild regularity condition on the regression function. Also, we find an effective way to deal with the learning problem with samples cross empirical risk.
Upper and lower motor neuron lesions in tetraplegia: implications for surgical nerve transfer to restore hand function
Authors: Bersch Ines , Fridén Jan
Published: September 2020

Nerve transfers (neurotizations) performed under optimal conditions can restore some voluntary control in muscles of the upper extremities in patients with tetraplegia. However, the type of motoneuron lesions in target muscles for nerve transfers influences the functional outcome. Using standardized maps of motor point topography, surface electrical stimulation reliably defines the kind and extent of motoneuron lesion in the selected muscles. In a muscle with an intact lower motor motoneuron, nerve transfers can often successfully reinnervate the chosen key muscle. Conversely, in a lower motoneuron lesion, the nerve transfer outcome is less predictable. However, direct muscle stimulation appears to ameliorate the morphological precondition, a finding that necessitates new preoperative approaches to optimize reinnervation in denervated/partially denervated muscles. Therefore, understanding the impact of electrical stimulation in diagnostics, prognostics, and treatments of upper limbs in tetraplegia is critical for neurotization procedures.
Retinal Levels of Amyloid Beta Correlate with Cerebral Levels of Amyloid Beta in Young APPswe/PS1dE9 Transgenic Mice before Onset of Alzheimer’s Disease
Authors: Mei Xi , Yang Mengxiang , Zhu Lina , Zhou Qi , Li Xingxing , Chen Zhongming , Zou Chenjun
Published: September 2020

Objectives. Retina abnormalities are related to cognitive disorders in patients with Alzheimer’s disease (AD). Retinal amyloid beta (Aβ) can be labeled by curcumin. We measured Aβ content in the cerebrum and retina of APPswe/PS1dE9 (APP) transgenic mice with early age to investigate the correlation between cerebrum and retina. Methods. APP mice and age-matched wild-type mice were investigated every month from age 2 months to 6 months to assess changes in Aβ content in the retina and cerebrum. At the beginning of each month, mice were fed a curcumin diet (50 mg/kg/day) for 7 consecutive days. The Aβ levels in the retina and cerebrum were measured by ELISAs. Correlations were identified between retinal and cerebral Aβ contents using Pearson’s correlation. Results. In the absence of curcumin, there was a significant correlation between Aβ contents in the retina and cerebrum of APP mice (r=0.7291, P=0.0014). With increasing age, Aβ-mediated degenerative change in the cerebrum (P<0.001 in 5 months) and retina (P<0.01 in 5 months) increased significantly. The inhibitory effect of curcumin on the Aβ level was significant in the cerebrum (P<0.001) and retina (P<0.01) of older APP mice in the early stage of life. Conclusion. We observed a significant correlation between the Aβ content in the retina and Aβ content in the cerebrum of APP mice. Our data suggest an appropriate time to measure retinal Aβ. Although curcumin can label Aβ in the retina, it also suppresses Aβ levels and weakens the degree of correlation between Aβ in cerebrum and retina tissues.
Withaferin A Exerts Preventive Effect on Liver Fibrosis through Oxidative Stress Inhibition in a Sirtuin 3-Dependent Manner
Authors: Gu Jingya , Chen Chang , Wang Jue , Chen Tingting , Yao Wenjuan , Yan Tingdong , Liu Zhaoguo
Published: September 2020

Sirtuin 3 (SIRT3) is a deacetylase involved in the development of many inflammation-related diseases including liver fibrosis. Withaferin A (WFA) is a bioactive constituent derived from the Withania somnifera plant, which has extensive pharmacological activities; however, little is known about the regulatory role of SIRT3 in the WFA-induced antifibrogenic effect. The current study is aimed at investigating the role of SIRT3 in WFA-induced antioxidant effects in liver fibrosis. Our study verified that WFA attenuated platelet-derived growth factor BB- (PDGF-BB-) induced liver fibrosis and promoted PDGF-BB-induced SIRT3 activity and expression in JS1 cells. SIRT3 silencing attenuated the antifibrogenic and antioxidant effects of WFA in activated JS1 cells. Moreover, WFA inhibited carbon tetrachloride- (CCl4-) induced liver injury, collagen deposition, and fibrosis; increased the SIRT3 expression; and suppressed the CCl4-induced oxidative stress in fibrotic livers of C57/BL6 mice. Furthermore, the antifibrogenic and antioxidant effects of WFA could be available in CCl4-induced WT (129S1/SvImJ) mice but were unavailable in CCl4-induced SIRT3 knockout (KO) mice. Our study suggested that WFA inhibited liver fibrosis through the inhibition of oxidative stress in a SIRT3-dependent manner. WFA could be a potential compound for the treatment of liver fibrosis.
On Local Weak Solutions for Fractional in Time SOBOLEV-Type Inequalities
Authors: Jleli Mohaemd , Samet Bessem
Published: September 2020

We consider two fractional in time nonlinear Sobolev-type inequalities involving potential terms, where the fractional derivatives are defined in the sense of Caputo. For both problems, we study the existence and nonexistence of nontrivial local weak solutions. Namely, we show that there exists a critical exponent according to which we have existence or nonexistence.
Investigating the Mediation and Moderation Effect of Students’ Addiction to Virtual Reality Games: A Perspective of Structural Equation Modeling
Authors: Zhai Xuesong , Asmi Fahad , Zhou Rongting , Ahmad Intikhab , Anwar Muhammad Azfar , Saneinia Saba , Li Man
Published: September 2020

Virtual reality (VR) games construct an immersive context for the youth’s entertainment and learning. VR game addiction (VAD) occurs simultaneously and brings about psychological issues. The current research employed a maximum likelihood estimation method to construct a structural equation model, by which learners’ VR consumption behaviors were examined. The bootstrapping approach was adopted to explore further the mediation of VR realism (VRR) and the moderation of VR affordance on learners’ VAD, which potentially leads to distressing behavioral and psychological circumstances. Data were collected from 575 students recruited in the survey, which was followed by a test of reliability and validity through confirmative factor analysis. Results concluded that VRR and consumers’ cognitive satisfaction played a significant role as mediators while conceptualizing addictive behavior based on VR-perceived experience of consumers, self-efficacy, and interactivity. Moreover, this study conceptualized addictive behavior toward VR games through a structural equation model in a media-rich environment and suggested practical implications to reduce addictive behavior.
Identification of Potential Type II Diabetes in a Large-Scale Chinese Population Using a Systematic Machine Learning Framework
Authors: Xue Mingyue , Su Yinxia , Li Chen , Wang Shuxia , Yao Hua
Published: September 2020

Background. An estimated 425 million people globally have diabetes, accounting for 12% of the world’s health expenditures, and the number continues to grow, placing a huge burden on the healthcare system, especially in those remote, underserved areas. Methods. A total of 584,168 adult subjects who have participated in the national physical examination were enrolled in this study. The risk factors for type II diabetes mellitus (T2DM) were identified by p values and odds ratio, using logistic regression (LR) based on variables of physical measurement and a questionnaire. Combined with the risk factors selected by LR, we used a decision tree, a random forest, AdaBoost with a decision tree (AdaBoost), and an extreme gradient boosting decision tree (XGBoost) to identify individuals with T2DM, compared the performance of the four machine learning classifiers, and used the best-performing classifier to output the degree of variables’ importance scores of T2DM. Results. The results indicated that XGBoost had the best performance (accuracy=0.906, precision=0.910, recall=0.902, F‐1=0.906, and AUC=0.968). The degree of variables’ importance scores in XGBoost showed that BMI was the most significant feature, followed by age, waist circumference, systolic pressure, ethnicity, smoking amount, fatty liver, hypertension, physical activity, drinking status, dietary ratio (meat to vegetables), drink amount, smoking status, and diet habit (oil loving). Conclusions. We proposed a classifier based on LR-XGBoost which used fourteen variables of patients which are easily obtained and noninvasive as predictor variables to identify potential incidents of T2DM. The classifier can accurately screen the risk of diabetes in the early phrase, and the degree of variables’ importance scores gives a clue to prevent diabetes occurrence.
Association of Vitamin D with the TaqI Polymorphism of the VDR Gene in Older Women Attending the Basic Health Unit of the Federal District, DF (Brazil)
Authors: de Souza Freitas Renata , Fratelli Caroline Ferreira , de Souza Silva Calliandra Maria , Lima Luciano Ramos de , Stival Marina Morato , da Silva Izabel Cristina Rodrigues , Schwerz Funghetto Silvana
Published: September 2020

Aging is accompanied by various functional modifications determined by their environment, lifestyle, nutrition, and genetics. Based on these factors, it is essential to verify the vitamin deficiency in the elderly population. Hypovitaminosis D is commonly present in human aging, increasing the chances of developing noncommunicable chronic diseases. The VDR gene TaqI polymorphism may modify the vitamin D metabolic pathway by altering the interaction between the vitamin D receptor and the active circulating vitamin D. Therefore, this study aimed to investigate the association between serum vitamin D and biochemical and genetic factors, considering the TaqI polymorphism of the VDR gene, in an elderly population of the Federal District. The study was a descriptive, case-control, quantitative, and cross-sectional type and was conducted in two basic health units in the administrative region of Ceilândia, Federal District, DF, Brazil, with women aged 60 years or older. Anthropometric, biochemical, and genetic parameters (VDR TaqI polymorphism) were evaluated. The adopted significance level was 5%, and statistical analyses were performed using the SPSS version 20.0 program. The study consisted of 128 participants. The most prevalent age was from 60 to 65 years (N = 53; 41.4%). 66 elderly (51.6%) were part of the case group (hypovitaminosis D), while 62 were in the control group. In the case group, 30.2% had grade I obesity, 77.3% were hypertensive, and 51.5% were diabetic. The TT genotype was present in 47% of the case group and 54.8% in the control group (p=0.667). There was no association between serum vitamin D levels and the VDR gene variant TaqI polymorphism in an elderly Brazilian population.
Assessing Barriers to and Level of Adherence to Hypertension Therapy among Palestinians Living in the Gaza Strip: A Chance for Policy Innovation
Authors: Abu-El-Noor Nasser Ibrahim , Aljeesh Yousef Ibrahim , Bottcher Bettina , Abu-El-Noor Mysoon Khalil
Published: September 2020

Introduction. Hypertension is a major health concern, especially in low-income countries. Nonadherence and poor or no persistence in adhering to hypertension treatment regimens result in uncontrolled high blood pressure, increasing rates of mortality and morbidity, and preventable healthcare costs. The aim of this study was to assess the level of adherence and barriers to treatment regimens among hypertensive patients living in the Gaza Strip, Palestine. Methods. A convenience sample of 648 participants completed the Hill-Bone Compliance to High Blood Pressure Therapy Scale. The great majority of participants (n = 521, 80.4%) was highly adherent to their treatment regimen, 123 participants (18.98%) were classified as moderately nonadherent, and 4 (0.62%) participants were classified as highly nonadherent to their hypertension treatment regimen. Participants of this study showed the highest adherence rate to the domain of medication adherence (mean of 1.42 out of 4) followed by appointment keeping (mean 1.8), while they were least adherent to diet (mean of 2.18). The greatest three barriers to adherence to the recommended treatment regimen reported by participants were inability to exercise, inability to resist fast and fried food, and inability to keep themselves away from salty foods. Conclusion. Overall adherence to medication in Gaza was surprisingly good in patients with a diagnosis of hypertension for at least one year. However, adherence to lifestyle advice or dietary regimes remains poor. A combination of interventions using low-cost mobile technology, combined with face-to-face interventions by healthcare professionals, can be applied to improve adherence to hypertension treatment regimens in order to reduce the consequences of uncontrolled blood pressure.
Cytokine Storm in COVID-19 Patients, Its Impact on Organs and Potential Treatment by QTY Code-Designed Detergent-Free Chemokine Receptors
Authors: Mustafa Mujahed I. , Abdelmoneim Abdelrahman H. , Mahmoud Eiman M. , Makhawi Abdelrafie M.
Published: September 2020

The novel coronavirus is not only causing respiratory problems, but it may also damage the heart, kidneys, liver, and other organs; in Wuhan, 14 to 30% of COVID-19 patients have lost their kidney function and now require either dialysis or kidney transplants. The novel coronavirus gains entry into humans by targeting the ACE2 receptor that found on lung cells, which destroy human lungs through cytokine storms, and this leads to hyperinflammation, forcing the immune cells to destroy healthy cells. This is why some COVID-19 patients need intensive care. The inflammatory chemicals released during COVID-19 infection cause the liver to produce proteins that defend the body from infections. However, these proteins can cause blood clotting, which can clog blood vessels in the heart and other organs; as a result, the organs are deprived of oxygen and nutrients which could ultimately lead to multiorgan failure and consequent progression to acute lung injury, acute respiratory distress syndrome, and often death. However, there are novel protein modification tools called the QTY code, which are similar in their structure to antibodies, which could provide a solution to excess cytokines. These synthetic proteins can be injected into the body to bind the excess cytokines created by the cytokine storm; this will eventually remove the excessive cytokines and inhibit the severe symptoms caused by the COVID-19 infection. In this review, we will focus on cytokine storm in COVID-19 patients, their impact on the body organs, and the potential treatment by QTY code-designed detergent-free chemokine receptors.
The Application of Mechanical Stimulations in Tendon Tissue Engineering
Authors: Sheng Renwang , Jiang Yujie , Backman Ludvig J. , Zhang Wei , Chen Jialin
Published: September 2020

Tendon injury is the most common disease in the musculoskeletal system. The current treatment methods have many limitations, such as poor therapeutic effects, functional loss of donor site, and immune rejection. Tendon tissue engineering provides a new treatment strategy for tendon repair and regeneration. In this review, we made a retrospective analysis of applying mechanical stimulation in tendon tissue engineering, and its potential as a direction of development for future clinical treatment strategies. For this purpose, the following topics are discussed; (1) the context of tendon tissue engineering and mechanical stimulation; (2) the applications of various mechanical stimulations in tendon tissue engineering, as well as their inherent mechanisms; (3) the application of magnetic force and the synergy of mechanical and biochemical stimulation. With this, we aim at clarifying some of the main questions that currently exist in the field of tendon tissue engineering and consequently gain new knowledge that may help in the development of future clinical application of tissue engineering in tendon injury.
The Influence of Physical and Chemical Reactions on Water Leakage in a Multiarch Tunnel
Authors: Shi Jian-Xun , Li Zhao-Hui , He Yong-Qiang , Zhang Guo-Ming , Wei Ming-Qiang
Published: September 2020

In many tunnels in China, the groundwater is acidic and carbonated, causing in challenges in the prevention and control of leakages of the existing tunnels and tunnels under construction. Research on tunnel leakage and the physical and chemical effects of water due to water‐rock interactions is a trending topic. In addition, there is a big difference between the waterproof and drainage of multiarch tunnels and separate tunnels. In this study, the mechanism of the interaction between the groundwater and the surrounding rock of a multiarch tunnel were analyzed. The relationship between the leakage of a multiarch tunnel and the interaction between the surrounding rocks and groundwater was determined by analyzing the interaction between the chemical components in the groundwater, rocks, and the concrete lining. A mathematical model was established based on the physical and chemical reactions in the rock surrounding the tunnel, and the RNCDX.FOR program was compiled using the simplex Monte Carlo method. The total free energy in the entire system varied significantly, and the value of objective function (J) reflected the trend of the system′s spontaneous reaction. As J decreased, the reaction power of the system increased. The more significant the erosion of the rocks was by the groundwater, the more channels were created by the groundwater in the rock, and the more likely the water leakage was.
AGNES-SMOTE: An Oversampling Algorithm Based on Hierarchical Clustering and Improved SMOTE
Authors: Wang Xin , Yang Yue , Chen Mingsong , Wang Qin , Qin Qin , Jiang Hua , Wang Huijiao
Published: September 2020

Aiming at low classification accuracy of imbalanced datasets, an oversampling algorithm—AGNES-SMOTE (Agglomerative Nesting-Synthetic Minority Oversampling Technique) based on hierarchical clustering and improved SMOTE—is proposed. Its key procedures include hierarchically cluster majority samples and minority samples, respectively; divide minority subclusters on the basis of the obtained majority subclusters; select “seed sample” based on the sampling weight and probability distribution of minority subcluster; and restrict the generation of new samples in a certain area by centroid method in the sampling process. The combination of AGNES-SMOTE and SVM (Support Vector Machine) is presented to deal with imbalanced datasets classification. Experiments on UCI datasets are conducted to compare the performance of different algorithms mentioned in the literature. Experimental results indicate AGNES-SMOTE excels in synthesizing new samples and improves SVM classification performance on imbalanced datasets.
Rational Protocols and Attacks in Blockchain System
Authors: Li Tao , Chen Yuling , Wang Yanli , Wang Yilei , Zhao Minghao , Zhu Haojia , Tian Youliang , Yu Xiaomei , Yang Yixian
Published: September 2020

Blockchain has been an emerging technology, which comprises lots of fields such as distributed systems and Internet of Things (IoT). As is well known, blockchain is the underlying technology of bitcoin, whose initial motivation is derived from economic incentives. Therefore, lots of components of blockchain (e.g., consensus mechanism) can be constructed toward the view of game theory. In this paper, we highlight the combination of game theory and blockchain, including rational smart contracts, game theoretic attacks, and rational mining strategies. When put differently, the rational parties, who manage to maximize their utilities, involved in blockchain chose their strategies according to the economic incentives. Consequently, we focus on the influence of rational parties with respect to building blocks. More specifically, we investigate the research progress from the aspects of smart contract, rational attacks, and consensus mechanism, respectively. Finally, we present some future directions based on the brief survey with respect to game theory and blockchain.
Evaluation of Altered Glutamatergic Activity in a Piglet Model of Hypoxic-Ischemic Brain Damage Using 1H-MRS
Authors: Dang Yuxue , Wang Xiaoming
Published: September 2020

Background and Objective. The excitotoxicity of glutamate (Glu) is a major risk factor for neonatal hypoxic-ischemic brain damage (HIBD). The role of excitatory amino acid transporter 2 (EAAT2) and the α-amino-3-hydroxy-5-methyl-4-isoxazole-proprionic acid receptor (AMPAR) subunit GluR2 in mediating the Glu excitotoxicity has always been the hotspot. This study was aimed at investigating the early changes of glutamate metabolism in the basal ganglia following hypoxia-ischemia (HI) in a neonatal piglet model using 1H-MRS. Methods. Twenty-five newborn piglets were selected and then randomly assigned to the control group (n=5) and the model group (n=20) subjected to HI. HI was induced by blocking bilateral carotid blood flow under simultaneous inhalation of a 6% oxygen mixture. 1H-MRS data were acquired from the basal ganglia at the following time points after HI: 6, 12, 24, and 72 h. Changes in protein levels of EAAT2 and GluR2 were determined by immunohistochemical analysis. Correlations among metabolite concentrations, metabolite ratios, and the protein levels of EAAT2 and GluR2 were investigated. Results. The Glu level sharply increased after HI, reached a transient low level of depletion that approached the normal level in the control group, and subsequently increased again. Negative correlations were found between concentrations of Glu and EAAT2 protein levels (Rs=−0.662, P<0.001) and between the Glu/creatine (Cr) ratio and EAAT2 protein level (Rs=−0.664, P<0.001). Moreover, changes in GluR2 protein level were significantly and negatively correlated with those in Glu level (the absolute Glu concentration, Rs=−0.797, P<0.001; Glu/Cr, Rs=−0.567, P=0.003). Conclusions. Changes in Glu level measured by 1H-MRS were inversely correlated with those in EAAT2 and GluR2 protein levels following HI, and the results demonstrated that 1H-MRS can reflect the early changes of glutamatergic activity in vivo.
Too Aggressive Drop in Blood Pressure in a Hypertensive Male Leading to “Man-in-the-Barrel Syndrome”
Authors: Dalugama Chamara , Jayasinghe Achila , Ralapanawa Udaya , Abeygunawardena Shamali , Jayalath Thilak
Published: September 2020

Introduction. “Man-in-the-barrel syndrome” is a neurological phenotype with brachial diplegia, normal sensation, and preserved motor function of the lower limb. It has been described in various neuropathological conditions affecting the cerebral hemispheres, pons, upper spinal cord, and peripheral neurons. Severe hypotension leading to watershed infarctions leading to this phenotype has been reported. We describe the first case of “man-in-the-barrel syndrome” in a patient with a precipitous drop in blood pressure following oral antihypertensive medications. Case Presentation. A 75-year-old Sri Lankan male presented following a generalized tonic-clonic seizure to a tertiary care hospital. Upon recovery, he was noted to have severe brachia diplegia affecting shoulder movements with preserved hand muscle power and motor functions of the lower limb. The previous day, he was newly diagnosed with markedly elevated blood pressure without acute end organ involvement. Treatment with three antihypertensives had been initiated. Noncontrast CT of the brain revealed watershed infarctions affecting both cerebral hemispheres. Conclusion. It is generally unwise to lower blood pressure very rapidly, as ischemic damage can occur in vascular beds that are habituated to high levels of blood pressure in the brain. Ischemic damage caused by rapid lowering of blood pressure may rarely result in “man-in-the-barrel syndrome” leading to severe functional disability.
RIPTE: Runtime Integrity Protection Based on Trusted Execution for IoT Device
Authors: Qin Yu , Liu Jingbin , Zhao Shijun , Feng Dengguo , Feng Wei
Published: September 2020

Software attacks like worm, botnet, and DDoS are the increasingly serious problems in IoT, which had caused large-scale cyber attack and even breakdown of important information infrastructure. Software measurement and attestation are general methods to detect software integrity and their executing states in IoT. However, they cannot resist TOCTOU attack due to their static features and seldom verify correctness of control flow integrity. In this paper, we propose a novel and practical scheme for software trusted execution based on lightweight trust. Our scheme RIPTE combines dynamic measurement and control flow integrity with PUF device binding key. Through encrypting return address of program function by PUF key, RIPTE can protect software integrity at runtime on IoT device, enabling to prevent the code reuse attacks. The results of our prototype’s experiment show that it only increases a small size TCB and has a tiny overhead in IoT devices under the constraint on function calling. In sum, RIPTE is secure and efficient in IoT device protection at runtime.
Brain Functional Network in Chronic Asymptomatic Carotid Artery Stenosis and Occlusion: Changes and Compensation
Authors: He Shihao , Liu Ziqi , Xu Zongsheng , Duan Ran , Yuan Li , Xiao Chu , Yi Zhe , Wang Rong
Published: September 2020

Asymptomatic carotid artery stenosis (CAS) and occlusion (CAO) disrupt cerebral hemodynamics. There are few studies on the brain network changes and compensation associated with the progression from chronic CAS to CAO. In the current study, our goal is to improve the understanding of the specific abnormalities and compensatory phenomena associated with the functional connection in patients with CAS and CAO. In this prospective study, 27 patients with CAO, 29 patients with CAS, and 15 healthy controls matched for age, sex, education, handedness, and risk factors underwent neuropsychological testing and resting-state functional magnetic resonance (rs-fMRI) imaging simultaneously; graph theoretical analysis of brain networks was performed to determine the relationship between changes in brain network connectivity and the progression from internal CAS to CAO. The global properties of the brain network assortativity (p=0.002), hierarchy (p=0.002), network efficiency (p=0.011), and small-worldness (p=0.009) were significantly more abnormal in the CAS group than in the control and CAO groups. In patients with CAS and CAO, the nodal efficiency of key nodes in multiple brain regions decreased, while the affected hemisphere lost many key functional connections. In this study, we found that patients with CAS showed grade reconstruction, invalid connections, and other phenomena that impaired the efficiency of information transmission in the brain network. A compensatory functional connection in the contralateral cerebral hemisphere of patients with CAS and CAO may be an important mechanism that maintains clinical asymptomatic performance. This study not only reveals the compensation mechanism of cerebral hemisphere ischemia but also validates previous explanations for brain function connectivity, which can help provide interventions in advance and reduce the impairment of higher brain functions. This trial is registered with Clinical Trial Registration-URL http://www.chictr.org.cn and Unique identifier ChiCTR1900023610.
Position Tracking Control of Robotic System Subject to Matched and Mismatched Disturbances
Authors: Liu Xia , Liu Dandan , Sheng Hao
Published: September 2020

For nonlinear coupled robotic system subject to matched and mismatched disturbances, this paper designs an adaptive disturbance observer-based exponential sliding mode controller to achieve position tracking. Firstly, matched disturbance, mismatched disturbance, and the derivative of mismatched disturbance are defined as the lumped disturbance in robotic system. Secondly, a nonlinear disturbance observer is constructed to estimate the lumped disturbance, and an adaptive law is proposed to estimate the bound of the lumped disturbance. Finally, an exponential sliding mode controller is derived by combining the nonlinear disturbance observer and exponential convergence law. Stability and tracking performance of the robotic system is analyzed via Lyapunov function approach. Simulation results show that, with the proposed approach, both matched and mismatched disturbances in robotic system can be effectively depressed while achieving position tracking.
Amuletos em cantos dentro e fora do Pitt Rivers Museum: a antropologia que fazemos e a crítica das hegemonias contemporâneas
Authors: Jardim Marta Da Rosa
Published: September 2020

Este artigo apresenta reflexões de uma pesquisa etnográfica sobre amuletos e encantos do Pitt Rivers Museum. Pretende contribuir com reflexões críticas sobre a produção do conhecimento. Apresenta os desafios e as práticas dos antropólogos contemporâneos na gestão, no estudo e na exibição de amuletos e encantos de outras sociedades. Evidencia a constante noção de transformação na história do museu. A seguir, registra reflexões acerca de inesperadas experiências na pesquisa: recente resultado de pesquisa da equipe do museu; Movimentos de uma etnografia em grupos de cantos; as quais sugerem investigação em torno de amuletos e encantos contemporâneos. Finaliza resgatando o potencial da etnografia realizada na prática de cantar coletivamente. Assinala a importância de uma atitude crítica diante de categorias de análise e pressupostos reproduzidos pela antropologia e permitidos pela posição ocupada pela disciplina e por suas alianças – muitas vezes silenciadas – com as práticas hegemônicas de produção de conhecimento.