bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of occupation type on the association between sleep duration and impaired fasting glucose: results from a Chinese population-based study
Authors: Lu Qingyun , Wu Shangxi , Wang Shiyu , Xiao Jing
Published: June 2021

Objectives

Systematic evaluation of the influence of occupation type on the association between sleep–glucose metabolism

Design

A cross-sectional study.

Setting

The Nantong Metabolic Syndrome Study is a Chinese population-based study.

Participants

20 502 participants aged 18–74 years old.

Intervention

No intervention.

Primary and secondary outcome measures

Impaired fasting glucose (IFG).

Results

A total of 1503 participants (7.33%) with a slightly longer sleep duration had IFG. After being stratified according to occupation, a sleep duration of ≥10 hours daily corresponded to a 1.321-fold risk of IFG (95% CI 1.071 to 1.628, p=0.0092) among moderate and heavy physical workers compared with those with a daily sleep duration of 7–9 hours. There was no significant relationship between sleep and IFG among other types of workers. Moreover, we discovered a gender difference in the influence of occupation on the sleep–IFG. A positive association among moderate and heavy physical men and a negative association among light or sedentary men were established, but not in unemployed men. However, a positive association was evident only in unemployed women; there was no significant association among other occupations.

Conclusion

This study highlights the role of occupation in the relationship of sleep–glucose metabolism. A gender difference was found to have been influenced by occupational types on the sleep–metabolic association.
Updated systematic review and meta-analysis of studies examining the relationship between reported racism and health and well-being for children and youth: a protocol
Authors: Priest Naomi , Doery Kate , Truong Mandy , Guo Shuaijun , Perry Ryan , Trenerry Brigid , Karlsen Saffron , Kelly Yvonne , Paradies Yin
Published: June 2021

Introduction

Racism is a critical determinant of health and health inequities for children and youth. This protocol aims to update the first systematic review conducted by Priestet al(2013), including a meta-analysis of findings. Based on previous empirical data, it is anticipated that child and youth health will be negatively impacted by racism. Findings from this review will provide updated evidence of effect sizes across outcomes and identify moderators and mediators of relationships between racism and health.

Methods and analysis

This systematic review and meta-analysis will include studies that examine associations between experiences of racism and racial discrimination with health outcomes of children and youth aged 0–24 years. Exposure measures include self-reported or proxy reported systemic, interpersonal and intrapersonal racism. Outcome measures include general health and well-being, physical health, mental health, biological markers, healthcare utilisation and health behaviours. A comprehensive search of studies from the earliest time available to October 2020 will be conducted. A random effects meta-analysis will examine the average effect of racism on a range of health outcomes. Study-level moderation will test the difference in effect sizes with regard to various sample and exposure characteristics. This review has been registered with the International Prospective Register of Systematic Reviews.

Ethics and dissemination

This review will provide evidence for future research within the field and help to support policy and practice development. Results will be widely disseminated to both academic and non-academic audiences through peer-review publications, community summaries and presentations to research, policy, practice and community audiences.

PROSPERO registration number

CRD42020184055.
Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004–2019
Authors: Tao Ning-ning , Li Yi-fan , Song Wan-mei , Liu Jin-yue , Zhang Qian-yun , Xu Ting-ting , Li Shi-jin , An Qi-qi , Liu Si-qi , Li Huai-chen
Published: June 2021

Objective

This study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).

Design

A retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.

Results

A total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).

Conclusion

Smoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.
Difference in factors associated with continuum of care completion rate from pregnancy to postpartum period in rural Nepal: a community-based, cross-sectional study
Authors: Silwal Ram Chandra , Shibanuma Akira , Poudyal Amod Kumar , Ikeda Subaru , Jimba Masamine
Published: June 2021

Objectives

This study aimed to investigate the continuum of care (CoC) completion rate in maternal, neonatal and child health and its associated factors among mothers in two ecological regions in Nepal.

Design

This was a community-based, cross-sectional study, for which data were collected through face-to-face interviews using a structured questionnaire. Multiple logistic regression analyses were conducted to determine the associated factors.

Setting

This was carried out in two rural districts of Nepal, in different regions: one in the hills (Dhading) and another in the flatlands called Terai (Nawalparasi). The data were collected between July and December 2016.

Participants

Mothers who gave birth within a year before this study were included as participants. In total, there were 1803 participants.

An outcome measure

The outcome of this study was measured by the CoC completion rate when a mother completes four antenatal check-ups, deliver at a health facility and receives postnatal care within 24 hours of delivery.

Results

The CoC completion rates were 41% in Dhading and 28% in Nawalparasi. In Dhading, shorter travel time to a health facility and higher wealth quintiles were associated with a better CoC completion rate. In Nawalparasi, the CoC completion rate was affected by parity and decision-making for pregnancy care.

Conclusions

The CoC completion rate was low in both districts in Nepal. However, factors associated with the CoC completion rate varied by district. Differences in these factors might be reflected by geographical and socioeconomic conditions and the characteristics of household decision making in these districts.
Maternal childbirth experience and time of delivery: a retrospective 7-year cohort study of 105 847 parturients in Finland
Authors: Joensuu Johanna , Saarijärvi Hannu , Rouhe Hanna , Gissler Mika , Ulander Veli-Matti , Heinonen Seppo , Mikkola Tomi
Published: June 2021

Objectives

To explore how the time of delivery influences childbirth experience.

Design

A retrospective cohort study.

Setting

Childbirth in the four Helsinki and Uusimaa Hospital District hospitals, Finland, from 2012 to 2018.

Participants

105 847 childbirths with a singleton live fetus.

Main outcome measures

Childbirth experience measured by Visual Analogue Scale (VAS).

Results

The major difference in average childbirth experience measured by VAS was between primiparas (8.03; 95% CI 8.01 to 8.04) and multiparas (8.47; 95% CI 8.45 to 8.48). Risk ratio (RR) of the low VAS (≤5) was 2.3 when primiparas were compared with multiparas. Differences in VAS between distinct periods were found in two stages: annual and time of day. The decrease in VAS from 2012–2016 to 2017–2018 in primiparas was from 7.97 (95% CI 7.95 to 7.99) to 7.80 (95% CI 7.77 to 7.83) and from 2014–2016 to 2017–2018 in multiparas from 8.60 (95% CI 8.58 to 8.61) to 8.49 (95% CI 8.47 to 8.52). Corresponding RRs of low VAS were 1.3 for primiparas and 1.2 for multiparas. Hourly differences in VAS were detected in primiparas between office hours 08:00–15:59 (7.97; 95% CI 7.94 to 7.99) and other times (night 00:00–07:59; 7.91; 95% CI 7.88 to 7.94; and evening 16:00–23:59; 7.90; 95% CI 7.87 to 7.92). In multiparas differences in VAS were detected between evening (8.52; 95% CI 8.50 to 8.54) and other periods (night; 8.56; 95% CI 8.54 to 9.58; and office hours; 8.57; 95% CI 8.55 to 8.59).

Conclusion

The maternal childbirth experience depended on the time of delivery. Giving birth during the evening led to impaired childbirth experience in both primiparas and multiparas, compared with delivery at other times. The impact of labour induction on childbirth experience should be further examined. The reorganisation of delivery services and the reduction of birth preparations might affect annual VAS. VAS is a simple method of measuring the complex entity of childbirth experience, and our results indicate its ability to capture temporal variation.
Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study
Authors: Asahina Rokuhiro , Tsuda Hiroyuki , Nishiko Yuki , Fuma Kazuya , Kuribayashi Momoko , Tezuka Atsuko , Ando Tomoko , Mizuno Kimio
Published: June 2021

Objective

This study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.

Design

Retrospective cohort study.

Setting

Single institution.

Participants

This study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.

Results

The rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).

Conclusions

Abnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.
UTAH: Using Telemedicine to improve early medical Abortion at Home: a protocol for a randomised controlled trial comparing face-to-face with telephone consultations for women seeking early medical abortion
Authors: Reynolds-Wright John Joseph , Norrie John , Cameron Sharon Tracey
Published: June 2021

Introduction

Early medical abortion (EMA) is a two-stage process of terminating pregnancy using oral mifepristone (a progesterone-receptor antagonist) followed usually 1–2 days later by sublingual, vaginal or buccal misoprostol (a prostaglandin analogue). There are no published randomised controlled trials (RCTs) on the use of telemedicine for EMA. Our proposed research will determine if telephone consultations for EMA (the most common method of abortion in the UK) is non-inferior to standard face-to-face consultations with regard to the efficacy of EMA.

Methods and analysis

This study will be conducted as an RCT. The recruitment target is 1222 participants.

The primary outcome is success of EMA (complete abortion rate). This will be determined based on a negative low-sensitivity urine pregnancy test result (2 weeks after misoprostol use) and absence of surgical intervention or diagnosis of ongoing pregnancy (within 6 weeks of misoprostol).

Secondary outcomes include total time spent at a clinic appointment to receive EMA, self-reported preparedness for EMA, level of satisfaction with consultation and effective contraception uptake compared with when women attend for a face-to-face consultation.

The main analysis will be a modified intention-to-treat analysis. This will include all randomised women (with a viable pregnancy) using EMA and follow-up for the main outcome. The study initiated on 13 January 2020 and is anticipated to finish in late 2021.

Ethics and dissemination

Ethical approval was given by the South East Scotland NHS Research Ethics Committee, reference: 19/SS/0111. Results will be published in peer-reviewed journals, presented at clinical and academic meetings, and shared with participants via the clinic website.

Trial registration number

NCT04139382.
‘Overnight, things changed. Suddenly, we were in it’: a qualitative study exploring how surgical teams mitigated risks of COVID-19
Authors: Elliott Daisy , Ochieng Cynthia , Jepson Marcus , Blencowe Natalie S , Avery Kerry NL , Paramasivan Sangeetha , Cousins Sian , Skilton Anni , Hutchinson Peter , Jayne David , Birchall Martin , Blazeby Jane M , Donovan Jenny L , Rooshenas Leila
Published: June 2021

Objectives

COVID-19 presents a risk of infection and transmission for operating theatre teams. Guidelines to protect patients and staff emerged and changed rapidly based on expert opinion and limited evidence. This paper presents the experiences and innovations developed by international surgical teams during the early stages of the pandemic to attempt to mitigate risk.

Design

In-depth, semistructured interviews were audio recorded, transcribed and analysed thematically using methods of constant comparison.

Participants

43 participants, including surgeons from a range of specialties (primarily general surgery, otolaryngology, neurosurgery, cardiothoracic and ophthalmology), anaesthetists and those in nursing roles.

Setting

The UK, Italy, Spain, the USA, China and New Zealand between March and May 2020.

Results

Surgical teams sought to mitigate COVID-19 risks by modifying their current practice with an abundance of strategies and innovations. Communication and teamwork played an integral role in how teams adapted, although participants reflected on the challenges of having to improvise in real time. Uncertainties remained about optimal surgical practice and there were significant tensions where teams were forced to balance what was best for patients while contemplating their own safety.

Conclusions

The perceptions of risks during a pandemic such as COVID-19 can be complex and context dependent. Management of these risks in surgery must be driven by evidence‐based practice resulting from a pragmatic and novel approach to collation of global evidence. The context of surgery has changed dramatically, and surgical teams have developed a plethora of innovations. There is an urgent need for high-quality evidence to inform surgical practice that optimises the safety of both patients and healthcare professionals as the COVID-19 pandemic unfolds.
WHO Child Growth Standards in context: The Baby–bod Project - Observational study in Tasmania
Authors: Jayasinghe Sisitha , Herath Manoja P , Beckett Jeffrey M , Ahuja Kiran D K , Byrne Nuala M , Hills Andrew P
Published: June 2021

Objective

This research evaluated (1) differences in body size and composition of Tasmanian infants at birth and 3 and 6 months postpartum compared with WHO child growth standards and (2) body composition changes in Tasmanian infants at the extremes of the weight-for-length (WFL) spectrum.

Design

Observational study.

Setting

A hospital in Northern Tasmania, Australia.

Patients

315 healthy infants (~90% Caucasian) born between 2017 and 2019 in Tasmania.

Interventions

Body composition and anthropometric measures at 0, 3 and 6 months.

Main outcome measures

Growth characteristics at birth and growth trajectories from 0 to 6 months were compared against WHO child growth standards for 0–2 years.

Results

Overall, growth of Tasmanian infants in the first 6 months of life was similar to the global prescriptive standards. Trajectories of fat mass (FM) and fat-free mass (FFM) accrual in infants from the extremes of the size spectrum appear to converge at the 6-month time point. Infants in the lower extremity demonstrated the most precipitous accrual in percentage FM (and the steepest decline in percentage FFM), compared with all other infants.

Conclusion

No significant deviations of growth were observed in Tasmanian infants from 0 to 6 months in comparison to the WHO prescriptive growth standards. Infants below the third percentile WFL showed the most precipitous increase in FM accretion. Periodic comparisons local infants with global standards will enable identification of significant deviations from optimal growth patterns.
Impact of simulation training on decision to delivery interval in cord prolapse
Authors: Gallagher Gillian , Griffin Alison , Clipperton Sharon , Janssens Sarah
Published: June 2021

Background

Umbilical cord prolapse is a rare obstetric emergency requiring rapid coordination of a multidisciplinary team to effect urgent delivery. The decision to delivery interval (DDI) is a marker of quality of teamwork. Multidisciplinary team simulation-based training can be used to improve clinical and teamwork performance.

Aim

To assess the DDI for cord prolapse before and after the introduction of simulation-based training at a quaternary maternity unit in Australia.

Method

A retrospective, observational cohort study comparing the DDI before and after the introduction of simulation-based training activities. The general linear model was used to estimate the association between DDI and simulation training while adjusting for potential confounders including model of care (public or private) and time of birth (regular or after hours).

Results

After the introduction of simulation training, mean DDI decreased by 4.1 min (difference −4.1, 95% CI −6.2 to −1.9), after adjustment for confounding factors. Despite this, there was no difference in selected neonatal outcomes including Apgar score at 5 min and arterial cord pH.

Conclusions

The introduction of simulation-based training was associated with a decrease in the DDI in the setting of cord prolapse.
Epidemiological and Clinical Characteristics of Non-Severe and Severe Pediatric and Adult COVID-19 Patients across Different Geographical Regions in the Early Phase of Pandemic: A Systematic Review and Meta-Analysis of Observational Studies
Authors: Chua Pearleen Ee Yong , Shah Shimoni Urvish , Gui Hao , Koh Jiayun , Somani Jyoti , Pang Junxiong
Published: June 2021

This systematic and meta-review aimed to compare clinical presentation, outcomes, and care management among patients with COVID-19 during the early phase of the pandemic. A total of 77 peer-reviewed publications were identified between January 1, 2020 and April 9, 2020 from PubMed, Google Scholar, and Chinese Medical Journal databases. Subsequently, meta-analysis of 40 non-overlapping studies, comprising of 4844 patients from seven countries, was conducted to see differences in clinical characteristics and laboratory outcomes across patients from different geographical regions (Wuhan, other parts of China and outside China), severity (non-severe, severe and fatal) and age groups (adults and children). Patients from Wuhan had a higher mean age (54.3 years) and rates of dyspnea (39.5%) compared with patients from other parts of China and outside China. Myalgia, fatigue, acute respiratory distress syndrome (ARDS) and fatalities were also significantly more prevalent among Wuhan patients. A significant dose–response increase in prevalence of diabetes, D-dimer, white blood cells, neutrophil levels and ARDS was seen from non-severe to severe and fatal outcomes. A significant increase in mean duration of symptom onset to admission was seen between non-severe cases (4.2 days) and severe and fatal cases (6.3 days and 8.8 days, respectively). Proportion of asymptomatic cases was higher in children (20%) compared with adults (2.4%). In conclusion, patients with COVID-19 from Wuhan displayed more severe clinical disease during the early phase of the pandemic, while disease severity was significantly lesser among pediatric cases. This review suggests that biomarkers at admission may be useful for prognosis among patients with COVID-19.
EULAR portfolio for Rheumatology training: a EULAR School of Rheumatology initiative
Authors: van Onna Marloes , Ramiro Sofia , Haines Catherine , Holland-Fischer Mette , da Silva Jose Antonio Pereira , Dudler Jean , Edwards Chris , Alunno Alessia , Nikiphorou Elena , Falzon Louise , Sivera Francisca
Published: June 2021

Objective

About half of the rheumatology trainees do not use a portfolio. This project was established to reach consensus about the content of a EULAR portfolio for Rheumatology training and subsequently develop portfolio assessment forms.

Methods

After establishing a portfolio working group (WG), including nine rheumatologists and one educationalist, a systematic literature review (SLR) on the content and structure of portfolios for postgraduate learning was conducted (November 2018). This was followed by a survey among WG members and members of the EMerging EUlar NETwork, inquiring about the content and structure of existing national portfolios. The portfolio WG selected the key components of the portfolio, taking previous experience and feasibility into account. Assessment forms (eg, case-based discussion) were developed and pilot-tested.

Results

13/2034 articles were included in the SLR (12 high/1 moderate risk of bias). Information on procedural skills, personal reflections, learning goals and multisource feedback was most often included a portfolio. Twenty-five respondents completed the survey (response≈50%). Feedback from assessors, reflective writing and formulation of learning goals were considered important dimensions to be covered in a portfolio. Six key components of the portfolio were established: curriculum vitae, personal development plan, clinical work, professional behaviours, education and research activities. Suggested minimal content for each component was formulated. Four assessment forms were successfully pilot-tested by 11 rheumatologists and their trainees.

Conclusion

A EULAR portfolio for Rheumatology training and assessment forms were developed. Portfolio implementation, particularly in countries without an existing portfolio, may promote a higher standard of rheumatology training across Europe.
Establishment of a novel triage system for SARS-CoV-2 among trauma victims in trauma centers with limited facilities
Authors: Abdolrahimzadeh Fard Hossein , Borazjani Roham , Sabetian Golnar , Shayan Zahra , Boland Parvaz Shahram , Abbassi Hamid Reza , Aminnia Shiva , Salimi Maryam , Paydar Shahram , Taheri Akerdi Ali , Zare Masome , Shayan Leila , Mahmudi-Azer Salahaddin
Published: June 2021

Objectives

The triage of trauma patients with potential COVID-19 remains a major challenge given that a significant number of patients may be asymptomatic or pre-symptomatic. This study aimed to compare the specificity and sensitivity of available triage systems for COVID-19 among trauma patients. Furthermore, it aimed to develop a novel triage system for SARS-CoV-2 detection among trauma patients in centers with limited resources.

Methods

All patients referred to our center from February to May 2020 were enrolled in this prospective study. We evaluated the SARS-CoV-2 triage protocols from the WHO, the Iranian Ministry of Health and Medical Education (MOHME), and the European Centre for Disease Control and Prevention (ECDC) for their effectiveness in finding COVID-19 infected individuals among trauma patients. We then used these data to design a stepwise triage protocol to detect COVID-19 positive patients among trauma patients.

Results

According to our findings, the WHO protocol showed 100% specificity and 13.3% sensitivity. The MOHME protocol had 99% specificity and 23.3% sensitivity. While the ECDC protocol showed 93.3% sensitivity and 89.5% specificity, it did not prioritize patients based on traumatic injuries and unstable conditions. Our stepwise triage protocol, which prioritizes traumatic injuries, had 93.3% sensitivity and 90.3% specificity.

Conclusion

Our study shows that the triage protocols from the WHO, MOHME and ECDC are not best equipped to diagnose SARS-CoV-2 infected individuals among trauma patients. In our proposed stepwise triage system, patients are triaged according to their hemodynamic conditions, COVID-19 related clinical states, and COVID-19 related laboratory findings. Our triage model can lead to more accurate and resource-effective management of trauma patients with potential COVID-19 infection.

Level of evidence

Level Ⅲ.
Dunkl–Maxwell equation and Dunkl-electrostatics in a spherical coordinate
Authors: Chung Won Sang , Hassanabadi Hassan
Published: June 2021

This paper deals with Maxwell equations with Dunkl derivatives. Dunkl-deformed gauge transform is investigated. Dunkl-electrostatics in spherical coordinates is also studied. The multi-pole expansion of potential is obtained for even and odd potential for parity in z-direction. The conducting sphere in a uniform electric field in Dunkl-electrostatics is also discussed.
Anomalous hydrodynamics with dyonic charge
Authors: Nakayama Yu
Published: June 2021

In this paper, we study anomalous hydrodynamics with a dyonic charge. We show that the local second law of thermodynamics constrains the structure of the anomaly in addition to the structure of the hydrodynamic constitutive equations. In particular, we show that not only the usual [Formula: see text] term but also [Formula: see text] term should be present in the anomaly with a specific coefficient for the local entropy production to be positive definite.
Optimization design of centrifugal pump impeller based on multi-output Gaussian process regression
Authors: Zhang Renhui , Gao Liangde , Chen Xuebing
Published: June 2021

To overcome the problems of large calculation cost and high dependence on designers’ experience, an optimization design method based on multi-output Gaussian process regression (MOGPR) was proposed. The hydraulic design method of centrifugal pump based on the MOGPR model was constructed under Bayesian framework. Based on the available excellent hydraulic model, the complex relationship between the performance parameters such as head, flow rate and the geometric parameters of centrifugal pump impeller was trained. The hydraulic design of the impeller for M125-100 centrifugal pump was performed by the proposed MOGPR surrogate model design method. The initial MOGPR design was further optimized by using the proposed MOGPR and NSGA-II hybrid model. The initial sample set for NSGA-II was designed by Latin hypercube design based on the MOGPR initial design. The relationship between the impeller geometry and the CFD numerical results of the sample set was trained to construct the surrogate model for pump hydraulic performance prediction. The MOGPR surrogate model was used to evaluate the objective function value of the offspring samples in NSGA-II multi-objective optimization. The comparison of the pump hydraulic performance between the optimized designs and the initial design shows that the efficiency and the head of the tradeoff optimal design are increased by 2.5% and 2.6%, respectively. The efficiency of the optimal head constraint design is increased by 3.2%. The comparison of the inner flow field shows that turbulent kinetic energy decreases significantly and flow separation is effectively suppressed for the optimal head constraint design.
Optimal control of cytotoxic and antiangiogenic therapies on prostate cancer growth
Authors: Colli Pierluigi , Gomez Hector , Lorenzo Guillermo , Marinoschi Gabriela , Reali Alessandro , Rocca Elisabetta
Published: June 2021

Prostate cancer can be lethal in advanced stages, for which chemotherapy may become the only viable therapeutic option. While there is no clear clinical management strategy fitting all patients, cytotoxic chemotherapy with docetaxel is currently regarded as the gold standard. However, tumors may regain activity after treatment conclusion and become resistant to docetaxel. This situation calls for new delivery strategies and drug compounds enabling an improved therapeutic outcome. Combination of docetaxel with antiangiogenic therapy has been considered a promising strategy. Bevacizumab is the most common antiangiogenic drug, but clinical studies have not revealed a clear benefit from its combination with docetaxel. Here, we capitalize on our prior work on mathematical modeling of prostate cancer growth subjected to combined cytotoxic and antiangiogenic therapies, and propose an optimal control framework to robustly compute the drug-independent cytotoxic and antiangiogenic effects enabling an optimal therapeutic control of tumor dynamics. We describe the formulation of the optimal control problem, for which we prove the existence of at least a solution and determine the necessary first-order optimality conditions. We then present numerical algorithms based on isogeometric analysis to run a preliminary simulation study over a single cycle of combined therapy. Our results suggest that only cytotoxic chemotherapy is required to optimize therapeutic performance and we show that our framework can produce superior solutions to combined therapy with docetaxel and bevacizumab. We also illustrate how the optimal drug-naïve cytotoxic effects computed in these simulations may be successfully leveraged to guide drug production and delivery strategies by running a nonlinear least-square fit of protocols involving docetaxel and a new design drug. In the future, we believe that our optimal control framework may contribute to accelerate experimental research on chemotherapeutic drugs for advanced prostate cancer and ultimately provide a means to design and monitor its optimal delivery to patients.
EXPERIMENTAL ANALYSIS OF CUT QUALITY ON SS347 MATERIAL USING CO2 ASSISTED LASER BEAM CUTTING AND PARAMETRIC OPTIMIZATION USING GENETIC ALGORITHM
Authors: RAMAKRISHNAN H. , GANESH N. , JAMES D. JAFREY DANIEL , ASHOK B.
Published: June 2021

Laser Beam cutting is a type of non-conventional machining process in which the removal of materials takes place due to the melting and vaporization of material when the laser beam comes in contact with it. This work examines the impact of the cut quality characteristics of the SS347 material and to find reduced surface roughness, machining time and heat affected zone by laser beam cutting. The cutting process was assisted by CO2 gas pressure. Power, standoff distance, speed and CO2 gas pressure are the cutting parameters considered for this study and the output parameters measured are machining time, heat affected zone and surface roughness. In accordance with L-9 orthogonal arrays, the experiments were planned. Analysis of Variance has been used to study how input functions influence output functions which revealed that speed (59.75% and 89.75%) is the significant factor for machining time and surface roughness while power (91.27%) was the dominant factor for heat affected zone. Gas pressure did not have much influence in the output parameters. The mathematical expressions of the output are used as input for the multi-objective function of the genetic algorithm. Optimal solutions are compared to hybrid and without-hybrid functions. It is found that the hybrid function shows a higher performance compared to the without hybrid function.
Strong Subgraph Connectivity of Digraphs: A Survey
Authors: Sun Yuefang , Gutin Gregory
Published: June 2021

In this survey we overview known results on the strong subgraph [Formula: see text]-connectivity and strong subgraph [Formula: see text]-arc-connectivity of digraphs. After an introductory section, the paper is divided into four sections: basic results, algorithms and complexity, sharp bounds for strong subgraph [Formula: see text]-(arc-)connectivity, minimally strong subgraph [Formula: see text]-(arc-) connected digraphs. This survey contains several conjectures and open problems for further study.
INTELLIGENT UPPER-LIMB PROSTHETIC CONTROL (iULP) WITH NOVEL FEATURE EXTRACTION METHOD FOR PATTERN RECOGNITION USING EMG
Authors: PANCHOLI SIDHARTH , JOSHI AMIT M.
Published: June 2021

EMG signal-based pattern recognition (EMG-PR) techniques have gained lots of focus to develop myoelectric prosthesis. The performance of the prosthesis control-based applications mainly depends on extraction of eminent features with minimum neural information loss. The machine learning algorithms have a significant role to play for the development of Intelligent upper-limb prosthetic control (iULP) using EMG signal. This paper proposes a new technique of extracting the features known as advanced time derivative moments (ATDM) for effective pattern recognition of amputees. Four heterogeneous datasets have been used for testing and validation of the proposed technique. Out of the four datasets, three datasets have been taken from the standard NinaPro database and the fourth dataset comprises data collected from three amputees. The efficiency of ATDM features is examined with the help of Davies–Bouldin (DB) index for separability, classification accuracy and computational complexity. Further, it has been compared with similar work and the results reveal that ATDM features have excellent classification accuracy of 98.32% with relatively lower time complexity. The lower values of DB criteria prove the good separation of features belonging to various classes. The results are carried out on 2.6[Formula: see text]GHz Intel core i7 processor with MATLAB 2015a platform.
Deep Attentive Multimodal Network Representation Learning for Social Media Images
Authors: Huang Feiran , Li Chaozhuo , Gao Boyu , Liu Yun , Alotaibi Sattam , Chen Hao
Published: June 2021

The analysis for social networks, such as the socially connected Internet of Things, has shown a deep influence of intelligent information processing technology on industrial systems for Smart Cities. The goal of social media representation learning is to learn dense, low-dimensional, and continuous representations for multimodal data within social networks, facilitating many real-world applications. Since social media images are usually accompanied by rich metadata (e.g., textual descriptions, tags, groups, and submitted users), simply modeling the image is not effective to learn the comprehensive information from social media images. In this work, we treat the image and its textual description as multimodal content, and transform other metainformation into the links between contents (such as two images marked by the same tag or submitted by the same user). Based on the multimodal content and social links, we propose a
Deep Attentive Multimodal Graph Embedding
model named
DAMGE
for more effective social image representation learning. We introduce both small- and large-scale datasets to conduct extensive experiments, of which the results confirm the superiority of the proposal on the tasks of social image classification and link prediction.
Proof-of-Prestige: A Useful Work Reward System for Unverifiable Tasks
Authors: Król Michał , Sonnino Alberto , Al-Bassam Mustafa , Tasiopoulos Argyrios G. , Rivière Etienne , Psaras Ioannis
Published: June 2021

As cryptographic tokens and altcoins are increasingly being built to serve as utility tokens, the notion of useful work consensus protocols is becoming ever more important. With useful work consensus protocols, users get rewards after they have carried out some specific tasks useful for the network. While in some cases the proof of some utility or service can be provided, the majority of tasks are impossible to verify reliably. To deal with such cases, we design “Proof-of-Prestige” (PoP)—a reward system that can run directly on Proof-of-Stake (PoS) blockchains or as a smart contract on top of Proof-of-Work (PoW) blockchains. PoP introduces “prestige,” which is a volatile resource that, in contrast to coins, regenerates over time. Prestige can be gained by performing useful work, spent when benefiting from services, and directly translates to users minting power. Our scheme allows us to reliably reward decentralized workers while keeping the system free for the end-users. PoP is resistant against Sybil and collusion attacks and can be used with a vast range of unverifiable tasks. We build a simulator to assess the cryptoeconomic behavior of the system and deploy a full prototype of a content dissemination platform rewarding its participants. We implement the blockchain component on both Ethereum (PoW) and Cosmos (PoS), provide a mobile application, and connect it with our scheme with a negligible memory footprint. Finally, we adapt a fair exchange protocol allowing us to atomically exchange files for rewards also in scenarios where not all the parties have Internet connectivity. Our evaluation shows that even for large Ethereum traces, PoP introduces sub-millisecond computational overhead for miners in Cosmos and less than 0.013$ smart contract invocation cost for users in Ethereum.
Power Side-Channel Analysis of RNS GLV ECC Using Machine and Deep Learning Algorithms
Authors: Mehrabi Mohamad Ali , Mukhtar Naila , Jolfaei Alireza
Published: June 2021

Many Internet of Things applications in smart cities use elliptic-curve cryptosystems due to their efficiency compared to other well-known public-key cryptosystems such as RSA. One of the important components of an elliptic-curve-based cryptosystem is the elliptic-curve point multiplication which has been shown to be vulnerable to various types of side-channel attacks. Recently, substantial progress has been made in applying deep learning to side-channel attacks. Conceptually, the idea is to monitor a core while it is running encryption for information leakage of a certain kind, for example, power consumption. The knowledge of the underlying encryption algorithm can be used to train a model to recognise the key used for encryption. The model is then applied to traces gathered from the crypto core in order to recover the encryption key. In this article, we propose an RNS GLV elliptic curve cryptography core which is immune to machine learning and deep learning based side-channel attacks. The experimental analysis confirms the proposed crypto core does not leak any information about the private key and therefore it is suitable for hardware implementations.
Can Applications Recover from

fsync

Failures?
Authors: Rebello Anthony , Patel Yuvraj , Alagappan Ramnatthan , Arpaci-Dusseau Andrea C. , Arpaci-Dusseau Remzi H.
Published: June 2021

We analyze how file systems and modern data-intensive applications react to
fsync
failures. First, we characterize how three Linux file systems (ext4, XFS, Btrfs) behave in the presence of failures. We find commonalities across file systems (pages are always marked clean, certain block writes always lead to unavailability) as well as differences (page content and failure reporting is varied). Next, we study how five widely used applications (PostgreSQL, LMDB, LevelDB, SQLite, Redis) handle
fsync
failures. Our findings show that although applications use many failure-handling strategies, none are sufficient:
fsync
failures can cause catastrophic outcomes such as data loss and corruption. Our findings have strong implications for the design of file systems and applications that intend to provide strong durability guarantees.
β2 integrin activation and signal transduction in leukocyte recruitment
Authors: Sun Hao , Hu Liang , Fan Zhichao
Published: June 2021

Leukocyte recruitment is a critical step in the pathogenesis of inflammatory and immunological responses. Cell adhesion molecules (CAMs) are involved in controlling cell movements and the recruitment process, and the integrin family of CAMs plays a key role. During cell movement, integrin function is dynamically and precisely regulated. However, this balance might be broken under pathological conditions. Thus, the functional regulation and molecular mechanisms of integrins related to diseases are often a focus of research. Integrin β2 is one of the most commonly expressed integrins in leukocytes that mediate leukocyte adhesion and migration, and it plays an important role in immune responses and inflammation. In this review, we focus on specific functions of integrin β2 in leukocyte recruitment, the conformational changes and signal transduction of integrin β2 activation, the similarities between murine and human factors, and how new insights into these processes can inform future therapies for inflammation and immune diseases.
GLUT5 is a determinant of dietary fructose-mediated exacerbation of experimental colitis
Authors: Basu Srijani , Liu Catherine , Zhou Xi Kathy , Nishiguchi Ryohei , Ha Taehoon , Chen Justin , Johncilla Melanie , Yantiss Rhonda K. , Montrose David C. , Dannenberg Andrew J.
Published: June 2021

This study provides the first evidence that reduced levels of GLUT5, the fructose transporter, worsen experimental colitis upon fructose feeding, an effect mediated by changes in the gut microbiota. Moreover, GLUT5 expression is reduced in Crohn’s ileitis. Overall, these findings demonstrate the importance of interactions between dietary fructose and host GLUT5 as determinants of both the composition of colonic microbiota and severity of experimental colitis.
The impact of 6 months of exercise-based cardiac rehabilitation on sympathetic neural recruitment during apneic stress
Authors: D’Souza Andrew W. , Badrov Mark B. , Wood Katelyn N. , Lalande Sophie , Suskin Neville , Shoemaker J. Kevin
Published: June 2021

The current study evaluated the hypothesis that 6 mo of exercise-based cardiac rehabilitation (CR) would improve sympathetic neural recruitment in patients with ischemic heart disease (IHD). Microneurography was used to evaluate action potential (AP) discharge patterns within bursts of muscle sympathetic nerve activity (MSNA), in 11 patients with IHD (1 female; 61 ± 9 yr) pre (pre-CR) and post (post-CR) 6 mo of aerobic and resistance training-based CR. Measures were made at baseline and during maximal voluntary end-inspiratory (EI-APN) and end-expiratory apneas (EE-APN). Data were analyzed during 1 min of baseline and the second half of apneas. At baseline, overall sympathetic activity was less post-CR (all P < 0.01). During EI-APN, AP recruitment was not observed pre-CR (all P > 0.05), but increases in both within-burst AP firing frequency (Δpre-CR: 2 ± 3 AP spikes/burst vs. Δpost-CR: 4 ± 3 AP spikes/burst; P = 0.02) and AP cluster recruitment (Δpre-CR: −1 ± 2 vs. Δpost-CR: 2 ± 2; P < 0.01) were observed in post-CR tests. In contrast, during EE-APN, AP firing frequency was not different post-CR compared with pre-CR tests (Δpre-CR: 269 ± 202 spikes/min vs. Δpost-CR: 232 ± 225 spikes/min; P = 0.54), and CR did not modify the recruitment of new AP clusters (Δpre-CR: −1 ± 3 vs. Δpost-CR: 0 ± 1; P = 0.39), or within-burst firing frequency (Δpre-CR: 3 ± 3 AP spikes/burst vs. Δpost-CR: 2 ± 2 AP spikes/burst; P = 0.21). These data indicate that CR improves some of the sympathetic nervous system dysregulation associated with cardiovascular disease, primarily via a reduction in resting sympathetic activation. However, the benefits of CR on sympathetic neural recruitment may depend upon the magnitude of initial impairment.
Exogenous ketone ester delays CNS oxygen toxicity without impairing cognitive and motor performance in male Sprague-Dawley rats
Authors: Stavitzski Nicole M. , Landon Carol S. , Hinojo Christopher M. , Poff Angela M. , Rogers Christopher Q. , D’Agostino Dominic P. , Dean Jay B.
Published: June 2021

Hyperbaric oxygen (HBO2) is breathing >1 atmosphere absolute (ATA; 101.3 kPa) O2 and is used in HBO2 therapy and undersea medicine. What limits the use of HBO2 is the risk of developing central nervous system (CNS) oxygen toxicity (CNS-OT). A promising therapy for delaying CNS-OT is ketone metabolic therapy either through diet or exogenous ketone ester (KE) supplement. Previous studies indicate that KE induces ketosis and delays the onset of CNS-OT; however, the effects of exogeneous KE on cognition and performance are understudied. Accordingly, we tested the hypothesis that oral gavage with 7.5 g/kg induces ketosis and increases the latency time to seizure (LSz) without impairing cognition and performance. A single oral dose of 7.5 g/kg KE increases systemic β-hydroxybutyrate (BHB) levels within 0.5 h and remains elevated for 4 h. Male rats were separated into three groups: control (no gavage), water-gavage, or KE-gavage, and were subjected to behavioral testing while breathing 1 ATA (101.3 kPa) of air. Testing included the following: DigiGait (DG), light/dark (LD), open field (OF), and novel object recognition (NOR). There were no adverse effects of KE on gait or motor performance (DG), cognition (NOR), and anxiety (LD, OF). In fact, KE had an anxiolytic effect (OF, LD). The LSz during exposure to 5 ATA (506.6 kPa) O2 (≤90 min) increased 307% in KE-treated rats compared with control rats. In addition, KE prevented seizures in some animals. We conclude that 7.5 g/kg is an optimal dose of KE in the male Sprague-Dawley rat model of CNS-OT.