bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimizing Guidewire Unwilling Passage and Related Perforation: Prevention is Better Than Cure
Authors: Yang Hongbo , Cao Jiatian , Zhang Feng , Zhang Meng , Li Chenguang , Dai Yuxiang , Song Yanan , Huang Zheyong , Yao Kang , Wang Xiangfei , Qian Juying , Ge Junbo
Published: October 2020

Background: Current guidewires for transradial coronary angiography had defects of passage difficulty or branch injury. This study sought to investigate the safety and efficiency of a novel method of active knuckle angle 0.035-inch hydrophilic guidewire in transradial coronary angiography.Methods: Patients who underwent a transradial coronary procedure from August 2015 to June 2020 were consecutively noted. Of them, 1457 patients were allocated into the Traditional group, while the following 1322 patients were allocated into the Knuckle group to investigate the safety. In addition, 239 patients were randomly divided to evaluate its efficiency. Results: Unwilling passage of guidewire into branches occurred more in Traditional group than in Knuckle group (9.5% vs. 0.08%, p<0.001). Of them, 2 patients experienced guidewire associated perforation in Traditional group. Covered stent was used for 1 patient with internal mammarian artery perforation, and the other was treated with compression for brachial branch perforation. Furthermore, duration of guidewire advancement from the sheath to aortic root significantly decreased in the Knuckle group (22.6±8.0s vs. 33.4±16.9s, p<0.001). Conclusions: Active knuckle angle guidewire was a novel method to prevent unwilling passage and associated perforation, which also improved the efficiency and reduced radiation exposure.
Ultrastructural analysis of cardiomyocytes shows that loss of left ventricular desmosomes leads to shortening of ST segment time in patients with arrhythmogenic cardiomyopathy
Authors: Chang Yuan , Hua Xiumeng , Hu Yiqing , Liu Wendao , Chen Xiao , Fan Xuexin , Menghao Tao. , Chen Shi , Song Jiangping , Hu Shengshou
Published: October 2020

Background: Arrhythmogenic cardiomyopathy (AC) is an inherited myocardial disease affecting the both ventricles. It shows large heterogeneity on its clinical, genetic, and pathological manifestations. The intercalated disc remodeling has been investigated in right ventricle (RV) of AC, however, the ultrastructural features in left ventricle (LV) and among different genotypes remain unknown.Methods: The ultrastructure characters of both ventricles from 24 AC who fulfilled the international Task Force diagnostic and 10 normal donor hearts were studied by transmission electron microscope. We applied Pearson correlation analysis to identify the relationship between D structure and electrocardiogram changes.Results: These 24 patients were divided into two subtypes based on whether they carried desmosome (D) gene mutation. We found that more D structures in LV than that in the right ventricles (RV) in the normal hearts (LV vs. RV, 10.82 ± 3.12% vs. 6.75 ± 1.11%, p=0.001), but the density (AC vs. Control, 3.77 ± 1.58 per 10 μm vs. 4.21 ± 1.76 per 10 μm, p=0.001) and proportion (AC vs. Control, 6.65 ± 2.77% vs. 10.82 ± 3.12%, p=0.001) of D was declined in LV of AC compared with that in normal hearts. The width (AC vs. Control, 21.38 ± 2.31 nm vs. 18.09 ± 0.98 nm, p=0.001) and length (AC vs. Control, 0.17 ± 0.05 μm vs. 0.14 ± 0.01 μm, p=0.002) of D was increased in RV of AC compared with that in normal hearts. Destroyed D structures were found in all AC patients, regardless of carrying a D gene mutation or not. The proportion of D in LV are positively correlated with ST segment time in AC patients. The ultrastructure of mitochondria was not different between AC and normal hearts.Conclusions: The D remodeling patterns had no correlation with the type of mutation. The D of LV mainly showed a decrease in density and proportion, but the D of RV were mainly manifested as compensatory widening and lengthening. The D loss in LV may cause ST segment shortening. From the perspective of ultrastructure, we concluded that increased output power of heart may accelerate the desmosome remodeling or disintegration.
Antimicrobial Resistance Genes and Bacteria Detected in Hospital Sewage May Provide Valuable Information in Clinical Antimicrobial Resistance
Authors: Cai Leshan , Sun Jiayu , Yao Fen , Zhang Qiaoxin , Yuan Yumeng , Xie Qindong , Wang Shiwei , Wang Zhen , Jiao Xiaoyan
Published: October 2020

Aim: Clinical antimicrobial resistance (AMR) is a significant threat to public health, which is often unclear due to representative data from human populations that are challenging to obtain. Study the associations between consumption of antibiotics and antimicrobial resistance bacteria or genes (ARB or ARGs) that will benefit from elucidating the AMR. Methods: The details of antibiotics usage were calculated based on the actual consumption in the target hospital, ARB was detected by culture method, and ARGs were evaluated by metagenomics. Results: Our study revealed that culture-based single-indicator-strain approaches only capture the AMR in 16.17% infectious samples. 1573 bacterial species and 885 types of ARGs were found in the hospital sewage. The consumption of antibiotics influences the resistance profiles that were significant in E.coli, but the strength varies among bacteria. In all ARGs group, ARGs of aminoglycosides was the most common, followed by sulfonamide, tetracycline, phenicol, macrolides, and quinolones, comprising to 82.6% of all ARGs. Five hundred nineteen pairs of ARGs and bacterial species showed a significant correlation (r > 0.8). The co-occurrence patterns of bacteria- ARGs mirrors the AMR of the clinic. Antibiotic usage will affect the abundance of ARG in sewage, with a hysteresis effect. Conclusion: The ARGs- bacteria co-occurrence patterns from wastewater could be a valuable bio-indicator to reflect the emergence of ARB in the future. Developing a predictive risk model of AMR on this basis will facilitate the rational use of antibiotics.
The Possibility of Analyzing Endometrial Receptivity Using Cells From Embryo Transfer Catheters
Authors: Goto Kaori , Kawano Yasushi , Utsunomiya Takafumi , Narahara Hisashi
Published: October 2020

Background: Endometrial receptivity issues represent a potential source of implantaion failure. It is very important to investigate the expression of endometrial receptive markers in the endometrium during implantation. Therefore, we examined whether it would be possible to analyze endometrial receptivity using cells from embryo transfer catheters. In addition, we analyzed the relationship between the gene expression profile associated with pregnancy from endometrial cells taken during embryo transfer.Methods: A total of 88 cycles from 88 consenting patients were enrolled in this study. The tip of the embryo transfer (ET) catheter was cut and immersed in a dedicated reagent. Confirmation of cell distribution was carried out using a Papanicolaou stain (n=6) and immunocytochemistry (n=3). Protein expression was carried out by immunocytochemistry (n=12). Total RNA was extracted, and the expression of endometrial receptive markers (estrogen receptor α, progesterone receptor, and homeobox A10) were analyzed using quantitative reverse transcription polymerase chain reaction (n=67). we analyzed the relationship between the gene expression profile associated with pregnancy from endometrial cells. Results: Samples collected from the ET catheter showed clear staining for endometrial cells. Most of the cells were endometrial epithelial cells. Cervical cells were not included. The protein expression of endometrial receptive markers in cells was also confirmed. Three genes were analyzed that are associated with endometrial receptivity. Progesterone receptor expression was 1.5-fold and homeobox A10 expression was 2-fold higher in patients who became non-pregnant group, compared to the pregnant group. Both increases were statistically significant (p < 0.05). Estrogen receptor α expression tended to be higher in the non-pregnant group, but there was no significant difference. Conclusion: Our results suggest that endometrial receptivity can be evaluated using cells obtained from the ET catheter. This method may be useful for elucidating the cause of implantation failure by comparing a receptive and non-receptive endometrium at the time of ET.
Bronchiolitis obliterans after severe adenovirus pneumonia:a review of 46 cases
Authors: Lan Yuan-Mei , Yang Yun-Gang , Lin Xiao-Liang , Chen Qi-Hong
Published: October 2020

Background:This study aimed to investigate the risk factors of bronchiolitis obliterans caused by severe adenovirus pneumonia. Methods: The First Affiliated Hospital of Xiamen University in January, 2019 was collected The clinical data of 229 children with severe adenovirus pneumonia from January to January 2020 were divided into obliterative bronchiolitis group (BO group) and non obstructive bronchiolitis group (non BO group) according to the follow-up clinical manifestations and imaging data. The clinical data, laboratory examination and imaging data of the children were retrospectively analyzed. Results: Among 229 children with severe adenovirus pneumonia, 46 cases were in BO group. The number of days of hospitalization, oxygen consumption time, LDH, IL-6, AST, D-dimer and hypoxemia in BO group were significantly higher than those in non BO group; The difference was statistically significant (P < 0.05). Univariate logistic regression analysis showed that there were significant differences in the blood routine neutrophil ratio, platelet level, Oxygen supply time, hospitalization days, AST level, whether there was hypoxemia, timing of using hormone, more than two bacterial feelings were found in the two groups, levels of LDH, albumin and Scope of lung imaging (P < 0.05). Conclusions: The related risk factors of BO caused by severe adenovirus pneumonia were long hospitalization days and oxygen consumption time, elevated platelet levels, AST and LDH levels in laboratory tests, and more than two kinds of bacterial infections, double lung involvement, and hypoxemia. Early use of glucocorticoid had a significant effect on reducing the formation of BO.
Tracking the introduction and spread of SARS-CoV-2 in coastal Kenya
Authors: Githinji George , de Laurent Zaydah , Mohamed Khadija , Omuoyo Donwilliams , Macharia Peter , Morobe John , Otieno Edward , Kinyanjui Sam , Agweyu Ambrose , Maitha Eric , Kitole Ben , Suleiman Thani , Mwakinangu Mohamed , Nyambu John , Otieno John , Salim Barke , Kasera Kadondi , Kiiru John , Aman Rashid , Barasa Edwine , Warimwe George , Bejon Philip , Tsofa Benjamin , Ochola-Oyier Lynette Isabella , Nokes D James , Agoti Charles
Published: October 2020

We generated 274 SARS-CoV-2 genomes from samples collected during the early phase of the Kenyan pandemic. Phylogenetic analysis identified 8 global lineages and at least 76 independent SARS-CoV-2 introductions into Kenyan coast. The dominant B.1 lineage (European origin) accounted for 82.1% of the cases. Lineages A, B and B.4 were detected from screened individuals at the Kenya-Tanzania border or returning travellers but did not lead to established transmission. Though multiple lineages were introduced in coastal Kenya within three months following the initial confirmed case, none showed extensive local expansion other than cases characterised by lineage B.1, which accounted for 45 of the 76 introductions. We conclude that the international points of entry were important conduits of SARS-CoV-2 importations. We speculate that early public health responses prevented many introductions leading to established transmission, but nevertheless a few undetected introductions were sufficient to give rise to an established epidemic.
An Ambient-temperature Collection and Stabilization Device Performs Comparably to Flash-frozen Collection for Stool Metabolomics in Infants
Authors: Ramamoorthy Sivapriya , Levy Shira , Mohamed Masouma , Abdelghani Alaa , Evans Anne M , Miller Luke AD , Mehta Lopa , Moore Sean , Freinkman Elizaveta , Hourigan Suchitra K
Published: October 2020

Background: Stool metabolites provide essential insights into the function of the gut microbiome. The current gold standard for collection and storage of stool samples for metabolomics is flash-freezing at -80°C which can be inconvenient and expensive. Ambient temperature collection of stool is more practical, however no available methodologies adequately preserve the metabolomic profile of stool. A novel sampling kit (OMNImet.GUT; DNA Genotek, Inc.) was introduced for ambient temperature collection and stabilization of feces for metabolomics; we aimed to test the performance of this kit vs. flash-freezing.Methods: Stool collected from an infant’s diaper was divided into two aliquots: 1) flash-frozen and 2) stored in an OMNImet.GUT tube at ambient temperature for 3-4 days. Samples from the same infant were collected at 2 different time points to assess metabolite changes over time. Subsequently, all samples underwent metabolomic analysis by liquid chromatography – tandem mass spectrometry (LC-MS/MS). Results: Paired fecal samples (flash-frozen and ambient temperature) from 16 infants were collected at 2 time points (n= 64 samples). Similar numbers of metabolites were detected in both the frozen and ambient temperature samples (1126 in frozen, 1107 in ambient temperature, 1064 shared between sample types). Metabolite abundances were strongly correlated between collection methods (median Spearman correlation Rs=0.785 across metabolites). Hierarchical clustering analysis and principal component analysis showed that samples from the same individuals at a given time point clustered closely, regardless of the collection method. Repeat samples from the same individual were compared by paired t-test, separately for the frozen and OMNImet.GUT. The number of metabolites in each biochemical class that significantly changed (p<0.05) at timepoint 2 relative to timepoint 1 was similar in flash-frozen versus ambient temperature collection. Changes in microbiota modified metabolites over time were also consistent across both methodologies. Conclusion: Ambient temperature collection and stabilization of stool in the OMNImet.GUT device yielded comparable metabolomic results to flash freezing in terms of 1) the identity and abundance of detected biochemicals 2) the distinct metabolomic profiles of subjects and 3) the biochemical signature of microbiome development over time. This method potentially provides a more convenient, less expensive home collection option for stool metabolomic analysis.
Thermo-responsive Polymer Encapsulated Gold Nanorods for Single Continuous Wave Laser-induced Photodynamic/photothermal Tumour Therapy
Authors: Li Wei , Gong Beilei , Shen Yuanbing , Li Huiyan , Li Xiaojun , Huan Xia , Zhou Jihong , Chen Yuqing , Wu Jian
Published: October 2020

Owing to strong and tunable surface plasmon resonance (SPR) effect and good biocompatibility, gold nanoparticles have been suggested to be a versatile platform for a broad range of biomedical applications. In this study, a new nanoplatform of thermo-responsive polymer encapsulated gold nanorods incorporating indocyanin green (ICG) was designed to couple the photothermal properties of gold nanorods (AuNRs) and the photodynamic properties of ICG to enhanc the photodynamic/photothermal combination therapy (PDT/PTT). in addition to the significantly increased payload and enhancing photostability of ICG , the polymer shell in the nanoplatform also has thermo-responsive characteristics that can control the release of drugs at tumour sites upon the laser irradiation. On the basis of these improvements, the nanoplatform strongly increased drug aggregation at the tumour site and improved the photothermal/photodynamic therapeutic efficacy. These results suggest that this nanoplatform would be a great potential system for tumour imaging and antitumour therapy.
Applicability of Commercial Clinical Chemistry Test Kits for Horse Serum
Authors: Megerssa Yoseph Cherinet , Gari Fikru Regassa , Woldemariyam Fanos Tadesse
Published: October 2020

Objective: Validation of a test method is critical for conﬁrming that the test can generate accurate and precise data. Although commercial biochemical test kits exist there is no specific and validated commercial clinical chemistry test kits designed for horse. The aim of this study was to validate commercial clinical chemistry test kits designed for human serum for use in horses. Result: Blood samples were collected from 29 apparently healthy adult horses and pooled serum was prepared. Validation comprises replication and recovery experiments. Total observable error (TEo%), Sigma metrics and quality goal index (QGI) were used to support the validation studies. Intra- and inter-assay variability was 2.05% and 2.08%, 2.26% and 1.89%, 2.4% and 1.63%, for total cholesterol urea and total protein for respectively; recovery was 99.46%, 97.32% and 100.1% for total cholesterol urea and total protein for respectively. TEo% for the specified analytes was within the allowable error. All the three anaytes satisfied the recommended requirement (>3 sigma values). The QGI for urea, as it had below 6σ was 0.95 indicating imprecision and inaccuracy. The results endorse the suitability of the studied commercial test kits and illustrated the acceptance criteria for serum collected from horse.
Treatment with Zinc is Associated with Reduced In-Hospital Mortality Among COVID-19 Patients: A Multi-Center Cohort Study
Authors: frontera Jennifer A. , Rahimian Joseph O. , Yaghi Shadi , Liu Mengling , Lewis Ariane , Havenon Adam de , Mainali Shraddha , Huang Joshua , Scher Erica , Wisniewski Thomas , Troxel Andrea B. , Meropol Sharon , Balcer Laura J. , Galetta Steven L.
Published: October 2020

Background: Zinc impairs replication of RNA viruses such as SARS-CoV-1, and may be effective against SARS-CoV-2. However, to achieve adequate intracellular zinc levels, administration with an ionophore, which increases intracellular zinc levels, may be necessary. We evaluated the impact of zinc with an ionophore (Zn+ionophore) on COVID-19 in-hospital mortality rates.Methods: A multicenter cohort study was conducted of 3,473 adult hospitalized patients with reverse-transcriptase-polymerase-chain-reaction (RT-PCR) positive SARS-CoV-2 infection admitted to four New York City hospitals between March 10 through May 20, 2020. Exclusion criteria were: death or discharge within 24h, comfort-care status, clinical trial enrollment, treatment with an IL-6 inhibitor or remdesivir. Patients who received Zn+ionophore were compared to patients who did not using multivariable time-dependent cox proportional hazards models for time to in-hospital death adjusting for confounders including age, sex, race, BMI, diabetes, week of admission, hospital location, sequential organ failure assessment (SOFA) score, intubation, acute renal failure, neurological events, treatment with corticosteroids, azithromycin or lopinavir/ritonavir and the propensity score of receiving Zn+ionophore. A sensitivity analysis was performed using a propensity score-matched cohort of patients who did or did not receive Zn+ionophore matched by age, sex and ventilator status.Results: Among 3,473 patients (median age 64, 1947 [56%] male, 522 [15%] ventilated, 545[16%] died), 1,006 (29%) received Zn+ionophore. Zn+ionophore was associated with a 24% reduced risk of in-hospital mortality (12% of those who received Zn+ionophore died versus 17% who did not; adjusted Hazard Ratio [aHR] 0.76, 95% CI 0.60-0.96, P=0.023). More patients who received Zn+ionophore were discharged home (72% Zn+ionophore vs 67% no Zn+ionophore, P=0.003) Neither Zn nor the ionophore alone were associated with decreased mortality rates. Propensity score-matched sensitivity analysis (N=1356) validated these results (Zn+ionophore aHR for mortality 0.63, 95%CI 0.44-0.91, P=0.015). There were no significant interactions for Zn+ionophore with other COVID-19 specific medications.Conclusions: Zinc with an ionophore was associated with increased rates of discharge home and a 24% reduced risk of in-hospital mortality among COVID-19 patients, while neither zinc alone nor the ionophore alone reduced mortality. Further randomized trials are warranted.
Upregulation of KLK8 Predicts Poor Prognosis in Pancreatic Cancer
Authors: Hua Qing , Li Tianjiao , Liu Yixuan , Shen Xuefang , Zhu Xiaoyan , Xu Pingbo
Published: October 2020

Background: Pancreatic ductal adenocarcinoma (PDAC) is a growing cause of cancer-related mortality worldwide. Kallikrein-related peptidase 8 (KLK8) has potential clinical values in many cancers. However, the clinicopathological significances of KLK8 in PDAC remain unknown. Methods: The relationship of KLK8 to clinicopathological features of PDAC was investigated based on public databases. KLK8 expression was examined in human PDAC tissues. Cell proliferation and apoptosis were evaluated in KLK8-overexpressed human pancreatic cancer cell lines Mia-paca-2 and Panc-1. The related signaling pathways of KLK8 involved in pancreatic cancer progression were analyzed by gene set enrichment analysis (GSEA) and further verified in in vitro studies. Results: KLK8 was up-regulated in tumor tissues in the TCGA-PAAD cohort, and was an independent prognostic factor for both overall survival and disease-free survival of PDAC. KLK8 mRNA and protein expressions were increased in PDAC tissues compared with para-cancerous pancreas. KLK8 overexpression exerted pro-proliferation and anti-apoptotic functions in Mia-paca-2 and Panc-1 cells. GSEA analysis showed that KLK8 was positively associated with PI3K-Akt-mTOR and Notch pathways. KLK8-induced pro-proliferation and anti-apoptotic effects in Mia-paca-2 and Panc-1 cells were attenuated by inhibitors for PI3K, Akt, and mTOR, but not by inhibitor for Notch.Conclusion: KLK8 overexpression exerts pro-proliferation and anti-apoptotic functions in pancreatic cancer cells via PI3K/Akt/mTOR pathway. Upregulated KLK8 in PDAC predicts poor prognosis and may be a potential therapeutic target for PDAC.
Overview of Statistical and Machine Learning Techniques for Determining Causes of Death from Verbal Autopsies: A Systematic Literature Review
Authors: Mapundu Michael Tonderai , Kabudula Chodziwadziwa , Musenge Eustasius , Celik Turgay
Published: October 2020

Background: The process of determining causes of death in areas where there is limited clinical services using verbal autopsies has become a key issue in terms of accuracy on cause of death (prone to errors and subjective), quality of data among many drawbacks. This is mainly because there is no proper standard available in performing verbal autopsy, even though it is important for civil registration systems and strengthening of health priorities. Physician diagnosis is the only gold standard in reviewing verbal autopsy narratives. In practice, conventional statistical methods are used to perform verbal autopsies due to their simplicity and transparency. However, in literature complex machine learning models can be found that can replace the traditional statistical methods. There has not been much application of machine learning techniques in verbal autopsy to determine cause of death, despite the advances in technology. As such, there is a need for a thorough survey of recent literature on statistical and machine learning approaches applied in verbal autopsy to determine cause of death. Methods: A systematic review was conducted and included a search from six databases. Our study only included scientiﬁc articles published in last decade that reported on verbal autopsy and: (1) algorithms; (2) statistical techniques; (3) machine learning and (4) deep learning. The search yielded 110 articles, after meta analysis, we identiﬁed 85 articles as being relevant and discarded the other 25. We investigated and compared the most commonly used statistical and machine learning techniques in VAs, identiﬁed limitations of each of these techniques, proposed a guiding machine learning framework and pointed to future directions. Results: Eighty ﬁve studies met the inclusion criteria. Apart from physician diagnosis, statistical methods are the most currently applied tools to determine cause of death from verbal autopsies. However, there has been little application of traditional machine learning and emerging techniques, even though they have shown promising results in other domains. Conclusions: Technological application of machine learning to determine cause of death, should focus on effective ideal strategies of pre-processing, transparency, robust feature engineering techniques and data balancing in order to attain optimal model performance.
Association Between Heart Rate-corrected QT Interval and Severe Peripheral Arterial Disease in Patients with Type 2 Diabetes and Foot Ulcers:Aa Case Control Study
Authors: Hong Jing , Liu Wen-Yue , Hu Xiang , Jiang Fei-Fei , Xu Ze-Ru , Li Fang , Shen Fei-Xia , Zhu Hong
Published: October 2020

Background: Half of patients with diabetes and foot ulcers (DFUs) have co-existing peripheral arterial disease (PAD). Prolonged heart rate-corrected QT (QTc) interval was found to be associated with PAD in a general population. The goal of the present study was to investigate the relationship between QTc interval and PAD in patients with DFUs.Methods: The present multi-center cross-sectional study enrolled 281 patients with DFUs. Severity of PAD was classified as no-severe PAD group (no obvious abnormality or plaques) and severe PAD group (stenosis or occlusion) according to duplex ultrasonography. QTc was calculated according to the Bazett formula. The study population was divided into subgroups based on the QTc tertiles. Results: The patients with severe PAD had longer QTc interval (P = 0.004) and higher prevalence of prolonged QTc (P = 0.042) than those with no-severe PAD. After adjustment for gender and age, partial correlation analysis revealed positive relationship of QTc with prevalence of severe DFUs (r = 0.194, P = 0.001) and severe PAD (r = 0.118, P = 0.048). Univariate logistic analysis showed that the QTc was positively associated with severe PAD (odds ratio [OR] = 1.010, P = 0.014). Compared to those in lowest tertile of QTc, the ORs for severe PAD were increased significantly and independently for those in upper tertiles of QTc (both P < 0.05). Conclusions: Prolonged QTc interval was independently associated with severe PAD in patients with DFUs, which might indicate the worse progression of peripheral atherosclerosis in early stage for this population.
Economic impact of political ties in Vietnam: Evidence from northern rural households
Authors: To Nguyen The , Nguyen Tuan
Published: October 2020

This paper focuses on investigating the impacts of political connections on households’ income and their agricultural investment in mountainous areas of Vietnam by employing several matching methodologies. Propensity score matching (PSM) is an increasingly well-known approach for evaluation studies in agricultural economics. Additionally, this study attempts to verify the significance of political connection in rural economics. To conduct the empirical approach, the article uses surveyed data of 550 households from three provinces in the north of Vietnam. The findings indicate that political connection has a significantly positive impact on households’ total income and farming behaviour, but has a very negative impact on households’ agricultural investment. The difference between the income of the connected and non-connected group of households is estimated at approximately 30 million VND (US$ 1,304) per year. However, the total income of the connected households is not heavily based on agricultural production, their non-agricultural activities account for a larger share of their total income. Another important outcome is to confirm the privileges of politically connected households in terms of receiving extension courses that substantially increase the inequality between rural households in survey areas because the distribution of government subsidy is distorted to target the necessities.
Research on Accurate Modeling and Control for Pneumatic Electric Braking System of Commercial Vehicle Based on Multi-Dynamic Parameters Measurement
Authors: Zhao Yongtao , Yang Yiyong , Wu Xiuheng , Tao Xingjun
Published: October 2020

Accurate pressure control and fast dynamic response are vital to the pneumatic electric braking system (PEBS) for that commercial vehicles require higher regulation precision of braking force on four wheels when braking force distribution is carried out under some conditions. Due to the lagging information acquisition, most feedback-based control algorithms are difficult to further improve the dynamic response of PEBS. Meanwhile, feedforward-based control algorithms like predictive control perform well in improving dynamic performance. but because of the large amount of computation and complexity of this kind of control algorithm, it cannot be applied in real-time on single-chip microcomputer, and it is still in the stage of theoretical research at present. To address this issue and for the sake of engineering reliability, this article presents a logic threshold control scheme combining analogous model predictive control (AMPC) and proportional control. In addition, an experimental device for real-time measuring PEBS multi-dynamic parameters is built. After correcting the key parameters, the precise model is determined and the influence of switching solenoid valve on its dynamic response characteristics is studied. For the control scheme, numerical and physical validation are executed to demonstrate the feasibility of the strategy and for the performance of the controller design. The experimental results show that the dynamic model of PEBS can accurately reflect its pressure characteristics. Furthermore, under different air source pressures, the designed controller can stably control the pressure output of PEBS and ensure that the error is within 8KPa. Compared with the traditional control algorithm, the rapidity is improved by 32.5%.
Atomically resolved tomographic reconstruction of nanoparticles from Single Projection: influence of amorphous carbon support
Authors: Banerjee Pritam , Roy Chiranjit , De Subhra Kanti , Santos Antonio J. , Morales Francisco M. , Bhattacharyya Somnath
Published: October 2020

Nanoparticles have a wide range of applications due to their unique geometry and arrangement of atoms. For a precise structure-property correlation, information regarding atomically resolved 3D structures of nanoparticles is utmost beneficial. Though modern aberration-corrected transmission electron microscopes can resolve atoms with sub-angstrom resolution, an atomic-scale 3D reconstruction of nanoparticle is a challenge using tilt series tomography due to high radiation damage. Instead, inline 3D holography based tomographic reconstructions from single projection registered at low electron doses are more suitable for defining atoms dispositions at nanostructures. Nanoparticles are generally supported on amorphous carbon film for TEM experiments. However, neglecting the influence of carbon film on the tomographic reconstruction of the nanoparticle may lead to ambiguity. In order to address this issue, the effect of amorphous carbon support was quantitatively studied using simulations and experiments.
Heart Rate Variability Enhances the Accuracy of Non-invasive Continuous Blood Pressure Estimation Under Blood Loss
Authors: Zhang Guang , Wang Zongge , Hou Feixiang , Wang Huiquan , Chen Feng , Yu Ming , Wang Jinhai
Published: October 2020

Background: To propose a new method for real-time monitoring of human blood pressure under blood loss (BPBL), this article combines pulse transit time (PTT) and heart rate variability (HRV) as input parameters in order to establish a model for the estimation of BPBL.Methods: Effective parameters such as PTT, R-R internal (RRI), and HRV were extracted and used to establish the blood pressure (BP) estimation. Three BP estimation models were established: the PTT model, the RRI model, and the HRV model, and they were divided into experimental group and control group. Finally, the effects of different estimation models on the accuracy of BPBL estimation were evaluated based on the experimental results.Results: The Pearson correlation coefficients R were 0.7731, 0.8943 and 0.9169 for the PTT model, the RRI model, and the HRV model, respectively. The root means square error of the estimation set (RMSEP) were 16.83 mmHg, 11.87 mmHg and 10.59 mmHg, respectively.Conclusion: The results suggest that the accuracy of the BPBL estimated by the RRI and HRV models is better than that of the PTT model, which means that both RRI and HRV can enhance the accuracy of BPBL estimation, and HRV seems to be more effective in improving the accuracy of BP prediction compared to RRI. These results provide a new idea for other scholars in the field of BPBL estimation research.
Prevalence and Incidence of Venous Leg Ulcers – A Protocol for a Systematic Review
Authors: Probst Sebastian , Weller Carolina D , Bobbink Paul , Saini Camille , Pugliese Maite , Skinner Monika Buehrer , Gethin Georgina
Published: October 2020

Background: Venous leg ulcers (VLUs) are chronic wounds characterised by slow healing and high recurrence. Information on prevalence and incidence is essential for ascertaining the burden of VLU on the health care system and to inform epidemiological research, priority setting and health-care planning. The objective of this protocol is to present a transparent process for how we plan to review the existing international literature on the prevalence and incidence of VLU as well as the characteristics of the population reported within these studies.Methods: An exploratory search was performed using MEDLINE via PubMed and CINHAL via Ebsco to identify concepts, keywords, MeSH terms and headings to identify study types looking at data of VLU prevalence and/or incidence and related patient characteristics. The findings of this exploratory search will determine the final search strategy. The titles and abstracts of the identified articles will be screened independently be two authors for relevance. Study which pass the quality assessment will be included. Data extraction will be performed independently by two authors and in accordance with a pre-designed data extraction form. If the data allows, a meta-analysis will be performed otherwise a descriptive summary of the findings will be conducted. Discussion: The results of this review will contribute to the evidence base on VLU occurrence and may inform the decision making of healthcare professionals, policy-makers, and consumers. It will also inform future research in this area of VLU care.Systematic review registration: CRD42020205855
The Effect of Simulation-Based Neonatal Emergency Team Training on Clinical Performance and Patient Outcome: A Systematic Review
Authors: Lindhard Morten S. , Thim Signe , Laursen Henrik Sehested , Schram Anders Wester , Paltved Charlotte , Henriksen Tine Brink
Published: October 2020

BackgroundA number of neonatal simulation-training programmes have been deployed during the last decade, and a growing number of studies have investigated effects of simulation-based team training. However, the body of evidence remains to be compiled. Therefore, we performed a systematic review on the effects of simulation-based team training on clinical performance and patient outcome.MethodsThe review was conducted according to the preferred reporting items for systematic review and meta-analysis (PRISMA). We included studies on team training in emergency neonatal settings with reported outcome on clinical performance and patient outcome. Two reviewers independently selected articles and assessed risk-of-bias using the Cochrane risk-of-bias tool 2.0 and the Newcastle-Ottawa quality assessment scale. Kirkpatricks’ model for evaluation of training programs provided the framework for a narrative synthesis.ResultsWe screened 1,434 titles and abstracts, evaluated 173 full-texts for eligibility, and included 24 studies. We identified only two studies with neonatal mortality outcome, and they had significant methodological limitations, and no conclusion could be reached regarding effects of simulation training in developed countries. Considering clinical performance, randomized studies showed improved team performance in simulated re-evaluations 3 and 6 months after the intervention.ConclusionsSimulation-based team training in neonatal resuscitation improves team performance and technical performance in simulation-based evaluations 3 to 6 months later. The current evidence was insufficient to conclude on neonatal mortality after simulation-based team training, since no studies were available from developed countries. Future research should include patient outcomes or clinical proxies of treatment quality whenever possible.
Secretomes of human pluripotent stem cell-derived smooth muscle cell progenitors upregulate extracellular matrix metabolism in the lower urinary tract and vagina
Authors: Zhuang Guobing , Wen Yan , Briggs Mason , Shao Qingchun , Tran Darlene , Wang Hongbo , Chen Bertha
Published: October 2020

Background: Adult mesenchymal stem cells (MSCs) have been studied extensively for regenerative medicine, however, they have limited proliferation in vitro, and the long culture time induces cell senescence. MSCs also contribute to tissue repair through their paracrine function. In this study, we sought to examine the paracrine effects of smooth muscle cell progenitors (pSMC) on the urethra and adjacent vagina of stress urinary incontinence rodents. We use human pluripotent stem cell (PSC) lines to derive pSMCs to overcome the issue of decreased proliferation and to obtain a homogenous cell population. This novel approach for treatment of urinary incontinence can also be expanded into treatments for other pelvic floor disorders. Method: Three human PSC lines were differentiated into pSMCs. The conditioned medium (CM) from pSMC culture, which contain pSMC secretomes, was harvested. To examine the effect of the CM on the extracellular matrix of the lower urinary tract, human bladder smooth muscle cells (bSMCs) and vaginal fibroblasts were treated with pSMC-CM in vitro. Stress urinary incontinence (SUI) was induced in rats by surgical injury of the urethra and adjacent vagina. SUI rats were treated with pSMC-CM and monitored for 5 weeks. Urethral pressure testing was performed prior to euthanasia, and tissues were harvested for PCR, Western Blot and histological staining. Kruskal-Wallis one-way ANOVA test and Student t-test were used for statistical comparisons. Results: pSMC-CM upregulated MMP-2, TIMP-2, collagen, and elastin gene expression, and MMP-9 activity in human bladder and vaginal cells consistent with elastin metabolism modulation. pSMC-CM treatment restored in vivo urethral function (increase in leak point pressure compared to intact controls, p<0.05) and increased collagen and elastin expression in the urethra and the adjacent vagina. pSMC-CM also restored the smooth muscle cell layer in the adjacent vagina. Conclusion: Conditioned media from smooth muscle cell progenitors derived from pluripotent stem cells restored urethral function and vaginal smooth muscle cell and elastin content. These findings support a novel therapeutic potential for PSC-based treatments for SUI and pelvic floor disorders where tissues are affected by elastin and smooth muscle loss.
Youth Friendly Reproductive Health Services Among Students of Mizan-Tepi University, South-western Ethiopia
Authors: Zewudie Samuel Getachew , Adulo Lema Abate , Sirna Abel Mandefro , Asres Abiyot
Published: October 2020

Background: Youth friendly reproductive health services are designed to entertain the unique needs of youth. Nevertheless, in developing countries like Ethiopia, knowledge, attitude and utilization of these services is very limited. This study was designed to assess the knowledge, attitude and the extent of utilization of youth friendly reproductive health services (YFRHS) and associated factors among students of Mizan-Tepi University, Southwestern, Ethiopia. Method: A public University-based cross-sectional study was conducted between October and January 2019. Simple random sampling technique was used to select participants from target population. Descriptive analysis, Chi-square test and logistic regression model were employed to identify the factors associated with YFRHS. Result: The results of descriptive analysis showed that about 55.4% of participants had no knowledge, 40.2% had negative attitudes and 61.2% had not practiced YFRHS. Majority 258(60.30%) of the respondents were females and 209(48.80%) were in the age group of 21-22 years. Most of the respondents lack basic information and knowledge, and have no any YFRHS in their surroundings 220(51.4%). Out of the 428 respondents, 57.9%, 59.3%, and 36.4% had never been practiced services related to VCT, family planning and contraception and treatment of sexually transmitted infections (STIs), respectively. The multivariable binary logistic regression result revealed that sex, age, religion, mother’s and father’s educational background, availability of YFRHS in the area and source of information had statistical significant effect on the knowledge, attitude and practices of students toward YFRHS. Male students were more likely to have knowledge and practicing experiences (OR = 1.847, p-value =0.015) and (OR=1.821, p-value = 0.017) respectively, however they had less likely positive attitudes (OR=0.519, p-value = 0.010) compared to their counterpart females. Students from primary and above educated mothers and fathers were more likely to have knowledge, attitude and practicing experience compared to students from uneducated mothers and fathers. Conclusion: The overall utilization, attitude and knowledge of YFRHS among study respondents’ are lower and therefore, further efforts like availability of YFRHS providers and improvement of facility, and education related to the service to all young groups and allocation of appropriate time of services is essential.
A feasibility study using time-driven activity-based costing as a management tool for provider cost estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
Authors: Chirenda Joconiah , Simwaka Bertha Nhlema , Sandy Charles , Bodnar Katharine Donovan , Corbin Shevone , Desai Prathna , Mapako Tonderai , Shamu Shepherd , Timire Collins , Antonio Esther , Makone Albert , Birikorang Alexander , Mapuranga Tawanda , Masunda Tsitsi , Dube M , Wandwalo Eliud , Ngwenya Mkhokheli , Morrison Linden , Kaplan Robert Samuel
Published: October 2020

Background Insufficient cost data and limited capacity constrains understanding of true required resources for TB control. This study using time-drive activity-based costing documented service delivery processes, mapped resources that are required to sustain and identified areas to optimise efficiency in delivery of TB services was conducted in Zimbabwe. Methods A multi-disciplinary team applied time-driven activity-based costing (TDABC) to develop process maps and measure the cost of clinical pathways used for Drug Susceptible TB (DS-TB) at urban polyclinics, rural district and provincial hospitals, and community based targeted screening for TB (Tas4TB). The team performed interviews and observations to collect data on the time taken by health care worker-patient pairs at every stage of the treatment pathway. The personnel’s practical capacity and capacity cost rates were calculated on 5 cost domains. An MS Excel model was used to calculate diagnostic and treatment costs.Findings Twenty-five stages were identified in the TB care pathway across all health facilities except for community targeted screening for TB. Variations existed in health care professionals providing services between facilities for client registration, vital signs, treatment follow-up, medicines dispensing and sample processing.The average cost per patient for the entire DS-TB care was USD324 with diagnosis costing USD69 and treatment costing USD255. The average cost for diagnosis and treatment was higher in clinics than in hospitals (USD392 versus USD256). Nurses in clinics were 1.6 time more expensive than in hospitals. The main cost drivers were human resources (USD130) and laboratory (USD119). Diagnostic cost in Tas4TB was twice that of health facility setting (USD153 vs USD69), with major cost drivers being demand creation (USD89) and sputum specimen transportation (USD5 vs USD3). Conclusion We concluded that TDABC can be used as a costing and management tool in a low resource setting. Results from this study were used to identify areas of innovative improvements in the NTP under public health programme settings. Re-engineering laboratory testing processes and synchronising TB treatment follow-up with antiretroviral treatments could achieve significant cost savings in Zimbabwe.
Effect of oral rehydration solution versus spring water intake during exercise in the heat on muscle cramp susceptibility of young men
Authors: Lau Wing Yin , Kato Haruyasu , Nosaka Kazunori
Published: October 2020

Background: Muscle cramp is a painful, involuntary muscle contraction, and occurs during or following exercise, which is referred to as exercise-associated muscle cramp (EAMC). The causes of EAMC are likely to be multifactorial, but dehydration and electrolytes deficits have been considered to be factors. This study tested the hypothesis that post-exercise muscle cramp susceptibility would be increased with spring water ingestion, but reduced with oral rehydration solution (ORS) ingestion during exercise. Methods: Ten men performed downhill running (DHR) in the heat (35–36°C) for 40–60 min to reduce 1.5–2% of their body mass in two conditions (spring water vs ORS) in a cross-over design. The body mass was measured at 20 min and every 10 min thereafter during DHR, and 30 min post-DHR. The participants ingested either spring water or ORS for the body mass loss in each period. The two conditions were counter-balanced among the participants and separated by a week. Calf muscle cramp susceptibility was assessed by a threshold frequency (TF) of an electrical train stimulation to induce cramp before, immediately after, 30 and 65 min post-DHR. Blood samples were taken before, immediately and 65 min after DHR to measure serum sodium, potassium, magnesium and chroride concentrations, hematocrit (Hct), hemoglobin (Hb), and serum osmolarity. Changes in these varaibles over time were compared between conditions by two-way repeated measures of analysis of variance. Results: The average (±SD) baseline TF (25.6 ± 0.7 Hz) was the same between conditions. TF decreased by 3.8 ± 2.7 to 4.5 ± 1.7 Hz from immediately to 65 min post-DHR for the spring water condition, but increased by 6.5 ± 4.9 to 13.6 ± 6.0 Hz in the same time period for the ORS condition (P<0.05). Hct and Hb did not change significantly (P>0.05) for both conditions, but osmolarity decreased (P<0.05) only for the spring water condition. Serum sodium and chloride concentrations decreased (<2%) at immediately post-DHR for the spring water condition only (P<0.05). Conclusions: These results suggest that ORS intake during exercise decreased muscle cramp susceptibility. It was concluded that ingesting ORS appeared to be effective for preventing EAMC.