bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated diagnoses of age-related macular degeneration and polypoidal
choroidal vasculopathy using bi-modal deep convolutional neural networks
Authors: Xu Zhiyan , Wang Weisen , Yang Jingyuan , Zhao Jianchun , Ding Dayong , He Feng , Chen Di , Yang Zhikun , Li Xirong , Yu Weihong , Chen Youxin
Published: June 2020

Aims

To investigate the efficacy of a bi-modality deep convolutional neural
network (DCNN) framework to categorise age-related macular degeneration (AMD)
and polypoidal choroidal vasculopathy (PCV) from colour fundus images and
optical coherence tomography (OCT) images.

Methods

A retrospective cross-sectional study was proposed of patients with AMD or
PCV who came to Peking Union Medical College Hospital. Diagnoses of all
patients were confirmed by two retinal experts based on diagnostic gold
standard for AMD and PCV. Patients with concurrent retinal vascular diseases
were excluded. Colour fundus images and spectral domain OCT images were taken
from dilated eyes of patients and healthy controls, and anonymised. All images
were pre-labelled into normal, dry or wet AMD or PCV. ResNet-50 models were
used as the backbone and alternate machine learning models including random
forest classifiers were constructed for further comparison. For human-machine
comparison, the same testing data set was diagnosed by three retinal experts
independently. All images from the same participant were presented only within
a single partition subset.

Results

On a test set of 143 fundus and OCT image pairs from 80 eyes (20 eyes
per-group), the bi-modal DCNN demonstrated the best performance, with accuracy
87.4%, sensitivity 88.8% and specificity 95.6%, and a perfect agreement with
diagnostic gold standard (Cohen’s κ 0.828), exceeds slightly over the best
expert (Human1, Cohen’s κ 0.810). For recognising PCV, the model outperformed
the best expert as well.

Conclusion

A bi-modal DCNN for automated classification of AMD and PCV is accurate
and promising in the realm of public health.
Panenteric capsule endoscopy versus ileocolonoscopy plus magnetic resonance enterography in Crohn’s disease: a multicentre, prospective study
Authors: Bruining David Henry , Oliva Salvatore , Fleisher Mark R , Fischer Monika , Fletcher Joel G
Published: June 2020

Introduction

Crohn’s disease diagnosis and monitoring remains a great clinical challenge and often requires multiple testing modalities. Assessing Crohn’s disease activity in the entire gastrointestinal (GI) tract using a panenteric capsule endoscopy (CE) system could be used as an alternative to colonoscopy and cross-sectional imaging. This study assessed the accuracy and safety of panenteric CE in Crohn’s disease as compared with ileocolonoscopy (IC) and/or magnetic resonance enterography (MRE).

Methods

A prospective, multicentre study was performed in subjects with established Crohn’s disease. Individuals with proven small bowel patency underwent a standardised bowel preparation, followed by CE ingestion and IC either the same or following day. MRE, IC, and CE interpretations were performed by blinded central readers using validated scoring systems. The primary endpoint was the overall sensitivity of CE vs MRE and/or IC in Crohn’s disease subjects.

Results

Study enrolment included 158 subjects from 21 sites in the USA, Austria, and Israel. Of those, 99 were included in the analysis. Imaging modality scores indicated none to mild inflammation in the proximal small bowel and colon, but discrepant levels of inflammation in the terminal ileum. Overall sensitivity for active enteric inflammation (CE vs MRE and/or IC) was 94% vs 100% (p=0.125) and specificity was 74% vs 22% (p=0.001). Sensitivity of CE was superior to MRE for enteric inflammation in the proximal small bowel (97% vs 71%, p=0.021), and similar to MRE and/or IC in the terminal ileum and colon (p=0.500–0.625). There were seven serious adverse advents of which three were related to the CE device.

Conclusion

Panenteric CE is a reliable tool for assessing Crohn’s disease mucosal activity and extent compared with more invasive methods. This study demonstrates high performance of the panenteric CE as compared to MRE and/or IC without the need for multiple tests in non-stricturing Crohn’s disease.

Trial registration number

ClinicalTrials.govNCT03241368
Acute appendicitis is associated with appendiceal microbiome changes including elevatedCampylobacter jejunilevels
Authors: Oh Sun Jung , Pimentel Maya , Leite Gabriela G S , Celly Shreya , Villanueva-Millan Maria Jesus , Lacsina Isabela , Chuang Brennan , Parodi Gonzalo , Morales Walter , Weitsman Stacy , Singer-Englar Tahli , Barlow Gillian M , Zhai Jing , Pichestshote Nipaporn , Rezaie Ali , Mathur Ruchi , Pimentel Mark
Published: June 2020

Objectives

To compare the appendiceal microbiomes and examine the prevalence ofCampylobacterspecies in the appendices of adult subjects with confirmed acute non-perforated appendicitis and controls with healthy appendices.

Design

Archived samples of formalin-fixed paraffin-embedded appendiceal tissues were obtained from 50 consecutive female subjects who underwent appendectomy for acute, non-perforated appendicitis, and 35 consecutive female controls who underwent incidental appendectomy during gynaecological surgery.

Results

16S rRNA gene sequencing revealed that the relative abundances (RAs) of the major phyla in appendiceal tissues (Firmicutes, Proteobacteria, Bacteroidetes, and Actinobacteria) were similar in both groups. Beta diversity was significantly different due to differences in Bacteroidetes and Proteobacteria (p<0.0001). Within Proteobacteria, RAs of classes Alphaproteobacteria (~21%, fold change (FC)=1.31, false discovery rate (FDR) p value=0.03) and Epsilonproteobacteria (~1%, FC=0.25, FDR p value>0.05) were increased in acute appendicitis samples. RAs of unknown genera from families Burkholderiaceae and Enterobacteriaceae were decreased in appendicitis samples, and 14 genera were increased, includingNeisseria,AcinetobacterandCampylobacter. Quantitative PCR revealed that levels ofCampylobacterjejuniDNA, but not otherCampylobacterspecies or pathogens tested, were significantly higher in appendicitis samples than in controls (p=0.013). Using a cut-off of 0.31 pg/µL, 40% of appendicitis cases and 6% of controls were positive forC. jejuni, indicating specificity of 93.7% (95% Cl 79.2 to 99.2), sensitivity of 40.9% (95% Cl 24.7 to 54.5), and OR of 10.38 (Fisher’s p value=0.0006, 95% Cl 2.3 to 47.4).

Conclusions

Our findings indicate thatCampylobacter jejunimay be a significant cause of acute appendicitis. This supports earlier studies and suggests that targeted antibiotic therapies could be an alternative treatment for a subset of non-complicated acute appendicitis cases.
Sociodemographic predictors of early postnatal growth: evidence from a Chilean infancy cohort
Authors: Von Holle Ann , North Kari E , Gahagan Sheila , Burrows Raquel A , Blanco Estela , Lozoff Betsy , Howard Annie Green , Justice Anne , Graff Misa , Voruganti Venkata Saroja
Published: June 2020

Objectives

Infant anthropometric growth varies across socioeconomic factors, including maternal education and income, and may serve as an indicator of environmental influences in early life with long-term health consequences. Previous research has identified sociodemographic gradients in growth with a focus on the first year and beyond, but estimates are sparse for growth before 6 months. Thus, our objective was to examine the relationship between sociodemographic factors and infant growth patterns between birth and 5 months of age.

Design

Prospective cohort study.

Settings

Low-income to middle-income neighbourhoods in Santiago, Chile (1991–1996).

Participants

1412 participants from a randomised iron-deficiency anaemia preventive trial in healthy infants.

Main outcome measures

Longitudinal anthropometrics including monthly weight (kg), length (cm) and weight-for-length (WFL) values. For each measure, we estimated three individual-level growth parameters (size, timing and velocity) from SuperImposition by Translation and Rotation models. Size and timing changes represent vertical and horizontal growth curve shifts, respectively, and velocity change represents growth rate shifts. We estimated the linear association between growth parameters and gestational age, maternal age, education and socioeconomic position (SEP).

Results

Lower SEP was associated with a slower linear (length) velocity growth parameter (−0.22, 95% CI –0.31 to –0.13)—outcome units are per cent change in velocity from the average growth curve. Lower SEP was associated with later WFL growth timing as demonstrated through the tempo growth parameter for females (0.25, 95% CI 0.05 to 0.42)—outcome units are shifts in days from the average growth curve. We found no evidence of associations between SEP and the weight size, timing or velocity growth rate parameters.

Conclusion

Previous research on growth in older infants and children shows associations between lower SEP with slower length velocity. We found evidence supporting this association in the first 5 months of life, which may inform age-specific prevention efforts aimed at infant length growth.
Interventions to promote access to eye care for non-Indigenous, non-dominant ethnic groups in high-income countries: a scoping review protocol
Authors: Hamm Lisa Marie , Black Joanna , Burn Helen , Grey Corina , Harwood Matire , Peiris-John Roshini , Gordon Iris , Burton Matthew J , Evans Jennifer R , Ramke Jacqueline
Published: June 2020

Introduction

For many people, settling in a new country is associated with a new identity as an ‘ethnic minority’, one that can remain through future generations. People who are culturally distinct from the dominant population group may experience a variety of barriers to accessing healthcare, including linguistic and cultural barriers in communication, navigation of an unfamiliar health system and unconscious or overt discrimination. Here, we outline the protocol of a scoping review to identify, describe and summarise interventions aimed at improving access to eye care for non-Indigenous, non-dominant ethnic groups residing in high-income countries.

Methods and analysis

We will search MEDLINE, Embase and Global Health from their inception to July 2019. We will include studies of any design that describe an intervention to promote access to eye care for non-Indigenous, non-dominant ethnic groups. Two authors will independently review titles, abstracts and full-text articles for inclusion. Reference lists from all included articles will also be searched. In cases of disagreement between initial reviewers, a third author will help resolve the conflict. For each included article, we will extract data about the target population, details of the intervention delivered and the effectiveness of or feedback from the intervention. Overall findings will be summarised with descriptive statistics and thematic analysis.

Ethics and dissemination

This review will summarise existing literature and as such ethics approval is not required. We will publish the review in an open-access, peer-reviewed journal, and draft appropriate summaries for dissemination to the wider community. This wider community could include clinicians, policymakers, health service managers and organisations that work with non-dominant ethnic groups. Our findings will also feed into the ongoing Lancet Global Health Commission on Global Eye Health.
Mortality inequalities by occupational status and type of job in men and women: results from the Rome Longitudinal Study
Authors: Paglione Lorenzo , Angelici Laura , Davoli Marina , Agabiti Nera , Cesaroni Giulia
Published: June 2020

Objectives

Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We aimed at investigating the association between occupation and mortality in a large metropolitan study.

Design

Cohort study.

Setting

Rome, capital of Italy.

Participants

We used the Rome Longitudinal Study, the administrative cohort of residents in Rome at the 2001 general census, followed until 2015. We selected residents aged 15–65 years at baseline. For each subject, we had information on sex, age and occupation (occupational status and type of job) according to the Italian General Census recognition.

Main outcome measures

We investigated all-cause, cancer, cardiovascular and accidental mortality, major causes of death in the working-age population. We used Cox proportional hazards models to investigate the association between occupation and all-cause and cause-specific mortality in men and women.

Results

We selected 1 466 726 subjects (52.1% women). 42 715 men and 29 915 women died during the follow-up. In men, 47.8% of deaths were due to cancer, 26.7% to cardiovascular causes and 6.4% to accidents, whereas in women 57.8% of deaths were due to cancer, 19.3% to cardiovascular causes and 3.5% to accidents. We found an association between occupational variables and mortality, more evident in men than in women. Compared with employed, unemployed had a higher risk of mortality for all causes with an HR=1.99 (95% CI 1.92 to 2.06) in men and an HR=1.49 (95% CI 1.39 to 1.60) in women. Compared with high-qualified non-manual workers, non-specialised manual workers had a higher mortality risk (HR=1.68, 95% CI 1.59 to 1.77 and HR=1.30, 95% CI 1.20 to 1.40, for men and women, respectively).

Conclusions

This study shows the importance of occupational variables as social health determinants and provides evidence for policy-makers on the necessity of integrated and preventive policies aimed at improving the safety of the living and the working environment.
Risk of transition from occasional neck/back pain to long-duration activity limiting neck/back pain: a cohort study on the influence of poor work ability and sleep disturbances in the working population in Stockholm County
Authors: Holm Lena W , Bohman Tony , Lekander Mats , Magnusson C , Skillgate Eva
Published: June 2020

Objectives

The prevalence of neck/back pain (NBP) is high worldwide. Limited number of studies have investigated workers with occasional NBP regarding the risk of developing long-duration activity limiting NBP (LNBP). The objectives were to assess (1) the effect of poor work ability and sleep disturbances in persons with occasional NBP on the risk of LNBP, and (2) the interaction effect of these exposures.

Design

Cohort study based on three subsamples from the Stockholm Public Health Cohort.

Settings

The working population in Stockholm County.

Participants

Persons aged 18–60 years, reporting occasional NBP the past 6 months at baseline year 2010 (n=16 460).

Measures

Work ability was assessed with items from the Work Ability Index, perceived mental and/or physical work ability. Sleep disturbances were self-reported current mild/severe disturbances. The outcome in year 2014 was reporting NBP the previous 6 months, occurring ≥couple of days per week and resulting in decreased work ability/restricted other daily activities. The additive effect of having both poor work ability and sleep disturbances was modelled with a dummy variable, including both exposures. Poisson log-linear regression was used to calculate risk ratios (RRs) and 95% CIs.

Results

At follow-up, 9% had developed LNBP. Poor work ability and sleep disturbances were independent risk factors for LNBP; adjusted RR 1.7 (95% CI: 1.4 to 2.0) and 1.4 (95% CI: 1.2 to 1.5), respectively. No additive interaction was observed.

Conclusion

Workers with occasional NBP who have poor work ability and/or sleep disturbances are at risk of developing LNBP. Having both conditions does not exceed additive risk.
Maternal cardiovascular disease risk factors as predictors of preterm birth in California: a case–control study
Authors: Rohlfing Anne B. , Nah Gregory , Ryckman Kelli K. , Snyder Brittney D. , Kasarek Deborah , Paynter Randi A. , Feuer Sky K. , Jelliffe-Pawlowski Laura , Parikh Nisha I
Published: June 2020

Objective

To determine whether maternal cardiovascular disease (CVD) risk factors predict preterm birth.

Design

Case control.

Setting

California hospitals.

Participants

868 mothers with linked demographic information and biospecimens who delivered singleton births from July 2009 to December 2010.

Methods

Logistic regression analysis was employed to calculate odds ratios for the associations between maternal CVD risk factors before and during pregnancy (including diabetes, hypertensive disorders and cholesterol levels) and preterm birth outcomes.

Primary outcome

Preterm delivery status.

Results

Adjusting for the other maternal CVD risk factors of interest, all categories of hypertension led to increased odds of preterm birth, with the strongest magnitude observed in the pre-eclampsia group (adjusted OR (aOR), 13.49; 95% CI 6.01 to 30.27 for preterm birth; aOR, 10.62; 95% CI 4.58 to 24.60 for late preterm birth; aOR, 17.98; 95% CI 7.55 to 42.82 for early preterm birth) and chronic hypertension alone for early preterm birth (aOR, 4.58; 95% CI 1.40 to 15.05). Diabetes (types 1 and 2 and gestational) was also associated with threefold increased risk for preterm birth (aOR, 3.06; 95% CI 1.12 to 8.41). A significant and linear dose response was found between total and low-density lipoprotein (LDL) cholesterol and aORs for late and early preterm birth, with increasing cholesterol values associated with increased risk (likelihood χ2 differences of 8.422 and 8.019 for total cholesterol for late and early, and 9.169 and 10.896 for LDL for late and early, respectively). Receiver operating characteristic curves using these risk factors to predict late and early preterm birth produced C statistics of 0.601 and 0.686.

Conclusion

Traditional CVD risk factors are significantly associated with an increased risk of preterm birth; these findings reinforce the clinical importance of integrating obstetric and cardiovascular risk assessment across the healthcare continuum in women.
Association of the neutrophil to lymphocyte ratio and clinical outcomes in patients with lung cancer receiving immunotherapy: a meta-analysis
Authors: Jin Jing , Yang Lan , Liu Dan , Li Weimin
Published: June 2020

Objectives

To explore the relationship between the pretreatment or post-treatment neutrophil to lymphocyte ratio (NLR) and overall survival (OS)/progression-free survival (PFS) in patients with lung cancer receiving immunotherapy.

Design

We searched several databases to collect relevant studies conducted until July 2019. We carefully reviewed the full text of the included publications and combined the HRs and 95% CIs to assess the association between the NLR and survival time in patients with lung cancer receiving immunotherapy.

Data sources

PubMed, the Cochrane Library, Embase and Web of Science

Eligibility criteria

Studies reporting the prognostic value of the NLR in patients with lung cancer receiving immunotherapy were enrolled.

Data extraction and synthesis

Basic information on the articles and patients (NLR cut-off value, NLR at baseline and HRs with 95% CIs for OS and PFS) was extracted by two authors independently. The pooled HRs of OS and PFS were synthesised using the random effects or fixed effects model.

Results

Twenty-three studies with 2068 patients were enrolled. Among all patients, 1305 (64.0%) were men and 643 (31.4%) were diagnosed with squamous cell carcinoma (SCC). In a pooled analysis of OS and PFS from all studies, an elevated NLR predicted poor OS (HR=1.62; 95% CI: 1.41 to 1.87; p<0.001) and PFS (HR=1.47; 95% CI: 1.25 to 1.72; p<0.001). Subgroup analyses stratified showed that the post-treatment NLR was not significantly related to OS and that patients in Asia had significantly higher HRs than those in Europe and America. Furthermore, the proportion of SCC and baseline NLR could affect the prognostic value of the NLR.

Conclusions

Our study found that an elevated NLR was associated with poor OS and PFS in patients with lung cancer receiving immunotherapy and that several clinical factors might have an impact on the predictive value of the NLR in the survival of patients with lung cancer.
EUPRON: nurses’ practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries
Authors: De Baetselier Elyne , Van Rompaey Bart , Batalha Luis M , Bergqvist Monica , Czarkowska-Paczek Bozena , De Santis Alberto , Dijkstra Nienke E , Fernandes Maria I , Filov Izabela , Grøndahl Vigdis Abrahamsen , Heczkova Jana , Helgesen Ann Karin , Isfort Michael , Jordan Susan , Karnjus Igor , Keeley Sarah , Kolovos Petros , Langer Gero , Lillo-Crespo Manuel , Logan Vera , Malara Alba , Meyer Gabriele , Olah Andras , Padysakova Hana , Prosen Mirko , Pusztai Dorina , Sino Carolien G , Tziaferi Styliani , Ziakova Elena , Dilles Tinne
Published: June 2020

Objectives

Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists.

Design

A cross-sectional survey.

Setting

The study was conducted in 17 European countries, each with their own health systems.

Participants

Pharmacists, physicians and nurses with an active role in PC were surveyed.

Main outcome measures

Nurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences.

Results

A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC.

Conclusions

ME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.
Refractory angina is a growing challenge for palliative medicine: a systematic review of non-invasive interventions
Authors: Murphy Iain , Sivashankar Akshara , Gadoud Amy
Published: June 2020

Background

Refractory angina can have a significant effect on quality of life. Non-invasive interventions have been suggested but there are few guidelines on management. Our aim was to systematically review all studies that reported non-invasive interventions for refractory angina and report on their effectiveness and safety.

Methods

We performed a literature search of six databases and a grey literature search. Treatments considered first line or second line according to the European Society of Cardiology were excluded, as were interventions that had undergone review within the last 3 years. Design, setting and outcomes were extracted and quality was assessed. A narrative synthesis was undertaken, including an analysis of adverse effects.

Results

4476 studies were screened, 14 studies were included in our analysis. Interventions were specialist multidisciplinary programmes, transcutaneous electrical nerve stimulation (TENS), perhexiline, medical optimisation, morphine and intranasal alfentanil. The effects of specialist programmes and perhexiline treatment were mixed. Positive effects were reported with TENS, opioids and medical optimisation, with improvements in symptoms, exercise capacity and quality of life. No major adverse effects were noted in any of the treatments.

Conclusion

There are non-invasive treatments for refractory angina that are overlooked by current guidelines. While the quality of these studies varies, positive changes have been reported in symptoms, exercise tolerance and quality of life with few adverse effects. There is a need for further research into these treatments which could be useful within the contexts of cardiology and palliative care.
COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis?
Authors: Imazio Massimo , Klingel Karin , Kindermann Ingrid , Brucato Antonio , De Rosa Francesco Giuseppe , Adler Yehuda , De Ferrari Gaetano Maria
Published: June 2020

The initial mechanism for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is the binding of the virus to the membrane-bound form of ACE2, which is mainly expressed in the lung. Since the heart and the vessels also express ACE2, they both could become targets of the virus. However, at present the extent and importance of this potential involvement are unknown. Cardiac troponin levels are significantly higher in patients with more severe infections, patients admitted to intensive care units or in those who have died. In the setting of COVID-19, myocardial injury, defined by an increased troponin level, occurs especially due to non-ischaemic myocardial processes, including severe respiratory infection with hypoxia, sepsis, systemic inflammation, pulmonary thrombosis and embolism, cardiac adrenergic hyperstimulation during cytokine storm syndrome, and myocarditis. At present, there are limited reports on definite diagnosis of myocarditis caused by SARS-CoV-2 in humans and limited demonstration of the virus in the myocardium. In conclusion, although the heart and the vessels are potential targets in COVID-19, there is currently limited evidence on the direct infection of the myocardium by SARS-CoV-2. Additional pathological studies and autopsy series will be very helpful to clarify the potentiality of COVID-19 to directly infect the myocardium and cause myocarditis.
Parkin, an E3 ubiquitin ligase, enhances airway mitochondrial DNA release and inflammation
Authors: Dimasuay Kris Genelyn , Schaunaman Niccolette , Martin Richard J , Pavelka Nicole , Kolakowski Christena , Gottlieb Roberta A , Holguin Fernando , Chu Hong Wei
Published: June 2020

Introduction

Parkin (Park2), an E3 ubiquitin ligase, is critical to maintain mitochondrial function by regulating mitochondrial biogenesis and degradation (mitophagy), but recent evidence suggests the involvement of Parkin in promoting inflammation. In the present study, we determined if Parkin regulates airway mitochondrial DNA (mtDNA) release and inflammatory responses to type 2 cytokine interleukin (IL)-13 and allergens.

Methods

We measured Parkin mRNA expression in brushed bronchial epithelial cells and mtDNA release in the paired bronchoalveolar lavage fluid (BALF) from normal subjects and asthmatics. Parkin-deficient primary human tracheobronchial epithelial (HTBE) cells generated using the CRISPR-Cas9 system were stimulated with IL-13. To determine thein vivofunction of Parkin, Parkin knockout (PKO) and wild-type (WT) mice were treated with IL-13 or allergen (house dust mite, HDM) in the presence or absence of mtDNA isolated from normal mouse lungs.

Results

Parkin mRNA expression in asthmatic airway epithelium was upregulated, which positively correlated with the levels of released mtDNA in BALF. IL-13-stimulated HTBE cells increased Parkin expression. Moreover, IL-13 induced mtDNA release in Parkin-sufficient, but not in Parkin-deficient HTBE cells. PKO (vs WT) mice attenuated airway mtDNA release and inflammation following IL-13 or HDM treatments. mtDNA amplified airway inflammation in mice treated with IL-13 or HDM. Notably, Parkin also mediated mtDNA-induced exacerbation of airway inflammation.

Conclusion

Our research findings suggest that Parkin promotes mtDNA release and inflammation in airways, thus improving our understanding of the complex role of Parkin and mitochondrial dysfunction in asthma pathogenesis.
Implementation of a mobile app for trauma education: results from a multicenter study
Authors: Childs Benjamin R , Breslin Mary A. , Nguyen Mai P. , Simske Natasha M. , Whiting Paul S. , Vasireddy Aswinkumar , Vallier Heather A
Published: June 2020

Background

In an era of shared decision making, patient expectations for education have increased. Ideal resources would offer accurate information, digital delivery and interaction. Mobile applications have potential to fulfill these requirements. The purpose of this study was to demonstrate adoption of a patient education application (app:http://bit.ly/traumaapp) at multiple sites with disparate locations and varied populations.

Methods

A trauma patient education application was developed at one trauma center and subsequently released at three new trauma centers. The app contains information regarding treatment and recovery and was customized with provider information for each institution. Each center was provided with promotional materials, and each had strategies to inform providers and patients about the app. Data regarding utilization was collected. Patients were surveyed about usage and recommendations.

Results

Over the 16-month study period, the app was downloaded 844 times (70%) in the metropolitan regions of the study centers. The three new centers had 380, 89 and 31 downloads, while the original center had 93 downloads. 36% of sessions were greater than 2 min, while 41% were less than a few seconds. The percentage of those surveyed who used the app ranged from 14.3% to 44.0% for a weighted average of 36.8% of those having used the app. The mean patient willingness to recommend the app was 3.3 on a 5-point Likert scale. However, the distribution was bimodal: 60% of patients rated the app 4 or 5, while 32% rated it 1 or 2.

Discussion

The adoption of a trauma patient education app was successful at four centers with disparate patient populations. The majority of patients were likely to recommend the app. Variations in implementation strategies resulted in different rates of download. Integration of the app into patient education by providers is associated with more downloads.

Level of evidence

Level III care management.
Effect of cobalt supplementation on lamb growth rates in the face of cobalt deficiency
Authors: Hamer Kim , Mylin Hannah , Barrie Donald , Busin Valentina , Denholm Katharine
Published: June 2020

A hill farm in eastern Scotland had noted poor lamb growth rates since 2014. Cobalt, selenium and copper deficiencies were reported from historical blood sample results, and trace element supplementation had been administered to the ewes, but not the lambs. A supplementation trial was undertaken in 2018 to compare the daily liveweight gain (DLWG) between lambs supplemented with trace elements and unsupplemented lambs. The trace element supplements used were intraruminal boluses containing 51‐mg cobalt, 10‐mg selenium and 60‐mg iodine (Downland Essential Lamb bolus, Downland). Blood samples taken two months postsupplementation showed that unsupplemented lambs had cobalt‐deficient status, but not selenium deficiency. Lambs supplemented with the trace element boluses had an increase in DLWG of 49 g/day compared with unsupplemented lambs. This case confirms that cobalt supplementation on deficient farms can be associated with a significant improvement in growth rates of growing lambs on Scottish hill farms.
Mixed culture microalgae removal for water quality improvement using chitosan
Authors: Singh Gulab , Patidar S.K.
Published: June 2020

The presence of microalgae affects water quality and beneficial uses of surface freshwaters. Chitosan with proven potential for harvesting specific microalgae species from their culture medium to produce biofuels and bioproducts also appears promising for efficient removal of mixed microalgae species from surface freshwaters. The main focus of the present study was on removal of mixed microalgae species using chitosan as a coagulant to help improve water quality. Important operational parameters were optimized for economical microalgae removal. The microalgae cells, chlorophyll-a, total nitrogen, and total phosphorous removal efficiency were 82.06%, 89.90%, 69.32%, and 44.01%, respectively, at an optimum chitosan dose of 10 mg/L, pH 8, slow mixing time 7 min, slow mixing rate 30 rpm, and settling time of 15 min. The results show that chitosan coagulation efficiently removed mixed microalgae species from surface freshwater with significant improvement in water quality and recovery of algal biomass for other beneficial applications.
Science for integrative management of a diadromous fish stock: interdependencies of fisheries, flow, and habitat restoration
Authors: Munsch Stuart H. , Greene Correigh M. , Johnson Rachel C. , Satterthwaite William H. , Imaki Hiroo , Brandes Patricia L. , O’Farrell Michael R.
Published: June 2020

Fish face many anthropogenic stressors. Authorities in marine, estuarine, and freshwater realms often share interdependent fisheries management goals, but address singular stressors independently. Here, we present a case study suggesting that coordinating stressor relief across management realms may synergize conservation efforts, especially to actualize restoration benefits. Major efforts are underway to restore juvenile salmon habitat across California’s Central Valley landscape, but it is unclear how fisheries and flow management will influence juvenile salmon occupancy of restored sites. Leveraging monitoring data, we find that for juvenile salmon (<55 mm) to actualize benefits of restored habitats will likely require maintaining spawner abundances and flows at or above intermediate values, especially in less-connected portions of the landscape. Furthermore, restoration efforts may prioritize more connected regions to promote use of restored areas, considering that less connected areas are often uninhabited when water and spawners are scarcer. This ecosystem-based framework that evaluates interdependencies of management decisions may be applied to realize natural productivity and enhance conservation in many systems.
Diabetes-related sex differences in the brain endothelin system following ischemia in vivo and in human brain endothelial cells in vitro
Authors: Abdul Yasir , Li Weiguo , Vargas Juan D. , Grant Emily , He Lianying , Jamil Sarah , Ergul Adviye
Published: June 2020

The endothelin (ET) system has been implicated to contribute to the pathophysiology of cognitive impairment and stroke in experimental diabetes. Our goals were to test the hypotheses that (1) circulating and (or) periinfarct ET-1 levels are elevated after stroke in both sexes and this increase is greater in diabetes, (2) ET receptors are differentially regulated in the diabetic brain, (3) brain microvascular endothelial cells (BMVEC) of female and male origin express the ETA receptor subtype, and (4) diabetes- and stroke-mimicking conditions increase ET-1 levels in BMVECs of both sexes. Control and diabetic rats were randomized to sham or stroke surgery. BMVECs of male (hBEC5i) and female (hCMEC/D3) origin, cultured under normal and diabetes-mimicking conditions, were exposed to normoxia or hypoxia. Circulating ET-1 levels were higher in diabetic animals and this was more pronounced in the male cohort. Stroke did not further increase plasma ET-1. Tissue ET-1 levels were increased after stroke only in males, whereas periinfarct ET-1 increased in both control and diabetic females. Male BMVECs secreted more ET-1 than female cells and hypoxia increased ET-1 levels in both cell types. There was sexually dimorphic regulation of ET receptors in both tissue and cell culture samples. There are sex differences in the stroke- and diabetes-mediated changes in the brain ET system at the endothelial and tissue levels.
Fermionic decay of a massive scalar in the early universe
Authors: Lankinen Juho , Malmi Joonas , Vilja Iiro
Published: June 2020

We derive a curved space generalization of a scalar to fermion decay rate with a Yukawa coupling in expanding Friedmann–Robertson–Walker universes. This is done using the full theory of quantum fields in curved spacetime and the added-up transition probability method. It is found that in an expanding universe the usual Minkowskian decay rates are considerably modified for early times. For conformally coupled scalars the decay rate is modified by a positive additive term proportional to the inverse of mass and related to the expansion rate of the Universe. We compare and contrast our results with previous studies on scalar to scalar decay and find that in general the decay channel into fermions is the dominant channel of decay in the very early Universe.
Optimization of modular data center air conditioning system
Authors: Chen Yong-Liang , Qin Zi-Qiang , Li Yao , Wang Hai-Bo , Muhammad Sheryar , Si Hai-Qing
Published: June 2020

In high-density data center, energy consumption is increasing dramatically. For reducing the energy consumption, CFD software, Fluent 15.0, is used to simulate the flow and temperature field distribution with [Formula: see text] turbulence model and fluid–solid coupling method. Fans on the back of racks are simplified as walls with a certain pressure jump. Severs are treated as solid heat sources and porous media. Simulation results reveal that the temperature distribution on the back of racks is not uniform when air conditioners are arranged face-to-face, and local high temperature points emerge near the side wall of air conditioners. Factors affecting cooling efficiency, such as location of air conditioners, speed of inlets, distance of racks, etc., need to be improved. Geometric model is optimized by using a diagonal rack arrangement and drilling holes on the side wall. Based on this, four different cases with various hot aisle distance are proposed. Single and double modular data center are both simulated. Results of new model are better than those of baseline model.
Conserved densities and fluxes for nonlinear Schrödinger equations using scaling invariance approach
Authors: Rizvi Syed Tahir Raza , Ali Ijaz , Ali Kashif , Mustafa Ghulam
Published: June 2020

We have adopted a direct method for the computation of polynomial conservation laws (CLs) of three nonlinear Schrödinger equations (NLSEs). The equations under consideration are firstly converted to evolution forms. Instead of using advanced differential-geometric tools, our method utilizes tools from linear algebra and variational calculus. This method can be implemented on NLSEs which occur in quantum physics, plasma physics, and fluid dynamics. In case of NLSEs with parameters, our method evaluates conditions on the parameters involved in order to find a sequence of conserved densities. The complete integrability of a NLSE can be predicted by the existence of a large number of CLs of the equation. The method utilizes linear combinations of scaling homogeneous terms having undetermined coefficients for the computation of conserved densities. The undetermined coefficients are being evaluated with the help of variational derivative (Euler operator) while Homotopy operator assists in the determination of conserved fluxes.
An Ensemble Learning-Based Cooperative Defensive Architecture Against Adversarial Attacks
Authors: Liu Tian , Song Yunfei , Hu Ming , Xia Jun , Zhang Jianning , Chen Mingsong
Published: June 2020

Since Deep Neural Networks (DNNs) have been more and more widely used in safety-critical Intelligent System (IS) applications, the robustness of DNNs becomes a great concern in IS design. Due to the vulnerability of DNN models, adversarial examples generated by malicious attacks may result in disasters. Although there are plenty of defense methods for these adversarial attacks, existing methods can only resist special adversarial attacks. Meanwhile, the accuracy of existing methods degrades dramatically when they process nature examples. To address this problem, we propose an effective Cooperative Defensive Architecture (CDA) that can enhance the robustness of IS devices by integrating heterogeneous base classifiers. Because of the parallel mechanism in ensemble learning, the compressed heterogeneous base classifiers do not increase the prediction time on device. Comprehensive experimental results show that the modified DNNs by our approach cannot only resist adversarial examples more effectively than original model, but also achieve a high accuracy when they process nature examples.
Domains of elliptic operators on sets in Wiener space
Authors: Addona Davide , Cappa Gianluca , Ferrari Simone
Published: June 2020

Let [Formula: see text] be a separable Banach space endowed with a non-degenerate centered Gaussian measure [Formula: see text]. The associated Cameron–Martin space is denoted by [Formula: see text]. Consider two sufficiently regular convex functions [Formula: see text] and [Formula: see text]. We let [Formula: see text] and [Formula: see text]. In this paper, we study the domain of the self-adjoint operator associated with the quadratic form [Formula: see text] and we give sharp embedding results for it. In particular, we obtain a characterization of the domain of the Ornstein–Uhlenbeck operator in Hilbert space with [Formula: see text] and on half-spaces, namely if [Formula: see text] and [Formula: see text] is an affine function, then the domain of the operator defined via (0.1) is the space [Formula: see text] where [Formula: see text] is the Feyel–de La Pradelle Hausdorff–Gauss surface measure.
Resolving resolution dimension of recollements of abelian categories
Authors: Zhang Houjun , Zhu Xiaosheng
Published: June 2020

In this paper, we investigate the resolving resolution dimension with respect to the recollements of abelian categories. Let [Formula: see text] be a recollement of abelian categories such that [Formula: see text] and [Formula: see text] have enough projective objects and let [Formula: see text], [Formula: see text], [Formula: see text] be resolving subcategories of [Formula: see text], [Formula: see text] and [Formula: see text], respectively. We establish some upper and lower bounds of [Formula: see text]-resolution dimension of [Formula: see text] in terms of the [Formula: see text]-resolution dimension of [Formula: see text] and [Formula: see text]-resolution dimension of [Formula: see text]. Based on these upper and lower bounds, we study the Gorensteinness of abelian categories involved in [Formula: see text]. Under some suitable assumptions, we show that if [Formula: see text] and [Formula: see text] are Gorenstein, then [Formula: see text] is Gorenstein. As applications, we apply our results to ring theory and the triangular matrix artin algebras, we study the quasi-Frobenius and Gorenstein hereditary properties of the ring [Formula: see text] and [Formula: see text], where [Formula: see text] is an idempotent element of [Formula: see text]. We also investigate Gorensteinness of the triangular matrix artin algebras, some known results are obtained as corollaries. At the end of this paper, we give two examples to illustrate our results.
Paddy variety identification using hyperspectral imagery under non-ideal illumination conditions
Authors: Liu Weihua , Zeng Shan , Li Hao , Xiao Zuyin , Huang Xin , Jiang Haohui
Published: June 2020

Hyperspectral imaging (HSI) has shown great potential in the use of paddy variety identification. However, the quality of HSI images taken by a hyperspectral camera under non-ideal illumination is vulnerable to environmental influences such as shadows and noises, leading to a degraded identification result. This problem is addressed in this study by a two-stage image processing method. First, to eliminate the influence of shadows, a grayscale image based on the reflectance slope is synthesized. The synthetic reflectance slope image (SRSI) is binarized for image segmentation and shape features extraction. Secondly, an HSI image de-noising technology based on weighted spatial filtering (WSF), which integrates both spatial and spectral information of the HSI image, is proposed to reduce the influence of noises. Finally, the extracted shape, spectral and texture features are combined and input into the support vector machine for paddy variety identification. Four varieties of paddy with different origins were tested in the experiments. The experiment results showed that compared with color images, the SRSIs could help obtain more accurate shape features. The results also showed that the WSF method can significantly reduce noises and improves the paddy variety identification accuracy.
A Radial Basis Function–Based Ghost Cell Method for Complex Rigid or Flexible Moving Boundary Flows
Authors: Xin Jianjian , Chen Zhenlei , Shi Fan , Shi Fulong , Jin Qiu
Published: June 2020

A radial basis function (RBF)-based ghost cell method is presented to simulate flows around a rigid or flexible moving hydrofoil on a Cartesian grid. A compactly supported radial basis function (CSRBF) is introduced to the ghost cell immersed boundary method to treat the complex flexible boundaries in the fluid. The results indicate that this RBF representation method can accurately track tempo-spatially varied interfaces and avoid the identification failure encountered in original RBF. In addition, an interface cell interpolation method is developed to treat the irregular boundaries such as sharp points and thin boundaries. Solution quality is improved by constructing the interface cells along the local irregular boundaries, instead of the ghost cells. To validate the proposed method, uniform flows around stationary and pitching hydrofoils are simulated. Then, a flexible hydrofoil undulating in the fluid is simulated. Good agreements are obtained by comparing the present results with the reference results. Furthermore, the relationship between the oscillation frequency and the force coefficient is studied. Also, generation mechanism of the thrust force is explained.
Between a Rock and a Hard Place: How Lesser Powers Respond to Competing Great Powers in the Asia-Pacific Region
Authors: WANG HSIN-HSIEN , WANG SHINN-SHYR , TZENG WEI-FENG
Published: June 2020

In comparison to hegemony, lesser powers usually struggle for survival between two or more great powers under state power asymmetry, a perpetual phenomenon in international politics. With the rise of China and the increasingly strengthening role of the US in the Asia-Pacific region, it is important to learn how lesser powers manage their relations with the two. To explore this issue, we propose that the strength of state power will constrain the strategies of lesser powers as they choose between the US and China. Borrowing from existing theories and ideas on strategies that include balancing, bandwagoning, and hedging, we argue that the stronger a country’s power, the more likely it will choose a balancing strategy. At the same time, the weaker the country, the more likely that it will go with bandwagoning. Regional middle powers will show varied strategy choices, as they possess a higher degree of freedom in choosing which great power to side with. To validate these arguments, we construct two indicators — differences in trade dependence on the US and China and differences in the voting score consistent with the US and China — to quantify the strategies of lesser powers toward great powers and examine whether the variable of strategies follows the expected pattern. Our analysis shows that countries in the middle of the spectrum of state power demonstrated great freedom in choosing strategies toward the two powers.