bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Cognitive Anxiety and the Rating of Pain on Care Processes in a Vigilance Task: The Important Part Played by Age
Authors: Pinel Luis , Perez-Nieto Miguel A. , Redondo Marta , Rodríguez-Rodríguez Luis , Mateos Leticia L.
Published: April 2020

Chronic pain is a serious public health problem that has grown exponentially in recent years, which is why it has received the attention of numerous researchers. Most of the studies in the field of chronic pain have focused on care as a mediating variable on the perception of painful stimuli and emotions. Nevertheless, there are very few studies that have gone in the opposite direction. This study’s aim is therefore to analyse the impact of emotional variables (anxiety and depression), the rating of pain, and age on vigilance processes in a sample of patients with chronic pain. To do so, the attentional performance of a cohort of 52 patients with chronic pain was measured through the use of a modified dot-probe task. Furthermore, all the participants were evaluated using the following self-report measures: Beck’s Depression Inventory-II (BDI-II), the McGill Pain Questionnaire, and the Pain Anxiety Symptoms Scale-20 (PASS-20). Stepwise multiple linear regression analysis revealed a significant negative correlation between the pain rating index and the number of mistakes the participants made during the attention test. There was also a positive and significant correlation with age and another negative and significant correlation with cognitive anxiety regarding the overall performance times during the undertaking of the experimental task. These results point to the importance of a more in-depth understanding of the impact that the emotional variables and other variables such as age have on attentional processes and the rating of pain. Finally, the discussion focuses on the implications these results could have for clinical practice or for future research studies in this field.
Environmental Impact Analysis of Hub-and-Spoke Network Operation
Authors: Tian Yong , Sun Mengyuan , Wan Lili , Hang Xu
Published: April 2020

The hub-and-spoke network has demonstrated its economies of scale and scope in the rapid development of the civil aviation industry. In order to fit the development trend of green civil aviation, a series of environmental problems such as fuel consumption and pollutant emissions caused by air transportation cannot be ignored. Firstly, this paper selects six cities of Shenyang, Beijing, Qingdao, Zhengzhou, Guangzhou, and Nanjing as the research objects, collects the passenger flow and the distance information of the corresponding segment, determines the location of the hub airport, analyzes the operating environment of the aircraft in the hub-and-spoke network, establishes an aircraft emission assessment model, and calculates the mass of aircraft emissions and fuel consumption. Secondly, based on the calculation results, the comparison of aircraft emissions and fuel consumption between the hub-and-spoke network and the point-to-point network shows that the total carbon monoxide (CO) emissions are reduced by 35.84%, the total hydrocarbon compounds (HC) emissions are increased by 68.82%, and the total nitrogen oxides (NOx) emissions are increased by 24.87%. The total mass of pollutants (including CO, HC, and NOx) decreased by 29.37%, and the total fuel consumption decreased by 68.17%. In general, the use of a hub-and-spoke network reduces the pollutant emissions and fuel consumption of aircraft as a whole while ensuring the lowest passenger transportation cost. Finally, based on the current international situation and the enhancement of people’s awareness of environmental protection, a summary analysis of the hub-and-spoke network and the point-to-point network is obtained, and some enlightenment and research significance are obtained.
Asian Option Pricing under an Uncertain Volatility Model
Authors: Han Yuecai , Liu Chunyang
Published: April 2020

In this paper, we study the asymptotic behavior of Asian option prices in the worst-case scenario under an uncertain volatility model. We derive a procedure to approximate Asian option prices with a small volatility interval. By imposing additional conditions on the boundary condition and splitting the obtained Black–Scholes–Barenblatt equation into two Black–Scholes-like equations, we obtain an approximation method to solve a fully nonlinear PDE.
Enhancing Preparedness for Arbovirus Infections with a One Health Approach: The Development and Implementation of Multisectoral Risk Assessment Exercises
Authors: Dente Maria Grazia , Riccardo Flavia , Van Bortel Wim , Marrama Laurence , Mollet Thomas , Derrough Tarik , Sudre Bertrand , Calistri Paolo , Nacca Gloria , Ranghiasci Alessia , Escadafal Camille , Gaayeb Lobna , Guillot Ariane , Jiménez-Clavero Miguel Angel , Manuguerra Jean-Claude , Mikaty Guillain , Picard Marie , Fernández-Pinero Jovita , Pérez-Ramírez Elisa , Robert Vincent , Victoir Kathleen , Declich Silvia
Published: April 2020

Background. One Health is receiving attention for arbovirus infection prevention and control and for defining national “intersectoral” priorities. Increasing awareness of intersectoral priorities through multisectorial risk assessments (MRA) is promising, where data are not systematically shared between sectors. Towards this aim, the MediLabSecure project organized three MRA exercises (hereby called exercises): one on West Nile virus, one on Crimean–Congo haemorrhagic fever, and one on Rift Valley fever, assessing the added value of this approach. Methods. The exercises relied on RA methodologies of international organisations. Country representatives of the human and animal virology, medical entomology, and public health sectors (hereby called “sectors”) involved in the surveillance of vector‐borne diseases participated in the exercises. Background documentation was provided before each exercise, and a guide was developed for the facilitators. All three exercises included technical and methodological presentations and a guided RA directed at bringing into play the different sectors involved. To assess the added value of the approach, each participant was asked to rank the level of perceived benefit of the multisectoral collaboration for each “risk question” included in the exercises. Results. In total, 195 participants from 19 non‐EU countries in the Mediterranean and Black Sea regions took part in the exercises. The participants assessed the multisectoral approach as valuable in analysing comprehensively the situation by having access to information and knowledge provided by each of the sectors involved. Sharing of information and discussion facilitated reaching a consensus on the level of risk in each country. Conclusions. Increasing awareness of intersectoral priorities, including cross‐border ones, through MRA is relevant to reduce gaps due to unavailability of shared data and information. Given that six out of the ten threats to global health listed by WHO are occurring at the human‐animal‐environmental interfaces, comprehensive regional RA with a One Health approach made by national authorities can be a relevant added value for the global health security.
Knowledge on Hypertension and Self-Care Practice among Adult Hypertensive Patients at University of Gondar Comprehensive Specialized Hospital, Ethiopia, 2019
Authors: Worku Kassahun Chanyalew , Asasahegn Ayele , Hagos Desalegn , Ashenafi Elshaday , Tamene Firegenet , Addis Getachew , Endalkachew Kidist
Published: April 2020

Background. Patients with hypertension need to be aware of various aspects of hypertension and exercise self-care. But, there is limited information regarding this issue. Objective of the Study. This study was designed to assess knowledge on hypertension and self-care practice among adult hypertensive patients in the University of Gondar Comprehensive Specialized Hospital, Ethiopia. Materials and Methods. Descriptive cross-sectional study was conducted among 384 hypertensive patients from April to May 2019. The study participants were selected using a systematic random sampling technique. Data were collected using a pretested interviewer-administered questionnaire. Descriptive statistics such as percentage and frequency of patients’ knowledge on hypertension and their self-care practice were computed. Cross-tabulation was used to see the frequency and percentage of selected sociodemographic variables and knowledge level with self-care practice subscales. Finally, the results were summarized and presented in texts, figures, and tables. Results. Among the study participants, 215 (56%) and 228 (59.4%) had good knowledge and self-care practice towards hypertension, respectively. The participants who had good knowledge had good self-care practice frequency. Conclusions. In this study, knowledge on hypertension was low, while self-care practice was moderate on the self-care interventions. Hence, increasing patients’ awareness and intervention on medication adherence, low salt diet consumption, physical activity, weight management, cigarette smoking cessation, and alcohol consumption reduction is important.
Image Interpolation via Gradient Correlation-Based Edge Direction Estimation
Authors: Khan Sajid , Lee Dong-Ho , Khan Muhammad Asif , Siddiqui Muhammad Faisal , Zafar Raja Fawad , Memon Kashif Hussain , Mujtaba Ghulam
Published: April 2020

This paper introduces an image interpolation method that provides performance superior to that of the state-of-the-art algorithms. The simple linear method, if used for interpolation, provides interpolation at the cost of blurring, jagging, and other artifacts; however, applying complex methods provides better interpolation results, but sometimes they fail to preserve some specific edge patterns or results in oversmoothing of the edges due to postprocessing of the initial interpolation process. The proposed method uses a new gradient-based approach that makes an intelligent decision based on the edge direction using the edge map and gradient map of an image and interpolates unknown pixels in the predicted direction using known intensity pixels. The input image is subjected to the efficient hysteresis thresholding-based edge map calculation, followed by interpolation of low-resolution edge map to obtain a high-resolution edge map. Edge map interpolation is followed by classification of unknown pixels into obvious edges, uniform regions, and transitional edges using the decision support system. Coefficient-based interpolation that involves gradient coefficient and distance coefficient is applied to obvious edge pixels in the high-resolution image, whereas transitional edges in the neighborhood of an obvious edge are interpolated in the same direction to provide uniform interpolation. Simple line averaging is applied to pixels that are not detected as an edge to decrease the complexity of the proposed method. Applying line averaging to smooth pixels helps to control the complexity of the algorithm, whereas applying gradient-based interpolation preserves edges and hence results in better performance at reasonable complexity.
Herbal Medication, Macmoondong Decoction, Attenuates LPS‐Induced COPD in Small Airways via TGF‐β, CCL‐2, and CXCL1
Authors: Lee Soon-Young , Kang Bossng , Bae Chun-Sik , Cho Seung-Sik , Park Dae-Hun
Published: April 2020

Chronic obstructive pulmonary disease (COPD) is an incurable disease related to the respiratory system. A 2017 report by the World Health Organization stated that it was the third most common cause of death in 2015. Macmoondong decoction is a prescription that has been used widely in Korea for the treatment of respiratory diseases, but there have been few investigations into the therapeutic mechanism. To investigate the anti‐COPD effect of macmoondong decoction, the animals were divided into five treatment groups: control; COPD‐induced control; Spiriva; 150 mg/kg macmoondong decoction; and 1500 mg/kg macmoondong decoction. Changes typically observed in COPD, such as the populations of WBC and neutrophils in BALF, the level of IgE in serum, morphological changes, the DNA levels, and the protein expression of cytokines and chemokines (TGF‐β, CCL‐2, CXCL1, and CXCL11) in the pulmonary system, were evaluated. Macmoondong decoction inhibited the populations of WBC and neutrophils in BALF and the level of IgE in serum. Dose‐dependent prevention of the pulmonary morphological changes, such as emphysema and airway fibrosis, was observed. Macmoondong decoction suppressed the expression of DNA and proteins related to the occurrence of COPD, such as TGF‐β, CCL‐2, CXCL1, and CXCL11. In particular, the expression of TGF‐β, CCL‐2, and CXCL1 was significantly suppressed by 1500 mg/kg macmoondong decoction treatment compared with Spiriva treatment. Macmoondong decoction exerted an anti‐COPD effect, and the mechanism of its action may be the suppression of TGF‐β, CCL‐2, CXCL1, and CXCL11 expression, which occurred in a dose‐dependent manner. The mechanism of action of macmoondong decoction may be the dose‐dependent suppression of TGF‐β, CCL‐2, CXCL1, and CXCL11, with TGF‐β, CCL‐2, and CXCL1 as the potential key factors involved in COPD suppression.
Second Generation Drug-Eluting Stent Implantation versus Coronary Artery Bypass Grafting in the Treatment of Young Patients with Left Main and/or Multivessel Coronary Disease
Authors: Chen Xue , Zhang Xuehui , Yan Yunfeng , Zhao Xin , Nie Maoxiao , Feng Tingting , Liang Zhe , Zhao Quanming
Published: April 2020

Background. Many studies have compared the outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD). However, no trials have focused on young patients (<45 years) with complex CAD. We conducted a retrospective evaluation to compare the outcomes of a second-generation drug-eluting stent (DES) and CABG in young patients with LM or three-vessel disease. Methods. In young patients with complex CAD who underwent PCI or CABG, a Kaplan-Meier analysis and Cox regression before and after propensity score matching were used to compare major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction (MI), stroke, death, and repeat revascularization. Results. During follow-up, MACCE occurred in 20.5% of patients in the PCI group and 8.6% of patients in the CABG group (hazard ratio (HR): 3.263, 95% confidence interval (CI): 1.379 to 7.722, p=0.007). Repeat revascularization occurred more frequently in the PCI group (18.9% vs. 3.7%, respectively, HR: 6.968, 95% CI: 2.036 to 23.842, p=0.002). There were no significant differences in the other endpoints. After propensity score matching, no conclusions were modified. Conclusions. In young patients with LM or three-vessel disease, PCI showed a higher incidence of MACCE, which was mainly driven by repeat revascularization. However, this did not translate into hard endpoint differences. Therefore, PCI is an alternative treatment to CABG in young patients with complex CAD.
Validating the Capability for Measuring Age‐Related Changes in Grip‐Force Strength Using a Digital Hand‐Held Dynamometer in Healthy Young and Elderly Adults
Authors: Lee Shu-Chun , Wu Li-Chen , Chiang Shang-Lin , Lu Liang-Hsuan , Chen Chao-Ying , Lin Chia-Huei , Ni Cheng-Hua , Lin Chueh-Ho
Published: April 2020

Background. Grip‐force performance can be affected by aging, and hand‐grip weakness is associated with functional limitations of dasily living. However, using an appropriate digital hand‐held dynamometer with continuous hand‐grip force data collection shows age‐related changes in the quality of hand‐grip force control may provide more valuable information for clinical diagnoses rather than merely recording instantaneous maximal hand‐grip force in frail elderly adults or people with a disability. Therefore, the purpose of this study was to indicate the construct validity of the digital MicroFET3 dynamometer with Jamar values for maximal grip‐force assessments in elderly and young adults and confirmed age‐related changes in the maximal and the quality of grip‐force performance using the MicroFET3 dynamometer in elderly people. Methods. Sixty‐five healthy young (23.3 ± 4.5 years) and 50 elderly (69.5 ± 5.8 years) adults were recruited and asked to perform a validity test of the grip‐force maximum voluntary contraction (MVC) using both the dominant and nondominant hands with a Jamar dynamometer and a MicroFET3 dynamometer. Results. A strong correlation of maximal grip‐force measurements was found between the MicroFET3 dynamometer and Jamar standard dynamometer for both hands in all participants (p < 0.05). Although, the results showed that a lower grip force was measured in both hands by the MicroFET3 dynamometer than with the Jamar dynamometer by 49.9%~57% (p < 0.05), but confidently conversion formulae were also developed to convert MicroFET3 dynamometer values to equivalent Jamar values for both hands. Both dynamometers indicated age‐related declines in the maximum grip‐force performance by 36.7%~44.3% (p < 0.05). We also found that the maximal hand‐grip force values generated in both hand by the elderly adults were slower and more inconsistent than those of the young adults when using the MicroFET3 dynamometer. Conclusions. This study demonstrated that the digital MicroFET3 dynamometer has good validity when used to measure the maximal grip force of both hands, and conversion formulae were also developed to convert MicroFET3 dynamometer force values to Jamar values in both hands. Comparing with the Jamar dynamometer for measuring grip force, the MicroFET3 dynamometer not only indicated age‐related declines in the maximum grip‐force performance but also showed slower and more inconsistent maximal hand‐grip strength generation by the elderly.
Combinatory Attitude Determination Method for High Rotational Speed Rigid-Body Aircraft
Authors: An Liangliang , Wang Liangming , Liu Ning , Fu Jian
Published: April 2020

In this paper, we present a novel multisensor combinatory attitude determination method that enables high-accuracy measurement of the attitude of a high rotational speed rigid-body aircraft. We analyze the external moments of the aircraft during flight and develop the method using theoretical deductions based on the motion equations of a rigid body rotating around the centroid. The proposed method fuses the data measured from GPS, gyrometer, and magnetometer and uses the improved unscented Kalman filter (UKF) algorithm to perform filtering. First, appropriate assumptions and simplifying approximations are made for around-centroid motion equations of a rigid body according to the motion characteristics of the high rotational speed aircraft. Using these assumptions and approximations, the constraint equations between the Euler attitude angles and flight-path angle, trajectory deflection angle are derived to serve as the state equation. Second, the roll angle with error is calculated using the geomagnetic field model and the geomagnetic intensity measured by a three-axis magnetometer and then fused with the angular velocity information obtained from the gyroscope for constructing the measurement equations. Finally, the state equations are discretized using the Runge–Kutta method during the UKF prediction stage, improving the prediction accuracy. Simulation results show that the proposed method can effectively determine the attitude information of the high rotational speed aircraft, achieving high level of reliability and accuracy thanks to the combination of information from GPS, gyroscope, and magnetometer.
Optimal Reinsurance-Investment Problem under a CEV Model: Stochastic Differential Game Formulation
Authors: Li Danping , Chen Ruiqing , Li Cunfang
Published: April 2020

This paper focuses on a stochastic differential game played between two insurance companies, a big one and a small one. In our model, the basic claim process is assumed to follow a Brownian motion with drift. Both of two insurance companies purchase the reinsurance, respectively. The big company has sufficient asset to invest in the risky asset which is described by the constant elasticity of variance (CEV) model and acquire new business like acting as a reinsurance company of other insurance companies, while the small company can invest in the risk-free asset and purchase reinsurance. The game studied here is zero-sum where there is a single exponential utility. The big company is trying to maximize the expected exponential utility of the terminal wealth to keep its advantage on surplus while simultaneously the small company is trying to minimize the same quantity to reduce its disadvantage. In this paper, we describe the Nash equilibrium of the game and prove a verification theorem for the exponential utility. By solving the corresponding Fleming-Bellman-Isaacs equations, we derive the optimal reinsurance and investment strategies. Furthermore, numerical examples are presented to show our results.
Management of Choledochal Cysts at a Tertiary Care Centre: A Nine-Year Experience from India
Authors: Honnavara Srinivasan Pranav , Anbalagan Amudhan , Shanmugasundaram Rajendran , Obla Lakshmanamoorthy Naganathbabu
Published: April 2020

Background. Although choledochal cyst disease is seen predominantly in childhood, it is becomingly increasingly diagnosed in adult patients. Methods. Data of 36 patients with choledochal cysts managed in our institute between January 2010 and December 2018 were retrospectively analyzed. Results. Median age at presentation was 37 years (range: 13–72 years). Female-to-male ratio was 3.5 : 1. All patients were symptomatic, and abdominal pain was the most common symptom. 72.2% had other associated conditions. There was a considerable delay from the onset of symptoms to referral, median duration being 348 days. There were 28 cases of type I (77.8%), 5 cases of type IVA (13.9%), and 3 cases of type IVB (8.3%). Cyst excision with Roux-en-Y hepaticojejunostomy was performed in 29 (80.55%) cases. This procedure was combined with a left lateral sectionectomy, left hepatectomy, and radical cholecystectomy in 1, 2, and 1 cases, respectively. Lilly’s technique was used in 2 cases, and cyst excision with hepaticoduodenostomy was performed in 1 case. Early complications were seen in 21 patients (58.3%), and late complications were seen in 5 patients (13.8%). 2 patients were found to have associated malignancies. One patient was detected to have cholangiocarcinoma in the resected liver incidentally, and another patient was diagnosed to have gall bladder cancer intraoperatively. Conclusion. Choledochal cysts should be considered in the differential diagnosis of adults presenting with epigastric or right hypochondrium pain or jaundice. A thorough preoperative evaluation is required. Cyst excision with Roux-en-Y hepaticojejunostomy forms the standard treatment in most cases. Long-term follow-up is essential for management of complications and early detection of malignant change.
Inhibition of Proinflammatory Cytokines in Cutibacterium acnes-Induced Inflammation in HaCaT Cells by Using Buddleja davidii Aqueous Extract
Authors: Nguyen Anh Thu , Kim Ki-young
Published: April 2020

Acne is an inflammatory skin disorder; although some anti-inflammatory medicines for treating acne are available in a market, they have considerable side effects; therefore, new treatment options are needed. In the present study, among the 16 aqueous extracts of plants collected from Jeju Island in Korea which are used to test anti-inflammatory activity, B. davidii showed the strong decline of the proinflammatory cytokine expression against the inflammatory process caused by C. acnes in Human HaCaT keratinocyte cells. B. davidii downregulated the expression of 57% of COX-2, 41% of iNOS, and proinflammatory cytokines 29% of TNF-α, 32% of IL-1β, 21% of IL-6, and 35% of IL-8. Furthermore, B. davidii inhibited NF-κB and MAPK signaling cascades in keratinocytes that activated by toll-like receptor 2 (TLR-2) in response to C. acnes. Given those results, B. davidii is a potential agent to reduce the proinflammatory cytokine expression against C. acnes-induced inflammation and might provide an alternative to the current medications.
Carrageenan-Free Diet Shows Improved Glucose Tolerance and Insulin Signaling in Prediabetes: A Randomized, Pilot Clinical Trial
Authors: Feferman Leo , Bhattacharyya Sumit , Oates Erin , Haggerty Nicole , Wang Tianxiu , Varady Krista , Tobacman Joanne K.
Published: April 2020

Objectives. Carrageenan is well known to cause inflammation and is used in laboratory experiments to study mediators and treatments of inflammation. However, carrageenan is added to hundreds of processed foods to improve texture. Previous work indicated that low concentrations of carrageenan in drinking water caused marked glucose intolerance and insulin resistance in a mouse model. This exploratory, clinical study tested the impact of the no-carrageenan diet in prediabetes. Research Design and Methods. Participants with prediabetes (n=13), defined as HbA1c of 5.7%-6.4%, enrolled in a 12-week, randomized, parallel-arm, feeding trial. One group (n=8) was provided all meals and snacks with no carrageenan. A second group (n=5) received a similar diet with equivalent content of protein, fat, and carbohydrate, but with carrageenan. Blood samples were collected at baseline and during oral glucose tolerance tests at 6 and 12 weeks. The primary outcome measure was changed in %HbA1c between baseline and 12 weeks. Statistical analysis included paired and unpaired t-tests, correlations, and 2×2 ANOVAs. Results. Subjects on no carrageenan had declines in HbA1c and HOMA-IR (p=0.006, p=0.026; paired t-test, two tailed). They had increases in C-peptide (p=0.029) and Matsuda Index (2.1±0.7 to 4.8±2.3; p=0.052) and declines in serum IL-8, serum galectin-3, and neutrophil phospho-(Ser307/312)-IRS1 (p=0.049, p=0.003, and p=0.006; paired t-tests, two tailed). Subjects on the diet with carrageenan had no significant changes in these parameters. Significant differences between no-carrageenan and carrageenan-containing diet groups for changes from baseline to 12 weeks occurred in C-peptide, phospho-Ser-IRS1, phospho-AKT1, and mononuclear cell arylsulfatase B (p=0.007, p=0.038, p=0.0012, and p=0.0008; 2×2 ANOVA). Significant correlations were evident between several of the variables. Conclusions. Findings indicate improvement in HbA1c and HOMA-IR in participants on no-carrageenan diets, but not in participants on carrageenan-containing diets. Significant differences between groups suggest that removing carrageenan may improve insulin signaling and glucose tolerance. Larger studies are needed to further consider the impact of carrageenan on development of diabetes.
Vanillic Acid Alleviates Acute Myocardial Hypoxia/Reoxygenation Injury by Inhibiting Oxidative Stress
Authors: Yao Xiuya , Jiao Shoufeng , Qin Mingming , Hu Wenfeng , Yi Bo , Liu Dan
Published: April 2020

Oxidative stress is an important factor of myocardial hypoxia/reoxygenation (H/R) injury. Our research focuses on how to reduce the cardiac toxicity caused by oxidative stress through natural plant extracts. Vanillic acid (VA) is a phenolic compound found in edible plants and rich in the roots ofAngelica sinensis. Experimental studies have provided evidence for this compound’s effectiveness in cardiovascular diseases; however, its mechanism is still unclear. In this study, molecular mechanisms related to the protective effects of VA were investigated in H9c2 cells in the context of H/R injury. The results showed that pretreatment with VA significantly increased cell viability and decreased the percentage of apoptotic cells, as well as lactate dehydrogenase and creatine phosphokinase activity, in the supernatant, accompanied by reduced levels of reactive oxygen species and reduced caspase-3 activity. VA pretreatment also restored mitochondrial membrane potentials. Moreover, preincubation with VA significantly attenuated mitochondrial permeability transition pore activity. VA administration upregulated adenosine monophosphate-activated protein kinaseα2 (AMPKα2) protein expression, and interestingly, pretreatment with AMPKα2-siRNA lentivirus effectively attenuated the cardioprotective effects of VA in response to H/R injury.
Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study
Authors: Peng Xuenan , Ge Jinzhuo , Wang Congju , Sun Hongpeng , Ma Qinghua , Xu Yong , Ma Yana
Published: April 2020

Background. Diabetes is a known independent risk factor for stroke. However, whether higher glucose levels (126–139.9 mg/dl) can increase the risk of stroke in people without diabetes is still unknown. Moreover, as a fluctuating parameter, long-term glucose levels may also be related to the risk of stroke outcome. It is important to explore the correlation between long-term average blood glucose, as well as its variability, and stroke. Methods. We used 40,975 clinical measurements of glucose levels and 367 measurements of glycated hemoglobin A1c levels from 12,321 participants without stroke to examine the relationship between glucose levels and the risk of stroke. Participants were from the Weitang Geriatric Diseases study, including 5,707 men and 6,614 women whose mean age at baseline was 60.8 years; 1,011 participants had diabetes, and 11,310 did not. We estimated the long-term average blood glucose level based on the multilevel Bayesian model and fit in Cox regression models, stratified according to diabetes status. Results. Over a median follow-up period of 5 years, stroke developed in 279 of the 12,321 participants (244 without diabetes and 35 with). For people with an average glucose level of 126–139.9 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted hazard ratio (HR) for total stroke was 1.78 (95% confidence interval (CI), 1.16–2.75), and the HR for levels higher than 140 mg per deciliter was 1.89 (95% CI, 1.09–3.29). Among those without diabetes whose glucose level was higher than 140 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted HRs for total stroke and fatal stroke were 3.66 (95% CI, 1.47–9.08) and 5 (95% CI, 1.77–14.15), respectively. For a glucose standard deviation level higher than 13.83 mg per deciliter, compared with that lower than 5.91 mg per deciliter, the adjusted HR for total stroke was 2.31 (95% CI, 1.19–4.48). Conclusions. Our results suggest that higher average glucose levels (126–139.9 mg/dl) and variance may be risk factors for stroke, even among people without diabetes diagnosis.
Sparse Bayesian Perspective for Radar Coincidence Imaging with Model Errors
Authors: Fan Bo , Zhou Xiaoli , Chen Shuo , Jiang Zhijie , Cheng Yongqiang
Published: April 2020

Sparsity-driven methods are commonly applied to reconstruct targets in radar coincidence imaging (RCI), where the reference matrix needs to be computed precisely and the prior knowledge of the accurate imaging model is essential. Unfortunately, the existence of model errors in practical RCI applications is common, which defocuses the reconstructed image considerably. Accordingly, this paper aims to formulate a unified framework for sparsity-driven RCI with model errors based on the sparse Bayesian approach. Firstly, a parametric joint sparse reconstruction model is built to describe the RCI when perturbed by model errors. The structured sparse Bayesian prior is then assigned to this model, after which the structured sparse Bayesian autofocus (SSBA) algorithm is proposed in the variational Bayesian expectation maximization (VBEM) framework; this solution jointly realizes sparse imaging and model error calibration. Simulation results demonstrate that the proposed algorithm can both calibrate the model errors and obtain a well-focused target image with high reconstruction accuracy.
Prevalence and Factors Associated with Current Cigarette Smoking among Ethiopian University Students: A Systematic Review and Meta-Analysis
Authors: Deressa Guracho Yonas , Addis Getachew Setotaw , Tafere Sileshi Mulatu , Hurisa Kidanu , Bifftu Berhanu Boru , Goedert Martha H. , Gelaw Yared Mulu
Published: April 2020

Background. Although tobacco use is highest in high-income countries, most tobacco-related deaths occur in low- and middle-income countries with the highest number of deaths recorded in East Africa. The aim of this systematic review and meta-analysis is to determine the pooled prevalence and associated factors of current cigarette smoking among Ethiopian university students. Methods. The authors searched databases from PubMed, PsycINFO, Google Scholar, EMBASE, and Web of Sciences. The publications included in the analysis were inclusive, the literature was searched from January 2011 to December 2018. The JBI-MAStARI critical appraisal tool was applied to 13 publications identified by the database search. I2 statistics were used to indicate heterogeneity. Publication bias was evaluated using the visual funnel plot. A p value < 0.1 was considered as indicative of statistically significant publication bias. A random effect meta-analysis model was computed to estimate the pooled prevalence of cigarette smoking, and the variables associated with cigarette smoking were examined. Results. The meta-analysis of 13 studies showed that the pooled prevalence of current cigarette smoking was found to be 12.55% (95% CI: 10.39–14.72; I2 = 94.0%) with no publication bias according to Egger’s test (p=0.007) for cigarette smoking by 2.05 (95% CI: 1.52–2.75). Factors associated with cigarette smoking were peer influence 2.79 (95% CI: 1.62–4.82; I2 = 35.7), khat chewing (95% CI: 2.81–15.26; I2 = 82.5), and alcohol use 11.16 (95% CI: 7.46–16.71). Conclusion. Our findings indicate a high prevalence of cigarette smoking among Ethiopian university students as compared to the general population. Gender, peer influence, khat chewing, and current alcohol use were significantly associated with cigarette smoking. The authors recommend promoting antismoking campaigns, emphasizing health hazard public service announcements about cigarettes, and integrating health education on smoking in youth-friendly services, especially targeting higher educational institutions.
A Division Method of Determining the Early-Warning Zone on an Expressway for Automated Vehicles
Authors: Wang Jiawen , Li Shaobo , Lu Yining , Wang Lubang
Published: April 2020

Using a cellular automaton model, this paper studied the evolution mechanism of traffic incidents affecting the capacity of urban expressway under the mixed traffic environment of manual driving and automatic driving. It showed that the length of the automated-driving early-warning zone could affect the capacity of expressway. Specifically, the early-warning zone is divided into an accelerate lane-changing area, a decelerate lane-changing area, and a forced lane-changing area. The areas vary according to the distance between the vehicle and the location of incident. Based on the study, this paper establishes a codirectional two-lane cellular automaton model. The analysis showed that the capacity of the urban expressway varies under different combinations of early-warning area length and division ratio of early-warning zone. In the case of two-lane reduction caused by traffic incidents, the capacity of the expressway is optimized when the length of early-warning zone is between 450 and 600 m, and the ratio of accelerate zone, decelerate zone, and forced zone to the length of early-warning zone is, respectively, 75%, 10%, and 15%. In addition, this study showed that the capacity will rise with the increase in automated vehicles.
Strengthening Resilience and Adaptive Capacity to Disasters in Cancer Control Plans: Lessons Learned from Puerto Rico
Authors: Ortiz Ana P. , Calo William A. , Mendez-Lazaro Pablo , García-Camacho Sandra , Mercado-Casillas Ana , Cabrera-Márquez Jessica , Tortolero-Luna Guillermo
Published: April 2020

Patients with cancer are among the most vulnerable populations in the aftermath of a disaster. They are at higher risk of medical complications and death due to the collapse of or disruptions in the health care system, the community infrastructure, and the complexity of cancer care. The United Nations' Sendai Framework for Disaster Reduction states that people with life-threatening and chronic diseases should be considered in disaster plans to manage their risks. With extreme weather or disasters becoming more intense and frequent and with the high burden of cancer in the United States and its territories, it is important to develop region-specific plans to mitigate the impact of these events on the cancer patient population. After Hurricanes Irma and Maria hit Puerto Rico and the U.S. Virgin Islands in 2017, the need to develop and implement such plans for patients with cancer was evident. We describe ongoing efforts and opportunities for disseminating and implementing emergency response plans to maintain adequate cancer care for patients during and after disasters. While plans for patients with cancer should be housed within the emergency support function infrastructure of each jurisdiction, the Centers for Disease Control and Prevention's Comprehensive Cancer Control Plans provide excellent community-centered mechanisms to support these efforts.
Comparison of Genotoxic Effect in Buccal Exfoliated Cells between Cigarette and Waterpipe Smokers
Authors: Rajabi-Moghaddam Mahdieh , Haji Mirzamohammad Mohammad , Yahyazadeh Elham , Gholinia Hemmat , Abbaszadeh Hamid
Published: April 2020

Background/Aim: Cytogenetic biomarkers such as micronuclei (MN) are used for the evaluation of exposure to carcinogens and genotoxic effects in oral epithelial cells. Tobacco is one of the strongest carcinogens responsible for the development of cancer in oral mucosa. The aim of this study was to compare the genotoxic effect of waterpipe smoking with that of cigarette smoking. Methods: This case-control study was performed on 30 waterpipe smokers, 30 cigarette smokers, and 30 nonsmokers. Buccal exfoliated cells were prepared using cytobrushes and stained with the Papanicolaou technique. The cytologic slides were examined under a light microscope for counting the number of MN and the number of cells with MN per 1,000 epithelial cells. Results: The mean number ± standard deviation (SD) of MN in waterpipe smokers, cigarette smokers, and nonsmokers was 7.55 ± 5.530, 4.95 ± 5.633, and 2.00 ± 2.406, respectively. The mean number ± SD of cells with MN in waterpipe smokers, cigarette smokers, and nonsmokers was 6.20 ± 4.830, 3.50 ± 3.832, and 1.45 ± 1.701, respectively. Numbers of cells with MN differed significantly between waterpipe smokers and cigarette smokers (p = 0.04) and between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN differed significantly between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN did not differ significantly between waterpipe smokers and cigarette smokers (p = 0.10). Numbers of MN and of cells with MN did not differ significantly between cigarette smokers and nonsmokers (p = 0.06 and p = 0.052, respectively). Conclusions: Waterpipe smoking is associated with a significantly higher frequency of MN, and it seems that waterpipe smoking has a greater genotoxic effect than cigarette smoking.
Effect of Noise Exposure on 1,382 Metallurgical Workers in Periodic Audiometric Evaluation: A Cohort Study
Authors: Silva Vagner Antonio Rodrigues , Guimarães Alexandre Caixeta , Lavinsky Joel , Pauna Henrique Furlan , Castilho Arthur Menino , Crespo Agrício Nubiato
Published: April 2020

Introduction: Noise-induced hearing loss is the most preventable cause of auditory impairment. Periodic audiometric evaluations are essential to monitor the hearing health of noise-exposed workers. Objective: To compare the evolution of audiometric thresholds in the initial three evaluations at frequencies of 3, 4, and 6 kHz in groups of workers exposed or not to noise. Methods: In this historical cohort study, audiometric evaluations were obtained from male workers between 18 and 40 years of age at six different metallurgical companies in Brazil. The workers were separated into noise-exposed and non-noise-exposed groups. The mean thresholds for 3, 4, and 6 kHz were calculated for both ears at baseline and the first and second periodic evaluations. The non-parametric Wilcoxon test was used for statistical analysis. Results: A total of 1,382 metallurgical workers were evaluated (1,199 noise-exposed and 183 non-noise-exposed). There was a significant difference between baseline and the first periodic evaluation (right ear – effect size = 0.62; p = 0.0030 and left ear – effect size = 0.74; p = 0.0063) and between baseline and the second periodic evaluation (right ear – effect size = 0.85; p = 0.004 and left ear – effect size = 0.96; p = 0.0002). In the non-noise-exposed group, there was no difference between baseline and the first periodic evaluation (right ear – effect size = 0.18; p = 0.2703 and left ear – effect size = 0.12; p = 0.7907) and between baseline and the second periodic evaluation (right ear – effect size = 0.29; p = 0.4475 and left ear – effect size = 0.41; p = 0.6381). Conclusion: In noise-exposed workers, there was a significant worsening of audiometric thresholds between baseline and the initial periodic evaluation, but there was no difference between the two post-baseline evaluations. This shows that noise exposure can quickly affect hearing, despite protective measures.
Rapidly Growing Desmoid-Type Fibromatosis of the Mesentery of the Small Intestine after Distal Gastrectomy for Gastric Cancer
Authors: Koyama Ryota , Maeda Yoshiaki , Minagawa Nozomi , Shinohara Toshiki
Published: April 2020

We report the case of a 55-year-old man with a surgical history of distal gastrectomy with Roux-en-Y reconstruction performed 3 years prior to the present episode. During the follow-up, a newly developed, rapidly growing intraabdominal mass was detected in the mesentery of the small intestine. Although the patient had been asymptomatic, surgical resection was planned with the suspicion of malignancy, especially lymph node recurrence of the gastric cancer, owing to its rapid growth. Laparotomy showed that the tumor was located in the mesentery of the small intestine near the Roux-en-Y limb, and due to the involvement of the feeding vessels to the Roux-en-Y limb, the anastomotic site was resected en bloc with the tumor, and the whole Roux-en-Y limb was reconstructed. The histopathological finding was compatible with desmoid-type fibromatosis of the mesentery of the small intestine. Here we report our case and discuss the previously reported literature, especially related to gastric cancer.
The Early Decline of α-Fetoprotein and Des-γ-Carboxy Prothrombin Predicts the Response of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma Patients
Authors: Yamamoto Shumpei , Onishi Hideki , Takaki Akinobu , Oyama Atsushi , Adachi Takuya , Wada Nozomu , Sakata Masahiro , Yasunaka Tetsuya , Shiraha Hidenori , Okada Hiroyuki
Published: April 2020

Introduction: Molecular targeting drugs are recommended as second-line treatment for intrahepatic advanced hepatocellular carcinoma (HCC). However, in Asia, hepatic arterial infusion chemotherapy (HAIC) is also considered as a second-line treatment because it improves the survival of responders. The aim of this study was to predict responders and non-responders to HAIC with low-dose cisplatin plus 5-fluorouracil (LFP) using tumor markers. Objective and Methods: The data of 47 patients who received LFP for the first time in our hospital were analyzed retrospectively. We evaluated the association between treatment response by Response Evaluation Criteria in Solid Tumors and the changing ratio of the serum concentration of α-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-γ-carboxy prothrombin (DCP) 2 weeks after LFP initiation. Results: The number of patients showing a complete response (CR), a partial response (PR), stable disease (SD), and progressive disease (PD) was 0 (0%), 20 (43%), 18 (38%), and 9 (19%), respectively. The AFP ratio showed significant positive correlations for PR vs. SD (p = 0.004) and PR vs. PD (p = 0.003). The DCP ratio correlated significantly for PR vs. SD (p = 0.02). The optimal cutoff values for responders were 0.79 for the AFP ratio and 0.53 for the DCP ratio. Prediction using both or either cutoff value showed 93% sensitivity, 53% specificity, a 94% negative predictive value, and a 57% positive predictive value. Conclusion: Optimal cutoff values for AFP and DCP ratios enable prediction of nonresponders to HAIC with LFP. This simple and early assessment method allows the use of HAIC and molecular targeting drugs for HCC treatment.
Role of Brain Biomarkers S-100-Beta and Neuron-Specific Enolase for Detection and Follow-Up of Hepatic Encephalopathy in Cirrhosis before, during and after Treatment with L-Ornithine-L-Aspartate
Authors: Strebel Hendrik , Haller Bernhard , Sohn Maximilian , Schepp Wolfgang , Gundling Felix
Published: April 2020

Introduction: Hepatic encephalopathy (HE), in the context of liver cirrhosis, seems to result from low-grade cerebral edema of the astrocytes. Serum brain biomarkers S-100-beta und neuron-specific enolase (NSE) are often elevated in brain injury. We hypothesized that neuromarkers S-100-beta and NSE can be used in the diagnosis of HE, compared with standardized diagnostic tools. Material and Methods: A prospective non-randomized intervention study was performed using L-ornithine-L-aspartate (LOLA) for HE treatment. Primary endpoint was the evaluation of neuromarkers S-100-beta and NSE for detection and diagnosis of follow-up of HE. As secondary endpoints, the efficacy of LOLA on the course of HE and the diagnostic role of Portosystemic-Encephalopathy-Syndrome score (PHES) and critical flicker frequency (CFF) were analyzed. For diagnosis of covert (CHE) and overt (OHE) HE, West-Haven criteria (WHC), PHES and CFF were assessed at study entry. LOLA was applied (20 g i.v.) for 6 days. At the end of the study, HE evaluation was repeated. S-100-beta, NSE and ammonia were assessed in each patient before, during and after therapy with LOLA. Results: 30 patients were included. At study entry, CHE was diagnosed in 50% and OHE in 50% of all subjects. A total of 25 participants completed the study. After LOLA therapy, deterioration of HE occurred in <11%, while most patients showed improvement (e.g. improved CFF in 79%). No significant correlation with HE severity (as diagnosed by WHC, PHES and CFF) could be demonstrated for any biochemical parameter. In addition, there were no significant changes in brain biomarkers during the treatment period. Discussion: While CFF as well as PHES showed good correlation with treatment response, S-100-beta and NSE did not significantly correlate with HE severity compared to proven diagnostic methods, and do not seem reliable biochemical markers for the follow-up under therapy.
Genetic Testing for Diagnosis of Hypertrophic Cardiomyopathy Mimics
Authors: Hoss Sara , Habib Manhal , Silver Josh , Care Melanie , Chan Raymond H. , Hanneman Kate , Morel Chantal F. , Iwanochko Robert M. , Gollob Michael H. , Rakowski Harry , Adler Arnon
Published: April 2020

Background

Genetic testing is helpful for diagnosis of hypertrophic cardiomyopathy (HCM) mimics. Little data are available regarding the yield of such testing and its clinical impact.

Methods

The HCM genetic database at our center was used for identification of patients who underwent HCM-directed genetic testing including at least 1 gene associated with an HCM mimic (
GLA
,
TTR
,
PRKAG2
,
LAMP2
,
PTPN11
,
RAF1
, and
DES
). Charts were retrospectively reviewed and genetic and clinical data extracted.

Results

There were 1731 unrelated HCM patients who underwent genetic testing for at least 1 gene related to an HCM mimic. In 1.45% of cases, a pathogenic or likely pathogenic variant in one of these genes was identified. This included a yield of 1% for Fabry disease, 0.3% for familial amyloidosis, 0.15% for
PRKAG2
-related cardiomyopathy, and 1 patient with Noonan syndrome. In the majority of patients, diagnosis of the HCM mimic based on clinical findings alone would have been challenging. Accurate diagnosis of an HCM mimic led to change in management (eg, enzyme replacement therapy) or family screening in all cases.

Conclusions

Genetic testing is helpful in the diagnosis of HCM mimics in patients with no or few extracardiac manifestations. Adding these genes to all HCM genetic panels should be considered.