bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety and clinical outcomes of patients with acute coronary syndrome: a meta-analysis
Authors: Li Jie , Ji Feng , Song Junxian , Gao Xiangyang , Jiang Deguo , Chen Guangdong , Chen Suling , Lin Xiaodong , Zhuo Chuanjun
Published: July 2020

Objectives

Anxiety has been suggested to be associated with poor outcomes in patients with acute coronary syndrome (ACS). However, results of previous follow-up studies were inconsistent. The aim of this meta-analysis was to evaluate the association between anxiety and clinical outcomes in patients with ACS, and to investigate the potential role of depression underlying the above association.

Design

A meta-analysis of prospective follow-up studies.

Setting

Hospitals.

Participants

Patients with ACS.

Interventions

We included related prospective follow-up studies up through 20 July 2019 that were identified by searching PubMed and Embase databases. A random-effect model was used for the meta-analysis. Anxiety was evaluated by validated instruments at baseline.

Primary and secondary outcome measures

We determined the association between anxiety and risks of mortality and adverse cardiovascular events (MACEs) in patients with ACS.

Results

Our analysis included 17 studies involving 39 038 patients wqith ACS. Anxiety was independently associated with increased mortality risk (adjusted risk ratio (RR) 1.21, 95% CI 1.07 to 1.37, p=0.002) and MACEs (adjusted RR 1.47, 95% CI 1.24 to 1.74, p<0.001) in patients with ACS. Subgroup analyses showed that depression may at least partly confound the association between anxiety and poor outcomes in patients with ACS. Adjustment of depression significantly attenuated the association between anxiety and MACEs (adjusted RR 1.25, 95% CI 1.04 to 1.52, p=0.02). Moreover, anxiety was not significantly associated with mortality risk after adjusting for depression (adjusted RR 0.88, 95% CI 0.66 to 1.17, p=0.37).

Conclusions

Anxiety is associated with increased risk of mortality and MACEs in patients with ACS. However, at least part of the association may be confounded by concurrent depressive symptoms in these patients.
Stellar structure of quark stars in a modified Starobinsky gravity
Authors: Mathew Arun , Shafeeque Muhammed , Nandy Malay K.
Published: July 2020

We propose a form of gravity–matter interaction given by $$\omega RT$$ωRT in the framework of f(R, T) gravity and examine the effect of such interaction in spherically symmetric compact stars. Treating the gravity–matter coupling as a perturbative term on the background of Starobinsky gravity, we develop a perturbation theory for equilibrium configurations. For illustration, we take the case of quark stars and explore their various stellar properties. We find that the gravity–matter coupling causes an increase in the stable maximal mass which is relevant for recent observations on binary pulsars.
The minimal polynomials of powers of cycles in the ordinary representations of symmetric and alternating groups
Authors: Yang Nanying , Staroletov Alexey M.
Published: July 2020

Denote the alternating and symmetric groups of degree [Formula: see text] by [Formula: see text] and [Formula: see text], respectively. Consider a permutation [Formula: see text], all of whose nontrivial cycles are of the same length. We find the minimal polynomials of [Formula: see text] in the ordinary irreducible representations of [Formula: see text] and [Formula: see text].
Botanical and Traditional Uses and Phytochemical, Pharmacological, Pharmacokinetic, and Toxicological Characteristics of Ziziphi Spinosae Semen: A Review
Authors: He Su-Rong , Zhao Chong-Bo , Zhang Jing-Xia , Wang Jing , Wu Bo , Wu Chun-Jie
Published: July 2020

Ziziphi Spinosae Semen (ZS, the seeds of Ziziphus jujuba Mill. var. spinosa (Bunge) Hu ex H. F. Chou) is used as a traditional Chinese medicine referred to as Suan zao ren (酸枣仁). This paper aims to provide a systematic review of its traditional uses and its botanical, phytochemical, pharmacological, pharmacokinetic, and toxicological characteristics. The future development and research prospects for ZS have also been discussed in detail. To date, over 150 compounds have been identified in this plant, including terpenoids, alkaloids, flavonoids, fatty acids, volatile oils, polysaccharides, and others. Both extracts and purified compounds have excellent biological activities, especially sedative and hypnotic effects. Other effects include ameliorating effect of learning and memory, anti‐inflammation, antioxidation, blood pressure and lipid lowering, antiaging, and antitumor effects. Thus, this traditional Chinese medicine can be used to treat many diseases such as insomnia, forgetfulness, headaches, and dizziness. Although many of the traditional uses of ZS are well established, the relationship between structure and function still needs to be further studied. In order to better pave the way for research and the establishment of quality control standards for ZS, it will be very important to elucidate its pharmacological mechanisms of action and explore new clinical effects.
Signal Denoising Method Based on Improved Wavelet Threshold Function for Microchip Electrophoresis C4D Equipment
Authors: Tong Yaonan , Li Jingui , Xu Yaohui , Cao Lichen
Published: July 2020

A signal denoising method using improved wavelet threshold function is presented for microchip electrophoresis based on capacitively coupled contactless conductivity detection (ME-C4D) device. The evaluation results of denoising effect for the ME-C4D simulation signal show that using Daubechies 5 (db5) wavelet at a decomposition level 4 can produce the best performance. Furthermore, the denoising effect is compared with, as well as proved to be superior to, the existing techniques, such as Savitzky–Golay, Fast Fourier Transform, and soft threshold method. This method has been successfully applied to the self-developed ME-C4D equipment. After executing this method, the noise is cleanly removed, and the signal peak shape and peak area are well maintained.
Design of Low-Power Structural FIR Filter Using Data-Driven Clock Gating and Multibit Flip-Flops
Authors: Touil Lamjed , Hamdi Abdelaziz , Gassoumi Ismail , Mtibaa Abdellatif
Published: July 2020

Optimization for power is one of the most important design objectives in modern digital signal processing (DSP) applications. The digital finite duration impulse response (FIR) filter is considered to be one of the most essential components of DSP, and consequently a number of extensive works had been carried out by researchers on the power optimization of the filters. Data-driven clock gating (DDCG) and multibit flip-flops (MBFFs) are two low-power design methods that are used and often treated separately. The combination of these methods into a single algorithm enables further power saving of the FIR filter. The experimental results show that the proposed FIR filter achieves 25% and 22% power consumption reduction compared to that using the conventional design.
Downregulation of LUZP2 Is Correlated with Poor Prognosis of Low‐Grade Glioma
Authors: Li Yong , Deng Gang , Qi Yangzhi , Zhang Huikai , Jiang Hongxiang , Geng Rongxin , Ye Zhang , Liu Baohui , Chen Qianxue
Published: July 2020

Background. LUZP2 is a protein limitedly expressed in the brain and spinal cord, while there are few studies on it in brain tumors. Low‐grade glioma (LGG) is one of the most common brain tumors. However, the biological behavior of LGG is not very clear at present. This study was aimed at exploring the role of LUZP2 in LGG. Methods. By data mining in The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA), the expression, clinical characteristics, and potential regulatory mechanism of LUZP2 in LGG were assessed. The regulatory miRNAs of LUZP2 were predicted using miRDB, TargetScan, and miRTarBase. Meanwhile, the potential biological function of coexpressed genes was investigated by GO and KEGG analyses. Results. LUZP2 expression was downregulated with the increase of tumor grade (p < 0.05). Low LUZP2 expression independently predicted poor OS in LGG in TCGA cohort and the CGGA part B and part C cohorts (all p < 0.001). Additionally, LUZP2 was targeted by miR‐142‐5p according to 2 prediction databases and 1 validated database, which was negatively related to LUZP2 mRNA expression (p < 0.001). Kaplan‐Meier analyses demonstrated that low miR‐142‐5p expression was significantly associated with poor OS (p < 0.001). Furthermore, coexpression genes of LUZP2 were significantly involved in nervous system development and metabolic pathways.Conclusions. LUZP2 may be crucial for nervous system extracellular matrix development and serve as an important clinical biomarker for LGG patients. miR‐142‐5p upregulation could be the upstream regulator that contributed to LUZP2 downregulation.
Are Pediatric Triage Systems Reliable in the Emergency Department?
Authors: Ebrahimi Mohsen , Mirhaghi Amir , Najafi Zohre , Shafaee Hojjat , Hamechizfahm Roudi Mahin
Published: July 2020

Background. Few studies have focused on the agreement level of pediatric triage scales (PTSs). The aim of this meta-analytic review was to examine the level of inter-rater reliability of PTSs. Methods. Detailed searches of a number of electronic databases were performed up to 1 March 2019. Studies that reported sample sizes, reliability coefficients, and a comprehensive description of the assessment of the inter-rater reliability of PTSs were included. The articles were selected according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy. Two reviewers were involved in the study selection, quality assessment, and data extraction and performed the review process. The effect size was estimated by z-transformation of reliability coefficients. Data were pooled with random-effects models, and a metaregression analysis was performed based on the method of moments estimator. Results. Thirteen studies were included. The pooled coefficient for the level of agreement was 0.727 (confidence interval (CI) 95%: 0.650–0.790). The level of agreement on PTSs was substantial, with a value of 0.25 (95% CI: 0.202–0.297) for the Australasian Triage Scale (ATS), 0.571 (95% CI: 0.372–0.720) for the Canadian Triage and Acuity Scale (CTAS), 0.810 (95% CI: 0.711–0.877) for the Emergency Severity Index (ESI), and 0.755 (95% CI: 0.522–0.883) for the Manchester Triage System (MTS). Conclusions. Overall, the reliability of pediatric triage systems was substantial, and this level of agreement should be considered acceptable for triage in the pediatric emergency department. Further studies on the level of agreement of pediatric triage systems are needed.
Genome feature optimization and coronary artery disease prediction using cuckoo search
Authors: Neelima E. , Prasad Babu M.S.
Published: July 2020

CVD (Cardiovascular Diseases) is among the major health ailment issue leading to millions of deaths every year. CVDs are resulting as an outcome of implications in terms of environmental and the genetic factors that result in the CVD for individuals. Phenomenal advancements that has taken place in the diagnosis solutions like usage of genomic tools are contributing towards predicting and diagnosis of heart diseases more accurately. In recent past, analyzing gene expression data, particularly using machine learning strategies to predict and classify the given unlabeled gene expression record is a generous research issue. Concerning this, a substantial requirement is feature optimization, which is since the overall genes observed in human body are closely 25000 and among them 636 are cardio vascular related genes. Hence, it complexes the process of training the machine learning models using these entire cardio vascular gene features. Hence, this manuscript is using bidirectional pooled variance strategy of ANOVA standard to select optimal features. Along the side to surpass the constraint observed in traditional classifiers, which is unstable accuracy at k-fold cross validation, this manuscript proposed a classification strategy that build upon the swarm intelligence technique called cuckoo search. The experimental study indicating that the number of optimal features those selected by proposed model is substantially low that compared to the other contemporary model that selects features using Forward Feature Selection and classifies using SVM classifier (FFSSVM). The experimental study evinced that the proposed model, which selects feature by bidirectional pooled variance estimation and classifies using proposed classification strategy that build on cuckoo search (BPVECS) outperformed the selected contemporary model (FFSSVM).
ПРОМОЦІЯ ЗДОРОВ’Я ЧЕРЕЗ ПРИЗМУ ФОРМУВАННЯ САНОГЕННОГО МИСЛЕННЯ В МОЛОДІ
Authors: Hilman A. Yu.
Published: July 2020

Мета: з’ясувати роль формування саногенного мислення студентів у промоції здоров’я; проаналізувати результати фактурної структури особистісно-поведінкових детермінант, які визначають розвиток саногенного мислення студентської молоді.

Матеріали і методи. Теоретичні: аналіз, порівняння, систематизація даних психологічної, педагогічної літератури з проблем саногенного мислення; емпіричні: методика виявлення саногенного (патогенного) мислення у студентів вищих навчальних закладів за Л. Рубцовою; методика діагностики рівня розвитку рефлексивності А. Карпова; тест на визначення ригідності Н. Левітова; чотирьохмодальний емоційний опитувальник за Л. Рабінович; шкала психологічного благополуччя К. Ріфф; методика діагностики типу емоційної реакції на вплив стимулу навколишнього середовища за В. Бойко; тест смисложиттєвих орієнтацій Дж. Крамбо і Л. Махоліка; оцінка рівня задоволеності якістю життя за Н. Водоп’яновою; методика «Мотивація успіху і страх невдачі» (А. Реан); методика дослідження вольової саморегуляції А. Звєрькова та Є. Ейдмана; опитувальник оцінки нервово-психічної стійкості; «Дослідження тривожності» (опитувальник Ч. Спілбергера в адаптації Ю. Ханіна); шкала соціальної адаптації Т. Холмса і Р. Раге; методика визначення типу особистості «Опитувальник Дженкінса»; Гісенський опитувальник психосома­тич­них скарг; методи математико-статистичної обробки емпіричних даних: методи описової статистики, метод рангової кореляції Пірсона, критерій Кайзера.

Результати. За результатами дослідження саногенного мислення у студентської молоді (на вибірці 175 осіб) з’ясовано, що існує прямий кореляційний зв᾽язок саногенного мислення з мотивацією на досягнення успіху (rху=+0,71); з нервово-психічною стійкістю (rху=+0,69); з рефлексивністю (rху=+0,77); з наполегливістю (rху=+0,54); з самовладанням (rху=+0,49) та обернений кореляційний зв᾽язок саногенного мислення з ригідністю (rху=-0,65) і опірністю до стресу (rху=-0,76).

Висновки. Для формування саногенного мислення у студентської молоді варто формувати якості та властивості, які були визначені в результаті факторного аналізу, серед яких: наполегливість, рефлексивність, самовладання, висока опірність стресу, низька ригідність, емоційне переживання радості. Саногенне мислення має на меті управління своїми емоціями, воно зменшує внутрішній конфлікт, напруженість та може зміцнювати здоров’я в результаті рефлексивного аналізу проблемних ситуацій.
Early changes in bacterial communities in wound tissues of Pinus massoniana after inoculation with Bursaphelenchus xylophilus
Authors: Liu Jinyan , Wu Songqing , Hu Xia , Xie Wanfeng , Huang Xiuping , Liang Guanghong , Guo Dan , Wu Jieqin , Zhang Feiping
Published: July 2020

The bacterial communities in the wound tissues of Pinus massoniana were analysed by 16S rDNA amplicon sequencing. The results showed that the bacterial richness and diversity changed remarkably whether the wound was inoculated with pine wood nematode (PWN; Bursaphelenchus xylophilus) or not after 12 h. However, the predominant bacteria Stenotrophomonas, Burkholderiaceae, Pseudomonas, Serratia and Delftia, introduced by PWN in the wound tissues, changed within 6 h. After 6 h of PWN inoculation, the most abundant genus associating with PWN, Stenotrophomonas, failed to colonise the wound tissues, and the abundance of Delftia decreased, while the other representative bacteria, Burkholderiaceae, Pseudomonas and Serratia, from the PWN were markedly enriched. In addition, our study is the first to report the association of Serratia liquefaciens with PWN. Predicted functional analyses using the Tax4Fun tool showed that the alterations in bacterial composition also led to shifts in their functional pathways, especially after 12 h of PWN inoculation. These findings clarified that the bacteria carried by PWN were responsible for the alterations in bacterial communities in the wound tissues and will shed light on the invasion mechanism of PWN.
On Constructing Typologies of Young People’s Cosmopolitanism
Authors: Pronovost Gilles
Published: July 2020

This paper addresses a number of fundamental epistemological obstacles faced by researchers interested in studying young people’s cosmopolitanism, more specifically, the normative temptation and “first experience” obstacles. It goes on to tackle the inherent temporality of cosmopolitan behaviour, seeing how it is a fundamentally dynamic phenomenon that entails itineraries, trajectories and pathways through young people’s life cycles. As such, the text proposes six typical trajectories. In terms of temporalities: “the confirmed cosmopolitan,” “late starters,” “cosmopolitan and uncosmopolitan at the same time,” and “disengagement from cosmopolitanism”; in terms of moving through social space: “focusing on social space close to home,” “the ordinary tourist.”
Taxonomic contribution to the genus Zodarion Walckenaer, 1826 in Turkey with description of a new species (Araneae: Zodariidae)
Authors: DIMITROV DRAGOMIR
Published: July 2020

A new species of the genus Zodarion Walckenaer, 1826, Zodarion imroz spec. nov. is described based on a male from Gökçeada Island, Turkey. A new synonymy is established: Zodarion tireboluensis Danışman & Rubio, 2017 n. syn. = Zodarion abantense Wunderlich, 1980. New taxonomic images of the type specimens (male and female) of Z. abantense are given. Its distribution is summarized and discussed.
The impact of the analytical performance specifications of calcium and albumin on adjusted calcium
Authors: Jassam N , Thomas A , Hayden K , Dearman R , Barth JH
Published: July 2020

Aim

The generation of accurate, comparable results from traceable measurement procedures is a primary goal in harmonization efforts. In this study, the analytical performance of routine methods for calcium and albumin measurement is assessed to define the impact of the analytical bias of calcium and albumin on adjusted calcium equation performance and on reference intervals.

Method

In collaboration with the Wales External Quality Assurance Scheme, six months’ worth of anonymized data that cover a concentration range of clinical interest were collected. The data were grouped by analytical platforms/methods.

Results

Albumin BCG methods are positively biased (8%) to BCP methods. The overall bias for BCP methods ranges from 5.1 to –4.3% and the overall bias for BCG methods is from 2 to –6.7%. Bias for both methods is higher than the allowable minimal bias for albumin. Calcium concentrations for Roche Cobas CPC and NM-BAPTA, Beckman Arsenazo III, Abbott Architect Arsenazo III were within bias of 1.5 to –1%. However, Siemens calcium methods CPC and Arsenazo III appear to suffer from concentration-dependent bias ranging from +3 to –6%, which exceeds even the minimal allowable limits for calcium (1.3%). Adjusted calcium shows significant bias of 11%. Even with the exclusion of Siemens Advia, the scatter of adjusted calcium results exceeds that for total calcium.

Conclusion

This study shows wider than acceptable analytical variation for albumin and calcium. This variation may contribute to overall adjusted calcium equations variation and invalidate the application of a harmonized reference interval for calcium and albumin.
The Dynamic Relationship between Export, Import and Inflation: Empirical Evidence from India
Authors: Sahoo Malayaranjan , Sethi Narayan
Published: July 2020

This article aims to examine the relationship between inflation, export, import and foreign direct investment (FDI) in India from1975 to 2017. The study employed Johansen co-integration test to find out the long-run relationship among the variables and further variance decomposition analysis (VDA) and impulse response function (IRF) through vector autoregression (VAR) used to find out the dynamic relationship. Both VDA and IRF results indicate that export has positive or greater influence in inflation in India than other variables like import and FDI. The pair-wise granger causality approach finds that there is unidirectional causality running between exports and inflation and not vice versa, whereas inflation granger causes import. Toda Yamamoto causality also has shown similar result. Both the causality tests revealed that no causal relationships exist between inflation and FDI in India during the study period. As the exports of India have been continuously declining for past few years, the outcomes of this study are the true depiction of India’s economic situation. So, the government should provide a competitive environment and incentives to the local industry to produce at competitive prices to the international market.
Public Sector Reform and the Challenges of Open and Expansive Unionism in Zambia
Authors: Madimutsa Clever , Pretorius Leon G
Published: July 2020

This article analyses the challenges of open and expansive unionism in the era of public sector reform in Zambia. A sample of 20 former and current leaders of the Civil Servants and Allied Workers Union of Zambia was engaged in the research. The research reveals that trade unions in poor countries like Zambia are more vulnerable to the challenges of open and expansive unionism. These include inter-union conflict and lack of resources for union organising. Despite their vulnerability, these unions make strategic choices to deal with these challenges. Their strategies include networking and information gathering and sharing.
Criminal Justice Contacts and Psychophysiological Functioning in Early Adulthood: Health Inequality in the Carceral State
Authors: Boen Courtney E.
Published: July 2020

Despite increased attention to the links between the criminal justice system and health, how criminal justice contacts shape health and contribute to racial health disparities remains to be better understood. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 5,488) and several analytic techniques—including a quasi-treatment–control design, treatment-weighting procedures, and mediation analyses—this study examines how criminal justice contacts shape inflammatory and depressive risk and contribute to black–white health gaps. Findings revealed that incarceration is associated with increased C-reactive protein and depressive risk, particularly for individuals who experienced long durations of incarceration. Arrests are also associated with mental health, and mediation analyses showed that racial disparities in arrests and incarceration were drivers of black–white gaps in depressive symptoms. Together, this study provides new evidence of the role of the criminal justice system in shaping health and patterning black–white health gaps from adolescence through early adulthood.
What Matters to Formerly Incarcerated Men? Looking Beyond Recidivism as a Measure of Successful Reintegration
Authors: Andersen Tia S. , Scott Deena A. Isom , Boehme Hunter M. , King Sarah , Mikell Toniqua
Published: July 2020

This study explored how men recently released from prison conceptualized successful reentry. Qualitative analysis of 12 in-depth life history interviews with formerly incarcerated men revealed that they defined success beyond the literature’s typical focus on criminal behavior avoidance and future criminal justice system contact. The study found several interconnected definitions of success. Central to participants’ conceptions were connection to legitimate employment, ownership, or entrepreneurship, using past experiences to assist other former offenders or recovering addicts with their problems, and the achievement of heteronormative masculine expectations. The implications of these findings for future research and practice are discussed.
Sociocultural Sustainability and the Formation of Social Capital from Community-based Tourism
Authors: Zhang Yang , Xiong Yu , Lee Timothy J. , Ye Min , Nunkoo Robin
Published: July 2020

Favorable resident perceptions of the development of social capital resulting from hosting community-based tourism is an important issue for the Chinese authorities. This study aimed to develop and test a multidimensional scale to evaluate the perceived social impacts from tourism on social capital from sustainable community-based tourism in China. A questionnaire was distributed to host community residents (430) in Fanhe village, Guangdong Province. Analysis from this survey resulted in the development of a six-factor model incorporating 20 items in the six groups. This allowed the researchers to assess perceived social impacts on social capital: covering collective efficacy, community belonging, traditional social regulations, community cohesion, social networking, and community competence. The study reveals the multidimensional nature of perceived tourism social impacts on social capital in the Chinese tourism community and contributes to a better understanding of how residents view the social capital associated with community-based tourism as part of sustainable development.
Possible neuroprotective effects of rasagiline in Alzheimer’s disease: a SPECT study
Authors: Song In-Uk , Im Jooyeon Jamie , Jeong Hyeonseok , Na Seung-Hee , Chung Yong-An
Published: July 2020

Background

The current lack of effective treatments for Alzheimer’s disease (AD) and the rapidly increasing burden of the disease highlight the urgent need to find new treatments. Despite accumulating evidence of the beneficial effects of rasagiline in neurodegenerative diseases such as Parkinson’s disease, the effects of rasagiline on the brains of patients with AD have not been elucidated.

Purpose

To examine the effects of rasagiline on regional cerebral flow (rCBF) in patients with AD using single photon emission computed tomography (SPECT).

Material and Methods

Among 22 patients with AD, 11 patients received adjunctive rasagiline at 1 mg/day in conjunction with acetylcholinesterase inhibitors (AChEI); 11 patients were only treated with AChEI for about 1.6 years. All patients underwent brain technetium-99m hexamethylpropylene amine oxime SPECT scans and clinical assessments at baseline and follow-up visits. Annual percent changes in rCBF were compared between the groups in a voxel-wise manner.

Results

SPECT analysis revealed that the rasagiline-treated group showed more increased rCBF in the cingulate gyrus, inferior frontal gyrus, putamen, and thalamus compared to the comparison group ( P < 0.005).

Conclusion

We demonstrated that adjunctive rasagiline treatment may have beneficial effects on brain perfusion in patients with AD, suggesting potential neuroprotective effects.
Characteristics of and reference ranges for peripheral blood lymphocytes and CD4+ T cell subsets in healthy adults in Shanxi Province, North China
Authors: Xu Dan , Wu Yanyao , Gao Chong , Qin Yan , Zhao Xiangcong , Liang Zhaojun , Wang Yanlin , Feng Min , Zhang Chen , Liu Guangying , Luo Jing
Published: July 2020

Objective

To guide clinical decision making, race-, age- and gender-specific reference ranges for lymphocytes and CD4+ T-cell subsets are required.

Methods

Single platform flow cytometry to determine reference intervals for lymphocyte subpopulations and CD4+ T-cell subsets in 196 healthy Han Chinese adults.

Results

The frequencies and absolute numbers of B cells were slightly lower in Han Chinese individuals of the Shanxi region than in individuals from Hong Kong, Germany and Singapore, while percentages and absolute numbers of NK cells were slightly higher compared with individuals from Hong Kong. CD4+/CD8+ T-cell ratios, CD4+ T cell percentages and Th2 cell counts were higher, while frequencies and numbers of CD8+ T cells, numbers of NK cells and percentages of Th1 cells were lower, in females compared with males. CD4+ T cell percentages, CD4+/CD8+ T-cell ratios, numbers of CD8+ T cells and Treg cells, and Th17/Treg cell ratios differed by age.

Conclusion

We established lymphocyte and CD4+ T-cell subset reference intervals for healthy Han Chinese adults of the Shanxi region. Ethnicity, gender and age affected lymphocyte subset composition.
A Scalable Energy–Economy Model for State-Level Policy Analysis Applied to a Demand-Side Management Program
Authors: Wendling Zachary A. , Warren David C. , Rubin Barry M. , Carley Sanya , Richards Kenneth R.
Published: July 2020

Over the past two decades, states and cities implemented low-carbon energy development, renewable portfolio standards, demand-side management (DSM), renewable energy production incentives, green building requirements, regional carbon trading agreements, and other energy-based economic development initiatives. Yet the dearth of state-level and substate-level models makes it difficult to predict the effects of such actions. This article addresses this shortcoming by presenting the performance results of the new Indiana Scalable Economy and Energy Model (IN-SEEM)—a model utilizing a dynamic, simultaneous equations framework—and demonstrates the model’s capabilities with an analysis of electricity price increases from a DSM program in the state of Indiana. Overall performance of the model is strong, with high adjusted R2 values and low mean absolute percent errors for most of 30 endogenous variables. A DSM price increase analysis finds variation in impact across the state’s 10 major economic sectors and small changes in energy consumption.
Assessment of Glycemic Control in Veterans With Chronic Obstructive Pulmonary Disease and Type 2 Diabetes Mellitus on Inhaled Corticosteroid Therapy
Authors: Lempp Madison P. , Sigler Meredith A. , Adesoye Adebola A. , Ponnuru Anusha , Duval Courtney E.
Published: July 2020

Objective

To determine if the use of inhaled corticosteroid (ICS) therapy affects glycemic control in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM).

Background

Studies have shown mixed evidence on the association between ICS use and worsening glycemic control in patients with preexisting diabetes.

Methods

Data were recorded from electronic medical records of veteran patients aged 18 to 80 with COPD and T2DM on at least 2 oral antiglycemic medications from January 1, 2000, to December 31, 2017, at the Veterans Affairs (VA) North Texas Health Care System (VANTHCS). The primary outcome was the rate of A1c progression >10% at 12 months and 5 years.

Results

This study included 127 (64 in the ICS group and 63 in the non-ICS group) patients; baseline characteristics between groups were similar with the exception of age and tobacco use. No statistically significant difference was found between groups with regard to the primary outcome. More patients in the non-ICS group had antiglycemic medications initiated at 12 months ( P = .009) and 5 years ( P = .003) compared to the ICS group.

Conclusion

Inhaled corticosteroids did not negatively impact glycemic control among veterans with comorbid COPD and T2DM.
Intelligent fault prediction of rolling bearing based on gate recurrent unit and hybrid autoencoder
Authors: Che Changchang , Wang Huawei , Fu Qiang , Ni Xiaomei
Published: July 2020

Accurate fault prediction of rolling bearing can predict the operation condition in advance, which is an important means to ensure the safety and reliability of rotating machinery. Aimed at the data processing of rolling bearing vibration signal with multi-fault and long time series, an intelligent fault prediction model based on gate recurrent unit and hybrid autoencoder is proposed in this paper. Firstly, vibration signals of multi-faults are brought into multi-layer gate recurrent unit model for multi-step and multi-variable time series prediction. Secondly, variational autoencoder is used for data augmentation of fault samples. Thirdly, the augmented fault samples are brought into stacked denoising autoencoder for noise reduction and fault prediction. Finally, fault prediction results of rolling bearing can be achieved on the basis of gate recurrent unit and hybrid autoencoder of variational autoencoder and stacked denoising autoencoder. The bearing datasets of Case Western Reserve University are used to verify the effectiveness of the proposed method. Comparative experiment results show that the proposed fault prediction model has more accurate time series prediction result and higher fault prediction accuracy than other deep learning models. With 98.68% accuracy of fault prediction, the proposed fault prediction model can be taken as an effective tool for intelligent predictive maintenance of rolling bearing.
Equivalence Gain of the Global Financial Crisis: A Note
Authors: Lee Chui Ying , Kaneko Shinji , Yoshida Yuichiro , Hangcheng Sun , Ichihashi Masaru , Fukuda Katsufumi
Published: July 2020

By using the methodologies of Grinols (1984 , Journal of International Economics, 16[3–4], 271–293) and Grinols and Wong (1991 , Canadian Journal of Economics, 24[2], 428–449), we estimate the magnitudes of the welfare changes of China during the global financial crisis from 2007 to 2010. The results show that China’s welfare decreased in 2007, and the bursting of the housing bubble in the USA negatively affected China through international trade. However, the collapse of Lehman Brothers did not negatively affect China from 2008 to 2010. This may be because of the fiscal and monetary stimulus policies in the USA and China.

JEL: F00, F53, F62
Comparison of Web-Based and Paper Advance Directives: A Pilot Randomized Clinical Trial
Authors: Rolnick Joshua A. , Oredeko Francisca , Cooney-Zingman Elizabeth , Asch David A. , Halpern Scott D.
Published: July 2020

Background:

Digital tools to document care preferences in serious illnesses are increasingly common, but their impact is unknown. We developed a web-based advance directive (AD) featuring (1) modular content eliciting detailed care preferences, (2) the ability to electronically transmit ADs to the electronic health record (EHR), and (3) use of nudges to promote document transmission and sharing.

Objective:

To compare a web-based, EHR-transmissible AD to a paper AD.

Methods:

Patients with gastrointestinal and lung malignancies were randomized to the web or paper AD. The primary outcome was the proportion of patients with newly documented advance care plans in the EHR at 8 weeks. Secondary outcomes assessed through an e-mail survey included the change in satisfaction with end-of-life plans, AD acceptability, and self-reported sharing with a surrogate.

Results:

Ninety-one participants were enrolled: 46 randomly allocated to the web AD and 45 to paper. Thirteen patients assigned to web AD (28%) had new documentation versus 7 (16%) assigned to paper ( P = .14). Adjusted for demographic factors and primary diagnosis, the odds ratio of new documentation with web AD was 3.7 (95% CI: 0.8-17.0, P = .10). Satisfaction with advance care planning and AD acceptability were high in both groups and not significantly different. Among patients completing web ADs, 79% reported sharing plans with their caregivers, compared with 65% of those completing paper ADs ( P = .40).

Conclusion:

Web-based ADs hold promise for promoting documentation and sharing of preferences, but larger studies are needed to quantify effects on these intermediate end points and on patient-centered outcomes.
Managing Access by Generating Improvements in Cannulation: A national quality improvement project
Authors: Fielding Catherine Ann , Oliver Scott William , Swain Alison , Gagen Alayne , Kattenhorn Sarah , Waters Dan , Graham Maureen , Gallagher Hugh , Kumwenda Mick John , Aitken Margaret
Published: July 2020

Cannulation is essential for haemodialysis with arteriovenous access, but also damages the arteriovenous access making it prone to failure, is associated with complications and affects patients’ experiences of haemodialysis. Managing Access by Generating Improvements in Cannulation is a national UK quality improvement project, designed to improve cannulation practice in the United Kingdom, ensuring it reflects current needling recommendations. It uses a simple quality improvement method, the Model for Improvement, to structure improvement to cannulation practice. It assists units in the practical implementation of the British Renal Society and Vascular Access Society of Britain and Ireland needling recommendations, ensuring actual cannulation practice reflects what is defined as best practice in cannulation. An eLearning package and awareness materials have been developed, to assist units in changing their cannulation practice. The Kidney Quality Improvement Partnership provides a structure for Managing Access by Generating Improvements in Cannulation that promotes development and dissemination. It is hoped that Managing Access by Generating Improvements in Cannulation will raise an understanding about the cannulation of arteriovenous access and change behaviours and beliefs around correct cannulation practice, to ensure longevity of this lifeline.
Catheter-related bloodstream infections in a nephrology unit: Analysis of patient- and catheter-associated risk factors
Authors: Zanoni Francesca , Pavone Laura , Binda Valentina , Tripepi Giovanni , D’Arrigo Graziella , Scalamogna Antonio , Messa Piergiorgio
Published: July 2020

Background:

Central venous catheter use is rising in chronic and acute hemodialysis. Catheter-related bloodstream infections are a major complication of central venous catheter use. This article examines clinical factors associated with catheter-related bloodstream infections incidence.

Methods:

In this retrospective, single-center study, 413 patients undergoing extracorporeal treatments between 1 February 2014 and 31 January 2017 with 560 central venous catheters were recruited. Clinical parameters, such as gender, age, kidney disease status, diabetes, immunosuppression, and vintage dialysis, were collected at study entry. An incidence rate ratio (95% confidence interval) was calculated to assess the association between catheter-related bloodstream infections incidence rate and each clinical variable/central venous catheter type. Significant associations at the univariate analyses were investigated with multivariate Cox models.

Results:

During a cumulative time of 66,686 catheter-days, 54 catheter-related bloodstream infections (incidence rate: 0.81) events occurred. Gram negative bacteria were more frequent in patients with age < 80 years (16 (36%) vs. 0, p = 0.02). At the univariate analyses, male sex (incidence rate ratio: 1.9 (1.1–3.5), p = 0.03), age < 80 years (incidence rate ratio: 2.4 (1.1–5.5), p = 0.016) and acute kidney injury (incidence rate ratio: 5.6 (3.1–10), p < 0.0001) were associated with higher catheter-related bloodstream infections incidence rate. Compared with tunneled jugular central venous catheter, higher catheter-related bloodstream infections incidence rate was associated with non-tunneled jugular (incidence rate ratio: 6.45 (2.99–13.56), p < 0.0001) and non-tunneled femoral (incidence rate ratio: 12.90 (5.87–27.61), p < 0.0001) central venous catheter use; tunneled femoral central venous catheter was associated with higher non-significant incidence rate (incidence rate ratio: 2.45 (0.93–5.85), p = 0.07). The multivariate analyses showed that acute kidney injury (hazard ratio: 3.03 (1.38–6.67), p = 0.006), non-tunneled (hazard ratio: 3.11 (1.30–7.41), p = 0.01) and femoral (hazard ratio: 2.63 (1.36–5.07), p = 0.004) central venous catheter were associated with higher catheter-related bloodstream infections incidence rate.

Conclusion:

Central venous catheter characteristics and acute kidney injury are independently associated with higher catheter-related bloodstream infections rate.
Patients’ and clinicians’ experiences of the DSM-5 Cultural Formulation Interview: A mixed method study in a Swedish outpatient setting
Authors: Wallin Malin Idar , Dahlin Marie , Nevonen Lauri , Bäärnhielm Sofie
Published: July 2020

This study is an evaluation of clinicians’ and patients’ experiences of the core Cultural Formulation Interview (CFI) in DSM-5. The CFI provides a framework for gathering culturally relevant information, but its final form has not been sufficiently evaluated. Aims were to assess the Clinical Utility (CU), Feasibility (F) and Acceptability (A) of the CFI for clinicians and patients, and to explore clinicians’ experiences of using the CFI in a multicultural clinical setting in Sweden. A mixed-method design was applied, using the CFI Debriefing Instrument for Clinicians ( N = 15) and a revised version of the Debriefing Instrument for Patients ( N = 114) (DIC and DIP, scored from −2 to 2). Focus group interviews were conducted with clinicians. For patients (response rate 50%), the CU mean was 0.98 ( SD = 0.93) and F mean 1.07 ( SD = 0.83). Overall rating of the interview was 8.30 ( SD = 1.75) on a scale from 0 and 10. For clinicians (response rate 94%), the CU mean was 1.14 ( SD = 0.52), F 0.58 ( SD = 0.93) and A 1.42 ( SD = 0.44). From clinician focus-group interviews, the following themes were identified: approaching the patient and the problem in a new manner; co-creating rapport and understanding; and affecting clinical reasoning and assessment. Patients and clinicians found the CFI in DSM-5 to be a feasible, acceptable, and clinically useful assessment tool. The focus group interviews suggested that using the CFI at initial contact can help make psychiatric assessment patient-centred by facilitating patients’ illness narratives. We argue for further refinements of the CFI.
PSP-FTD Complex: A Possible Variant of PSP
Authors: Pradhan Sunil , Tandon Ruchika
Published: July 2020

Introduction:

This study tried to find out type of lobar features found in patients with progressive supranuclear palsy (PSP) and whether they differ from those of frontotemporal dementia (FTD) as both of these are tauopathies.

Methods:

We studied lobar functions of 45 patients with PSP.

Results:

Five (11.1%) patients had no lobar feature; 11 (24.4%) had PSP-like features like apathy, frontal release signs, impaired motor Luria written sequences, and fist-edge-palm test; and 29 (64.4%) patients had FTD-like lobar features like disinhibition, poor naming, and word finding difficulty. Among features resembling FTD, behavioural variant type occurred in 31.1%, primary progressive aphasia type occurred in 58.6%, 3.4% patients had semantic dementia type features, and 6.9% were unclassified.

Conclusions:

Hence, patients with PSP with lobar features may fall in the middle of PSP-FTD spectrum with frontal lobe features typical of PSP (PSP-frontal like) and those with frontal lobe features resembling FTD (PSP-FTD complex) in between.
Preoperative education improves the preparedness for extubation at emergence from general anaesthesia!
Authors: Sameen Zaka , Talib Khan , Wani Shaqul Q , Ashraf Muntasir , Nengroo Showkat H
Published: July 2020

Background

Preoperative patient education is an essential responsibility of any healthcare provider, especially an anaesthetist, and is beneficial for perioperative outcome. A smooth emergence and extubation is a clinical skill that needs to be mastered by an anaesthetist. The aim of this study was to analyse whether a detailed preoperative patient education improves the quality of and preparedness for extubation at emergence from general anaesthesia.

Methods

One hundred patients were randomly assigned to two groups. The study group received a detailed preoperative patient education and counselling about the mode of anaesthesia, extubation process and their expected response at extubation while the control group received the routine counselling. The Extubation Quality Scale at emergence and the recovery profile in the post anaesthesia care unit were assessed for both groups.

Results

The primary outcome was a better quality of extubation in the patients who received a detailed preoperative patient education. The Extubation Quality Scale was found to be better for patients in the study group (p < 0.001). The endotracheal tube tolerance at a minimum alveolar concentration of ≤0.2 and response to verbal commands at extubation were better for the study group (p < 0.05) besides an earlier discharge from post anaesthesia care unit (p < 0.005).

Conclusion

Preoperative patient education improves the patients’ preparedness for and quality of extubation and recovery from general anaesthesia.
Radiographic parameters associated with excellent versus poor range of motion outcomes following reverse shoulder arthroplasty
Authors: Haidamous Georges , Lädermann Alexandre , Hartzler Robert U , Parsons Bradford O , Lederman Evan S , Tokish John M , Denard Patrick J
Published: July 2020

Background

The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion.

Methods

A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent ( n = 42), defined as forward flexion >140° and external rotation > 30°, or poor ( n = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups.

Results

A larger glenosphere size was associated with an excellent outcome ( p = 0.009). A 2-mm posterior offset humeral cup ( p = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; p = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome. Conclusion: Larger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty.

Level of Evidence

Level 3, retrospective comparative study.
Visual Cues to the Hidden Agenda: Investigating the Effects of Ideology-Related Visual Subtle Backdrop Cues in Political Communication
Authors: Dan Viorela , Arendt Florian
Published: July 2020

Politicians’ reticence to communicate their views clearly increases the information asymmetry between them and the electorate. This study tested the potential of subtle ideological cues to redress the balance. By spotlighting visual rather than the already much-examined verbal cues, we sought to contribute to building theory on cue effects. Specifically, we aimed to determine whether the effects from the literature on verbal cues could also be shown for visual ones. We used an experiment ( N = 361) to test the effects of subtle backdrop cues (SBCs), that is, of visual cues to ideology embedded in the background of political images. We manipulated photos of a fictitious politician to include liberal or conservative SBCs. We embedded these images in Twitter posts and tested whether they influenced perceptions of the politician’s ideology and the intention to vote for him. We analyzed the relationship between exposure to SBCs, the politician’s perceived political ideology, and voting intention—including the study of conditional effects elicited by cue awareness and ideological consistency between the depicted politician and participant. The conditional process analysis suggested that SBCs mattered, as they influenced citizens’ perceptions of a politician’s political ideology, and consequently, voting intention. These effects were moderated by cue awareness and ideological consistency. We concluded that SBCs can elicit substantial effects and that their use by politicians is paying off.