bluuebunny/crossref_metadata_2025 huggingface dataset:
Alternaria induces airway epithelial cytokine expression independent of protease‐activated receptor
Authors: Daines Michael , Zhu Lingxiang , Pereira Rhea , Zhou Xu , Bondy Cheryl , Pryor Barry M. , Zhou Jin , Chen Yin
Published: August 2019

Background and objective

A novel fungal allergen, Alternaria (Alt), has been previously shown to associate with the pathogenesis of allergic rhinitis and bronchial asthma, particularly in arid and semi‐arid regions. Airway epithelial cells are among the first to encounter Alt, and epithelial cytokine production and subsequent airway inflammation are early events in the response to Alt exposure. However, the underlying mechanism is unclear. As protease‐activated receptor 2 (PAR2) has been implicated in most of the Alt‐induced biological events, we investigated the regulation of airway inflammation and epithelial cytokine expression by PAR2.

Methods

Wild‐type (WT) and Par2 knockout (Par2‐KO) mice were used to evaluate the in vivo role of PAR2. Primary human and mouse airway epithelial cells were used to examine the mechanistic basis of epithelial cytokine regulation in vitro.

Results

Surprisingly, Par2 deficiency had no negative impact on the change of lung function, inflammation and cytokine production in the mouse model of Alt‐induced asthma. Alt‐induced cytokine production in murine airway epithelial cells from Par2‐KO mice was not significantly different from the WT cells. Consistently, PAR2 knockdown in human cells also had no effect on cytokine expression. In contrast, the cytokine expressions induced by synthetic PAR2 agonist or other asthma‐related allergens (e.g. cockroach extracts) were indeed mediated via a PAR2‐dependent mechanism. Finally, we found that EGFR pathway was responsible for Alt‐induced epithelial cytokine expression.

Conclusion

The activation of EGFR, but not PAR2, was likely to drive the airway inflammation and epithelial cytokine production induced by Alt.
Acute and sustained effects of a periodized carbohydrate intake using the sleep‐low model in endurance‐trained males
Authors: Riis Simon , Møller Andreas Buch , Dollerup Ole , Høffner Line , Jessen Niels , Madsen Klavs
Published: August 2019

Repeated periodization of carbohydrate (CHO) intake using a diet‐exercise strategy called the sleep‐low model can potentially induce mitochondrial biogenesis and improve endurance performance in endurance‐trained individuals. However, more studies are needed to confirm the performance‐related effects and to investigate the sustained effects on maximal fat oxidation (MFO) rate and proteins involved in intramuscular lipid metabolism. Thirteen endurance‐trained males (age 23‐44 years; O2‐max, 63.9 ± 4.6 mL·kg−1·min−1) were randomized into two groups: sleep‐low (LOW‐CHO) or high CHO availability (HIGH‐CHO) in three weekly training blocks over 4 weeks. The acute metabolic response was investigated during 60 minutes of exercise within the last 3 weeks of the intervention. Pre‐ and post‐intervention, 30‐minute time‐trial performance was investigated after a 90‐minute pre‐load, which as a novel approach included nine intense intervals (and estimation of MFO). Additionally, muscle biopsies (v. lateralis) were obtained to investigate expression of proteins involved in intramuscular lipid metabolism using Western blotting. During acute exercise, average fat oxidation rate was ~36% higher in LOW‐CHO compared to HIGH‐CHO (P = .03). This did not translate into sustained effects on MFO. Time‐trial performance increased equally in both groups (overall time effect: P = .005). We observed no effect on intramuscular proteins involved in lipolysis (ATGL, G0S2, CGI‐58, HSL) or fatty acid transport and β‐oxidation (CD‐36 and HAD, respectively). In conclusion, the sleep‐low model did not induce sustained effects on MFO, endurance performance, or proteins involved in intramuscular lipid metabolism when compared to HIGH‐CHO. Our study therefore questions the transferability of acute effects of the sleep‐low model to superior sustained adaptations.
Imagination and Knowledge in the Metaphorology of Paul Ricœur
Authors: Travaglini Graziella
Published: August 2019

This article seeks to examine Ricœur's reflection on metaphor through an intertextual reading. This reading relates The Rule of Metaphor (1975) with lines of thought developed in a series of lectures held at the Centre de recherches phénoménologiques in Paris, from 1973–1974, on the theme From Language to Image, and an essay which appeared in 1978, “The Metaphorical Process as Cognition, Imagination and Feeling”. This work starts with an analysis of Ricœur's interpretation of the Aristotelian theory of metaphor, a theory which the French philosopher principally develops in The Rule of Metaphor. In the other two papers, Ricœur develops his metaphorology through a dialogue with Kant and he reformulates in linguistic terms the doctrine of productive imagination and transcendental schematism, which become the ontological sphere on which metaphorical and narrative activity are founded. Through the long journey of language, Ricœur's hermeneutics builds a bridge between Aristotle and Kant. This article examines this link to understand and explain further, also at the epistemological level, the relationship between metaphor and narrative.
The roles of light and pericarp on seed dormancy and germination in feral Raphanus sativus (Brassicaceae)
Authors: Vercellino R B , Pandolfo C E , Cerrota A , Cantamutto M , Presotto A
Published: August 2019

The timing of seed germination may determine the success of a weed species in an agroecosystem, and its expression is modulated by environmental conditions, but also by seed physiology and anatomy. The aims of this study were to investigate the roles of light, pericarp, dry storage and cold stratification on seed dormancy and germination in feral radish, a troublesome agricultural weed in temperate zones of the Americas that reduces crop yields. To this end, we used isolated intact pods and extracted seeds to test germination over time under contrasting temperature, light and storage conditions. Here, we showed that fresh seeds were non‐dormant, but that light and the presence of the pericarp reduced germination, especially under low temperatures. The pericarp reduced the final water content absorbed by seeds inside pods and decreased absorption/dehydration rates. The pericarp showed several small lignified cell layers in the endocarp, and x‐ray images displayed the lack of space between the partially embedded seed and the endocarp. Dry storage and cold stratification were ineffective in breaking the dormancy imposed by the pericarp. The apparent requirement for darkness and the mechanical restriction of the pericarp may have the potential to induce dormancy, spreading the timing of seed germination over a more extended period and hindering the control of feral radish.
A NEW METHODOLOGY FOR CHRISTIAN SYSTEMATIC THEOLOGY
Authors: Bracken Joseph A.
Published: August 2019

Science and religion are the two strongest influences on the conduct of human life, yet their respective truth claims frequently clash. To facilitate better communication between scientists and theologians on these rival truth claims, the author recommends that Christian theologians use the language and current methodology of science as far as possible so as to present the content of Church teaching in an idiom that would be intelligible not only to scientists but to the educated public as well. In this way, the rival truth claims might complement rather than compete with one another. That is, clothed in the language of science, the truth claims of religion would gain in rational coherence and intelligibility. Natural scientists in turn would have conversation partners better able to deal with philosophical and ethical issues arising out of new scientific discoveries.
LIMITATIONS ON THE SCIENTIFIC STUDY OF DRUG‐ENABLED MYSTICAL EXPERIENCES
Authors: Jones Richard H.
Published: August 2019

Scientific interest in drug‐induced mystical experiences reemerged in the 1990s. This warrants reexamining the philosophical issues surrounding such studies: Do psychedelic drugs cause mystical experiences? Are drug‐induced experiences the same in nature as other mystical experiences? Does the fact that mystical experiences can be induced by drugs invalidate or validate mystical cognitive claims? Those questions will be examined here. An overview of the scientific examination of drug‐induced mystical experiences is included, as is a brief overview of the history of the use of psychedelic drugs in religion.
Thermal decomposition kinetics of a coumarin based copolymer: Poly(3-benzoyl coumarin-7-yl-methacrylate:0.54-co-methyl methacrylate:0.46)
Authors: Kurt Adnan , Ayhan Ahmet Faruk , Koca Murat
Published: August 2019

In present study, thermal decomposition studies of a copolymer based the coumarin containing monomer 3-benzoyl coumarin-7-yl-methacrylate (BCMA) and methyl methacrylate [poly(BCMA:0.54-co-MMA:0.46)] were performed by thermogravimetric analysis (TGA). The temperature for maximum rate losses was increased from 384.81 °C to 407.45 °C with the increasing in heating rate from 5 °C/min to 20°C/min. The thermal decomposition activation energies of copolymer in the conversion range of 9% - 21% were resulted to be 212.98 kJ/mol and 210.30 kJ/mol by Kissinger’s and Flynn–Wall–Ozawa methods, respectively. The study of kinetic equations such as Coats-Redfern, Tang, Madhusudanan and Van-Krevelen methods exhibited that the thermal decomposition process of the studied copolymer was followed with a D3 mechanism, a three-dimensional diffusion type deceleration solid state mechanism, at the optimum heating rate of 20 °C/min.
An improved cost estimation for unit commitment using back propagation algorithm
Authors: Atiyha Baqer Turki , Aljabbar Salahaldain , Ali Ammar , Jaber Abdullah
Published: August 2019

The daily load is the main issue for many power plant industries that are affected by the varying maximum and minimum peak hours. Due to electricity being used less during the weekends, compared to weekdays, where the spending is higher. The same logic applies to day and night spending, which requires balancing among the units so that it can operate during high demand hours. The main problem is to determine the units that will be affected according to the operation schedule which means which unit, and for how long, will it stay on or off. In this context, the main objective for unit commitment, in general, minimizes the total cost of operating a unit, and at the same time maintain the constraints met. Several approaches and techniques used in existing studied, each have a solution for the optimal unit commitment problem. Some of the approaches presented, use complex methods in order to address the issues, while others use simple forms to do the same task. The problem of operation scheduling for unit commitment will be different depending on the type of industry, and according to the plan of mixing unit and operating constraints.
Hydrolysis of microcrystalline cellulose isolated from waste seeds of Leucaena leucocephala for glucose production
Authors: Husin Maryam , Rahim Nurnadiah , Ahmad Mohd Radzi , Romli Ahmad Zafir , Ilham Zul
Published: August 2019

The waste seeds of Leucaena leucocephala (LLS) used in this study were unused residues obtained after oil and polysaccharides extraction. The microcrystalline cellulose (MCC) was isolated from LLS by acid treatment. MCC produced was, then, further converted to glucose by using sulphuric acid at 121 °C by varying the acid concentration and reaction time. The sugar composition was analyzed by using the phenol-sulfuric acid method and pre-column derivatization HPLC technique. The yield of glucose ranging from 70–85% could be obtained from MCC hydrolyzates, depending on the hydrolysis factors, which corresponding to around 57-75% of the percentage conversion of MCC to glucose.Cellulose isolated from LLS was, therefore, potentially suitable to be utilized in liquid biofuels and other value-added chemicals such as bioethanol, 5-hydroxymethylfurfural(HMF), and levulinic acid.
The usage of deep learning algorithm in medical diagnostic of breast cancer
Authors: Parikesit Arli Aditya , Ramanto Kevin Nathanael
Published: August 2019

Diagnosis is a crucial step to identify the disease that experienced by the patient. Diagnosis includes information gathering, integration, and interpretation. However, diagnosis process is not an easy task. Diagnostic accuracy is depending on the experience and cognitive ability of diagnosticians. The new algorithm called deep learning that is developed by simulating the human visual mechanism has been implemented in medical diagnostics. One of the diseases that can be diagnosed by using deep learning algorithm is the breast cancer. Several studies showed that deep learning algorithm can be used for detecting and classifying lesions, detecting mitosis, and predicting specific gene status.  In this review article, 16 research journals were reviewed and discussed. The limitations of each algorithm are provided. All of the journals showed that deep learning algorithm has high diagnostics accuracy in assisting the professional diagnosticians to determine diagnosis outcome accordingly.
An effect of physical exercise-induced fatigue on the vital sign parameters: A preliminary study
Authors: Ahmad Zulkifli , Jamaludin Mohd Najeb , Soeed Kamaruzaman
Published: August 2019

Vital sign monitoring is an important body measurement to identify health condition and diagnose any disease and illness. In sports, physical exercise will contribute to the changes of the physiological systems, specifically for the vital signs. Therefore, the objective of this study was to determine the effect of physical fatigue exercise on the vital sign parameters. This is significant for the fitness identification and prediction of each individual when performing an exercise. Five male subjects with no history of injuries and random BMI were selected from students of biomedical engineering, Universiti Teknologi Malaysia. Based on the relationship between physical movement and physiology, the parameters considered were heart rate, blood pressure, and body temperature. Subjects were required to run on the treadmill at an initial speed of 4 km/h with an increase of 1 km/h at every 2 minutes interval. The effect of exercise was marked according to the fatigue protocol where the subject was induced to the maximum condition of performance. All parameters were measured twice, for pre and post exercise-induced protocol. The analysis of relationship of each parameter between pre and post fatigue was p<0.05. The results revealed that the heart rate and gap between blood pressure’s systolic and diastolic were greater for all categories except underweight, where the systolic blood pressure dropped to below 100mmHg at the end of exercise. Also, the body temperature was slightly declined to balance the thermoregulatory system with sweating. Hence, the vigorous physical movement could contribute to the active physiological system based on body metabolism. Heart rate and blood pressure presented significant effects from the fatiguing exercise whereas the body temperature did not indicate any distinguishable impact. The results presented might act as the basis of reference for physical exercise by monitoring the vital sign parameters.
Biosynthesis of copper(II) oxide nanoparticles using Murayya koeniggi aqueous leaf extract and its catalytic activity in 4-nitrophenol reduction
Authors: Shamsuddin Mustaffa , Raja Nordin Nurulhuda
Published: August 2019

Copper(II) oxide nanoparticles (CuO NPs) has a wide range of applications as catalysts. The natural abundance of copper and its relatively low cost make it a viable alternative to catalysts made from expensive precious metals such as platinum and palladium. In this study, a rapid, simple and green method was developed for the synthesis of CuO NPs using an aqueous extract of Murayya koenigii leaves. Several parameters were optimized, namely, the volume of leaf extract, pH, reaction temperature and reaction time. The optimum condition for the biosynthesis was obtained by using 3 mL of leaf extract; 10 mL of 5 mM CuSO, at pH 11, at room temperature.  The biosynthesis was completed within 50 minutes. The synthesized CuO NPs were characterized using Ultraviolet-visible Spectroscopy (UV-Vis), Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), and Transmission Electron Microscope (TEM) analyses. The UV-Vis absorption spectra confirmed the formation of CuO NPs with characteristic peak at 634 nm. The FTIR spectroscopic analysis of the biosynthesized CuO NPs confirmed the surface adsorption of the bioactive components in the leaf extract that acted as the reducing agent and stabilizing agent for the metal nanoparticles. XRD analysis showed a series of diffraction peaks at 2θ of 32.5°, 35.5°, 38.6°, 48.8°, 53.4°, 58.1°, 61.5°, 66.3°, 68.0°, 72.4° and 75.0°, corresponding to (110), (002), (111), (202), (020), (202), (113), (311), (220), (311) and (222) respectively. From TEM images, CuO NPs were of spherical shape with a mean diameter of 8.4 nm. The biosynthesized CuO NPs demonstrated good catalytic activities on the reduction 4-nitrophenol (4-NP) to 4-aminophenol (4-AP) in the presence of sodium borohydride, NaBH4 and can be reused three times without significant decrease in the catalytic activities
The Politics of the Beast: Rewiring Revelation 17
Authors: Strømmen Hannah M.
Published: August 2019

Revelation’s Whore of Babylon and the hybrid animal upon which she rides provide a female-beastly assemblage against which is constructed the good sovereignty of the Lamb. Derrida’s thinking of animality and sovereignty indicates how the human political realm carves out its sovereign position in relation to the category “animal” and in reliance on a “reason of the strongest.” It is demonstrated that Revelation’s construction of a good and innocent sovereign Lamb—via contrast with the Whore-and-Beast—collapses due to the complexities of the two rival animalities. The importance of such a reading lies in the necessity to destabilise facile connotations and connections between animals and an “other” beastliness that must be violently conquered.
Aeroacoustic source characterization in a physical model of phonation
Authors: McPhail Michael J. , Campo Elizabeth T. , Krane Michael H.
Published: August 2019

This paper presents measurements conducted in a physical model of the adult human airway. The goals of this work are to (1) benchmark the physical model to excised larynx models in the literature and (2) empirically demonstrate the relationship between vocal fold drag and sound production. Results from the airway model are first benchmarked to published time-averaged behavior of excised larynx models. The airway model in this work exhibited higher glottal volume flow, lower glottal resistance, and less fundamental frequency variation than excised larynx models. Next, concurrent measurements of source behavior and radiated sound were compared. Unsteady transglottal pressure (a surrogate measure for vocal fold drag) and radiated sound, measured at the mouth, showed good correlation. In particular, the standard deviation and the ratio of the power of the first and second harmonics of the transglottal and mouth pressures were strongly correlated. This empirical result supports the assertion that vocal fold drag is the principal source of sound in phonation.
CRISPR/Cas9-Assisted Seamless Genome Editing in Lactobacillus plantarum and Its Application in
N
-Acetylglucosamine Production
Authors: Zhou Ding , Jiang Zhennan , Pang Qingxiao , Zhu Yuan , Wang Qian , Qi Qingsheng
Published: August 2019

CRISPR/Cas9-assisted recombineering is restricted in lactic acid bacteria because of the lack of available antibiotics and vectors. In this study, a seamless genome editing method was carried out in
Lactobacillus plantarum
using CRISPR/Cas9-assisted double-stranded DNA (dsDNA) and single-stranded DNA (ssDNA) recombineering, and recombination efficiency was effectively improved by endogenous adenine-specific methyltransferase overexpression.
L. plantarum
WCFS1 produced 797.3 mg/liter
N
-acetylglucosamine (GlcNAc) through reinforcement of the GlcNAc pathway, without introducing exogenous genes or plasmids. This seamless editing strategy, combined with the potential exogenous GlcNAc-producing pathway, makes this strain an attractive candidate for industrial use in the future.
Long Noncoding RNA Lnc-MxA Inhibits Beta Interferon Transcription by Forming RNA-DNA Triplexes at Its Promoter
Authors: Li Xinda , Guo Guijie , Lu Min , Chai Wenjia , Li Yucen , Tong Xiaomei , Li Jing , Jia Xiaojuan , Liu Wenjun , Qi Dandan , Ye Xin
Published: August 2019

IAV can be recognized as a nonself molecular pattern by host immune systems and can cause immune responses. However, the intense immune response induced by influenza virus, known as a “cytokine storm,” can also cause widespread tissue damage (X. Z. J. Guo and P. G. Thomas, Semin Immunopathol 39:541–550, 2017,
https://doi.org/10.1007/s00281-017-0636-y
; S. Yokota, Nihon Rinsho 61:1953–1958, 2003; I. A. Clark, Immunol Cell Biol 85:271–273, 2007). Meanwhile, the detailed mechanisms involved in the balancing of immune responses in host cells are not well understood. Our studies reveal that, as an IFN-inducible gene, lnc-MxA functions as a negative regulator of the antiviral immune response. We uncovered the mechanism by which lnc-MxA inhibits the activation of IFN-β transcription. Our findings demonstrate that, as an ISG, lnc-MxA plays an important role in the negative-feedback loop involved in maintaining immune homeostasis.
Monoclonal Antibody Responses after Recombinant Hemagglutinin Vaccine versus Subunit Inactivated Influenza Virus Vaccine: a Comparative Study
Authors: Henry Carole , Palm Anna-Karin E. , Utset Henry A. , Huang Min , Ho Irvin Y. , Zheng Nai-Ying , Fitzgerald Theresa , Neu Karlynn E. , Chen Yao-Qing , Krammer Florian , Treanor John J. , Sant Andrea J. , Topham David J. , Wilson Patrick C.
Published: August 2019

There are ongoing efforts to increase the efficacy of influenza vaccines and to promote production strategies that can rapidly respond to newly emerging viruses. It is important to understand if current alternative seasonal vaccines, such as Flublok and Flucelvax, that use alternate production strategies can induce protective influenza-specific antibodies and to evaluate what type of epitopes are targeted by distinct vaccine formulations.
Environmental Persistence of Influenza Viruses Is Dependent upon Virus Type and Host Origin
Authors: Kormuth Karen A. , Lin Kaisen , Qian Zhihong , Myerburg Michael M. , Marr Linsey C. , Lakdawala Seema S.
Published: August 2019

The rapid spread of influenza viruses (IV) from person to person during seasonal epidemics causes acute respiratory infections that can lead to hospitalizations and life-threatening illness. Atmospheric conditions such as relative humidity (RH) can impact the viability of IV released into the air. To understand how different IV are affected by their environment, we compared the levels of stability of human-pathogenic seasonal and avian IV under a range of RH conditions and found that highly transmissible seasonal IV were less sensitive to decay under midrange RH conditions in droplets. We observed that certain RH conditions can support the persistence of infectious viruses on surfaces and in the air for extended periods of time. Together, our findings will facilitate understanding of factors affecting the persistence and spread of IV in our environment.
Episodic fluid flow in an active fault
Authors: Louis Sarah , Luijendijk Elco , Dunkl István , Person Mark
Published: August 2019

We present a reconstruction of episodic fluid flow over the past ∼250 k.y. along the Malpais normal fault, which hosts the Beowawe hydrothermal system (Nevada, USA), using a novel combination of the apatite (U-Th)/He (AHe) thermochronometer and a model of the thermal effects of fluid flow. Samples show partial resetting of the AHe thermochronometer in a 40-m-wide zone around the fault. Numerical models using current fluid temperatures and discharge rates indicate that fluid flow events lasting 2 k.y. or more lead to fully reset samples. Episodic fluid pulses lasting 1 k.y. result in partially reset samples, with 30–40 individual fluid pulses required to match the data. Episodic fluid flow is also supported by an overturned geothermal gradient in a borehole that crosses the fault, and by breaks in stable isotope trends in hydrothermal sinter deposits that coincide with two independently dated earthquakes in the past 20 k.y. This suggests a system where fluid flow is triggered by repeated seismic activity, and that seals itself over ∼1 k.y. due to the formation of clays and silicates in the fault damage zone. Hydrothermal activity is younger than the 6–10 Ma age of the fault, which means that deep (∼5 km) fluid flow was initiated only after a large part of the 230 m of fault offset had taken place.
Drainage reversal toward cliffs induced by lateral lithologic differences
Authors: Harel Elhanan , Goren Liran , Shelef Eitan , Ginat Hanan
Published: August 2019

Drainage reversals, an end-member case of drainage reorganization, often occur toward cliffs. Reversals are commonly identified by the presence of barbed tributaries, with a junction angle >90°, that preserve the antecedent drainage geometry. The processes that form reversed drainages are largely unknown. Particularly, barbed tributaries cannot form through a spatially uniform migration of the cliff and drainage divide, which would be expected to erase the antecedent drainage pattern, and tectonic tilting toward the cliff that could reverse the flow direction is inconsistent with geodynamic models of large-scale escarpment, where many reversals are documented. Here, we propose a new mechanism for drainage reversal, where the slope imbalance across a cliff, together with the high erodibility of sediments that fill cliff-truncated valleys, result in faster divide migration along valleys compared to interfluves. We demonstrate this mechanism along channels that drain toward the escarpment of the Arava Valley in Israel. Reversal is established by observations of barbed tributaries and opposite-grading terraces. We show that drainage reversal occurs when erodible valley fill exists, and that the reversal extent correlates with the thickness of this fill, in agreement with the predictions of the proposed mechanism. This new reversal mechanism demonstrates that valley fill could play an acute role in fluvial reorganization processes, and that reversals could occur independently of tectonic tilting.
Evidence for widespread oil migration in the 1.88 Ga Gunflint Formation, Ontario, Canada
Authors: Rasmussen Birger , Muhling Janet R.
Published: August 2019

The abundance of Precambrian organic-rich shales, heated beyond the oil and gas window, requires that enormous volumes of hydrocarbons were generated and transported through the ancient crust. However, the former passage of fluid hydrocarbons rarely leaves a trace, so evidence for this process in the early Precambrian rock record is sparse. Here, we report the widespread presence of solidified oil (pyrobitumen) in the iron formation of the 1.88 Ga Gunflint Formation, Ontario, Canada. Petrographic textures indicate at least two phases of oil migration, an early phase marked by pyrobitumen in granules and intergranular pores, synchronous with synsedimentary silica cementation, and a later phase restricted to crosscutting fractures. The paragenetic relationships between the pyrobitumen and iron oxides indicate that oil migration commenced before hematite and some magnetite growth. Our evidence for early oil migration can be explained by petroleum generation during the 1.86–1.80 Ga Penokean orogeny, expelling hydrocarbons generated in the core of the fold-and-thrust belt outwards and updip through the sediments of the Gunflint Formation.
‘Walking their walk’: reducing conflict between families of ill children and the medical profession
Authors: Gottardo Nicholas G
Published: August 2019

In recent years, several high-profile court cases generated headlines across the globe. Notably, they brought conflict between families of seriously ill children and the medical profession to the forefront. These conflicts, especially when the courts become involved, are highly destructive to all parties concerned, as the focus inevitably shifts from the child to the conflict itself. Often, at the heart of conflict, is a lack of effective communication between a patient’s family and their health providers. In order to assist health workers in the prevention, recognition and management of conflict in paediatrics, a Conflict Management Framework (CMF) and a set of guidelines endorsed by the Royal College of Paediatrics and Child Health (RCPCH) have been developed. Here, I review recent high-profile court cases to underscore the changing landscape of conflict and the central role that the media (and social media in particular) can play in fuelling and intensifying conflicts. The CMF and RCPCH-endorsed guidelines are discussed in the context of my own experience utilising some of these, as well as implementing other strategies aimed at reducing conflict in a paediatric oncology and haematology unit.
‘Start smart’: using front-line ownership to improve the quality of empiric antibiotic prescribing in a paediatric hospital
Authors: Cunney Robert , Kirrane-Scott Michelle , Rafferty Aisling , Stapleton Patrick , Okafor Ikechukwu , McNamara Roisin
Published: August 2019

Infection is the most frequent indication for non-scheduled admission to paediatric hospitals, leading to high levels of empiric antibiotic prescribing. Antibiotic prescribing in line with local guidelines, improves patient outcomes, reduces adverse drug events and helps to reduce the emergence of antimicrobial resistance. We undertook an improvement project at Temple Street Children’s University Hospital targeting documentation of indication and compliance with empiric antibiotic prescribing guidelines among medical admissions via the emergency department (ED). Results of weekly audits of empiric antibiotic prescribing were fed back to prescribers. Front-line ownership techniques were used to empower prescribers to generate ideas for change, such as regular discussion of antibiotic prescribing issues at weekly clinical meetings, antibiotic ‘spot quiz’, updates to prescribing guidelines, improved access and promotion of a prescribing app, laminated guideline summary cards, and reminders and guideline summaries at a point of prescribing in ED. Documentation of indication and guideline compliance increased from a median of 30% in December 2014 to 100% in March 2015, and was sustained at 100% to September 2016, then 90% to December 2017. The intervention was associated with improvements in non-targeted indicators of prescribing quality, an overall reduction in antimicrobial consumption in the hospital, and a €105 000 reduction in annual antimicrobial acquisition costs. We found that a simple, paper-based, data collection system was effective, provided opportunities for a point-of-care interaction with prescribers, and facilitated weekly data feedback. We also found that using a pre-existing weekly clinical meeting to foster prescriber ownership of the data, allowing prescribers to identify possible tests of change, and exploiting the competitive nature of doctors, led to a rapid and sustained improvement in prescribing quality. Awareness of local prescribing processes and culture are essential to delivering improvements in antimicrobial stewardship.
Medic One Pediatric (MOPed) cards: standardising paramedic paediatric resuscitation
Authors: Woods Brandon , Lang Benjamin , Blayney Carolyn , O'Mahony Lila , Vander Tuig Amanda , Rea Tom , Carlbom David , Sayre Michael , King Mary
Published: August 2019

Objective

Paediatric resuscitation is highly stressful, technically challenging and infrequently performed by paramedics. Length-based equipment selection, weight-based medication dosing and less familiar paediatric clinical scenarios create high cognitive load. Our project aimed to decrease cognitive load and increase paramedic comfort by providing standardised paediatric resuscitation cards across an entire Emergency Medical Services (EMS) system.

Methods

After 2 years of collaboration between EMS and regional paediatric subspecialists, we created and implemented a novel set of length-based, colour-coded cards: Medic One Pediatric (MOPed) cards. MOPed cards standardise the approach to paediatric scenarios, such as rapid sequence intubation (RSI), seizure management and cardiac arrest. We standardised drug concentrations across all five EMS agencies to allow for volume-based dosing, removing medication calculations, simplifying the process of medication administration and potentially decreasing both calculation error and time to intervention. We consolidated medications on MOPed cards to the 12 most commonly used in Paediatric Advanced Life Support scenarios. We surveyed 240 EMS personnel before and after implementation to determine use and effect on paramedic comfort.

Results

After 12 months of implementation, 97% of respondents reported using the new cards as their primary reference, and 94% reported improved speed and accuracy of medication administration. Specifically, RSI medication administration received the greatest improvement in comfort (p=0.001). Additionally, paramedics increased the use of MOPed cards when selecting endotracheal tubes: 45% of the respondents had done so by 6 months, and 60% had done so after 12 months of implementation (p=0.01).

Conclusions

MOPed cards were well adopted across a large EMS system, with improvement in paramedic comfort in managing some paediatric resuscitation scenarios.
Improving critical incident reporting in primary care through education and involvement
Authors: Müller Beate Sigrid , Beyer Martin , Blazejewski Tatjana , Gruber Dania , Müller Hardy , Gerlach Ferdinand Michael
Published: August 2019

Background

Critical incident reporting systems (CIRS) can be an important tool for the identification of organisational safety needs and thus to improve patient safety. In German primary care, CIRS use is obligatory but remains rare. Studies on CIRS implementation in primary care are lacking, but those from secondary care recommend involving management personnel.

Objective

This project aimed to increase CIRS use in 69 practices belonging to a local practice network.

Methods

The intervention consisted of the provision of a web-based CIRS, accompanying measures to train practice teams in error management and CIRS, and the involvement of the network’s management. Three measurements were used: (1) number of incident reports and user access rates to the web-based CIRS were recorded, (2) staff were given a questionnaire addressing incident reporting, error management and safety climate and (3) qualitative reflection conferences were held with network management.

Results

Over 20 months, 17 critical incidents were reported to the web-based CIRS. The number of staff intending to report the next incident online decreased from 42% to 20% of participants. In contrast, the number of practices using an offline CIRS (eg, incident book) increased from 23% to 49% of practices. Practices also began proactively approaching network management for help with incidents. After project completion, participants scored higher in the patient safety climate factor ‘perception of causes of errors’. For many practices, the project provided the first contact with structured error management.

Conclusion

Specific measures to improve the use of CIRS in primary care should focus on network management and practice owners. Practices need basic training on safety culture and error management. Continuing, practices should implement an offline CIRS, before they can profit from the exchange of reports via web-based CIRS. It is crucial that practices receive feedback on incidents, and trained network management personnel can provide such support.
Evidence-based practice ‘on-the-go’: using ViaTherapy as a tool to enhance clinical decision making in upper limb rehabilitation after stroke, a quality improvement initiative
Authors: Hancock Nicola J , Collins Kathryn , Dorer Charlie , Wolf Steven L , Bayley Mark , Pomeroy Valerie M
Published: August 2019

Recovery of upper limb function after stroke is currently sub-optimal, despite good quality evidence showing that interventions enabling repetitive practice of task-specific activity are effective in improving function. Therapists need to access and engage with such evidence to optimise outcomes with people with stroke, but this is challenging in fast-paced stroke rehabilitation services. This quality improvement project aimed to investigate acceptability and service impact of a new, international tool for accessing evidence on upper limb rehabilitation after stroke—‘ViaTherapy’—in a team of community rehabilitation therapists. Semi-structured interviews were undertaken at baseline to determine confidence in, and barriers to, evidence-based practice (EBP) to support clinical decision making. Reported barriers included time, lack of access to evidence and a research-practice disconnect. The clinicians then integrated use of ‘ViaTherapy’ into their practice for 4 weeks. Follow-up interviews explored the accessibility of the tool in community rehabilitation practice, and its impact on clinician confidence, treatment planning and provision. Clinicians found the tool, used predominantly in mobile device app format, to be concise and simple to use, providing evidence ‘on-the-go’. Confidence in accessing and using EBP grew by 22% from baseline. Clinicans reported changes in intensity of delivery of interventions, as rapid access to recommended doses via the tool was available. Following this work, the participating health and social care service provider changed provision of therapists’ technology to enable use of apps. Barriers to use of EBP in stroke rehabilitation persist; the baseline situation here supported the need for more accessible means of integrating best evidence into clinical processes. This quality improvement project successfully integrated ViaTherapy into clinical practice, and found that the tool has potential to underpin positive changes in upper limb therapy service delivery after stroke, by increasing accessibility to, use of and confidence in EBP. Definitive evaluation is now indicated.
Anisotropic cosmological solutions to the Y(R)F2 gravity
Authors: Sert Özcan , Adak Muzaffer
Published: August 2019

We investigate anisotropic cosmological solutions of the theory with non-minimal couplings between electromagnetic fields and gravity in [Formula: see text] form. After we derive the field equations by the variational principle, we look for spatially flat cosmological solutions with magnetic fields or electric fields. Then, we give exact anisotropic solutions by assuming the hyperbolic expansion functions. We observe that the solutions approach the isotropic case in late-times.
Heavy quarkonia properties from a hard-wall confinement potential model with conformal symmetry perturbing effects
Authors: Al-Jamel Ahmed
Published: August 2019

Heavy [Formula: see text] and [Formula: see text] quarkonia are considered as systems confined within a hard-wall potential shaped after a linear combination of a cotangent — with a square co-secant function. Wave functions and energy spectra are then obtained in closed forms in solving by the Nikiforov–Uvarov method the associated radial Schrödinger equation in the presence of a centrifugal term. The interest in this potential is that in one parametrization, it can account for a conformal symmetry of the strong interaction, and in another for its perturbation, a reason for which we here employ it to study status of conformal symmetry in the heavy flavor sector. The resulting predictions on heavy quarkonia mass spectra and root mean square radii are compared with the available experimental data, as well as with predictions by other theoretical approaches. We observe that a relatively small conformal symmetry perturbing term in the potential suffices to achieve good agreement with data.
Faster DBSCAN and HDBSCAN in Low-Dimensional Euclidean Spaces
Authors: de Berg Mark , Gunawan Ade , Roeloffzen Marcel
Published: August 2019

We present a new algorithm for the widely used density-based clustering method dbscan. For a set of [Formula: see text] points in [Formula: see text] our algorithm computes the dbscan-clustering in [Formula: see text] time, irrespective of the scale parameter [Formula: see text] (and assuming the second parameter MinPts is set to a fixed constant, as is the case in practice). Experiments show that the new algorithm is not only fast in theory, but that a slightly simplified version is competitive in practice and much less sensitive to the choice of [Formula: see text] than the original dbscan algorithm. We also present an [Formula: see text] randomized algorithm for hdbscan in the plane — hdbscan is a hierarchical version of dbscan introduced recently — and we show how to compute an approximate version of hdbscan in near-linear time in any fixed dimension.
Sodium Alginate-Assisted Synthesis of PdAg Bimetallic Nanoparticles and their Enhanced Activity for Electrooxidation of Ethanol
Authors: Yin Yanru , Wen Changna , Ma Ning , Wang Baoyan , Zhang Lianying , Li Hongliang , Guo Peizhi
Published: August 2019

Palladium and palladium-silver bimetallic nanocrystals have been synthesized hydrothermally by using environmental-friendly sodium alginate as the stabilizer and reducing agent. The pure palladium nanoparticles were spherical-like possibly due to the principle of the lowest surface energy, however, the formation of bimetallic palladium-silver nanoparticles was much more complicated, which was thinner and more irregular nanostructures than pure palladium nanoparticles. Electrochemical measurements showed that the electrocatalytic activity toward ethanol oxidation was increased first with the increase of silver content in bimetallic nanoparticles, from pure palladium of around 1070[Formula: see text]mA/mg, to PdAg-20 of 1160[Formula: see text]mA/mg and to PdAg-10 of 1750[Formula: see text]mA/mg, and declined greatly at a high content of silver, approximately 279[Formula: see text]mA/mg. Electrochemical stability test showed that PdAg-10 and PdAg-5 were the best and worst among four palladium-based samples, respectively. Based on the experimental data, the formation mechanism of pure palladium and palladium-silver bimetallic nanoparticles and the structure-property relationship of these samples have been discussed.
Simulation-based verification of homogenization approach in predicting effective thermal conductivities of wavy orthotropic fiber composite
Authors: Mahesh C. , Govindarajulu K. , Balakrishna Murthy V.
Published: August 2019

In this work, applicability of homogenization approach is verified with the micromechanics approach by considering wavy orthotropic fiber composite. Thermal conductivities of [Formula: see text]-300 orthotropic wavy fiber composite are determined for micromechanical model and compared with the results obtained by two stage homogenized model over volume fraction ranging from 0.1 to 0.6. Also, a methodology is suggested for reducing percentage deviation between homogenization and micromechanical approaches. Effect of debond on the thermal conductivities of wavy orthotrophic fiber composite is studied and compared with perfectly aligned fiber composite for different volume fraction. It is observed that results obtained by the homogenization approach are in good agreement with the results obtained through micromechanics approach. Maximum percentage deviation between homogenized and micromechanics models is 2.13%.
Health and Disease After Assisted Reproductive Technology
Authors: Allen Cathy
Published: August 2019

Long-term health outcomes after ART have largely focused on offspring health and perinatal parameters. Longer-term health outcomes in female patients remain difficult to fully assess. Hypothetical concerns about the effects of endocrine manipulation on hormone-sensitive conditions, e.g. breast disease, are confounded by variable factors in patients and treatments. Obstetric and perinatal factors endow an additional layer of complexity to the overall analysis and more research is required to appreciate all aspects of ART. Notwithstanding the knowledge gap, clinicians must endeavour to individualise management plans, taking into account the pros and cons of ART in the context of immediate, maternity-related and long-term health risks for their patients.

This review of recent literature examines current ART practice in terms of female health and disease as we strive for best practice in an ever-changing clinical and demographic fertility landscape.
Real-Time Middleware for Cyber-Physical Event Processing
Authors: Wang Chao , Gill Christopher , Lu Chenyang
Published: August 2019

Cyber-physical systems (CPS) involve tight integration of cyber (computation) and physical domains, and both the effectiveness and correctness of a cyber-physical system application may rely on successful enforcement of constraints such as bounded latency and temporal validity subject to physical conditions. For many such systems (e.g., edge computing in the Industrial Internet of Things), it is desirable to enforce such constraints within a common middleware service (e.g., during event processing). In this article, we introduce CPEP, a new real-time middleware for cyber-physical event processing, with (1) extensible support for complex event processing operations, (2) execution prioritization and sharing, (3) enforcement of time consistency with load shedding, and (4) efficient memory management and concurrent data processing. We present the design, implementation, and empirical evaluation of CPEP and show that it can (1) support complex operations needed by many applications, (2) schedule data processing according to consumers’ priority levels, (3) enforce temporal validity, and (4) reduce processing delay and improve throughput of time-consistent events.
Extensive Analysis of a Real-Time Dense Wired Sensor Network Based on Traffic Shaping
Authors: Loureiro João , Rangarajan Raghuraman , Nikolic Borislav , Indrusiak Leandro Soares , Tovar Eduardo
Published: August 2019

XDense is a novel wired 2D mesh grid sensor network system for application scenarios that benefit from densely deployed sensing (e.g., thousands of sensors per square meter). It was conceived for cyber-physical systems that require real-time sensing and actuation, like active flow control on aircraft wing surfaces. XDense communication and distributed processing capabilities are designed to enable complex feature extraction within bounded time and in a responsive manner. In this article, we tackle the issue of deterministic behavior of XDense. We present a methodology that uses traffic-shaping heuristics to guarantee bounded communication delays and the fulfillment of memory requirements. We evaluate the model for varied network configurations and workload, and present a comparative performance analysis in terms of link utilization, queue size, and execution time. With the proposed traffic-shaping heuristics, we endow XDense with the capabilities required for real-time applications.