bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of new roll pass designs for ball-rolling rolls with continuously variable parameters
Authors: Rubcov V Ju , Shevchenko O I
Published: November 2020

This article outlines modern approaches to the creation of roll passes for helical rolling mills for the production of grinding balls. The key feature is the roll design with continually varying parameters of its elements. Such elements include: flange width varying along the length of the roll; flange height, with a nonlinear function of flange rising; pitch of the helical groove which maintains constancy of the volume of the metal being deformed. Particular attention is paid to a new conceptual pass design for ball-rolling rolls with a variable groove depth, the prospects of which are connected with uniformity of reduction and the production of balls not only with the correct geometry, but also with a more homogeneous structure. The article shows functions of a continuously varying pitch of a helical groove of rolls with a constant and variable flange width, as well as with a variable depth of the groove. A practical test was conducted on ball-rolling rolls for production of balls with a nominal diameter 120 mm with continuously varying pitch. Experience has shown positive results both in reducing loads and in increasing the dimensional accuracy.
Development of algorithm for excavation control
Authors: Lukashuk O A , Letnev K Y , Komissarov A P
Published: November 2020

In open-pit excavators there exists a discrepancy between their engineering designs and underuse of performance potential due to complexity of excavation and such intensity of carrying out working procedures which borders on physical limits of an operator. The excavating procedure is shown to involve joint functioning of main actuating mechanisms of an open-pit excavator for its thrusting and lifting operations and formation of a leverage transmission mechanism connecting those with a bucket. In that case, it was established, the excavation process is characterized by a ‘conversion’ of the main mechanisms since their operation parameters are formed according to kinematic properties of the leverage and energy-force parameters realized on the bucket. Dependencies were derived to calculate kinematic transfer functions of the leverage, which correlate the velocity of excavation and those of working motions (speeds of thrusting and lifting). The algorithm of calculating the velocities of working motions could be used to develop a digital system to control the motors of the main mechanisms.
Organizational factors for manufacturing defects reduction in small batch production
Authors: Ershova I V , Baranchikova S G , Cherepanova E V , Chistyakov N N
Published: November 2020

The study is devoted to the defects organizational causes analysis in the machine building products production process. The companies with the small batch production were taken into consideration. Factors related to the time norms fulfilling percentage, the work rhythm, the consolidation of operations at one workplace, the new technologies introduction and equipment failures were chosen. A preliminary factors selection according to independence criteria allowed us to build a reliable regression model for the defects rate calculating. The main factors influencing the defects rate in small batch production are the time norms fulfilling percentage, the rate of consolidation of operations at one workplace, and the number of new technological processes introduced. This allowed us to offer recommendations on the machining sites work organization. The final operations and productswhich are made from expensive metals should be carried out at workplaces with a low rate of operations consolidation. Also, it is important that the wage system should not contribute to over-fulfillment of norms. The maintenance and repair system should prevent malfunctions during operations fulfilment.
Interactional experience with the employer during a selection of educational content in a single-industry town
Authors: Karelova R A
Published: November 2020

Training of personnel for industrial enterprises of a single-industry town is an opportunity for the stable development of the local labor market. As a rule, single-industry towns of our country are mechanical engineering or coal-metallurgical towns. Nizhny Tagil is no exception. On its territory there are metallurgical, mining and machine-building enterprises. Colleges and universities that train specialists for town-forming enterprises can be a driver for the stable functioning of a single-town economy. For this, it is necessary to adapt the content of educational programs to the actual needs of employers. The article describes a number of problems that representatives of educational institutions had to solve in the process of interaction with an employer to update the content of education. Such problems were: difficulties in visiting enterprises, in particular, defense (machine-building) ones, ambiguity in the interpretation of the concept of ‘competence’ by teachers and employers, the difficulty of dividing workers by education levels on the part of employers. A simplified version of the employer survey form is proposed. It allows to determine the priority areas in the training of personnel for the industry.
Possibilities of an artificial neural network use to control oxygen consumption in a converter shop
Authors: Karelova R A
Published: November 2020

Converter steelmaking process uses high-performance processing plants and a high level of process automation. Complex multi-stage processes typically use many factors that have effect both on individual stages of the processes and on how a combination of the processes runs as a whole. This makes it necessary to select and/or develop control methods for the converter process having no full current data on process parameters and effects of random disturbances. Use of artificial neural networks is the most effective method available now for analyzing and predicting parameters of different processes (including converter process). This article deals with an algorithm for oxygen measurement based on chemical analysis of steel and process history through some period, using an artificial neural network and machine learning. Initial data were reviewed using correlation and regression analysis, the artificial neural network architecture chosen is reasoned as the most appropriate for the objective on hand and the results are analyzed. The element measurement accuracy achieved is satisfactory, which makes the resulting artificial neural network usable in an automation system for testing purposes. Network performance can be improved with the help of experts in the subject area, whose expertise can be used to correct the model.
The use of homomorphic image processing to analyze coke grading
Authors: Krouglov V N , Gruh A G , Gapak A L , Khurelchuluun I
Published: November 2020

The estimation of the geometrical sizes of particles of crushed solid fuel (coke), moving on the conveyor belt, is associated with a number of technical difficulties. One of the problems is the need for a non-invasive way of determining particle geometry. A promising way to solve it is to use devices based on machine vision systems. This paper describes the algorithmic part of the prototype of such a device. It is proposed to improve the quality of boundary detection between fragments of coke particles to perform homomorphic processing of the initial low-contrast video images. The algorithm for calculating the Fourier spectrum has been optimized based on the Fast Fourier Transform (FFT) with the mixed base. As a result, it becomes possible to reduce the computational cost for calculating two-dimensional Fourier spectra for complex multiplication operations by 1.33 times, and the number of complex addition operations by 1.67 times. The software of the prototype, built using the proposed methods, made it possible to obtain good convergence of the results for assessing the particle size distribution of samples of crushed coke with laboratory estimates. Thus, the maximum absolute average error of the machine vision system in assessing the size of crushed coke is only 3.37%, and the maximum error for all measurement classes do not exceed 6.9%.
Adapting standard maintenance approaches for mining excavators to actual operating condition
Authors: Shibanov D A , Ivanov S L , Safronchuk K A , Knyazkina V I
Published: November 2020

Significant portion of the annual calendar fund-time work of mining excavators spent on maintaining its working condition by carrying out preventive and repair regulatory activities and recovery in the event of emergency failures and maintenance and repair expenses constitute a significant proportion of the cost of excavation of mining rock. To assess the effectiveness of machinery a non-standard indicator, the coefficient of technical readiness, applied which does not have a single assessment methodology. At the present stage of machinery development, existing quarry dispatching systems allow you to allocate any of its elements from the fund-time of mining excavators: productive time, time spent in repair and maintenance and also classify other time costs of a particular machine which allowed an appropriate analysis. Analysis showed that at the current organization of MaR (maintenance and repair) there is significant potential to reduce repair impacts, as well as to ensure a reduction in the cost of routine maintenance, to remove maintenance and repair measures from the category of costly ones, at least for self-sufficiency without compromising the quality of these works and the reliability of the excavator as a whole.
A local representation formula for quaternionic slice regular functions
Authors: Gentili Graziano , Stoppato Caterina
Published: November 2020

After their introduction in 2006, quaternionic slice regular functions have mostly been studied over domains that are symmetric with respect to the real axis. This choice was motivated by some foundational results published in 2009, such as the Representation Formula for axially symmetric domains.

The present work studies slice regular functions over domains that are not axially symmetric, partly correcting the hypotheses of some previously published results. In particular, this work includes a Local Representation Formula valid without the symmetry hypothesis. Moreover, it determines a class of domains, called simple, having the following property: every slice regular function on a simple domain can be uniquely extended to the symmetric completion of its domain.
Truths . . . Audacious and Flawed
Authors: Norton Mary Beth
Published: November 2020

This AHR Roundtable features four short essays on Jill Lepore’s widely read synthesis of American history, These Truths: A History of the United States (2018). Lepore’s framework insists that the “self-evident” truths of the nation’s founding were anything but. The driving force of her narrative is the struggle of those excluded from this magic circle—really, the majority of the country’s population—to extend those truths beyond their narrow core of elite white men. The four reviewers—Ned Blackhawk, Matt Garcia, Mary Beth Norton, and Paul Ortiz—appreciate the “shared sense of national destiny” that clearly informs Lepore book. At the same time, they chide her for what they regard as significant omissions. These critical essays invite further consideration of how best to write a fully inclusive (and therefore dramatically reconfigured) national narrative
Hypertensive Urgency: An Emergency Department Pipeline to Primary Care Pilot Study
Authors: Giaimo Antonio A , Kang Angela J , Huot Stephen J
Published: November 2020

BACKGROUND

Optimal triage of patients with hypertensive urgency (HU) in the emergency department (ED) is not well established. 2017 ACC/AHA hypertension (HTN) guidelines recommend treatment initiation and follow-up within 1 week. Objectives of our pilot study were to evaluate feasibility and impact of directly connecting ED patients with HU to outpatient HTN management on blood pressure (BP) control and ED utilization.

METHODS

ED patients with HU and no primary care physician were scheduled by a referral coordinator for an initial appointment in a HTN clinic embedded within a primary care practice. BP control and ED utilization over the subsequent 90 days were tracked and compared with BP at time of the referral ED visit, and ED utilization in the 90 days preceding referral.

RESULTS

Data are reported for the first 40 referred patients. Average time to first visit was 7.8 days. Mean age was 51 years (range 28–76), 75% were African-American, and mean pooled 10-year atherosclerotic cardiovascular disease (ASCVD) risk was 20.8%. Mean BP declined from 198/116 mm Hg at ED visit to 167/98 mm Hg at HTN clinic visit 1 to 136/83 by 6 weeks and was sustained at 90 days. Total ED visits for the group decreased from 61 in the 90 days prior to referral, to 18 in the 90 days after the first HTN clinic visit.

CONCLUSIONS

In this pilot study, coordinated referral between the ED and primary care provides safe, timely care for this high ASCVD risk population and leads to sustained reductions in BP and ED utilization.
Testing Routine Activity Theory in Mexico
Authors: Vilalta Carlos , Fondevila Gustavo
Published: November 2020

Using a comprehensive victimization survey data set, we develop the first test of routine activity (RA) theory in a Latin American country. Estimating a complementary log–log multilevel model of the theory in several stages, we investigate what factors in the theory predict residential burglary risk. We find that measures associated with the exposure to potential offenders, target attractiveness, target accessibility, personal guardianship, social guardianship, and natural guardianship predict residential burglary in our sample of Mexican cities. As such, residential burglary is a complex crime with multiple factors at play, for which RA theory is a suitable theory given the conciseness of its propositions and operational definitions. We foresee RA theory successfully influencing future studies of crime in the Latin American region.
Asynchronous Glutamate Release at Autapses Regulates Spike Reliability and Precision in Mouse Neocortical Pyramidal Cells
Authors: Li Junlong , Deng Suixin , He Quansheng , Ke Wei , Shu Yousheng
Published: November 2020

Autapses are self-synapses of a neuron. Inhibitory autapses in the neocortex release GABA in 2 modes, synchronous release and asynchronous release (AR), providing precise and prolonged self-inhibition, respectively. A subpopulation of neocortical pyramidal cells (PCs) also forms functional autapses, activation of which promotes burst firing by strong unitary autaptic response that reflects synchronous glutamate release. However, it remains unclear whether AR occurs at PC autapses and plays a role in neuronal signaling. We performed whole-cell recordings from layer-5 PCs in slices of mouse prefrontal cortex (PFC). In response to action potential (AP) burst, 63% of PCs showed robust long-lasting autaptic AR, much stronger than synaptic AR between neighboring PCs. The autaptic AR is mediated predominantly by P/Q-type Ca2+ channels, and its strength depends on the intensity of PC activity and the level of residual Ca2+. Further experiments revealed that autaptic AR enhances spiking activities but reduces the temporal precision of post-burst APs. Together, the results show the occurrence of AR at PC autapses, the delayed and persistent glutamate AR causes self-excitation in individual PCs but may desynchronize the autaptic PC population. Thus, glutamatergic autapses should be essential elements in PFC and contribute to cortical information processing.
Deep Belief Network and Closed Polygonal Line for Lung Segmentation in Chest Radiographs
Authors: Peng Tao , Xu Thomas Canhao , Wang Yihuai , Li Fanzhang
Published: November 2020

Due to the varying appearance in the upper clavicle bone region, sharp corner at the costophrenic angle, the presence of strong edges at the rib cage and clavicle and the lack of a consistent anatomical shape among different individuals, accurate segmentation of lung on chest radiographs remains challenging. In this work, we propose a novel segmentation method for lung segmentation, containing two subnetworks, where few manually delineated points are used as the approximate initialization. The first one is a preprocessing subnetwork based on a deep learning model (i.e. Deep Belief Network and K-Nearest Neighbor). The second one is a refinement subnetwork, designed to make the preprocessed result to be optimized by combining an improved principal curve method and a machine learning method. To prove the performance of the proposed method, several public datasets were evaluated with Dice Similarity Coefficient (DSC), overlap score (Ω), Sensitivity (Sen), Positive Predictive Value (PPV), global Error (E) and execution time (t). Compared with state-of-the-art methods, our method reaches superior segmentation performance.
Robust Anomaly Detection in Feature-Evolving Time Series
Authors: Wambura Stephen , Huang Jianbin , Li He
Published: November 2020

This paper addresses the anomaly detection problem in feature-evolving systems such as server machines, cyber security, financial markets and so forth where in every millisecond, $N$-dimensional feature-evolving heterogeneous time series are generated. However, due to stochasticity and uncertainty in evolving heterogeneous time series coupled with temporal dependencies, their anomaly detection are extremely challenging. Furthermore, it is practically impossible to train an anomaly detection model per single time series across millions of metrics, leave alone memory space required to maintain the model and evolving data points in memory for timely processing in feature-evolving data streams. Thus, this paper proposes $\underline{o}$ne sketch $\underline{f}$its all $\underline{a}$lgorithm (OFA), which is a real-time stochastic recurrent deep neural network anomaly detector built on assumption-free probabilistic conditional quantile regression with well-calibrated predictive uncertainty estimates. The proposed framework is capable of detecting anomalies robustly, accurately and efficiently in real time while handling randomness and variabilities in feature-evolving heterogeneous time series. Extensive experiments and rigorous evaluation on large-scale real-world data sets showcase that OFA outperforms other competitive state-of-the-art anomaly detector methods.
Orthogonal electrical cardioversion in atrial fibrillation refractory to biphasic shocks: a case series
Authors: Velázquez-Rodríguez Enrique , Pérez-Sandoval Hipólito Alfredo , Rangel-Rojo Francisco Javier
Published: November 2020

Background

Biphasic waveform shock has been established as the standard method for cardioversion of atrial fibrillation (AF). Depending on various factors, standard electrical cardioversion for AF may be unsuccessful in some cases, even with biphasic shocks.

Case summary

We report the safety and efficacy of orthogonal electrical cardioversion (OECV) as an alternative in patients with paroxysmal AF refractory to standard biphasic electrical cardioversion after up to three subsequent shocks of increasing energy and/or two or three initial shocks with maximum energy of 200-Joules. Shocks were delivered with two external defibrillators via two sets of adhesive electrode pads to apply two perpendicular electrical vectors in a simultaneous-sequential mode in antero-lateral and antero-posterior configuration. Five patients, mean age 54.4 ± 11, three with hypertensive heart disease and a body mass index 27.2 ± 2 kg/m2. All individual mean impedance before OECV was 79 ± 5 Ω with a mean peak current applied of 22 ± 4.5 A. Restoration of sinus rhythm with OECV was achieved acutely and sustained in all five patients. No patients developed haemodynamic instability or thromboembolic events.

Discussion

Double simultaneous shocks in an orthogonal configuration could theoretically decrease the defibrillation threshold through the ability of sequential pulses applying a more efficient and uniform current density. OECV using lower/medium energy may be another useful rescue strategy in AF refractory to standard biphasic shocks.
Lipoprotein(a) and PCSK9 inhibition: clinical evidence
Authors: Ruscica Massimiliano , Greco Maria Francesca , Ferri Nicola , Corsini Alberto
Published: November 2020

Compelling evidence has emerged from epidemiological and Mendelian randomization analyses relative to the causality of lipoprotein(a) [Lp(a)] in atherosclerotic cardiovascular diseases (ASCVD), being elevated Lp(a) a strong risk factor regardless of the reduction of LDL-C achieved by statins. So far, no specific available agent can lower Lp(a) to the extent required to achieve a cardiovascular (CV) benefit, i.e. approximately 100 mg/dL. The most recent outcomes trial FOURIER with evolocumab showed that a 25 nmol/L (12 mg/dL) reduction in Lp(a) corresponded to a 15% decrement in the relative risk of cardiovascular disease. The ODYSSEY OUTCOMES trial with alirocumab has been the first demonstrating that a reduction in Lp(a) associates with less major adverse cardiovascular events (MACE), i.e. hazard ratio: 0.994 per 1 mg/dL decrement in Lp(a). The Lp(a) lowering effect driven by PCSK9 inhibition was confirmed in carriers of PCSK9 loss-of-function mutations in which Lp(a) and oxPL-apoB levels were decreased compared to non-carriers as was for a slight larger number of apo(a) Kringle IV repeats. Although PCSK9 inhibitors are not able to decrease Lp(a) to the extent required to achieve a CV benefit, their use has led to a higher discontinuation rate in lipoprotein apheresis in patients with progressive ASCVD and high plasma Lp(a).
Challenges in ischaemic heart disease: not sleeping enough, not brushing your teeth, and skipping breakfast—three ways of increasing your risk of myocardial infarction?
Authors: Muscente Francesca , De Caterina Raffaele
Published: November 2020

Despite optimal medical therapies, there is currently a persistent residual cardiovascular risk. The most likely pathway responsible for this residual risk has been identified in the inflammatory state. Recent studies have confirmed that inflammation increases cardiovascular risk independently from LDL cholesterol levels. Addressing traditional risk factors, such as obesity, cigarette smoking, diabetes, arterial hypertension, and dyslipidaemia, also provides an important reduction of the levels of inflammation. Nonetheless, inflammation is also a target for specific and focused therapeutic interventions. Recent studies have outlined an association between oral hygiene, sleep deprivation, and nutritional patterns on the one hand, with the development of multi-districts atherosclerosis and/or adverse cardiovascular events on the other. These lifestyle patterns appear to be involved in fostering inflammation associated with atherosclerosis. There is, however, a persistent need for further studies to clarify whether such associations with cardiovascular disease are direct and causal, and if they are all channelled through vascular inflammation.
Sodium-glucose co-transporter-2 drugs: are we sure they are useful only in the treatment of diabetes?
Authors: Vassiliki’ Coutsoumbas Gloria , Zagnoni Silvia , Corona Giovanni , Di Pasquale Giuseppe
Published: November 2020

The sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs acting through the inhibition of renal reabsorbtion of glucose. Three important randomized clinical trial in diabetic patients receiving SGLT2 inhibitors (vs. placebo), demonstrated a significant reduction of major adverse cardiovascular events, but only in patients with known atherosclerotic disease, and a clear-cut and early reduction in hospital admissions for heart failure in patients in primary as well as secondary prevention settings. This latter information prompted the design of a recent study the DAPA-HF (Dapagliflozin And Prevention Of Adverse-outcomes In Heart Failure) trial, comparing dapagliflozin vs. placebo, and showing a significant reduction of clinical relevant episodes of heart failure in patients with reduced left ventricular ejection fraction, regardless the presence of diabetes mellitus. The mechanism by which the SGLT2 inhibitors exert their anti-heart failure action is not well understood but appears to be independent from its hypoglycaemic action. These results, along with the scarcity of adverse side effects of the drug, render dapagliflozin a new tool in the treatment of heart failure.
Acute coronary syndromes with high thrombotic burden: therapeutic innovations
Authors: Menozzi Alberto , Caretta Giorgio
Published: November 2020

Antiplatelet agents represent one of the cornerstones of drug therapy for acute coronary syndromes (ACS). In the last decade, the arrival of prasugrel and ticagrelor, faster and more powerful oral platelet receptor P2Y12 inhibitors compared to clopidogrel, significantly improved platelet inhibition in patients with ACS. However, the reduction of thrombotic risk came at the cost of increased bleeding risk. Despite having similar indications, prasugrel and ticagrelor have different characteristics and methods of use, essentially due to a different design of the trials in which they have been studied. The optimal use of these antiplatelets in clinical practice should therefore be tailored in individual patients. In the acute phase of ACS with high thrombotic burden, all oral P2Y12 inhibitors have limitations, mainly due to the delay of onset of action related to oral administration. In this scenario, parenteral antiplatelet agents (glycoprotein inhibitors IIb/IIIa and cangrelor) may play a key role in case of percutaneous coronary interventions of high thrombotic coronary lesions and in the prevention of early thrombotic complications. Cangrelor, an intravenous inhibitor of the P2Y2 receptor, has peculiar pharmacokinetic and pharmacodynamic characteristics that make it particularly suitable to be used as an antiplatelet during coronary angioplasty as it achieves a rapid and powerful antiplatelet effect in patients not pretreated with oral medications, and has a favourable safety profile in relation to the bleeding risk.
Considerations on the use of MitraClip in the treatment of mitral regurgitation
Authors: Musumeci Giuseppe , Rossini Roberta
Published: November 2020

Mitral regurgitation (MR) is, by occurrence, the second most common valvular heart disease in the Western world, with a significant impact on prognosis and mortality. A significant number of patients with significant mitral incompetence cannot be submitted to conventional surgery due to high surgical risk. The need for an adequate therapeutical strategy prompted the development of innovative endovascular techniques. Among them, the MitraClip percutaneous system, mimicking the ‘edge-to-edge’ surgical technique introduced by Alfieri in 2003 has emerged as the treatment of choice in patients not suitable for conventional surgery. Since its introduction, this procedure has been effectively carried out in more than 35 000 patients. The evidences from the first randomized clinical trial, EVEREST II, suggested that the MitraClip system is effective in improving survival and quality of life in patients with severe MR. Further randomized trials, MITRA-FR and COAPT, added some more information, showing that an appropriate patient selection, close attention to the specific anatomical characteristics of the mitral valve, and adequate experience of the centre providing the treatment, are important determinants of the outcome of the procedure.
What connection is there between intestinal microbiota and heart disease?
Authors: Poli Andrea
Published: November 2020

Information on the correlation between intestinal microbiota and cardiovascular risk is growing. Some species of the microbiota influence the metabolism of specific food components (such as carnitine, choline, phosphatidyl-choline), synthesizing the precursor of trimethylamine oxide, a molecule with documented harmful activity on the vascular wall. Other strains, on the other hand, metabolize dietary fibre by synthesizing short-chain fatty acids, which have a significant anti-inflammatory activity, or produce secondary metabolites originating from molecules present in food (such as enterodiol, which derives from lignin), characterized by a vascular protection activity. Prebiotic effects from plant compounds (such as berberine or resveratrol) are also documented, which would induce favourable changes in the composition of the microbiota. The possibility of influencing the composition and activity of the intestinal microbiota will probably represent, in the future, an important component of cardiovascular prevention strategies.
Scientific progress and clinical uncertainty
Authors: Tavazzi Luigi
Published: November 2020

In the path underway towards Precision Medicine, two areas are in rapid development: genetics and artificial intelligence. In the genetic area, there are two current problems, both of the highest social importance. The first concerns the project, emerging in some countries, of systematic sequencing of the genome in the whole population. The problem is that reading the genome is very complex, requires specific knowledge, and the medical class is now unprepared. The second problem concerns the now achieved ability to modify the genome, which might be applied in the treatment of genetic diseases previously considered incurable. The techniques that can be used today are extremely delicate and expose to high risks. Artificial intelligence (AI) is a branch of neuroscience (‘computational neuroscience’) and advanced computer science which aims to apply the operational models of the human mind with the mnemonic and calculating power of advanced cybernetics. It is applied by conventional smartphone ‘apps’ to the most advanced computers used in various areas of diagnostic and prognostic medicine, image reading, big data management, setting of new pharmacological molecules, up to completely different applications, such as spoken language, automatic driving of vehicles, insurance plans, financial strategies, etc. Of course, with enormously different degrees of complexity. Will the doctors’ role survive?
Dose-related and contextual aspects of suboptimal adherence to antiretroviral therapy among persons living with HIV in Western Europe
Authors: Akinwunmi Babatunde , Buchenberger Daniel , Scherzer Jenny , Bode Martina , Rizzini Paolo , Vecchio Fabio , Roustand Laetitia , Nachbaur Gaelle , Finkielsztejn Laurent , Chounta Vasiliki , Van de Velde Nicolas
Published: November 2020

Background

The daily oral dosing requirement for antiretroviral therapy (ART) may be challenging for some people living with HIV (PLWHIV) with comorbid conditions, confidentiality concerns or pill fatigue. We investigated suboptimal adherence from the perspective of PLWHIV and HIV physicians.

Methods

PLWHIV on ART (n = 688) and HIV physicians (n = 120) were surveyed during 2019 in France, Germany, Italy and the UK. Suboptimal adherence was a report the participant missed taking their dose as prescribed ‘Sometimes’/‘Often’/‘Very often’. Physicians’ interest in offering a hypothetical long-acting HIV regimen for suboptimally adherent patients was assessed. Descriptive and multivariable analyses were performed (P < 0.05).

Results

Of PLWHIV, 23.8% (164/688) reported suboptimal adherence vs. providers’ estimated prevalence of 33.6% (SD = 28.8). PLWHIV-reported prevalence of specific suboptimal adherence behaviors were: mistimed dose [16.1% (111/688)]; missed a dose [15.7% (108/688)]; dosed under wrong conditions [e.g. food restrictions, 10.5% (72/688)] and overdosed [3.3% (23/688)]. Odds of suboptimal adherence were higher among those with vs. without a report of the following: dysphagia (AOR = 3.61, 95% CI = 2.28–5.74), stress/anxiety because of their daily dosing schedule (AOR = 3.09, 95% CI = 1.97–4.85), gastrointestinal side effects (AOR = 2.09, 95% CI = 1.39–3.15), neurocognitive/mental health conditions (AOR = 1.88, 95% CI = 1.30–2.72) or hiding their HIV medication (AOR = 1.51, 95% CI = 1.04–2.19). Of providers, 84.2% indicated they Definitely/Probably will offer a hypothetical long-acting HIV regimen ‘for patients who have suboptimal levels of adherence to daily oral therapy (50–90%) for non-medical reasons’.

Conclusions

Dysphagia, stressful daily oral dosing schedule, gastrointestinal side effects, neurocognitive/mental health conditions and confidentiality concerns were associated with suboptimal adherence in our study. Adherence support and alternative regimens, such as long-acting antiretroviral therapies, could help address these challenges.
The impact of the Fungus-Host-Microbiota interplay uponCandida albicansinfections: current knowledge and new perspectives
Authors: d'Enfert Christophe , Kaune Ann-Kristin , Alaban Leovigildo-Rey , Chakraborty Sayoni , Cole Nathaniel , Delavy Margot , Kosmala Daria , Marsaux Benoît , Fróis-Martins Ricardo , Morelli Moran , Rosati Diletta , Valentine Marisa , Xie Zixuan , Emritloll Yoan , Warn Peter A , Bequet Frédéric , Bougnoux Marie-Elisabeth , Bornes Stephanie , Gresnigt Mark S , Hube Bernhard , Jacobsen Ilse D , Legrand Mélanie , Leibundgut-Landmann Salomé , Manichanh Chaysavanh , Munro Carol A , Netea Mihai G , Queiroz Karla , Roget Karine , Thomas Vincent , Thoral Claudia , Van den Abbeele Pieter , Walker Alan W , Brown Alistair J P
Published: November 2020

Candida albicans is a major fungal pathogen of humans. It exists as a commensal in the oral cavity, gut or genital tract of most individuals, constrained by the local microbiota, epithelial barriers and immune defences. Their perturbation can lead to fungal outgrowth and the development of mucosal infections such as oropharyngeal or vulvovaginal candidiasis, and patients with compromised immunity are susceptible to life-threatening systemic infections. The importance of the interplay between fungus, host and microbiota in driving the transition from C. albicans commensalism to pathogenicity is widely appreciated. However, the complexity of these interactions, and the significant impact of fungal, host and microbiota variability upon disease severity and outcome, are less well understood. Therefore, we summarise the features of the fungus that promote infection, and how genetic variation between clinical isolates influences pathogenicity. We discuss antifungal immunity, how this differs between mucosae, and how individual variation influences a person's susceptibility to infection. Also, we describe factors that influence the composition of gut, oral and vaginal microbiotas, and how these affect fungal colonisation and antifungal immunity. We argue that a detailed understanding of these variables, which underlie fungal-host-microbiota interactions, will present opportunities for directed antifungal therapies that benefit vulnerable patients.
Two global ensemble seismicity models obtained from the combination of interseismic strain measurements and earthquake-catalogue information
Authors: Bayona J A , Savran W , Strader A , Hainzl S , Cotton F , Schorlemmer D
Published: November 2020

Global seismicity models provide scientific hypotheses about the rate, location and magnitude of future earthquakes to occur worldwide. Given the aleatory variability of earthquake activity and epistemic uncertainties in seismicity forecasting, the veracity of these hypotheses can only be confirmed or rejected after prospective forecast evaluation. In this study, we present the construction of and test results for two updated global earthquake models, aimed at providing mean estimates of shallow (d ≤ 70 km) seismicity for seismic hazard assessment. These approaches, referred to as the Tectonic Earthquake Activity Model (TEAM) and the World Hybrid Earthquake Estimates based on Likelihood scores (WHEEL) model, use the Subduction Megathrust Earthquake Rate Forecast (SMERF2), an earthquake-rate model for subduction zones constrained by geodetic strain measurements and earthquake-catalogue information. Thus, these global ensemble seismicity models capture two independent components necessary for long-term earthquake forecasting, namely interseismic crustal strain accumulation and sudden lithospheric stress release. The calibration period for TEAM and WHEEL extends from 1977 January 1 to 2013 December 31. Accordingly, we use m ≥ 5.95 earthquakes recorded during the 2014–2019 period to pseudo-prospectively evaluate the forecasting skills of these earthquake models, and statistically compare their performances to that of the Global Earthquake Activity Rate (GEAR1) model. As a result, GEAR1 and WHEEL are the most informative global seismicity models during the pseudo-prospective test period, as both rank with the highest information scores among all participant earthquake-rate forecasts. Nonetheless, further prospective evaluations are required to more accurately assess the abilities of these global ensemble seismicity models to forecast long-term earthquake activity.
CSDB_GT, a curated glycosyltransferase database with close-to-full coverage on three most studied nonanimal species
Authors: Egorova Ksenia S , Smirnova Nadezhda S , Toukach Philip V
Published: November 2020

We report the accomplishment of the first stage of the development of a novel manually curated database on glycosyltransferase (GT) activities, CSDB_GT. CSDB_GT (http://csdb.glycoscience.ru/gt.html) has been supplemented with GT activities from Saccharomyces cerevisiae. Now it provides the close-to-complete coverage on experimentally confirmed GTs from the three most studied model organisms from the three kingdoms: plantae (Arabidopsis thaliana, ca. 930 activities), bacteria (Escherichia coli, ca. 820 activities) and fungi (S. cerevisiae, ca. 270 activities).
Exploring new opportunities through collaboration within and beyond sectoral systems of innovation in thefourthindustrial revolution
Authors: Fu Xiaolan , Fu Xiaoqing (Maggie) , Romero Carmen Contreras , Pan Jianping
Published: November 2020

This article investigates how a leading Chinese multinational enterprise in a core sector of the fourth industrial revolution manages research collaborations within and beyond its sectoral systems of innovation to create novel innovations and push the technological frontier of the industry. We find the firm expanded its technology boundaries through collaborations, particularly multidisciplinary collaborations in both core and noncore technological areas of the industry to establish and maintain its leadership in this dynamic sector. High disciplinary diversity in the company’s collaborative research portfolio is positively associated with the novelty of its innovation outputs. Promising noncore technologies have been integrated into its production through collaborative research, thus promoting technological convergence at both the firm and the sectoral levels. As a result, the boundary of the industry is expanded.
Analysis of inappropriate prescribing in elderly patients of the Swiss HIV Cohort Study reveals gender inequity
Authors: Livio Françoise , Deutschmann Elisabeth , Moffa Giusi , Rrustemi Flamur , Stader Felix , Elzi Luigia , Braun Dominique L , Calmy Alexandra , Hachfeld Anna , Cavassini Matthias , Tarr Philip E , Wissel Kerstin , Battegay Manuel , Marzolini Catia ,   the Swiss HIV Cohort Study, Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Kahlert C R , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S
Published: November 2020

Background

The extent of inappropriate prescribing observed in geriatric medicine has not been thoroughly evaluated in people ageing with HIV. We determined the prevalence of and risk factors for inappropriate prescribing in individuals aged ≥75 years enrolled in the Swiss HIV Cohort Study.

Methods

Retrospective review of medical records was performed to gain more insights into non-HIV comorbidities. Inappropriate prescribing was screened using the Beers criteria, the STOPP/START criteria and the Liverpool drug–drug interactions (DDIs) database.

Results

For 175 included individuals, the median age was 78 years (IQR 76–81) and 71% were male. The median number of non-HIV comorbidities was 7 (IQR 5–10). The prevalence of polypharmacy and inappropriate prescribing was 66% and 67%, respectively. Overall, 40% of prescribing issues could have deleterious consequences. Prescribing issues occurred mainly with non-HIV drugs and included: incorrect dosage (26%); lack of indication (21%); prescription omission (drug not prescribed although indicated) (17%); drug not appropriate in elderly individuals (18%) and deleterious DDIs (17%). In the multivariable logistic regression, risk factors for prescribing issues were polypharmacy (OR: 2.5; 95% CI: 1.3–4.7), renal impairment (OR: 2.7; 95% CI: 1.4–5.1), treatment with CNS-active drugs (OR: 2.1; 95% CI: 1.1–3.8) and female sex (OR: 8.3; 95% CI: 2.4–28.1).

Conclusions

Polypharmacy and inappropriate prescribing are highly prevalent in elderly people living with HIV. Women are at higher risk than men, partly explained by sex differences in the occurrence of non-HIV comorbidities and medical care. Medication reconciliation and periodic review of prescriptions by experienced physicians could help reduce polypharmacy and inappropriate prescribing in this vulnerable, growing population.
Relationship between weaning age and antibiotic usage on pig growth performance and mortality
Authors: Faccin Jamil E G , Tokach Mike D , Allerson Matthew W , Woodworth Jason C , DeRouchey Joel M , Dritz Steve S , Bortolozzo Fernando P , Goodband Robert D
Published: November 2020

A total of 2,184 pigs (DNA 600 × PIC L42) were used to evaluate the effects of weaning age and antibiotic (AB) use on pig performance from weaning to marketing in a commercial production system. Experimental treatments were arranged in a 3 × 2 factorial with main effects of weaning age (18.5, 21.5, or 24.5 d of age) and with the use of ABs or an antibiotic-free (NAE) program. At birth, pigs were ear tagged, and the date of birth and sex recorded. Pigs were weaned from a 4,000-sow farm over four consecutive weeks. Four weaning batches (one per week) of 546 pigs were used. Each weaning batch had one-third of pigs of each weaning age. Pigs were placed in pens by weaning age and then randomly assigned to an AB or NAE program. There were 14 replicate pens per treatment and 26 pigs per pen (13 barrows and 13 gilts). Pigs allocated to the AB program were fed a diet containing 441 mg/kg chlortetracycline (CTC) from day 8 to 21 postweaning. They were also administered 22 mg/kg of body weight (BW) of CTC via drinking water for five consecutive days after a porcine respiratory and reproductive syndrome outbreak during week 7 after weaning. In the first 42 d postweaning, increasing weaning age improved (linear, P < 0.001) BW at day 42, average daily gain (ADG), and average daily feed intake (ADFI). From weaning to 197 d of age, increasing weaning age increased (linear, P < 0.001) ADG and ADFI. Pigs on the AB program had greater (P = 0.031) ADG and ADFI compared with NAE pigs. An interaction (linear, P = 0.005) was observed for feed efficiency (G:F). When ABs were provided, increasing weaning age did not result in any change in G:F; however, in the NAE program, increasing weaning age increased G:F. Pigs on the AB program had lower (P < 0.001) total losses (mortality and removals) than those on the NAE program. Increasing weaning age marginally (linear, P = 0.097) decreased total losses. Increasing weaning age decreased (quadratic, P < 0.001) the number of pigs treated with an injectable AB but the AB program did not (P = 0.238). The weight sold (at 197 d of age) per pig weaned was increased (linear, P = 0.050) by increasing weaning age and by using AB in feed and water (P = 0.019). In summary, increasing weaning age linearly improved most of the pig performance criteria and relatively the short-term use of ABs reduced mortality and removals with both factors contributing to increased weight sold per pig weaned.
Exogenous infusion of short-chain fatty acids can improve intestinal functions independently of the gut microbiota
Authors: Zhou Hua , Sun Jing , Ge Liangpeng , Liu Zuohua , Chen Hong , Yu Bing , Chen Daiwen
Published: November 2020

The present experiment was conducted to investigate the effects of exogenously infused short-chain fatty acids (SCFAs) on the growth development and intestinal functions in a germ-free (GF) pig model. Twelve hysterectomy-derived newborn piglets were reared in six sterile isolators. All piglets were hand-fed Co60-γ-irradiated sterile milk powder for 21 d and then were switched to sterile feed for another 21 d. During the second 21-d period, GF piglets (n = 6) were orally infused with 25 mL/kg sterile saline per day, and SCFA piglets (n = 6) were orally infused with 25 mL/kg SCFAs mixture (acetic, propionic, and butyric acids, 45, 15, and 11 mM, respectively) per day. We observed the concentrations of SCFAs in serum and intestine, and the messenger ribonucleic acid (mRNA) abundance of G-protein-coupled receptor-43 in the ileum was increased (P < 0.05) in the SCFA group. Meanwhile, oral infusion of SCFAs enhanced (P < 0.05) the contents of glucagon-like peptide-2 in the jejunum and serum and tended to increase the villi height in the ileum (P < 0.10). Besides, the activities of lipase, trypsin, sucrase, lactase, Na+-K+-adenosine triphosphatase ([ATPase] P < 0.05), and Ca2+-Mg2+-ATPase (P < 0.10) were stimulated and the mRNA expressions of solute carrier family 7 (SLC7A1) and regeneration protein (REG)-ΙΙΙ γ in the jejunum (P < 0.05) were upregulated in the SCFA group. Additionally, SCFAs infusion downregulated the mRNA abundances of interleukin (IL)-1β and IL-6 in the jejunum, ileum, or colon (P < 0.05) and increased the counts of white blood cell, neutrophils, and lymphocyte in the blood (P < 0.05). Collectively, exogenous infusion of SCFAs might improve intestinal health through promoting intestinal development and absorption function, and enhancing intestinal immune function, and these effects were occur independently of the gut microbiota.