bluuebunny/crossref_metadata_2025 huggingface dataset:
Final Year Nursing Students’ Knowledge and Attitudes regarding Children’s Pain
Authors: Kusi Amponsah Abigail , Kyei-Dompim Joana , Kyei Evans Frimpong , Oduro Evans , Afaya Richard Adongo , Ahoto Collins Kwadwo
Published: February 2020

Pain is one of the commonest reasons why children visit the hospital. Inadequately treated pain in children can negatively affect their physical, psychological, and social well-being; it also places financial burden on families of affected children and healthcare systems in general. Considering the eventual suffering of vulnerable children and their families if nursing students are insufficiently educated and ill-prepared, the current study aimed at assessing final year nursing student’s knowledge and attitudes pertaining to pediatric pain. A descriptive cross-sectional study was conducted among 100 final year undergraduate nursing students at a private university college in Ghana. In addition to their ages and gender, the students responded to the 42 individual items on the Pediatric Nurses’ Knowledge and Attitudes Survey regarding pain (PNKAS) instrument. Descriptive statistical analysis was aided by the Statistical Package for Social Sciences version 25 software. The mean age of the final year nursing students was 29 years (range of 21 to 47 years); a majority of them were females (78%). Participants had an average (SD) correct answer score of 44.0% (10.6%). Good pediatric pain knowledge and attitudes were observed in items that were related to the individualized and multidimensional nature of the pain experience and its treatment, benefits of pre-emptive analgesia, pharmacodynamics, and pain assessment. Poor pediatric pain knowledge and attitudes occurred in items that focused on pain perceptions, opioid drug administration, useful pain medications, pain physiology, and nonpharmacological pain management interventions. Final year nursing students have insufficient knowledge and attitudes toward children’s pain management. Areas of good and poor pediatric pain knowledge and attitudes should be considered when designing and implementing educational interventions on this subject. Curricular revisions should be made on existing nursing curriculum to lay more emphasis on children’s pain management and use educational interventions that support knowledge translation for improved care.
Damage and Degradation of Concrete under Coupling Action of Freeze‐Thaw Cycle and Sulfate Attack
Authors: Tian Wei , Gao Fangfang
Published: February 2020

In this study, the mechanical behaviors, failure characteristics, and microstructure of concrete containing fly ash (FA) against combined freeze‐thaw cycles and sulfate attack were studied compared with normal concrete, and the formation rates of corrosion products during coupling cycles were investigated. Results showed that, during the coupling action of freeze‐thaw cycles and sodium sulfate solution, concrete containing 10% fly ash exposed in 5% sodium sulfate solution exhibited better freeze‐thaw resistance. Meanwhile, the variation of compressive strength of concrete during the coupling cycles could be divided into two stages, including the strength enhancement stage and the strength reduction stage. Moreover, the proportion of micropores and capillary pores decreased obviously during combined freeze‐thaw cycles and sulfate attack, and excessive concentration of sodium sulfate solution led to more macropores after high‐frequency freeze‐thaw cycles.
Seven-Year Visual and Anatomical Outcomes of Intravitreal Vascular Endothelial Growth Factor Inhibition for Neovascular Age-Related Macular Degeneration
Authors: Stattin Martin , Forster Julia , Ahmed Daniel , Haas Anna-Maria , Graf Alexandra , Krepler Katharina , Ansari-Shahrezaei Siamak
Published: February 2020

Purpose. To evaluate 7-year visual and anatomical outcomes of intravitreal injections (IVI) with antivascular endothelial growth factor (anti-VEGF) for neovascular age-related macular degeneration (nAMD) based on a personalized pro re nata (PRN) regimen. Methods. Anonymized data of 124 consecutive eyes in 121 patients with treatment-naïve nAMD were initially collected in 2010. Of those, 45 received anti-VEGF IVI at least every 6months until 2017 in one single center in Austria and hence were retrospectively analyzed. All eyes had been initiated on a loading dose of 3 monthly IVI with different anti-VEGF agents followed by a PRN regimen in the first year. At year 2, monitoring as well as therapeutic intervention could be prolonged every 2weeks up to intervals of 3months without capping treatment. Primary outcome measure was the change of visual acuity (VA) assessed by Early Treatment Diabetic Retinopathy Study charts at 4 meters (ETDRS) in letters—counting every correctly read letter—and converted to Snellen. Secondary outcome measures were number of injections and change of central retinal thickness (CMT) from baseline. Results. Mean baseline VA was 20/63 + 1 (0.63 ± 0.26 ETDRS) and declined to 20/100 + 2 (0.45 ± 0.33) with an overall loss of 9 letters ETDRS after 7years (p = 0.001). An average of 3.5 ± 1.9 IVI was given per year and eye. Mean CMT at baseline was 322 ± 95 μm, decreased by 52 μm to 270 ± 70 μm within the first year, and remained below baseline at year 7 (271 ± 106 μm; p<0.001). Conclusions. Our data confirm an absolute vision loss in eyes compromised by nAMD after 7 years of continuous VEGF inhibition. The visual decline was significantly related to baseline VA as well as the number of injections. We suggest following patients thoroughly independent of the initial VA and a greater incentive for the physician to treat.
Build-a-Mouse: Melanoma Modeling Picks up Speed
Authors: Thorkelsson Andres , Merlino Glenn , Michael Helen
Published: February 2020

The study by Bok and colleagues in this issue introduces a new paradigm for generating new mouse models for melanoma research. Genetically engineered mouse models (GEMM) have been crucial for understanding tumor initiation and modeling potential therapies, but are time consuming to create. Bok and colleagues generated and validated high-contribution chimeric GEMM models using common melanoma GEMMs as a starting point and added additional CRISPR, Cre-inducible, and Dox-inducible alleles. This rapid method for generating new models has the potential to revolutionize mouse modeling for melanoma.

See related article by Bok et al., p. 912
Single-Cell Genomic Characterization Reveals the Cellular Reprogramming of the Gastric Tumor Microenvironment
Authors: Sathe Anuja , Grimes Susan M. , Lau Billy T. , Chen Jiamin , Suarez Carlos , Huang Robert J. , Poultsides George , Ji Hanlee P.
Published: February 2020

Purpose:

The tumor microenvironment (TME) consists of a heterogenous cellular milieu that can influence cancer cell behavior. Its characteristics have an impact on treatments such as immunotherapy. These features can be revealed with single-cell RNA sequencing (scRNA-seq). We hypothesized that scRNA-seq analysis of gastric cancer together with paired normal tissue and peripheral blood mononuclear cells (PBMC) would identify critical elements of cellular deregulation not apparent with other approaches.

Experimental Design:

scRNA-seq was conducted on seven patients with gastric cancer and one patient with intestinal metaplasia. We sequenced 56,167 cells comprising gastric cancer (32,407 cells), paired normal tissue (18,657 cells), and PBMCs (5,103 cells). Protein expression was validated by multiplex immunofluorescence.

Results:

Tumor epithelium had copy number alterations, a distinct gene expression program from normal, with intratumor heterogeneity. Gastric cancer TME was significantly enriched for stromal cells, macrophages, dendritic cells (DC), and Tregs. TME-exclusive stromal cells expressed distinct extracellular matrix components than normal. Macrophages were transcriptionally heterogenous and did not conform to a binary M1/M2 paradigm. Tumor DCs had a unique gene expression program compared to PBMC DCs. TME-specific cytotoxic T cells were exhausted with two heterogenous subsets. Helper, cytotoxic T, Treg, and NK cells expressed multiple immune checkpoint or co-stimulatory molecules. Receptor–ligand analysis revealed TME-exclusive intercellular communication.

Conclusions:

Single-cell gene expression studies revealed widespread reprogramming across multiple cellular elements in the gastric cancer TME. Cellular remodeling was delineated by changes in cell numbers, transcriptional states, and intercellular interactions. This characterization facilitates understanding of tumor biology and enables identification of novel targets including for immunotherapy.
Utilization of Novel High-Resolution, MRI-Based Vascular Imaging Modality for Preoperative Stereoelectroencephalography Planning in Children: A Technical Note
Authors: Feng Austin Y. , Ho Allen L. , Kim Lily H. , Sussman Eric S. , Pendharkar Arjun V. , Iv Michael , Yeom Kristen W. , Halpern Casey H. , Grant Gerald A.
Published: February 2020

Introduction: Stereoelectroencephalography (SEEG) is a powerful intracranial diagnostic tool that requires accurate imaging for proper electrode trajectory planning to ensure efficacy and maximize patient safety. Computed tomography (CT) angiography and digital subtraction angiography are commonly used, but recent developments in magnetic resonance angiography allow for high-resolution vascular visualization without added risks of radiation. We report on the accuracy of electrode placement under robotic assistance planning utilizing a novel high-resolution magnetic resonance imaging (MRI)-based imaging modality. Methods: Sixteen pediatric patients between February 2014 and October 2017 underwent SEEG exploration for epileptogenic zone localization. A gadolinium-enhanced 3D T1-weighted spoiled gradient recalled echo sequence with minimum echo time and repetition time was applied for background parenchymal suppression and vascular enhancement. Electrode placement accuracy was determined by analyzing postoperative CT scans laid over preoperative virtual electrode trajectory paths. Entry point, target point, and closest vessel intersection were measured. Results: For any intersection along the trajectory path, 57 intersected vessels were measured. The mean diameter of an intersected vessel was 1.0343 ± 0.1721 mm, and 21.05% of intersections involved superficial vessels. There were 157 overall intersection + near-miss events. The mean diameter for an involved vessel was 1.0236 ± 0.0928 mm, and superficial vessels were involved in 20.13%. Looking only at final electrode target, 3 intersection events were observed. The mean diameter of an intersected vessel was 1.0125 ± 0.2227 mm. For intersection + near-miss events, 24 were measured. An involved vessel’s mean diameter was 1.1028 ± 0.2634 mm. For non-entry point intersections, 45 intersected vessels were measured. The mean diameter for intersected vessels was 0.9526 ± 0.0689 mm. For non-entry point intersections + near misses, 126 events were observed. The mean diameter for involved vessels was 0.9826 ± 0.1008 mm. Conclusion: We believe this novel sequence allows better identification of superficial and deeper subcortical vessels compared to conventional T1-weighted gadolinium-enhanced MRI.
Assessing the Heterogeneity of Complaints Related to Tinnitus and Hyperacusis from an Unsupervised Machine Learning Approach: An Exploratory Study
Authors: Palacios Guillaume  , Noreña Arnaud , Londero Alain
Published: February 2020

Introduction: Subjective tinnitus (ST) and hyperacusis (HA) are common auditory symptoms that may become incapacitating in a subgroup of patients who thereby seek medical advice. Both conditions can result from many different mechanisms, and as a consequence, patients may report a vast repertoire of associated symptoms and comorbidities that can reduce dramatically the quality of life and even lead to suicide attempts in the most severe cases. The present exploratory study is aimed at investigating patients’ symptoms and complaints using an in-depth statistical analysis of patients’ natural narratives in a real-life environment in which, thanks to the anonymization of contributions and the peer-to-peer interaction, it is supposed that the wording used is totally free of any self-limitation and self-censorship. Methods: We applied a purely statistical, non-supervised machine learning approach to the analysis of patients’ verbatim exchanged on an Internet forum. After automated data extraction, the dataset has been preprocessed in order to make it suitable for statistical analysis. We used a variant of the Latent Dirichlet Allocation (LDA) algorithm to reveal clusters of symptoms and complaints of HA patients (topics). The probability of distribution of words within a topic uniquely characterizes it. The convergence of the log-likelihood of the LDA-model has been reached after 2,000 iterations. Several statistical parameters have been tested for topic modeling and word relevance factor within each topic. Results: Despite a rather small dataset, this exploratory study demonstrates that patients’ free speeches available on the Internet constitute a valuable material for machine learning and statistical analysis aimed at categorizing ST/HA complaints. The LDA model with K = 15 topics seems to be the most relevant in terms of relative weights and correlations with the capability to individualizing subgroups of patients displaying specific characteristics. The study of the relevance factor may be useful to unveil weak but important signals that are present in patients’ narratives. Discussion/Conclusion: We claim that the LDA non-supervised approach would permit to gain knowledge on the patterns of ST- and HA-related complaints and on patients’ centered domains of interest. The merits and limitations of the LDA algorithms are compared with other natural language processing methods and with more conventional methods of qualitative analysis of patients’ output. Future directions and research topics emerging from this innovative algorithmic analysis are proposed.
Understanding Fetal Hemodynamics Using Cardiovascular Magnetic Resonance Imaging
Authors: Sun Liqun , Marini Davide , Saini Brahmdeep , Schrauben Eric , Macgowan Christopher K. , Seed Mike
Published: February 2020

Human fetal circulatory physiology has been investigated extensively using grey-scale ultrasound, which provides excellent visualization of cardiac anatomy and function, while velocity profiles in the heart and vessels can be interrogated using Doppler. Measures of cerebral and placental vascular resistance, as well as indirect measures of intracardiac pressure obtained from the velocity waveform in the ductus venosus are routinely used to guide the management of fetal cardiovascular and placental disease. However, the characterization of some key elements of cardiovascular physiology such as vessel blood flow and the oxygen content of blood in the arteries and veins, as well as fetal oxygen delivery and consumption are not readily measured using ultrasound. To study these parameters, we have historically relied on data obtained using invasive measurements made in animal models, which are not equivalent to the human in every respect. Over recent years, a number of technical advances have been made that have allowed us to examine the human fetal circulatory system using cardiovascular magnetic resonance (CMR). The combination of vessel blood flow measurements made using cine phase contrast magnetic resonance imaging and vessel blood oxygen saturation and hematocrit measurements made using T1 and T2 mapping have enabled us to emulate those classic fetal sheep experiments defining the distribution of blood flow and oxygen transport across the fetal circulation in the human fetus. In addition, we have applied these techniques to study the relationship between abnormal fetal cardiovascular physiology and fetal development in the setting of congenital heart disease and placental insufficiency. CMR has become an important diagnostic tool in the assessment of cardiovascular physiology in the setting of postnatal cardiovascular disease, and is now being applied to the fetus to enhance our understanding of normal and abnormal fetal circulatory physiology and its impact on fetal well-being.
Chronic Small Cortical Cerebellar Infarctions on MRI are Associated with Patent Foramen Ovale in Young Cryptogenic Stroke
Authors: Renard Dimitri , Ion Ioana , Ricci Jean-Etienne , Mura Thibault , Thouvenot Eric , Wacongne Anne
Published: February 2020

Background: In acute infarction patients, small cortical cerebellar infarctions (SCCI) on MRI (assessed on diffusion-weighted imaging, with SCCI often chronic and asymptomatic) are associated with acute cardioembolic infarction. In young cryptogenic stroke patients, patent foramen ovale (PFO) is thought to be a potential source of cardioembolic infarction. We hypothesize that SCCI on MRI would be associated with PFO in young cryptogenic stroke patients. Methods: A total of 321 consecutive young (≤50 years) stroke patients admitted between January 2015 and July 2019 were screened. Of these patients, 287 patients had diagnostic work-up including early-phase MRI, intra- and extracranial vessel imaging, contrast transoesophageal or contrast transthoracic echocardiography, and ≥24 h ECG-monitoring. We retrospectively analyzed MRI scans of the 112 patients with cryptogenic stroke, including 63 with and 49 without PFO. Between both groups, we compared baseline characteristics (including cardiovascular risk factors and history of stroke), MRI characteristics of acute symptomatic infarction (cortical/subcortical localization, arterial territory, lesion number, and lesion size in case of subcortical infarction), atrial septum aneurysm (ASA) presence, and acute and chronic SCCI and non-SCCI lesions assessed on diffusion-weighted imaging. Results: Groups with and without PFO were comparable in regard to performed vessel imaging and echocardiography modalities, baseline characteristics, and acute infarction characteristics, except for more frequent current smoking (67 vs. 44%, p = 0.022) and multiterritorial infarction (14 vs. 0%, p = 0.0024) and less frequent ASA (10 vs. 48%, p < 0.001) in the group without PFO. Risk of Paradoxal Embolism score was >6 in 76% of patients with PFO. SCCI was more frequent in patients with than without PFO (33 vs. 10%, p = 0.0061; OR 4.4, 95% CI 1.5–12.7), with chronic and asymptomatic SCCI in the vast majority of cases. No difference was observed for non-SCCI lesions. Conclusions: Chronic SCCI are strongly associated with PFO in young cryptogenic stroke patients. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT04043559.
Deriving a Passive Surveillance Stroke Severity Indicator From Routinely Collected Administrative Data: The PaSSV Indicator
Authors: Yu Amy Y. X. , Austin Peter C. , Rashid Mohammed , Fang Jiming , Porter Joan , Hill Michael D. , Kapral Moira K.
Published: February 2020

Background:

Adjusting for stroke severity is crucial for stroke outcomes research. However, this information is not available in administrative healthcare data. We aimed to derive an indicator of baseline stroke severity using these data.

Methods and Results:

We identified patients with stroke enrolled in a population-based registry in Ontario, Canada, and used the Canadian Neurological Scale (CNS), documented in the registry, as a measure of stroke severity. We derived an estimated CNS from a linear regression model in which we regressed the observed CNS on predictor variables: age, sex, arrival by ambulance, interhospital transfer, mechanical ventilation, and an emergency department triage score. The effect of stroke severity on the estimated hazard ratios for 30-day mortality was determined in 3 Cox-proportional hazards models with (1) no CNS, (2) observed CNS, and (3) estimated CNS, all adjusted for age, sex, Charlson index, and stroke type. We assessed model discrimination using C statistics. To assess for construct validity, we repeated these analyses in a subset of patients with documented National Institute of Health Stroke Scale and in a cohort of patients with stroke external to the registry. We derived the estimated stroke severity in 41 481 patients (48.7% female, median age of 75 years [interquartile range, 64– 83]). The magnitude of the association between stroke severity and mortality was similar for the observed and estimated CNS. The discriminative ability of the Cox-proportional hazards models to predict mortality was highest when the observed CNS was included (C statistic, 0.82 [95% CI, 0.81–0.82]), moderate with estimated CNS (0.76 [0.75–0.76]), and lowest without CNS (0.69 [0.69–0.70]. Our findings were replicated with the National Institute of Health Stroke Scale and in the external cohort.

Conclusions:

We derived an estimated measure of stroke severity using administrative data. This can be applied for risk adjustment in population-based stroke outcomes research and in assessments of health system performance.
Vertebrobasilar Artery Calcification and Outcomes in Posterior Circulation Large Vessel Occlusion Thrombectomy
Authors: Diprose William K. , Diprose James P. , Tarr Gregory P. , Sutcliffe James , McFetridge Andrew , Brew Stefan , Caldwell James , McGuinness Ben , Wang Michael T.M. , Barber P. Alan
Published: February 2020

Background and Purpose—

Intracranial carotid artery calcification is associated with worse outcome in anterior circulation stroke patients who undergo endovascular thrombectomy. We investigated the association between vertebrobasilar artery calcification (VBAC) and outcome in patients undergoing endovascular thrombectomy for posterior circulation large vessel occlusion.

Methods—

Consecutive patients treated for posterior circulation large vessel occlusion from a prospective single-center registry were studied. VBAC was manually segmented on computed tomography brain scans. The associations between VBAC and VBAC volume, functional independence (90-day modified Rankin Scale score of 0–2), and 90-day mortality were assessed using propensity score–adjusted logistic regression.

Results—

Sixty-four posterior circulation large vessel occlusion patients were included. Twenty-five (39.1%) patients had VBAC, and of these, the median (interquartile range) VBAC volume was 19.8 (6.65–23.4) mm
3
. VBAC was associated with reduced functional independence (OR, 0.19 [95% CI, 0.04–0.78];
P
=0.03) and increased mortality (OR, 9.44 [95% CI, 2.43–36.62];
P
=0.005). Larger VBAC volumes were a significant predictor of reduced functional independence and increased mortality.

Conclusions—

VBAC is an independent predictor of outcome in patients undergoing endovascular thrombectomy for posterior circulation large vessel occlusion. Considering the presence of VBAC might improve prognostication and shared treatment decision-making between patients, families, and physicians.
What Is the Relationship Among Positive Emotions, Sense of Presence, and Ease of Interaction in Virtual Reality Systems? An On-Site Evaluation of a Commercial Virtual Experience
Authors: Pallavicini Federica , Pepe Alessandro , Ferrari Ambra , Garcea Giacomo , Zanacchi Andrea , Mantovani Fabrizia
Published: February 2020

Scientific knowledge is still limited about the effect of commercial virtual reality content, such as experiences developed for advertising purposes, on individual emotional experience. In addition, even though correlations between emotional responses and perceived sense of presence in virtual reality have often been reported, the relationship remains unclear. Some studies have suggested an important effect of ease of interaction on both emotions and the sense of presence, but only a few studies have scientifically explored this topic. Within this context, this study aimed to: (a) test the effect of inducing positive emotions of a commercial virtual experience developed for the promotion of an urban renewal project, (b) investigate the relationship between positive emotions and the perceived sense of presence, and (c) explore the association between the ease of interaction of the virtual experience with positive emotions and the sense of presence reported by the users. Sixty-one participants were recruited from visitors to the 2017 Milan Design Week “Fuorisalone” event. A survey was administered before and after the experience to collect information about users' demographics, positive emotions, sense of presence, and the ease of interaction with the virtual content. Results give evidence that: (a) the commercial virtual reality experience was able to induce positive emotions; (b) the positive emotions reported by users were associated with the sense of presence experienced in the virtual environment, with a directional effect from emotion to sense of presence; and (c) the easier the interaction, the more the sense of presence and positive emotions were reported by users.
A new species of Flavoperla Chu, 1929 (Plecoptera: Perlidae) from Guangxi Zhuang Autonomous Region of southern China
Authors: MO RAORAO , WANG GUOQUAN , LI WEIHAI
Published: February 2020

A new species of the stonefly perlid genus Flavoperla, F. galerispina sp. nov., is described from the Huaping National Nature Reserve in the Guangxi Zhuang Autonomous Region of southern China. The relationships based on morphological characteristics of the new species and related species are discussed.
The advertisement call of the moustache toad Leptobrachium liui Pope, 1947 (Anura: Megophryidae) from eastern China
Authors: DING GUO-HUA , CHEN ZHI-QIANG , TANG YUN , ZHENG WEI-CHENG , JI XIANG
Published: February 2020

The Leptobrachium genus is currently composed of 36 species distributed in Southern China, India, islands of the Sunda Shelf, and the Philippines (Frost 2019). In China, 11 species of the genus Leptobrachium are currently known (AmphibiaChina 2019), of which, the following nine are Chinese endemic: L. bompu (Sondhi & Ohler 2011), L. boringii (Liu 1945), L. guangxiense (Fei, Mo, Ye & Jiang 2009), L. hainanense (Ye & Fei 1993), L. huashen (Fei & Ye 2005), L. leishanense (Liu & Hu 1973), L. liui (Pope 1947), L. promustache (Rao, Wilkinson & Zhang 2006) and L. tengchongense (Yang, Wang & Chan 2016). These species have different morphologies, narrow distribution areas, and their taxonomy is subject to controversy (AmphibiaChina 2019). The megophryid genus Leptobrachium was considered to contain two subgenera Vibrissaphora and Leptobrachium (Matsui et al. 2010). Five Leptobrachium species, L. ailaonicum, L. boringii, L. leishanense, L. liui, and L. promustache, were originally classified as Vibrissaphora, based on adult males bearing spines on the upper lip (Fei & Ye 2016). However, recent phylogenetic studies showed that Vibrissaphora was not a subgenus and placed within the genus Leptobrachium (Zheng et al. 2008; Matsui et al. 2010).
Lower Extremity Muscle Morphology and Plantar Loading During Squatting with Different Heel Heights
Authors: Xie Tanyan , Zhang Yan , Awrejcewicz Jan , Gu Yaodong
Published: February 2020

Objective: Although it is widely reported that high-heeled changes gait pattern in terms of motions and forces throughout the body, the biomechanics while high-heeled squatting has not been examined. This study aimed to explore the acute effects of different heel heights on muscle
morphology and plantar loading during high-heeled squatting. Methods: Fourteen healthy females performed squats on high-heeled shoes with different heights: flat (0.8 cm), moderate (4.0 cm), and high (7.0 cm). Muscle thickness and pennation angle of selected lower limb muscles were
measured by ultrasound imaging. Plantar pressure distribution and COP trajectory during an entire squatting motion were recorded. Results: As the heel height increased, the average and peak pressure consistently increased in the heel and hallux regions, while reversely changed in MF
and LF regions. In addition, the selected lower limb muscles except for the lateral gastrocnemius and vastus medialis showed significant differences in muscle thickness and pennation angle between heel heights. Conclusion: The findings of this study indicate that increased heel height
would enhance the immediate effects on muscle morphology as well as plantar pressure redistribution potentially causing lower limb muscle fatigue and injuries.
In-Hospital Mortality Prediction for Heart Failure Patients Using Electronic Health Records and an Improved Bagging Algorithm
Authors: Wang Binhua , Ma Xiao , Wang Yifei , Dong Wei , Liu Chengyu , Bai Yongyi , Bian Suyan , Ying Jun , Hu Xin , Wan Shanshan , Xue Wanguo , Tian Yaping , Zhong Cheng , Zhang Yang , He Kunlun , Li Jiayue
Published: February 2020

An improved bagging algorithm, combined with a resample strategy, a neural network, and a support vector machine (SVM), is proposed for in-hospital mortality prediction using imbalanced data with very uneven ratio of positive and negative samples. This approach was compared with other
machine learning algorithms such as SVM, neural network and GBDT to evaluate its effectiveness. Permutation importance algorithm was employed to assess risk factors for heart failure patients and experimental validation was conducted using medical data from the Chinese PLA General Hospital
which consisted of 207 positive and 5975 negative samples, achieving area under curve (AUC), sensitivity, and specificity values of 0.850, 0.800, and 0.752, respectively. The top 5 risk factors extracted are creatinine, serum albumin, lactate dehydrogenase, platelet count, and lymphocytes.
These results suggest that the proposed method has the potential to be a valuable new tool for in-hospital mortality prediction using electronic health record data.
Vertical-Aligned Silicon Nanowire Arrays with Strong Photoluminescence Fabricated by Metal-Assisted Electrochemical Etching
Authors: Cao Dao Tran , Anh Cao Tuan , Ngan Luong Truc Quynh
Published: February 2020

Metal-assisted chemical etching of silicon is a commonly used method to fabricate vertical aligned silicon nanowire arrays. In this report we show that if in the above method the chemical etching is replaced by the electrochemical one, we can also produce silicon nanowire arrays, but
with a special characteristic-extremely strong photoluminescence. Further research showed that the huge photoluminescence intensity of the silicon nanowire arrays made by metal-assisted electrochemical etching is related to the anodic oxidation of the silicon nanowires which has occurred during
the electrochemical etching. It is most likely that the luminescence of the silicon nanowire arrays made with metal-assisted electrochemical etching is the luminescence of silicon nanocrystallites (located on the surface of silicon nanowire fibers) embedded in a silicon oxide matrix, similar
to that in a silicon rich oxide system.
Multi-Input Look-Up-Table Design Based on Nanometer Memristor
Authors: Sun Jun-Wei , Zhao Xing-Tong , Wang Yan-Feng
Published: February 2020

The logic blocks of Field Programmable Gate Array (FPGA) basic unit are mainly composed of Look-Up-Tables (LUTs). The traditional LUTs use the static random access memory (SRAM), which causes FPGA reach the limitation in term of the density, speed, and configuration overhead. In this
paper, a novel nanometer memristor-based LUT (NMLUT) is composed of memristors, MOS field effect transistors, decoders, resistors. A three-input NMLUT and a four-input NMLUT circuits are investigated. Moreover, an adder is used to verify the practicality of NMLUT circuit. The proposed NMLUT
circuit can implement some combinational logic functions through specific configuration and it is better in data transmission and data storage than the traditional LUT. Since NMLUT circuit is compatible with the mainstream circuit in the FPGA, it can effectively solve the limitations of the
field FPGA. The correctness of the results is verified in PSPICE software.
Current and Magnetic Field of a Simplex Wave Winding in a DC Generator
Authors: Chen Jun
Published: February 2020

The DC generator is widely used in the fields of industry motor control and energy transfer, and the simplex wave winding (SWW) is the main winding pattern of the DC generator. In this paper, a brief introduction to the structure of the SWW is presented first. Then the characteristics
of the current and electromagnetic fields of the SWW are analyzed particularly in a commutation cycle and two typical concepts of the “central slot” (CS) and the “widest magnetic peak area” (WMPA) are proposed respectively. The characteristic frequency which is 63 and
21 times higher than the fundamental frequency (FF) of the voltage between two brushes is obtained and verified from 6 conditions of different speeds and currents. Furthermore, with the help of an induction coil sensor between two main poles, the characteristic frequency 84 times higher than
the FF of the WMPA is also verified in 6 conditions and the results coincides with the theory well.
Effect of Strontium Doping Into CaBi2Nb2O9 Aurivillius Oxide Nanoceramics: Structural and Electrical Properties
Authors: Jalled Ouissem , Alhassan Mariah , Alharbi Seham R. , Alharbi Zaynab , Al-Hadeethi Yas , Mohammed Hiba , Miao Xiaohe
Published: February 2020

Herein, we report the synthesis and characterization of Ca1-xSrxBi2Nb2O9 (CSBNO) (0 ≤ x ≤ 1) nanoceramics prepared using sucrose-assisted sol–gel combustion methods. The synthesized nanoceramics
were characterized by different tools like differential thermal and thermogravimetric analyzer (DTA-TG), high resolution transmission electron microscopy (HRTEM), Fourier transform infrared (FTIR) spectrometer, X-ray powder diffraction (XRD), and impedance analyzer. DTA-TG reveals that the
optimum temperature of calcination of CBN is higher than 1000 °C. The FTIR revealed the formation of CaBi2Nb2O9 (CBNO) at 614 cm-1. The XRD confirmed that all samples exhibited orthorhombic crystal structure. Increased orthorhombic distortion
was spotted for doped CBNO and the structure acquires extra orthorhombicity through Sr doping. The TEM measurement inspected the increase of the grain size due to the inclusion of strontium into the orthorhombic crystal structure of CBNO from 56 nm to 76 nm. The dielectric constant measurement
demonstrated that the increase in Sr content is associated with steady decrease in Curie temperature from 1207 K up to 720 K. The dielectric loss exhibited a minimum value at x = 0.5 and high stability along the temperature range of 300–850 K. Such property may enable this nanocomposite
to be used for the application of FeRAM.
Grandparenting and Mortality: How Does Race-Ethnicity Matter?
Authors: Choi Seung-won Emily
Published: February 2020

Little is known about whether and how intergenerational relationships influence older adult mortality. This study examines the association between caring for grandchildren (i.e., grandparenting) and mortality and how the link differs by race-ethnicity. Drawing from the Health and Retirement Study (1998–2014, N = 13,705), I found different racial-ethnic patterns in the effects of grandparenting on mortality risk. White grandparents who provide intensive noncoresident grandparenting (i.e., over 500 hours of babysitting per two years) and multigenerational household grandparenting have a lower risk of mortality compared to noncaregiving grandparents. In contrast, black grandparents have a higher mortality risk than their noncaregiving counterparts when providing intensive noncoresident, multigenerational household, and skipped-generation household (i.e., grandparent-headed family) grandparenting. Caregiving Hispanic grandparents are not significantly different from their noncaregiving counterparts in mortality risk. These findings suggest that important variations in social and cultural contexts for racial-ethnic groups shape the consequences of grandparenting for older adult mortality.
The Two Faces of Diversity: The Relationships between Religious Polarization, Religious Fractionalization, and Self-rated Health
Authors: Lu Yun , Yang Xiaozhao Y.
Published: February 2020

A dominant discourse in the social sciences theorizes that religious diversity puts individuals’ health at risk via interreligious hostility. However, this discourse overlooks the different subtypes of religious diversity and the moderation of political institutions. To better understand the issue of diversity and health, in this study, we distinguish between two subtypes of religious diversity—polarization and fractionalization—and argue that their impacts on health are heterogeneous. Using a sample of 67,399 individuals from 51 societies drawn from the 2010–2014 wave of the World Values Survey, our multilevel analyses show that religious polarization is negatively associated with individual health, whereas the health effects of religious fractionalization are positive. Moreover, the associations between religious polarization/fractionalization and individual health are found to depend on the democratic level of the state. In more democratic countries, the negative effects of polarization on health are mitigated, and the positive effects of fractionalization are stronger.
Dependency versus sustainability in missions in the Russian and African contexts
Authors: Elliott Mark R.
Published: February 2020

All too often in missions’ history the unfortunate pattern has been to establish dependent, rather than independent, seminaries and churches that have had to struggle mightily to arrive at a point of self-sufficiency. Given this tendency, how can missionaries best foster indigenous churches, schools, and ministries that will become self-sustaining? Best practices in overcoming dependency include instruction in stewardship, bi-vocational ministry, and micro-enterprise development. Russian and African case studies of dependency and steps toward self-sustaining church life are examined. The article concludes with the details of a demonstration greenhouse project at six sites in Russia and Ukraine.
Associations between prenatal diet quality and gestational weight gain
Authors: Schlaff Rebecca A , Baruth Meghan , Deere Samantha J , Boggs Ashley , Odabasic Anya
Published: February 2020

Background:

Improving prenatal diet quality may promote appropriate gestational weight gain (GWG).

Aim:

To examine relationships between dietary quality in the second and third trimesters of pregnancy and GWG.

Methods:

Participants’ ( n = 41) dietary intake was assessed at 14–20 and 35 weeks gestation via the Automated Self-Administered 24-h recall (ASA-24). Kilocalories and Healthy Eating Index (HEI-2015) scores were calculated and associations with GWG were explored via linear regression.

Results:

Participants reported consuming 2139 ± 719 and 2085 ± 704 kilocalories at 18 and 35 weeks, respectively. HEI-2015 total scores at 18 (55.6 ±12.6) and 35 weeks gestation (56.6 ± 14.1) indicated a need for improvement. Greens and beans component score at 35 weeks was the only diet quality score associated with GWG.

Conclusions:

GWG was not associated with most diet quality indices. However, vegetable intake may help to attenuate GWG. Future research should seek to elucidate relationships between GWG and dietary quality/intake to provide valuable insight for researchers and clinicians.
Implications of relationship-induced self-concept change across partners: An Actor-Partner Interdependence Model approach
Authors: McIntyre Kevin P. , Mattingly Brent A. , Gorban Sarah A. , Cope Morgan A.
Published: February 2020

Investigations of relationship-induced self-concept change and relationship quality have generally been limited to intraindividual effects (i.e., actor effects). In the current study, we examined whether self-changes influence romantic partners’ perceptions of relationship satisfaction and commitment (i.e., partner effects). Using the actor–partner interdependence model, we tested how four self-concept change processes—self-expansion, self-pruning, self-contraction, and self-adulteration—are associated with relationship satisfaction and commitment. Results revealed robust actor effects across all self-change processes and partner effects on satisfaction for degradation processes only (i.e., self-contraction and self-adulteration), suggesting that self-changes differentially predict individuals’ and partners’ perceptions of the relationship.
Tight junctions in the blood–brain barrier promote edema formation and infarct size in stroke – Ambivalent effects of sealing proteins
Authors: Winkler Lars , Blasig Rosel , Breitkreuz-Korff Olga , Berndt Philipp , Dithmer Sophie , Helms Hans C , Puchkov Dmytro , Devraj Kavi , Kaya Mehmet , Qin Zhihai , Liebner Stefan , Wolburg Hartwig , Andjelkovic Anuska V , Rex Andre , Blasig Ingolf E , Haseloff Reiner F
Published: February 2020

The outcome of stroke is greatly influenced by the state of the blood–brain barrier (BBB). The BBB endothelium is sealed paracellularly by tight junction (TJ) proteins, i.e., claudins (Cldns) and the redox regulator occludin. Functions of Cldn3 and occludin at the BBB are largely unknown, particularly after stroke. We address the effects of Cldn3 deficiency and stress factors on the BBB and its TJs. Cldn3 tightened the BBB for small molecules and ions, limited endothelial endocytosis, strengthened the TJ structure and controlled Cldn1 expression. After middle cerebral artery occlusion (MCAO) and 3-h reperfusion or hypoxia of isolated brain capillaries, Cldn1, Cldn3 and occludin were downregulated. In Cldn3 knockout mice (C3KO), the reduction in Cldn1 was even greater and TJ ultrastructure was impaired; 48 h after MCAO of wt mice, infarct volumes were enlarged and edema developed, but endothelial TJs were preserved. In contrast, junctional localization of Cldn5 and occludin, TJ density, swelling and infarction size were reduced in affected brain areas of C3KO. Taken together, Cldn3 and occludin protect TJs in stroke, and this keeps the BBB intact. However, functional Cldn3, Cldn3-regulated TJ proteins and occludin promote edema and infarction, which suggests that TJ modulation could improve the outcome of stroke.
Structured MRI reporting in spinal dysraphism
Authors: Kumar Ishan , Sachan Ankita , Aggarwal Priyanka , Verma Ashish , Shukla Ram C
Published: February 2020

Magnetic resonance evaluation of spinal dysraphism can be confusing for inexperienced radiologists and a detailed, step-by-step evaluation of the normal and abnormal imaging findings can help garner the diagnosis. The purpose of this article is to review the existing literature and to provide a comprehensive, structured, template checklist-style format for reporting spinal dysraphism that can help inexperienced radiologists to systematically analyze and report all the significant and ancillary findings in cases of spinal dysraphism and efficiently communicate the findings to the treating physician/surgeon.
Prognostic value of [18F]FDG PET/CT parameters in surgically resected primary lung adenocarcinoma: a single-center experience
Authors: Ventura Luigi , Scarlattei Maura , Gnetti Letizia , Silini Enrico Maria , Rossi Maurizio , Tiseo Marcello , Sverzellati Nicola , Bocchialini Giovanni , Musini Luca , Balestra Valeria , Ampollini Luca , Rusca Michele , Carbognani Paolo , Ruffini Livia
Published: February 2020

Objective:

To evaluate the prognostic role of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) measured by FDG–positron emission tomography (PET)/computed tomography (CT) in patients with primary lung adenocarcinoma undergoing surgical resection.

Methods:

All consecutive patients undergoing curative surgery for primary lung adenocarcinoma at the Thoracic Surgery Unit of the University Hospital of Parma between January 2009 and December 2014 were retrospectively analyzed. The cutoff point of each continuous PET parameter was determined through receiver operating characteristic curve and Youden index, using overall survival (OS) as the classification status. Univariate and multivariate Cox proportional hazards models were applied to evaluate the association between OS and potential prognostic variables, including SUVmax, MTV, and TLG.

Results:

A total of 193 patients were considered eligible for this study. The mean 5-year OS rate was 70.5 ± 3.5%. Acinar and lepidic patterns were more frequently associated with absent or low (<2.5) SUVmax values [18F]FDG uptake. At univariate analysis, male sex, advanced stage, micropapillary and solid pattern, lymphatic, blood vessels and pleural invasion, high SUVmax, MTV, and TLG were significantly associated with poorer OS. Multivariate analyses revealed that only sex, stage, and TLG were independent factors for OS, with male sex, stage 3+4, and high TLG value ( p = 0.041) significantly associated with poorer OS.

Conclusions:

In this study, [18F]FDG PET/CT parameters SUVmax, MTV, and TLG were prognostic factors in patients with surgically resected lung adenocarcinoma, able to predict OS and helping to further stratify these patients into prognostic subsets. Elevated TLG was also an independent predictor for shorter OS.
Heterotopic sites of knowledge production: Notes on an architectural analysis of lecture halls
Authors: Haghighi Farzaneh
Published: February 2020

This article is concerned with the spatial analysis of lecture theaters in higher education institutions and it draws upon two concepts developed by Michel Foucault during the 1970s— heterotopia and the will to know. By examining the heterotopic potentials of lecture theaters where knowledge is rendered visible and articulable, the article argues that the notion of heterotopia is more relevant than panopticon for spatial analysis of these spaces. Heterotopias are defined as counter-sites inhabited by the abnormal, and as such include two dimensions. First there is an exclusion of the abnormal that is aimed at the fabrication of specific subjectivities, students and a more productive workforce. Second, as counter-spaces, heterotopias maintain a hopeful aspect that is providing an opportunity for unsettling the social norms. To support this exploration, the article uses higher education as a transitional environment for the production of an employable workforce and specifically focuses on auditoriums in universities. Contemporary lecture halls originating from the early modern anatomy halls are introduced as a strong spatial context for exploring the spatialization of knowledge and the construction of selves as subjects who desire to know.