bluuebunny/crossref_metadata_2025 huggingface dataset:
Community- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda (D²Rwanda): the protocol of a mixed-methods study including a cluster randomised controlled trial
Authors: Lygidakis Charilaos , Uwizihiwe Jean Paul , Kallestrup Per , Bia Michela , Condo Jeanine , Vögele Claus
Published: July 2019

Introduction

In Rwanda, diabetes mellitus prevalence is estimated between 3.1% and 4.3%. To address non-communicable diseases and the shortage of health workforce, the Rwandan Ministry of Health has introduced the home-based care practitioners (HBCPs) programme: laypeople provide longitudinal care to chronic patients after receiving a six-month training. Leveraging technological mobile solutions may also help improve health and healthcare. The D²Rwanda study aims at: (a) determining the efficacy of an integrated programme for the management of diabetes in Rwanda, which will provide monthly patient assessments by HBCPs, and an educational and self-management mHealth patient tool, and; (b) exploring qualitatively the ways the interventions will have been enacted, their challenges and effects, and changes in the patients’ health behaviours and HBCPs’ work satisfaction.

Methods and analysis

This is a mixed-methods sequential explanatory study. First, there will be a one-year cluster randomised controlled trial including two interventions ((1) HBCPs’ programme; (2) HBCPs’ programme + mobile health application) and usual care (control). Currently, nine hospitals run the HBCPs’ programme. Under each hospital, administrative areas implementing the HBCPs’ programme will be randomised to receive intervention 1 or 2. Eligible patients from each area will receive the same intervention. Areas without the HBCPs’ programme will be assigned to the control group. The primary outcome will be changes in glycated haemoglobin. Secondary outcomes include medication adherence, mortality, complications, health-related quality of life, diabetes-related distress and health literacy. Second, at the end of the trial, focus group discussions will be conducted with patients and HBCPs. Financial support was received from the Karen Elise Jensens Fond, and the Universities of Aarhus and Luxembourg.

Ethics and dissemination

Ethics approval was obtained from the Rwanda National Ethics Committee and the Ethics Review Panel of the University of Luxembourg. Findings will be disseminated via peer-reviewed publications and conference presentations.

Trial registration number

NCT03376607; Pre-results.
Cost-effectiveness of advanced life support and prehospital critical care for out-of-hospital cardiac arrest in England: a decision analysis model
Authors: von Vopelius-Feldt Johannes , Powell Jane , Benger Jonathan Richard
Published: July 2019

Objectives

This research aimed to answer the following questions: What are the costs of prehospital advanced life support (ALS) and prehospital critical care for out-of-hospital cardiac arrest (OHCA)? What is the cost-effectiveness of prehospital ALS? What improvement in survival rates from OHCA would prehospital critical care need to achieve in order to be cost-effective?

Setting

A single National Health Service ambulance service and a charity-funded prehospital critical care service in England.

Participants

The patient population is adult, non-traumatic OHCA.

Methods

We combined data from previously published research with data provided by a regional ambulance service and air ambulance charity to create a decision tree model, coupled with a Markov model, of costs and outcomes following OHCA. We compared no treatment for OHCA to the current standard of care of prehospital ALS, and prehospital ALS to prehospital critical care. To reflect the uncertainty in the underlying data, we used probabilistic and two-way sensitivity analyses.

Results

Costs of prehospital ALS and prehospital critical care were £347 and £1711 per patient, respectively. When costs and outcomes of prehospital, in-hospital and postdischarge phase of OHCA care were combined, prehospital ALS was estimated to be cost-effective at £11 407/quality-adjusted life year. In order to be cost-effective in addition to ALS, prehospital critical care for OHCA would need to achieve a minimally economically important difference (MEID) in survival to hospital discharge of 3%–5%.

Conclusion

This is the first economic analysis to address the question of cost-effectiveness of prehospital critical care following OHCA. While costs of either prehospital ALS and/or critical care per patient with OHCA are relatively low, significant costs are incurred during hospital treatment and after discharge in patients who survive. Knowledge of the MEID for prehospital critical care can guide future research in this field.

Trial registration number

ISRCTN18375201
Temporal trends in the prevalence and causes of visual impairment in the South Indian state of Telangana: a population-based cross-sectional study
Authors: Marmamula Srinivas , Khanna Rohit C , Yellapragada Shashank , Challa Rajesh , Mohd Javed , Rao Gullapalli Nageswara
Published: July 2019

Objectives

To investigate the temporal trends in the prevalence and causes of visual impairment (VI) in South India.

Design

Population-based cross-sectional studies conducted during the years 2011–2012 and 2017 using identical study methods and in geographical locations are compared. The L V Prasad Eye Institute established services in Khammam and not in Warangal district after the 2011–2012 study.

Setting

Khammam and Warangal districts in Telangana, India.

Participants

In total, 5357 participants aged ≥40 years were examined from two districts in the 2011–2012 study and 4923 participants were examined in the 2017 study.

Main outcome measures

Age-adjusted and gender-adjusted temporal trends in the prevalence and causes of VI.

Blindness and moderate VI (MVI) were defined as presenting visual acuity worse than 6/60 and 6/18–6/60 in the better eye, respectively. VI included MVI and blindness.

Results

Nearly 2500 participants were examined in each location in both the 2011–2012 and 2017 studies. In Khammam district, overall VI declined by 2.5% from 15.5% to 13.0% (p<0.001). While there was no significant change in MVI (p=0.566), blindness declined by 3.0% from 5.4% to 2.4% (p<0.001). In Warangal district, the overall VI remained unchanged (p=0.60). While MVI increased by 3% from 9.3% to 12.3% (p=0.001), blindness declined by 3.5% from 6.5% to 3.0% (p<0.001). While MVI due to cataract increased in both districts, there was a significant decline in MVI due to refractive errors in Khammam.

Conclusion

There was a significant decline in VI in Khammam district but not in Warangal district. The differential trends in prevalence and causes of VI can be explained by the availability and uptake of eye care services in these two districts.
Patient experience and reflective learning (PEARL): a mixed methods protocol for staff insight development in acute and intensive care medicine in the UK
Authors: Brookes Olivia , Brown Celia , Tarrant Carolyn , Archer Julian , Buckley Duncan , Buckley Lisa Marie , Clement Ian , Evison Felicity , Gao Smith Fang , Gibbins Chris , Hayton Emma , Jones Jennifer , Lilford Richard , Mullhi Randeep , Packer Greg , Perkins Gavin , Shelton Jonathan , Snelson Catherine , Sullivan Paul , Vlaev Ivo , Wolstenholme Daniel , Wright Stephen E , Bion Julian
Published: July 2019

Introduction

Patient and staff experiences are strongly influenced by attitudes and behaviours, and provide important insights into care quality. Patient and staff feedback could be used more effectively to enhance behaviours and improve care through systematic integration with techniques for reflective learning. We aim to develop a reflective learning framework and toolkit for healthcare staff to improve patient, family and staff experience.

Methods & analysis

Local project teams including staff and patients from the acute medical units (AMUs) and intensive care units (ICUs) of three National Health Service trusts will implement two experience surveys derived from existing instruments: a continuous patient and relative survey and an annual staff survey. Survey data will be supplemented by ethnographic interviews and observations in the workplace to evaluate barriers to and facilitators of reflective learning. Using facilitated iterative co-design, local project teams will supplement survey data with their experiences of healthcare to identify events, actions, activities and interventions which promote personal insight and empathy through reflective learning. Outputs will be collated by the central project team to develop a reflective learning framework and toolkit which will be fed back to the local groups for review, refinement and piloting. The development process will be mapped to a conceptual theory of reflective learning which combines psychological and pedagogical theories of learning, alongside theories of behaviour change based on capability, opportunity and motivation influencing behaviour. The output will be a locally-adaptable workplace-based toolkit providing guidance on using reflective learning to incorporate patient and staff experience in routine clinical activities.

Ethics & dissemination

The PEARL project has received ethics approval from the London Brent Research Ethics Committee (REC Ref 16/LO/224). We propose a national cluster randomised step-wedge trial of the toolkit developed for large-scale evaluation of impact on patient outcomes.
Comparison of N‐terminal proB‐type natriuretic peptide levels at different stages of visceral leishmaniosis and in patients with chronic kidney disease
Authors: Casamian‐Sorrosal Domingo , Barrera‐Chacon Rafael , Gómez Luis , Belinchón‐Lorenzo Silvia , Arroyo Javier Galapero , Gomez Luis Carlos , Cristobal Jose Ignacio , Duque Javier
Published: July 2019

N‐terminal proB‐type natriuretic peptide (NT‐proBNP) may be a useful marker in canine leishmaniosis (CanL). The aim was to compare NT‐proBNP in dogs at different LeishVet stages of CanL and with idiopathic chronic kidney disease (CKD). Dogs diagnosed with CanL or CKD and a group of healthy dogs were included (group A, five normal dogs; group B, six dogs LeishVet 1–2; group C, 13 dogs LeishVet 3–4; group D, six dogs with CKD). NT‐proBNP was higher (P<0.001) in group C (7.616 pmol/l, interquartile range (IQR) 3537–10,000 pmol/l) than in group A (293 pmol/l, IQR 257–373), group B (388.5 pmol/l, IQR 324–793) and group D (740 pmol/l, IQR 557–962 pmol/l). International Renal Interest Society (IRIS) kidney stage was not different between groups C and D or between groups A and B, but was different within all the rest of the group comparisons (P<0.001). In group C all dogs had echocardiographic increase in left ventricular mass index. NT‐proBNP had negative correlation with haematocrit (P<0.001, r=0.749) and positive correlation with systemic blood pressure (P<0.001, r=0.728). NT‐proBNP is consistently elevated in dogs with advanced CanL and is strongly correlated with the degree of systemic hypertension and anaemia. Moreover, dogs with advanced CanL exhibit increase in left ventricular mass. NT‐proBNP may however be a less desirable cardiac marker as unlike cardiac troponin I it is often not elevated at earlier stages of CanL.
Information Sharing and Integration of Buyer-Supplier Relationship in Small Suppliers’ Performance
Authors: Joensuu-Salo Sanna , Sorama Kirsti
Published: July 2019

Despite a growing scholarly interest in performance measurement systems (PMS) for collaborative networks, the literature highlights the success of co-operation from the buyer’s perspective, with far less attention given to the supplier’s perspective (Yeniyurt et al., 2014). In addition, only limited empirical research has been conducted on PMS in small and medium-sized enterprise networks (Bititci et al., 2012). This study investigates how information sharing and supplier integration in a buyer-supplier relationship (BSR) affect suppliers’ performance in the context of small firms. Information sharing includes both providing information (to a buyer) and receiving information (from a buyer). According to the results, neither BSR integration nor information sharing are associated with suppliers’ overall or financial performance. However, BSR integration showed a positive association with suppliers’ non-financial performance. Moreover, information sharing (both providing and receiving) in the innovation perspective showed a positive association with suppliers’ non-financial performance.
Labor Market and Household Debt in Asia Pacific Countries: Dynamic Heterogeneous Panel Data Analysis
Authors: Kusairi Suhal , Muhamad Suriyani , Musdholifah M , Chang Shu-Chen
Published: July 2019

An overwhelming increase in household debt in the last decade has stirred researchers to explore the determinants of this phenomena, especially the role of the labor market. This paper comes to identify these determinants using the macro panel data from Asia Pacific countries for 1994–2016 and dynamic heterogeneous panel data analysis. The empirical results found that household consumption, housing price index, and labor force have a long-run positive relationship with household debt. In contrast, the unemployment rate and dependency ratio have a long-run negative relationship with household debt. This implies that when consumption, housing price, and labor force increase, then the household debt will increase, and when the unemployment rate and dependency ratio increase, the household debt will decrease. Also, in the short-run, public debt does affect private consumption, and it is not different among countries. The labor market, as represented by the unemployment rate, dependency ratio, and labor force, has a strong effect on the household debt in the long-run. Based on these findings, the government should pay more attention to the household debt related to property and commodity markets because they expose the short-run volatility and create problems for the long-term.
Strategies for choosing an uncertainty budget in log-robust portfolio management
Authors: Pae Yuntaek , Sabbaghi Navid
Published: July 2019

This paper proposes six strategies for deciding upon “budget of uncertainty” parameters as input to a sequence of robust (portfolio) optimization problems over time, the solutions of which are a sequence of portfolios (i.e., a portfolio trajectory). Using 10 French Library datasets,1the performance of the portfolio trajectories resulting from these strategies are compared with one another and the 1/[Formula: see text] strategy. Before accounting for trading costs, all strategies result in portfolio trajectories that produce higher profit than the 1/[Formula: see text] strategy. Even after accounting for trading costs (of 1% of trading volume), two of the strategies result in portfolio trajectories that have higher profit and lower risk compared to the 1/[Formula: see text] strategy. Furthermore, we find that equal-weighted indices are better assets to manage than value-weighted indices in terms of achieving larger returns and lower risks.
Pricing S&P500 barrier put option of American type under Heston–CIR model with regime-switching
Authors: Mehrdoust Farshid , Noorani Idin
Published: July 2019

In this paper, we consider the regime-switching Heston–CIR model, where the parameters of the volatility process are modulated by a Hidden Markov chain and the unobserved regimes. Then, we calibrate the parameters of the volatility and interest rate processes by the expectation maximization (EM) and maximum likelihood estimation (MLE) algorithms, respectively. Next, we use the least square Monte-Carlo (LSM) algorithm to determine the S&P500 American barrier put option under the Heston–CIR model. Finally, by the binomial tree method as a benchmark, we provide some numerical experiments to illustrate the accuracy of the achieved results.
Tree ferns and tea trees in biogeochemical exploration for epithermal Au and Ag in New Zealand
Authors: Dunn C. E. , Christie A. B.
Published: July 2019

Biogeochemical orientation surveys were undertaken at low sulphidation epithermal Au–Ag occurrences in the Hauraki Goldfield–Coromandel Volcanic Zone and the Taupo Volcanic Zone, and at the Waiotapu active geothermal area in the Taupo Volcanic Zone. Several plant species were sampled, including the foliage of tree ferns and tea trees. The ferns – silver fern (
ponga
), rough tree fern (
wheki
) and black tree fern (
mamaku
) – were ubiquitous and were the easiest species to sample, although tea tree was the dominant genus at Waiotapu. At the Waiotapu geothermal area, significantly higher concentrations of Ag, Au, Sb, As, Cs and Rb were present in samples close to Champagne Pool than elsewhere, confirming its location as the main outflow source of Au, Ag and their pathfinder elements. The fern survey areas at Luck at Last mine, Pine Sinter and Ohui in the Coromandel Volcanic Zone each exhibited biogeochemical anomalies, which successfully highlighted most of the known quartz veins and provided additional anomalies for further investigation. Rough tree fern was the most common species at Goldmine Hill, Puhipuhi (Taupo Volcanic Zone). Although this species absorbs lower concentrations of many elements than the silver fern, the spatial distribution of elements is of greater significance than their absolute concentrations. The highest Au, Ag, As and Al concentrations occurred in samples from a ridge extending WNW from Goldmine Hill. Sb and Bi were at anomalous levels in an area peripheral to the precious metal anomalies, indicating the potential zonation of elements distal from the Au and Ag deposits.

Supplementary material:
The full datasets on the fern and tea tree chemistry, including quality assurance/quality control and multi-element plots, are available free of charge through the GNS Science website (search for Dunn) at
http://shop.gns.cri.nz/publications/science-reports/
.
Activity-centric computing systems
Authors: Bardram Jakob E. , Jeuris Steven , Tell Paolo , Houben Steven , Voida Stephen
Published: July 2019

The ability to build a construct that organizes work from different devices and information resources is as complex as it is invaluable.
Learning from Sets of Items in Recommender Systems
Authors: Sharma Mohit , Harper F. Maxwell , Karypis George
Published: July 2019

Most of the existing recommender systems use the ratings provided by users on individual items. An additional source of preference information is to use the ratings that users provide on sets of items. The advantages of using preferences on sets are twofold. First, a rating provided on a set conveys some preference information about each of the set’s items, which allows us to acquire a user’s preferences for more items than the number of ratings that the user provided. Second, due to privacy concerns, users may not be willing to reveal their preferences on individual items explicitly but may be willing to provide a single rating to a set of items, since it provides some level of information hiding. This article investigates two questions related to using set-level ratings in recommender systems. First, how users’ item-level ratings relate to their set-level ratings. Second, how collaborative filtering-based models for item-level rating prediction can take advantage of such set-level ratings. We have collected set-level ratings from active users of Movielens on sets of movies that they have rated in the past. Our analysis of these ratings shows that though the majority of the users provide the average of the ratings on a set’s constituent items as the rating on the set, there exists a significant number of users that tend to consistently either under- or over-rate the sets. We have developed collaborative filtering-based methods to explicitly model these user behaviors that can be used to recommend items to users. Experiments on real data and on synthetic data that resembles the under- or over-rating behavior in the real data demonstrate that these models can recover the overall characteristics of the underlying data and predict the user’s ratings on individual items.
Beauty Is in the Eye of the Beholder
Authors: Kairanbay Magzhan , See John , Wong Lai-Kuan
Published: July 2019

Aesthetics is a subjective concept that is likely to be perceived differently among people of different ages, genders, and cultural backgrounds. While techniques that directly compute this concept in images has seen increasing attention by the multimedia and machine-learning community, there are very few attempts at encoding the influences from the photographer’s viewpoint. This work demonstrates how the aesthetic quality of photos can be better learned by accounting for the demographic background of a photographer. A new AVA-PD (Photographer Demographic) dataset is created to supplement the AVA dataset by providing photographers’ age, gender and location attributes. Two deep convolutional neural network (CNN) architectures are proposed to utilize demographic information for aesthetic prediction of photos; both are shown to yield better prediction capabilities compared to most existing approaches. By leveraging on AVA-PD meta-data, we also present some additional machine-learnable tasks such as identifying the photographer and predicting photography styles from a person’s gallery of photos.
Open-Source Software and Hardware Platforms for Building Backscatter Systems
Authors: Xu Chenren , Zhang Pengyu
Published: July 2019

In this article, we will provide a brief introduction of available opensource backscatter platforms that can be used by researchers and engineers to build interesting applications or investigate novel backscatter communication technologies. Instead of diving into the details of each platform, we will focus our discussion on the principles used in designing each platform and the unique feature provided by each platform. At the end of this article, we will discuss several key hardware and software modules that can be used by researchers or engineers to build their own backscatter platforms.
Large Rhinophyma Treated by Surgical Excision and Electrocautery
Authors: Al Hamzawi Nabeel K. , Al Baaj Salih M.
Published: July 2019

Rhinophyma is a benign condition characterized by a large, bulbous nose with prominent pores. It is commonly associated with untreated cases of rosacea. The disease can carry a substantial psychological impact that causes patients to seek advice about how to improve their physical appearance. Many treatment options are available for rhinophyma, but there is no standard treatment protocol. Here, we describe the case of a 65-year-old man with a large rhinophyma that caused him cosmetic and psychosocial embarrassment. The condition was treated by surgical excision and bipolar electrocautery. No complications occurred after the procedures, and healing was completed 2 weeks later by secondary intention and reepithelialization. A simple surgical removal using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be considered as a good treatment option for rhinophyma, as it results in an excellent cosmetic outcome and has short recovery time.
The Additional Effect of Autologous Platelet Concentrates to Coronally Advanced Flap in the Treatment of Gingival Recessions: A Systematic Review and Meta-Analysis
Authors: Li Rong , Liu Yanqing , Xu Tong , Zhao Haijiao , Hou Jingya , Wu Yun , Zhang Dongmei
Published: July 2019

Background. To improve the efficacy of regenerative treatment for gingival recessions, the autologous platelet concentrates (APCs) combined with coronally advanced flap (CAF) have been investigated. However, few studies systematically assess the complementary effect of APCs in periodontal regeneration. The present study aims to evaluate the additional effect of different types of APCs to CAF in the treatment of gingival recessions. Methods. Electronic databases (EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trails) and relevant journals were searched until May 15, 2019. Only randomized controlled trials (RCTs) in English were included. Outcome variables include root coverage (RC), recession depth (RD), clinical attachment level (CAL), keratinized tissue width (KTW), and gingival thickness (GT). Data were analyzed with Revman5.3. The estimate of effect sizes was expressed as the mean differences and the 95% confidence interval. Results. 8 RCTs involving 170 patients (328 sites) were included. Our meta-analysis indicated RC, RD, CAL, KTW, and GT were better improved in the CAF plus APCs groups than the CAF alone. The subgroup analyses revealed that platelet-rich fibrin (PRF) brought significant improvement in RC, RD, CAL, and GT. Concentrated growth factors (CGF) lead clinic beneficial in CAL, KTW, and GT. No significant effect of platelet-rich plasma (PRP) could be found in any clinical parameters when combined with CAF. Conclusions. PRF could exert additional effect to CAF; the preferred treatment for gingival recessions was considered. Based on the limited studies, it seemed that PRP failed to show any additional effect and it was not suggested for gingival recessions. Given the limited research and high risk of bias, it is still needed to confirm the additional effect of CGF by more high-quality studies.
Prognostic Value of Functional Parameters of 18F-FDG-PET Images in Patients with Primary Renal/Adrenal Lymphoma
Authors: Wang Manni , Xu Hui , Xiao Liu , Song Wenpeng , Zhu Sha , Ma Xuelei
Published: July 2019

Objectives. The aim of this study is to explore the textural features that may identify the morphological changes in the lymphoma region and predict the prognosis of patients with primary renal lymphoma (PRL) and primary adrenal lymphoma (PAL). Methods. This retrospective study comprised nineteen non-Hodgkin’s lymphoma (NHL) patients undergoing 18F-FDG-PET/CT at West China Hospital from December 2013 to May 2017. 18F-FDG-PET images were reviewed independently by two board certificated radiologists of nuclear medicine, and the texture features were extracted from LifeX packages. The prognostic value of PET FDG-uptake parameters, patients’ baseline characteristics, and textural parameters were analyzed using Kaplan–Meier analysis. Cox regression analysis was used to identify the independent prognostic factors among the imaging and clinical features. Results. The overall survival of included patients was 18.84 ± 13.40 (mean ± SD) months. Univariate Cox analyses found that the tumor stage, GLCM (gray-level co-occurrence matrix) entropy, GLZLM_GLNU (gray-level nonuniformity), and GLZLM_ZLNU (zone length nonuniformity), values were significant predictors for OS. Among them, GLRLM_RLNU ≥216.6 demonstrated association with worse OS at multivariate analysis (HR 9.016, 95% CI 1.041–78.112, p=0.046). Conclusions. The texture analysis of 18F-FDG-PET images could potentially serve as a noninvasive strategy to predict the overall survival of patients with PRL and PAL.
Effect of Radix Hedysari Polysaccharide on Glioma by Cell Cycle Arrest and TNF-α Signaling Pathway Regulation
Authors: Du Xiaolong , Zhao Yujing , Ma Yongqian , Xing Hongshun , Li Xingang
Published: July 2019

Objective. To investigate the possible development of radix hedysari polysaccharide as an antiglioma drug, we studied the effect of radix hedysari polysaccharide on glioma cells in vitro and the growth of glioma in nude mice and on the phagocytosis of macrophages in nude mice with glioma. Methods. The effect of radix hedysari polysaccharide on the growth of glioma was studied based on U251 cell line in vitro. The effect of radix hedysari polysaccharide on the growth of glioma was studied in vivo. The growth inhibition rate of radix hedysari polysaccharide on U251 cell line was determined by the MTT assay. The cell cycle of U251 was analyzed by flow cytometry. The expression of cytokines in U251 cells and tumor tissues was detected using PCR. The phagocytosis of macrophages in the serum of glioma nude mice was detected by Giemsa staining. TNF-α signaling pathway proteins in the serum of glioma nude mice were detected by ELISA. Results. Radix hedysari polysaccharide inhibited the growth of U251 cells, induced apoptosis in G1 phase by cell cycle arrest, and facilitated apoptosis in glioma mice by regulating cell cycle. Mice injected with radix hedysari polysaccharide showed delayed tumor growth and grew slowly. Radix hedysari polysaccharide enhanced the phagocytosis of macrophages in glioma nude mice. Radix hedysari polysaccharides could inhibit tumor development by regulating the immune function of tumor mice and affecting the TNF-α signaling pathway. Conclusion. Radix hedysari polysaccharide can effectively inhibit the growth of glioma and affect the TNF-α signaling pathway, thus playing an antiglioma role.
A Quasi‐3D Numerical Model for Grout Injection in a Parallel Fracture Based on Finite Volume Method
Authors: Li Xiaolong , Hao Meimei , Zhong Yanhui , Zhang Bei , Wang Fuming , Wang Lianbang
Published: July 2019

The purpose of the present work is to develop a quasi‐3D numerical method that can be used to study the diffusion mechanism of grout injection in a rock fracture based on the collocated structured grid of the finite volume method (FVM). Considering the characteristics of fracture in geometry that the aperture is much less than its length and width, the Hele‐Shaw model is introduced to deduce the z-derivatives of velocities u and v at walls, which is a function of the relevant average velocity and the fracture aperture. The traditional difference scheme for the diffusive term is partly substituted with the derived analytical expressions; hence a three‐dimensional problem of grout flow in the parallel fracture can be transformed into a two‐dimensional one that concerns fracture aperture. The new model is validated by the analytical solution and experimental data on three cases of grouting in the parallel‐plate fracture. Compared with the results from ANSYS‐Fluent software, the present model shows better agreement with the analytical solution for the distribution of pressure and velocity. Furthermore, the new model needs less grid unit, spends less time, but achieves greater accuracy. The complexity of the grout flow field in the rock fracture is reduced; thus the computational efficiency can be improved significantly.
Antiproliferative and Antitumour Effect of Nongenotoxic Silver Nanoparticles on Melanoma Models
Authors: Valenzuela-Salas Lucía M. , Girón-Vázquez Nayeli G. , García-Ramos Juan C. , Torres-Bugarín Olivia , Gómez Claudia , Pestryakov Alexey , Villarreal-Gómez Luis J. , Toledano-Magaña Yanis , Bogdanchikova Nina
Published: July 2019

During the last 3 decades, there has been a slow advance to obtain new treatments for malignant melanoma that improve patient survival. In this work, we present a systematic study focused on the antiproliferative and antitumour effect of AgNPs. These nanoparticles are fully characterized, are coated with polyvinylpyrrolidone (PVP), and have an average size of 35±15 nm and a metallic silver content of 1.2% wt. Main changes on cell viability, induction of apoptosis and necrosis, and ROS generation were found on B16-F10 cells after six hours of exposure to AgNPs (IC50=4.2 μg/mL) or Cisplatin (IC50=2.0 μg/mL). Despite the similar response for both AgNPs and Cisplatin on antiproliferative potency (cellular viability of 53.95±1.88 and 53.62±1.04) and ROS production (20.27±1.09% and 19.50±0.35%), significantly different cell death pathways were triggered. While AgNPs induce only apoptosis (45.98±1.88%), Cisplatin induces apoptosis and necrosis at the same rate (22.31±1.72% and 24.07±1.10%, respectively). In addition to their antiproliferative activity, in vivo experiments showed that treatments of 3, 6, and 12 mg/kg of AgNPs elicit a survival rate almost 4 times higher (P<0.05) compared with the survival rate obtained with Cisplatin (2 mg/kg). Furthermore, the survivor mice treated with AgNPs do not show genotoxic damage determined by micronuclei frequency quantification on peripheral blood cells. These results exhibit the remarkable antitumour activity of a nongenotoxic AgNP formulation and constitute the first advance toward the application of these AgNPs for melanoma treatment, which could considerably reduce adverse effects provoked by currently applied chemotherapeutics.
Efficacy and Complications of Life-Control Portable Resuscitator for Transport of In-Hospital Patients
Authors: Afacan Mustafa Ahmet , Erdogan Mehmet Özgür , Algın Abdullah , Kırcı Miraç , Colak Sahin
Published: July 2019

Aim. Equipment used for in-hospital patient transfers should be safe for the patient, inexpensive, and easy to use. Disposable mechanical ventilators are a reasonable choice for in-hospital transfers. Life-control Portable Resuscitator (LPR) is a gas-powered automatic resuscitator designed for short-term ventilation during the transport of critically ill mechanically ventilated patients. The aim of this study was to investigate the efficacy and safety of, and complications associated with, the LPR. Materials and Methods. A total of 77 (age > 18 years) critically ill mechanically ventilated emergency service patients transported to in-hospital units with an LPR were included in this study. Categorical variables are presented as frequencies (numbers and percentages), and continuous variables are presented as means ± standard deviation with corresponding 95% confidence intervals (CIs). Paired-sample t-tests were used to analyze normally distributed variables. Results. Vital signs showed no significant difference after transport. After transport mean pH, PaCO2, and lactate levels of all patients increased statistically significantly and approached normal range values. PaO2 levels increased significantly after transport. HCO3, PIP, and BE showed no significant difference after transport. Device-related complications during transport included O2 cable disconnection (11.6%), device failure (2.59%), vomiting (1.2%), and extubation (2.59%). Conclusion. In our study group, the LPR was reliable according to the vital signs and blood gas analyses, although these devices should be used only by skilled personnel due to the possible risk of complications during transport.
Kinetic Study of Biodangerous Methylmercury Degradation under Various Light Conditions
Authors: Zhang Yutao , Chen Xia , Jiang Qixia , Zhang Xiaojuan , Zhang Qiuyun
Published: July 2019

Methylmercury (MeHg) has remarkable toxicological effects on humans, plants, and other lives in the environment, which may restrict the comprehensive utilization of biomass source in view of possibly forming biohazardous waste. In this study, a kinetic study of MeHg degradation under UVB, UVA, natural light, and dark was carried out. The result showed that light radiation enhanced MeHg degradation but had no significant influence on the final balance between MeHg and inorganic mercury (Hg2+) in pure water. The balance is of great importance and can be used as a key fundamental to estimate MeHg cycling in other complicated aquatic environments. MeHg degradation was identified to be second-order reaction using the fitting optimization level of the regression equation, and the second-order rate constants were 1.61, 0.82, and 0.91 L·ng−1·d−1, half-lives were calculated to be 0.62, 1.3, and 1.08 d for UVB, UVA, and natural light, respectively. A possible MeHg degradation mechanism was proposed, and it could perfectly explain the results obtained in this paper and some previous studies.
Microbiota- and Radiotherapy-Induced Gastrointestinal Side-Effects (MARS) Study: A Large Pilot Study of the Microbiome in Acute and Late-Radiation Enteropathy
Authors: Reis Ferreira Miguel , Andreyev H. Jervoise N. , Mohammed Kabir , Truelove Lesley , Gowan Sharon M. , Li Jia , Gulliford Sarah L. , Marchesi Julian R. , Dearnaley David P.
Published: July 2019

Purpose:

Radiotherapy is important in managing pelvic cancers. However, radiation enteropathy may occur and can be dose limiting. The gut microbiota may contribute to the pathogenesis of radiation enteropathy. We hypothesized that the microbiome differs between patients with and without radiation enteropathy.

Experimental Design: Three cohorts of patients (n = 134) were recruited. The early cohort (n = 32) was followed sequentially up to 12 months post-radiotherapy to assess early radiation enteropathy. Linear mixed models were used to assess microbiota dynamics. The late cohort (n = 87) was assessed cross-sectionally to assess late radiation enteropathy. The colonoscopy cohort compared the intestinal mucosa microenvironment in patients with radiation enteropathy (cases, n = 9) with healthy controls (controls, n = 6). Fecal samples were obtained from all cohorts. In the colonoscopy cohort, intestinal mucosa samples were taken. Metataxonomics (16S rRNA gene) and imputed metataxonomics (Piphillin) were used to characterize the microbiome. Clinician- and patient-reported outcomes were used for clinical characterization.

Results:

In the acute cohort, we observed a trend for higher preradiotherapy diversity in patients with no self-reported symptoms (P = 0.09). Dynamically, diversity decreased less over time in patients with rising radiation enteropathy (P = 0.05). A consistent association between low bacterial diversity and late radiation enteropathy was also observed, albeit nonsignificantly. Higher counts of Clostridium IV, Roseburia, and Phascolarctobacterium significantly associated with radiation enteropathy. Homeostatic intestinal mucosa cytokines related to microbiota regulation and intestinal wall maintenance were significantly reduced in radiation enteropathy [IL7 (P = 0.05), IL12/IL23p40 (P = 0.03), IL15 (P = 0.05), and IL16 (P = 0.009)]. IL15 inversely correlated with counts of Roseburia and Propionibacterium.

Conclusions:

The microbiota presents opportunities to predict, prevent, or treat radiation enteropathy. We report the largest clinical study to date into associations of the microbiota with acute and late radiation enteropathy. An altered microbiota associates with early and late radiation enteropathy, with clinical implications for risk assessment, prevention, and treatment of radiation-induced side-effects.

See related commentary by Lam et al., p. 6280
Epigenomics and Single-Cell Sequencing Define a Developmental Hierarchy in Langerhans Cell Histiocytosis
Authors: Halbritter Florian , Farlik Matthias , Schwentner Raphaela , Jug Gunhild , Fortelny Nikolaus , Schnöller Thomas , Pisa Hanja , Schuster Linda C. , Reinprecht Andrea , Czech Thomas , Gojo Johannes , Holter Wolfgang , Minkov Milen , Bauer Wolfgang M. , Simonitsch-Klupp Ingrid , Bock Christoph , Hutter Caroline
Published: July 2019

Langerhans cell histiocytosis (LCH) is a rare neoplasm predominantly affecting children. It occupies a hybrid position between cancers and inflammatory diseases, which makes it an attractive model for studying cancer development. To explore the molecular mechanisms underlying the pathophysiology of LCH and its characteristic clinical heterogeneity, we investigated the transcriptomic and epigenomic diversity in primary LCH lesions. Using single-cell RNA sequencing, we identified multiple recurrent types of LCH cells within these biopsies, including putative LCH progenitor cells and several subsets of differentiated LCH cells. We confirmed the presence of proliferative LCH cells in all analyzed biopsies using IHC, and we defined an epigenomic and gene-regulatory basis of the different LCH-cell subsets by chromatin-accessibility profiling. In summary, our single-cell analysis of LCH uncovered an unexpected degree of cellular, transcriptomic, and epigenomic heterogeneity among LCH cells, indicative of complex developmental hierarchies in LCH lesions.

Significance:

This study sketches a molecular portrait of LCH lesions by combining single-cell transcriptomics with epigenome profiling. We uncovered extensive cellular heterogeneity, explained in part by an intrinsic developmental hierarchy of LCH cells. Our findings provide new insights and hypotheses for advancing LCH research and a starting point for personalizing therapy.

See related commentary by Gruber et al., p. 1343.

This article is highlighted in the In This Issue feature, p. 1325
THIAMINE DEFICIENCY IN EXTREMELY PREMATURE NEWBORNS
Authors: Ushakova H. O. , Brazaluk O. Z. , Yevstafieva O. Yu.
Published: July 2019

Introduction. The critical state of extremely premature newborns is accompanied by significant oxidative stress, which leads to an increase in anaerobic metabolism; impaired oxygen utilization in mitochondrial oxidation may occur due to thiamine deficiency.

The aim of the study – to learn the thiamine status of extremely premature new-borns in the neonatal period follow-up.

Research Methods. The study involved 55 of premature newborns with birth weight less than 1000 g and 35 healthy full-term newborns. The indicated children’s blood tests were made in the first day of life and at the end of the neonatal period. The lactate and magnesium were determined by colorimetric method; the pyruvate content was determined enzymatically; the concentration of vitamin B1 was studied using a fluorimeter.

Results and Discussion. In the first days of life, all premature infants have a significantly lower level of thiamine in the blood than the normal one, with the low limit of the norm of mature infants, due to the greatest intensity of adaptive reactions and the redistribution of nutrients in fasting. The deficiency of thiamine of extremely premature infants is accompanied by hypomagnesemia. The defining factor of thiamine deficiency of premature infants is morphofunctional immaturity. Deficiency of thiamine of premature infants is correlated with hyperlactatemia throughout the neonatal period. The metabolic features of an organism of a newborn with an extremely low birth weight reflect hypoxic disturbances (increased lactate and pyruvate level, changes in their ratio), which indicates the activation of glycolysis. The highest level of pyruvate was observed in premature infants in the first day of life and significantly exceeded the reference values with subsequent decrease during the first month of life, but remained beyond the norm, resulting in the development of secondary acidosis and persistent decrease in aerobic metabolism. Thiamine deficiency contributes to the pathogenesis of suppression of the pyruvate-dehydrogenase complex, bypassing pyruvate towards lactate overproduction and the development of metabolic acidosis.

Conclusion. Deficiency of thiamine in premature newborns may lead to a deeper critical condition.
ДИНАМІКА ПОКАЗНИКІВ ОКИСНЮВАЛЬНОЇ МОДИФІКАЦІЇ БІЛКІВ ЗА УМОВ ЕКСПЕРИМЕНТАЛЬНОГО ПЕРИТОНІТУ НА ТЛІ ЦУКРОВОГО ДІАБЕТУ
Authors: Dzyubanovsky I. Ya. , Verveha B. M. , Pidruchna S. R. , Melnyk N. A. , Hudyma A. A.
Published: July 2019

Вступ. Накопичення окиснених білків розглядають як один із факторів регуляції синтезу і розпаду білків, активації мультикаталітичних протеаз, які вибірково руйнують окиснені білки. Відомо, що цукровий діабет супроводжується порушенням усіх видів обміну речовин, тому доцільним було вивчення особливостей однієї з патогенетичних ланок гострого поширеного перитоніту, який виник на тлі цукрового діабету, – окиснювальної модифікації білків.

Мета дослідження – вивчити та оцінити стан окиснювальної модифікації білків в організмі піддослідних тварин при змодельованому гострому поширеному перитоніті на тлі цукрового діабету порівняно зі щурами з експериментальним гострим поширеним перитонітом.

Методи дослідження. У роботі використано 56 білих щурів. Цукровий діабет моделювали шляхом внутрішньочеревного введення стрептозотоцину фірми “Sigmal” з розрахунку 7 мг на 100 г маси щура, гострий поширений перитоніт – введення 0,5 мл 10 % профільтрованої калової суспензії в черевну порожнину піддослідних тварин. Визначали показники окиснювальної модифікації білків – концентрацію альдегідо- та кетопохідних нейтрального (ОМБ370) й основного (ОМБ430) характеру. Терміни спостереження – 1-ша, 3-тя, 7-ма доби від початку моделювання перитоніту. Для проведення досліджень використовували сироватку крові.

Результати й обговорення. При порівнянні показників окиснювальної модифікації білків між досліджуваними групами тварин було встановлено статистично значиме більш вагоме зростання рівня середньомолекулярних пептидів протягом усіх термінів експерименту. Зокрема, концентрація ОМБ370 та ОМБ430 у тварин основної групи на 1-шу добу з моменту початку експерименту була на 35,56 і 84,94 % вищою стосовно таких показників у щурів із гострим перитонітом (p>0,05). На 3-тю добу ця різниця становила 30,51 та 42,85 %, а на 7-му – 26,49 і 21,02 % відповідно (p<0,05). Це свідчить про підсилення токсичного впливу гострого поширеного перитоніту на тлі цукрового діабету в організмі піддослідних тварин.

Висновки. У тварин із гострим поширеним перитонітом спостерігають виражену активацію процесів вільнорадикального окиснення білків, що проявляється достовірним зростанням показників окиснювальної модифікації. Інтенсивність окиснювальної модифікації білків за умов комбінованої патології переважає інтенсивність стосовно ізольованої, що свідчить про потенціювання прооксидантної дії продуктів метаболізму при цукровому діабеті, й ускладнює перебіг гострого поширеного перитоніту.
ДОСЛІДЖЕННЯ СТЕРОЇДНИХ СПОЛУК ГОРЛЯНКИ ПОВЗУЧОЇ (AJUGA REPTANS L.) ТРАВИ
Authors: Maliuvanchuk S. V. , Grytsyk A. R.
Published: July 2019

Вступ. На даний час актуальним є вивчення рослин, які широко розповсюджені не тільки в Україні, але й на всій земній кулі. До таких рослин належить горлянка повзуча. Відомо, що в народній медицині її застосовують при лікуванні запальних захворювань шлунково-кишкового тракту. Стероїди належать до класу біологічно активних сполук, що проявляють протизапальну дію. У літературних джерелах немає даних щодо вмісту стероїдів у горлянки повзучої траві. Тому перспективним є вивчення цієї групи сполук.

Мета дослідження – провести дослідження з ідентифікації і визначення кількісного та якісного вмісту стероїдних сполук у горлянки повзучої (Ajuga reptans L.) траві методом газової хроматографії/мас-спектрометрії.

Методи дослідження. Об’єктом дослідження була горлянки повзучої (Ajuga reptans L.) трава, заготовлена в період цвітіння у с. Гута Богородчанського району в 2017–2018 рр. Методом газової хромато-мас-спектрометрії досліджено вміст стероїдних сполук у горлянки повзучої траві. Дослідження проводили на хроматографі Agilent Technologies 6890 із мас-спектрометричним детектором 5973 з капілярною колонкою HP-5 ms (діаметром 0,25 мм, довжиною 30 м). Отримані дані фіксували за допомогою рисунків і таблиць.

Результати й обговоренння. Дані дослідження свідчать про наявність 54 речовин, з яких ідентифіковано 9 сполук: стигмастерол; прегна-5,17-дієн-3-ол; ергостерол; 3β-стеарилокси-ерс-12-ен; стигмаста-5,22-дієн-3-ол, ацетат; β-ситостерол; олеан-12-ен; 3β-метокси-5-холестен; сліди холестеролу. Встановлено, що найбільшу концентрацію має стигмастерол, вміст якого становить 1546,20 мг/кг сировини, або 44,28 % від усіх стероїдів цього дослідження. Виявлено значний вміст прегна-5,17-дієн-3-олу – 843,91 мг/кг, або 24,17 % від усіх стероїдів горлянки повзучої. Загальний вміст стероїдів у траві цієї рослини становить 3491,96 мг/кг.

Висновки. Методом газової хроматографії/мас-спектрометрії визначено якісний склад та кількісний вміст стероїдів у горлянки повзучої траві. Аналіз отриманих результатів показує, що стероїдний комплекс трави рослини представлений 54 стероїдами, 9 з яких було ідентифіковано та встановлено їх кількісний вміст. Ці дані буде враховано під час подальшого одержання фітозасобів на основі горлянки повзучої трави, а також як параметри стандартизації сировини.