bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of a short burst of exercise during the night on subsequent sleep
Authors: Dominiak Michelle , Kovac Katya , Reynolds Amy C. , Ferguson Sally A. , Vincent Grace E.
Published: June 2020

When on‐call workers wake during the night to perform work duties, they may experience reduced alertness and impaired performance as a result of sleep inertia. After performing their duties, on‐call workers may have the opportunity to return to sleep. Thus, it is important that sleep inertia countermeasures do not affect subsequent sleep. Exercise may be a suitable countermeasure; however, the impact on subsequent sleep is untested. Healthy participants (n = 15) completed three conditions in a counterbalanced order: sedentary, low‐intensity exercise or high‐intensity exercise, performed for 2 min upon awakening. Sleep was recorded 2 hr later using polysomnography, the Karolinska Sleepiness Scale was administered to measure subjective sleepiness, and core body temperature was measured continuously. Results indicate there was no effect of condition on most sleep variables; however, three variables had small differences, with longer total sleep time (p = .006), higher sleep efficiency (p = .006) and shorter N3 latency (p < .001) in the low‐intensity exercise condition. There was no difference in subjective sleepiness (p = .124) or core body temperature (p = .216) 90 min after the exercise intervention. These results indicate that using a short burst of exercise to counteract sleep inertia when woken during the night may be a suitable countermeasure for on‐call workers who not only need to be alert upon waking but also need quality sleep when returning to bed. Future research could include participants of other ages and health statuses to investigate whether the results are generalizable.
Preferred orientation distribution of shock‐induced planar microstructures in quartz and feldspar
Authors: Pittarello Lidia , Ferrière Ludovic , Feignon Jean‐Guillaume , Osinski Gordon R. , Koeberl Christian
Published: June 2020

Shocked quartz and feldspar grains commonly exhibit planar microstructures, such as planar fractures, planar deformation features, and possibly microtwins, which are considered to have formed by shock metamorphism. Their orientation and frequency are typically reported to be randomly distributed across a sample. The goal of this study is to investigate whether such microstructures are completely random within a given sample, or whether their orientation might also retain information on the direction of the local shock wave propagation. For this work, we selected samples of shatter cones, which were cut normal to the striated surface and the striation direction, from three impact structures (Keurusselkä, Finland, and Charlevoix and Manicouagan, Canada). These samples show different stages of pre‐impact tectonic deformation. Additionally, we investigated several shocked granite samples, selected at different depths along the drill core recovered during the joint IODP‐ICDP Chicxulub Expedition 364 (Mexico). In this case, thin sections were cut along two orthogonal directions, one parallel and one normal to the drill core axis. All the results refer to optical microscopy and universal‐stage analyses performed on petrographic thin sections. Our results show that such shock‐related microstructures do have a preferred orientation, but also that relating their orientation with the possible shock wave propagation is quite challenging and potentially impossible. This is largely due to the lack of dedicated experiments to provide a key to interpret the observed preferred orientation and to the lack of information on postimpact orientation modifications, especially in the case of the drill core samples.
Maternal knowledge in complementary feeding following Baby Friendly Community Initiative in Koibatek, Kenya
Authors: Maingi Mildred , Kimiywe Judith , Iron‐Segev Sharon
Published: June 2020

The Kenyan Ministry of Health has developed a National Strategy on Infant and Young Child Feeding with the goal of improving feeding practices for infants and children. In order to promote appropriate infant feeding, the government has explored implementation of the Baby Friendly Community Initiative (BFCI). This study assessed maternal knowledge of attributes of complementary feeding following implementation of BFCI in Koibatek, Kenya. A randomized control study composed of 270 mother–infant pairs previously enrolled in a BFCI programme in Koibatek was conducted. The study found that a significantly greater number of mothers in the intervention group were more knowledgeable about proper breastfeeding and complementary feeding aspects compared with controls (P ≤ 0.001). About half (53%) of mothers in the intervention group had high knowledge scores in comparison with 20% of mothers in the control group. When the relationship between mothers' knowledge and complementary feeding practices (minimum meal frequency, minimum dietary diversity and minimum acceptable diet) was assessed, significant associations were observed (P = 0.010, P ≤ 0.001 and P ≤ 0.001, respectively). The odds of having a high knowledge score regarding complementary feeding practices were significantly higher for the intervention group compared with the control group (odds ratio [OR]: 25.98, 95% confidence interval [CI] 13.62–49.55, P ≤ 0.001). The BFCI intervention effectively improved mothers' knowledge on complementary feeding and correlated with improved feeding practices.
In vivo measures of anterior scleral resistance in humans with rebound tonometry
Authors: Buckhurst Hetal D , Gilmartin Bernard , Lam Andrew , Cubbidge Robert P , Logan Nicola S
Published: June 2020

Purpose

To measure regional variations in anterior scleral resistance (ASR) using a ballistic rebound tonometer (RBT) and examine whether the variations are significantly affected by ethnicity and refractive error (RE).

Methods

ASR was measured using a RBT (iCare TA01) following calibration against the biomechanical properties of agarose biogels. Eight scleral regions (nasal, temporal, superior, inferior, inferior‐nasal, inferior‐temporal, superior‐nasal and superior‐temporal) were measured at locations 4mm from the limbus. Subjects were 130 young adults comprising three ethnic groups whose RE distributions [MSE (D) ± S.D.] incorporated individuals categorised as without‐myopia (NM; MSE ≥ −0.50) and with‐myopia (WM; MSE < −0.50); British‐White (BW): 26 NM + 0.52 ± 1.15D; 22 WM −3.83 ± 2.89D]; British‐South‐Asian (BSA): [9 NM + 0.49 ± 1.06D; 11 WM −5.07 ± 3.76D; Hong‐Kong‐Chinese (HKC): [11 NM + 0.39 ± 0.66D; 49 WM −4.46 ± 2.70D]. Biometric data were compiled using cycloplegic open‐field autorefraction and the Zeiss IOLMaster. Two‐ and three‐way repeated measures analysis of variances (anovas) tested regional differences for RBT values across both refractive status and ethnicity whilst stepwise forward multiple linear regression was used as an exploratory test.

Results

Significant regional variations in ASR were identified for the BW, BSA and HKC (p < 0.001) individuals; superior‐temporal region showed the lowest levels of resistance whilst the inferior‐nasal region the highest. Compared to the BW and BSA groups, the HKC subjects displayed a significant increase in mean resistance for each respective region (p < 0.001). With the exception of the inferior region, ethnicity was found to be the chief predictor for variation in the scleral RBT values for all other regions. Mean RE group differences were insignificant.

Conclusions

The novel application of RBT to the anterior sclera confirm regional variation in ASR. Greater ASR amongst the HKC group than the BW and BSA individuals suggests that ethnic differences in anterior scleral biomechanics may exist.
DNA methylation and mRNA expression of IGF‐1 and MMP‐2 after form‐deprivation myopia in guinea pigs
Authors: Ding Xuan , Fu Dan , Ge Shichao , Guan Qinghua , Chen Minjie , Yu Zhiqiang
Published: June 2020

Purpose

The molecular mechanism of form‐deprivation myopia is unclear. This study was aimed to investigate the roles of scleral DNA methylation and mRNA expression of IGF‐1 and MMP‐2 in a guinea pig model of form‐deprivation myopia.

Methods

Seventy 2‐week‐old male guinea pigs were assigned to three groups: (1) zero week group that was used to collect baseline data; (2) monocular deprivation treatment (MDT) group, in which a thin slice of opaque latex glove was placed over the right eyes of the animals for four weeks, and the left eyes were untreated and served as the monocular contralateral control (MCC) group; (3) control group (CG), in which the animals grew four weeks, but received no manipulation. Animals in each group were evenly divided for DNA methylation assay and quantitative PCR (qPCR). After eye enucleation, the sclerae were harvested for DNA methylation assay and qPCR. The DNA methylation pattern in the promoter and exon regions of IGF‐1 and MMP‐2, along with the mRNA expression level of them, were determined by base‐specific cleavage and mass spectrometry and qPCR, respectively.

Results

After four weeks of form‐deprivation, DNA methylation at 4/8 cytosine‐guanine sites in the IGF‐1 promoter was significantly lower in the MDT eyes than in the MCC or CG eyes. In addition, the level of IGF‐1 mRNA was moderately higher in MDT eyes compared to the MCC eyes and CG eyes. DNA methylation at 4/14 cytosine‐guanine sites in the MMP‐2 gene was very low, and no significant change was observed between the MDT eyes and the MCC or CG ones. However, the level of MMP‐2 mRNA in MDT eyes was significant higher compared with MCC eyes and CG eyes, with an increase of 217% and 222%, respectively.

Conclusions

In our guinea pig model of form‐deprivation myopia, the methylation of four cytosine‐guanine sites in the IGF‐1 gene promoter was significantly lower in the sclera after four weeks of MDT, and the transcription level of scleral IGF‐1 was moderately higher. Hence, the IGF‐1 gene methylation might play a role in the pathogenesis of form‐deprivation myopia in guinea pigs. The level of MMP‐2 mRNA in the sclera of MDT eyes was significantly higher, but not regulated by the methylation pathway, as the methylation status of MMP‐2 was unchanged.
iCareTrack: measuring the appropriateness of eyecare delivery in Australia
Authors: Ho Kam Chun , Stapleton Fiona , Wiles Louise , Hibbert Peter , White Andrew , Jalbert Isabelle
Published: June 2020

Purpose

To meet the needs of an ageing population and optimise health expenditure, delivery of care should be based on evidence. However, the level of evidence‐based care delivered to patients with eye conditions is rarely assessed. This study thus aimed to determine the percentage of eyecare encounters at which a sample of adult Australians received appropriate care (i.e., eyecare in line with evidence‐based or consensus‐based guidelines).

Methods

A cross‐sectional retrospective review of optometry practice records was conducted using random stratified (by state) sampling in mainland Australia. Eighty‐five clinical indicators were developed from evidence‐based clinical practice guideline recommendations and refined by panels of experts using a modified Delphi process. Healthcare records of patients 18 years and over were examined against these indicators, representing appropriate care for three common eye conditions (preventative eyecare, glaucoma, and diabetic eyecare). Encounters occurred in optometry practices that were selected to be representative of the socioeconomic profile of Australian practices. The primary outcome measure was percentage compliance of eyecare delivery against the clinical indicators.

Results

From 426 optometry practices contacted by mail or telephone, 90 (21%) replied, 46 proved eligible and 42 were included in the study and visited for data collection. From these 1260 patient records were reviewed. Appropriate eyecare was received by Australian patients at an average of 71% (95%CI 70%, 73%) of eligible encounters. The percentage of appropriateness of eyecare at the condition level for preventative, glaucoma and diabetic eyecare was 81% (95%CI 79%, 83%), 63% (95%CI 61%, 64%), and 69% (95%CI 66%, 73%), respectively. Appropriateness of eyecare delivery was lowest for the domains of history taking and physical examination for all eye conditions.

Conclusions

There were pockets of excellence but consistent delivery of appropriate eyecare needs improvement, and gaps in eyecare delivery should be addressed.
Long‐Term Clinical Outcomes and Pain Assessment after Posterior Lumbar Interbody Fusion for Recurrent Lumbar Disc Herniation
Authors: Yang Yalin , Yan Xu , Li Wenhui , Sun Weizong , Wang Kai
Published: June 2020

Objectives

The aim of this study was to investigate the long term effects of posterior lumbar interbody fusion (PLIF), applied after recurrent lumbar disc herniation (rLDH), on pain relief and clinical outcome improvement.

Methods

The current study is a retrospective study. We observed 22 cases from 85 patients that had undergone PLIF during February 2003 to October 2012 and all patients were followed for at least 5 years. The average age of those patients were 53 years, among them there were eight men and 14 women. Plain radiography and dynamic plain films were obtained, pre‐operation, for every patient. Magnetic resonance imaging (MRI) or computed tomography (CT) was conducted to confirm the diagnosis of rLDH before the operation. All surgeries were performed from posterior approach by the same surgeon using PLIF. Quality of life (QOL) and clinical outcomes were assessed by Numerical Rating Scale (NRS), Japanese Orthopaedic Association (JOA) scoring system, and Oswestry Disability Index (ODI) before revision surgery and at 1 week, 3 months, 12 months, and 24 months postoperative. These were also examined every time they came back to the hospital for a review.

Results

All patients were discharged and no serious comorbidities occurred. Three cases with wound infections and one case with dural laceration were cured and discharged. The end point of follow‐up was August 2018 and the mean follow‐up after revision surgery was 85 months. There were significant differences in NRS. It decreased from 7.32 ± 1.17 to 2.77 ± 1.31 (P < 0.05). The mean postoperative NRS score was 2.27 ± 1.48 (P < 0.05), 1.90 ± 1.51 (P < 0.05), and 2.36 ± 1.36 (P < 0.05) at 3, 12, and 24 months after surgery. There were no statistically significant differences (P > 0.05) in ODI scores. The average JOA score improved from 5.00 ± 1.08 to 8.18 ± 1.59 (P < 0.05) 1 week after revision surgery. RR was between 50% and 70%. Overall satisfaction rates were beyond 80%. Only one patient required subsequent lumber surgery during the follow‐up period.

Conclusion

If surgical indications are mastered, undergoing PLIF after rLDH may induce efficient pain relief and major improvements in clinical outcome scores, as well as quality of life scores.
Defibrillators in adult congenital heart disease: Long‐term risk of appropriate shocks, inappropriate shocks, and complications
Authors: Moore Benjamin M. , Cao Jacob , Cordina Rachael L. , McGuire Mark A. , Celermajer David S.
Published: June 2020

Aims

Sudden cardiac death (SCD) accounts for up to 25% of deaths in the adult congenital heart disease (ACHD) population. Current guidelines for defibrillator implantation are either extrapolated from acquired cardiac disease or are based upon single lesion studies, predominantly Tetralogy of Fallot (TOF). Defibrillator‐related morbidity appears to be substantially higher in ACHD patients.

Methods

We retrospectively evaluated all patients in our ACHD database who received an implantable cardioverter‐defibrillator (ICD) between 2000 and 2019, and who were ≥16 years old at time of implant. Patients were followed for appropriate shocks, inappropriate shocks, and complications.

Results

Of 4748 patients in our database, 59 patients (1.2%) underwent ICD implantation. ICDs were for primary prevention in 63% and secondary prevention in 37%. Over a median follow‐up of 6.6 years, 24% received an appropriate shock, 27% an inappropriate shock, and 42% suffered a device‐related complication (annualized risks of 3.2%, 3.6%, and 5.7%, respectively). There were no significant predictors of appropriate shocks or inappropriate shocks. All appropriate shocks in primary prevention patients occurred in TOF or transposition of the great arteries (TGA) with atrial switch, typically in the presence of multiple SCD risk factors. The majority of inappropriate shocks were due to supraventricular arrhythmias. Device‐related mortality was 1.7% (0.3% per annum).

Conclusions

Appropriate shocks were relatively common in an ACHD ICD population followed in the long term. Device‐related morbidity was significant. Although risk factors have been established for TOF, and to a lesser extent TGA, risk stratification for ICD implantation in ACHD remains challenging.
Role of cytokines in the clinical manifestation of exophthalmia in newborn calves with tropical theileriosis
Authors: Ram Pradeep K. , Singh Shanker K. , Kumari Priyambada , Srivastava Mukesh , Sudan Vikrant , Pandey Rudra P. , Garg Satish K.
Published: June 2020

The present study aimed to evaluate the pathology of the exophthalmia and the host‐immune response in naturally Theileria annulata‐infected calves. The newborn calves detected positive for theileriosis were grouped into calves with theileriosis and absence of exophthalmia (n = 30), and calves with theileriosis and the presence of exophthalmia (n = 13). Sixteen healthy calves, free from any haemoprotozoal infection, were kept as healthy controls. A significantly (P ≤ .001) higher circulating levels of tumour necrosis factor‐α (TNF‐α) and interleukin‐10 (IL‐10) were estimated in diseased calves with and without exophthalmia as compared to healthy controls. Contrarily, significantly (P ≤ .01) lower interferon‐γ (IFN‐γ) level was estimated in diseased calves. The diseased calves with exophthalmia revealed significantly higher levels of TNF‐α (P ≤ .001) and IL‐10 (P ≤ .006) as compared to the diseased calves without exophthalmia. The diseased calves were not found to have an elevated intraocular pressure; rather they had significantly (P ≤ .001) lower intraocular pressure compared to the healthy controls. An elevated systemic TNF‐α level might be attributed to the exophthalmia in calves with tropical theileriosis. The elevated circulatory IL‐10 and reduced IFN‐γ levels could be one of the strategies of Theileria annulata to escape the host immunity.
A novel model for determining tensile properties and hardness of steels by spherical indentations
Authors: Chen Hui , Cai Li‐xun , Bao Chen
Published: June 2020

An energy‐based spherical indentation (ESI) model according to equivalent energy principle is developed to determine the stress–strain relation, tensile strength and hardness of steels. Several parameters in the model are determined with finite element analysis (FEA). For a wide range of homogeneous and isotropic materials in power stress–strain law, a large number of FEA calculations are carried out to verify the ESI model. Results show that both the forward‐predicted load‐depth relations and the reverse‐predicted stress–strain relations from the model agree well with the results from FEA. For 12 steels, the tensile properties, Rockwell and Brinell hardness predicted by the ESI model are close to the standard testing results.
Independent translation of ORFs in dicistronic operons, synthetic building blocks for polycistronic chloroplast gene expression
Authors: Yu Qiguo , Tungsuchat‐Huang Tarinee , Verma Kanak , Radler Megan R. , Maliga Pal
Published: June 2020

We designed a dicistronic plastid marker system that relies on the plastid's ability to translate polycistronic mRNAs. The identification of transplastomic clones is based on selection for antibiotic resistance encoded in the first open reading frame (ORF) and accumulation of the reporter gene product in tobacco chloroplasts encoded in the second ORF. The antibiotic resistance gene may encode spectinomycin or kanamycin resistance based on the expression of aadA or neo genes, respectively. The reporter gene used in the study is the green fluorescent protein (GFP). The mRNA level depends on the 5′‐untranslated region of the first ORF. The protein output depends on the strengths of the ribosome binding, and is proportional with the level of translatable mRNA. Because the dicistronic mRNA is not processed, we could show that protein output from the second ORF is independent from the first ORF. High‐level GFP accumulation from the second ORF facilitates identification of transplastomic events under ultraviolet light. Expression of multiple proteins from an unprocessed mRNA is an experimental design that enables predictable protein output from polycistronic mRNAs, expanding the toolkit of plant synthetic biology.
Fiber Type and Size as Sources of Variation in Human Single Muscle Fiber Passive Elasticity
Authors: Noonan Alex M. , Zwambag Derek P. , Mazara Nicole , Weersink Erin , Power Geoffrey A. , Brown Stephen H. M.
Published: June 2020

Studies on single muscle fiber passive material properties often report relatively large variation in elastic modulus (or normalized stiffness), and it is not clear where this variation arises. This study was designed to determine if the stiffness, normalized to both fiber cross-sectional area and length, is inherently different between types 1 and 2 muscle fibers. Vastus lateralis fibers (n = 93), from ten young men, were mechanically tested using a cumulative stretch-relaxation protocol. SDS-PAGE classified fibers as types 1 or 2. While there was a difference in normalized stiffness between fiber types (p = 0.0019), an unexpected inverse relationship was found between fiber diameter and normalized stiffness (r = −0.64; p < 0.001). As fiber type and diameter are not independent, a one-way analysis of covariance (ANCOVA) including fiber diameter as a covariate was run; this eliminated the effect of fiber type on normalized stiffness (p = 0.1935). To further explore the relationship between fiber size and elastic properties, we tested whether stiffness was linearly related to fiber cross-sectional area, as would be expected for a homogenous material. Passive stiffness was not linearly related to fiber area (p < 0.001), which can occur if single muscle fibers are better represented as composite materials. The rule of mixtures for composite materials was used to explore whether the presence of a stiff perimeter-based fiber component could explain the observed results. The model (R2 = 0.38) predicted a perimeter-based normalized stiffness of 8800 ± 2600 kPa/μm, which is within the range of basement membrane moduli reported in the literature.
Media Convergence as Exogenous Forces in a NCAA DI Athletic Department: Organizational Climate and Resource Allocation Decision Making
Authors: Lee Seungbum , Kim Yongjae , Tang Tang
Published: June 2020

To successfully evolve, organizations should change at the same pace as the environment changes. It is particularly important when adapting and utilizing new media technology is a huge part of an organization’s success. Presently, media professionals in all industries including intercollegiate athletics are experiencing a significant change in their work environment due to the ever-changing nature of new media technology. In particular, media convergence, an integration of production by combining both old (e.g., television) and new media (e.g., the Internet), has been one of the most influential phenomena creating unexpected changes and complex dynamics in the current media industry. Nonetheless, what have been previously overlooked in sport communication literature are challenges generated by media convergence, which affects the nature of sport communication. This case study provides a scenario based on semi-fictitious information so that students can critically examine the dynamic nature as well as the effect of media convergence facing sport communication in intercollegiate sport. Further, the students are provided with an opportunity to practice decision-making skills to address the challenges stemming from media convergence. By doing so, discussion regarding media convergence in the context of intercollegiate sport could be better presented to relevant classroom discussion.
A Comparison of Cardiopulmonary Exercise Testing and Field Walking Tests in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer’s Dementia
Authors: Salisbury Dereck L. , Yu Fang
Published: June 2020

The purpose of this study was to investigate the relationships among peak exercise parameters on 6-min walk test, shuttle walk test, and laboratory-based cardiopulmonary exercise testing in persons with Alzheimer’s dementia. This study is a cross-sectional analysis of the baseline data of 90 participants (age 77.1 [6.6] years, 43% female) from the FIT-AD trial. Cardiopulmonary exercise testing produced significantly higher peak heart rate (118.6 [17.5] vs. 106 [22.8] vs. 106 [18.8] beats/min), rating of perceived exertion (16 [2.1] vs. 12 [2.3] vs. 11 [2.1]), and systolic blood pressure (182 [23.7] vs. 156 [18.9] vs. 150 [16.9] mmHg) compared with the shuttle walk test and 6-min walk test, respectively. Peak walking distance on shuttle walk test (241.3 [127.3] m) and 6-min walk test (365.0 [107.9] m) significantly correlated with peak oxygen consumption (17.1 [4.3] ml·kg−1·min−1) on cardiopulmonary exercise testing (r = .449, p ≤ .001 and r = .435, p ≤ .001), respectively, which is considerably lower than what is seen in older adults and persons with cardiopulmonary diseases.
One Shot—No Hit? Evaluation of a Stress-Prevention Workshop for Adolescent Soccer Players in a Randomized Controlled Trial
Authors: Belz Johanna , Kleinert Jens , Anderten Moritz
Published: June 2020

Adolescent soccer players experience many stressors and negative stress-related outcomes. Short-term stress-prevention programs are frequently implemented in youth sports, although there is limited evidence of their usefulness and effectiveness. Thus, the present study evaluated the usefulness and effectiveness of a stress-prevention workshop for adolescent soccer players. Ninety-two soccer players (age: M = 15.5 years, SD = 1.43; 31.5% female) were randomly allocated to either an intervention group or an intervention control group. To evaluate effectiveness, stress, coping, and depression were assessed at baseline (t1) and 4 weeks postworkshop (t2). To investigate usefulness, the perceived quality of results was assessed at t2. No intervention effects on stress, coping, and depression emerged, but both groups exhibited high values regarding perceived quality of results. Although one workshop might not be enough to modify stress-related parameters, it may be useful for adolescent soccer players and pave the way for long-term interventions.
Bill would supersize NSF's budget—and role
Authors: Mervis Jeffrey
Published: June 2020

Legislation calls for $100 billion increase, new technology directorate, and new name.
Patents, economics, and pandemics
Authors: Zerhouni Will , Nabel Gary J. , Zerhouni Elias
Published: June 2020

As coronavirus disease 2019 (COVID-19) has quickly killed hundreds of thousands across an unprepared world, destroyed the livelihoods of millions, and cost trillions of dollars, nations must now expand their mindsets and focus not only on overcoming the next phases but also on long-range strategies—for this and for future pandemics. The world needs a permanent preparedness enterprise to engage in a sustained effort to avert pandemics, and provide for the affordable and widespread administration of vaccines and therapies when they are discovered.
Time-driven activity-based costing for patients with multiple chronic conditions: a mixed-method study to cost care in a multidisciplinary and integrated care delivery centre at a university-affiliated tertiary teaching hospital in Stockholm, Sweden
Authors: Keel George , Muhammad Rafiq , Savage Carl , Spaak Jonas , Gonzalez Ismael , Lindgren Peter , Guttmann Christian , Mazzocato Pamela
Published: June 2020

Objective

This study can be applied to cost the complex non-standardised processes used to treat patients with multiple chronic conditions.

Design

A mixed-method approach to cost analysis, following a modified healthcare-specific version of the seven-step Time-Driven Activity-Based Costing (TDABC) approach.

Setting

A multidisciplinary integrated and person-centred care delivery centre at a university-affiliated tertiary teaching hospital in Stockholm, Sweden, designed to improve care coordination for patients with multiple chronic conditions, specifically diabetes, cardiovascular disease and kidney disease.

Participants

314 patients (248 men and 66 women) fit inclusion criteria. Average age was 80 years.

Results

This modified TDABC analysis costed outpatient care for patients with multiple chronic conditions. The approach accounted for the difficulty of conceptualising care cycles. The estimated total cost, stratified by resources, can be reviewed together with existing managerial accounting statements to inform management decisions regarding the multidisciplinary centre.

Conclusions

This article demonstrates that the healthcare-specific seven-step approach to TDABC can be applied to cost care for patients with multiple chronic conditions, where pathways are not yet discernable. It became clear that there was a need for slight methodological adaptations for this particular patient group to make it possible to cost these pathways, stratified by activity and resource. The value of this approach can be discerned from the way management incorporated the results of this analysis into the development of their hospital strategy. In the absence of integrated data infrastructures that can link patients and resources across financial, clinical and process data sets, the scalability of this method will be difficult.
NSAIDs for analgesia in the era of COVID-19
Authors: Herzberg Daniel L , Sukumaran Harry P , Viscusi Eugene
Published: June 2020

Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one’s likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.
Management of a geriatric alpaca with multiple neoplasms in a zoological setting
Authors: Moittie Sophie , Dobbs Phillipa , Waine Katie , Ashfield Samantha , Baiker Kerstin
Published: June 2020

During a routine health check, a 22‐year‐old female alpaca presented with an infected mass on the sternal pad. A squamous cell carcinoma was diagnosed on histopathology. Systemic antibiotics and topical treatment were initiated. Thoracic radiographs and blood analysis showed no abnormalities; therefore, surgical resection was performed, and the wound was allowed to heal by second intention with therapeutic laser therapy. The treatment plan for this animal was developed with the collaboration of the keeping team and zoo managers and considered the health status of the animal, overall prognosis and the possibility of frequent restraints with minimal stress. Six months after initial presentation, the alpaca showed dramatic weight loss and severe urine scalding with a mass identified in the urinary bladder and was euthanased on welfare grounds. Postmortem findings included squamous cell carcinoma metastases in the tributary lymph nodes and in the lung, adenocarcinoma in the lung, and a polyp in the urinary bladder.
Transcriptomic analysis of the heat-stress response in Boechera depauperata and Arabidopsis reveals a distinct and unusual heat-stress response in Boechera
Authors: Pierce Ian , Halter Gillian , Waters Elizabeth R.
Published: June 2020

Global surface temperatures are expected to rise throughout the 21st century, and negatively impact plant growth and reproduction. Thus, it is imperative that we deepen our understanding of plant thermotolerance. The examination of native plant species that have evolved tolerance to high temperatures can provide crucial information on how plants can adapt to climate change. Boechera (Brassicaceae), a large genus that is native to North America, is highly thermotolerant, and can maintain photosynthetic activity at high temperatures. Here we report results of transcriptomic studies that seek to reveal possible thermotolerance mechanisms in B. depauperata (A.Nelson & P.B.Kenn.) Windham & Al-Shehbaz. Analysis of RNA-seq datasets from heat stressed B. depauperata and Arabidopsis thaliana (L.) Heynh. plants identified significant differences in how each of these species responds to identical heat stress conditions. The most highly upregulated heat-stress genes in A. thaliana includes the well-characterized heat-shock genes. In contrast, the Boechera heat-stress response is composed of: novel genes that lack orthologs in other genomes; genes coding for proteins of uncharacterized function; and genes coding for proteins associated with the unfolded protein and endoplasmic reticulum stress responses. In addition, genes that are protective of photosynthetic capacity are also differentially upregulated in B. depauperata.
Occurrence of Aspergillus niger strains on a polychrome cotton painting and their elimination by anoxic treatment
Authors: Boniek Douglas , Bonadio Luciana , Damaceno Quésia Souza , dos Santos Antônio Fernando Batista , de Resende Stoianoff Maria Aparecida
Published: June 2020

This study aimed to isolate and identify the population of filamentous fungi colonizing a cotton painting, whose conservation status was compromised and showed signs of biodeterioration due to dirt accumulation and microbial metabolism. In addition, microbiological techniques such as cultivation-dependent approach and molecular biology were used to identify microbial populations and to eliminate their metabolic action. For this, the nondestructive anoxic atmosphere technique was used, in which the microbial metabolism was affected by the absence of oxygen. Prior to exposure to an anoxic atmosphere, only one fungal species, Aspergillus niger, was identified at 12 points sampled in the obverse and reverse of the artwork; no fungal species persisted as a result of anoxic treatment. These results showed that exposure to anoxic conditions was effective for the total elimination of isolated fungal strains as well as their spores. In conclusion, this study proved the unprecedented effectiveness of a nondestructive technique for artwork on textile colonized by black fungi species. Thus, this interdisciplinary work involving conservation, microbiology, and chemistry presents a tool to eliminate microorganisms, while maintaining the integrity of artwork and safety of the restorer, that can be applied prior to artwork restoration.
Remarks on Plücker embedding and totally antisymmetric gauge fields
Authors: Nieto J. A. , Nieto-Marín P. A. , León E. A. , García-Manzanárez E.
Published: June 2020

We make a number of comments about the way the Plücker embedding, which can be derived via the Grassmann-Plücker relations, can be associated to totally antisymmetric gauge fields. As a first step we discuss the case of the electromagnetic field strength, showing that the Plücker map implies both the true degrees of freedom of the electromagnetic field and the 1-brane (string) structure. The procedure is generalized in order to prove that the true degrees of freedom of a totally antisymmetric field and the p-brane structure are, in part, consequence of the Plücker coordinates.
Polarization issues in circular electron–positron super-colliders
Authors: Nikitin Sergei
Published: June 2020

We study a possibility of obtaining transversely polarized electron/positron beams in the CEPC collider. Also, original results are presented for another project, the FCCee collider, which allows us to identify some features and differences of these similar machines. Important is the comparison of the data obtained with the expected and measured polarizations at LEP. In estimation of the depolarizing effect of field errors, in addition to the usual nonresonant spin diffusion, an attempt was made to take into account the resonant diffusion, which is due to a large spin tune spread. We consider a possibility to obtain polarization by accelerating polarized particles in the CEPC booster and then injecting them into the main ring. This option can be crucial for obtaining longitudinal polarization. We propose a scheme in which long-term preservation of such polarization is possible.
Flow structure segmentation for vortex identification using butterfly convolutional neural networks
Authors: Ye Zhi-Xian , Chen Qian , Li Bing-Hua , Zou Jian-Feng , Zheng Yao
Published: June 2020

Vortex identification is important for understanding the physical mechanism of turbulent flow. The common vortex identification techniques based on velocity gradient tensor such as [Formula: see text] criterion will consume a lot of computing resources for processing great quantity of experimental data. To improve the vortex identification efficiency and achieve real-time recognition, we present a novel vortex identification method using segmentation with convolutional neural network (CNN) based on flow field image data, which is named “Butterfly-CNN”. Considering that the view of flow field is small, it is necessary to integrate both the local and global feature maps to achieve higher precision. The architecture consists of an encoded–decoded path, which is similar to [Formula: see text]-net but with different superimposed network part. In the Butterfly-CNN, the cross-expanding paths are designed with the global information to enable precise localization, and the feature maps after each convolution are regarded as the original pictures, then convolute to the size of the last feature map and upsample to the original size again. Finally, the decoded and cross-expanding networks are added up. The Butterfly-CNN can be trained end-to-end from a few images, and it is useful and efficient for vortex identification.
Nonlinear lift increase at high angles of attack for double swept waverider
Authors: Liu Chuan-Zhen , Bai Peng
Published: June 2020

The nonlinear increase of the lift of the double swept waverider at high angles of attack is of vital interest. The aerodynamic performance of the double swept waverider is calculated and compared with that of single swept waveriders. Results suggest that the lift nonlinearity of the double swept waverider is stronger than that of equal-planform-area single swept one, and the nonlinearity increases as Mach number increases. Some scholars have proposed the “vortex lift” to explain the nonlinear lift increase, but it is questionable as the main lift of the waverider comes from the lower surface rather than the upper surface. This paper proposes another explanation that the nonlinear lift increase is related to the attachment of shock wave, influenced by the leading-edge sweep angle. The shock wave is more inclined to attach under the lower surface with smaller swept than that of larger swept as angle of attack increases. When the shock wave attaches, the pressure increase via angle of attack is nonlinear, leading to the nonlinearity of lift increase.
Self-intersection local times for multifractional Brownian motion in higher dimensions: A white noise approach
Authors: Bock Wolfgang , da Silva Jose Luis , Suryawan Herry Pribawanto
Published: June 2020

In this paper, we study the self-intersection local times of multifractional Brownian motion (mBm) in higher dimensions in the framework of white noise analysis. We show that when a suitable number of kernel functions of self-intersection local times of mBm are truncated then we obtain a Hida distribution. In addition, we present the expansion of the self-intersection local times in terms of Wick powers of white noises. Moreover, we obtain the convergence of the regularized truncated self-intersection local times in the sense of Hida distributions.
Fair measures for countable-to-one maps
Authors: Rodrigues Ana , Roth Samuel , Roth Zuzana
Published: June 2020

In this paper, we generalize the recently introduced concept of fair measure [M. Misiurewicz and A. Rodrigues, Counting preimages, Ergod. Theor. Dyn. Syst. 38 (2018) 1837–1856]. We study fair measures for Markov and mixing interval maps with countably many branches. We investigate them in terms of the recurrence properties of some underlying countable Markov shifts, both from the stochastic viewpoint and from the viewpoint of thermodynamical formalism. Finally, we move beyond the interval and look for fair measures for graph maps.
Unique chords of unique cycles in 3-connected planar graphs
Authors: McKee Terry A.
Published: June 2020

Edges that are the unique chords of at least one cycle have been studied by a variety of authors over the past dozen years. This paper begins the study of those graphs in which each edge is the unique chord of exactly one cycle. The [Formula: see text]-connected planar graphs that enjoy this restriction are characterized by two infinite sequences (the dipyramid and trapezohedron [Formula: see text]-polytopes) together with three special graphs (the [Formula: see text]-antiprism, and the [Formula: see text]- and [Formula: see text]-prism graphs).
Herscovici’s conjecture on C2n × G
Authors: Lourdusamy A. , Mathivanan T.
Published: June 2020

The [Formula: see text]-pebbling number, [Formula: see text], of a connected graph [Formula: see text], is the smallest positive integer such that from every placement of [Formula: see text] pebbles, [Formula: see text] pebbles can be moved to any specified target vertex by a sequence of pebbling moves, each move taking two pebbles off a vertex and placing one on an adjacent vertex. A graph [Formula: see text] satisfies the [Formula: see text]-pebbling property if [Formula: see text] pebbles can be moved to any specified vertex when the total starting number of pebbles is [Formula: see text], where [Formula: see text] is the number of vertices with at least one pebble. We show that the cycle [Formula: see text] satisfies the [Formula: see text]-pebbling property. Herscovici conjectured that for any connected graphs [Formula: see text] and [Formula: see text], [Formula: see text]. We prove Herscovici’s conjecture is true, when [Formula: see text] is an even cycle and for variety of graphs [Formula: see text] which satisfy the [Formula: see text]-pebbling property.
Impact Modeling and Testing of Pouch and Prismatic Cells
Authors: Deng Jie , Smith Ian , Bae Chulheung , Rairigh Phil , Miller Theodore , Surampudi Bapiraju , L’Eplattenier Pierre , Caldichoury Inaki
Published: June 2020

Understanding battery response under impact is critical to improve the safety of electrified vehicles. Nevertheless, predicting the impact behaviors of batteries is not straightforward since a battery cell usually contains hundreds of thin layers with dramatically different material properties and multiple physical processes occur simultaneously during cell deformation. Here we utilized both empirical tests and numerical models to capture the failure process of pouch and prismatic cells in various impact scenarios. In each test, a cell was hit once by an indenter dropped from a certain height. During which the cell penetration, loading force, voltage and temperature were monitored to characterize the cell’s response. Meanwhile, numerical models were developed to capture the coupled mechanical, electrical, electrochemical and thermal responses of batteries. In these models, the cell bulk was treated as a homogeneous part to achieve computational efficiency required by large-scale simulations, and it was represented by the geologic cap model that allows both shear and compaction deformation. Simulation results showed agreement with experimental data in essential features of cell behaviors during impact. Details of the test setup, model development and cell failure behaviors are presented in this paper. Additionally, capabilities, limitations and future improvement of the battery safety modeling are discussed.
PCSK9 Expression in Epicardial Adipose Tissue: Molecular Association with Local Tissue Inflammation
Authors: Dozio Elena , Ruscica Massimiliano , Vianello Elena , Macchi Chiara , Sitzia Clementina , Schmitz Gerd , Tacchini Lorenza , Corsi Romanelli Massimiliano M.
Published: June 2020

Epicardial adipose tissue (EAT) has the unique property to release mediators that nourish the heart in healthy conditions, an effect that becomes detrimental when volume expands and proinflammatory cytokines start to be produced. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a proinflammatory mediator involved in atherosclerosis, is also produced by visceral fat. Due to the correlation of inflammation with PCSK9 and EAT enlargement, we evaluated whether PCSK9 was expressed in EAT and associated with EAT inflammation and volume. EAT samples were isolated during surgery. EAT thickness was measured by echocardiography. A microarray was used to explore EAT transcriptoma. The PCSK9 protein levels were measured by Western Blot in EAT and ELISA in plasma. PCSK9 was expressed at both the gene and protein levels in EAT. We found a positive association with EAT thickness and local proinflammatory mediators, in particular, chemokines for monocytes and lymphocytes. No association was found with the circulating PCSK9 level. The expression of PCSK9 in EAT argues that PCSK9 is part of the EAT secretome and EAT inflammation is associated with local PCSK9 expression, regardless of circulating PCSK9 levels. Whether reducing EAT inflammation or PCSK9 local levels may have beneficial effects on EAT metabolism and cardiovascular risk needs further investigations.
Manufacturing of Bathroom Wall Tile Composites from Recycled Low-Density Polyethylene Reinforced with Pineapple Leaf Fiber
Authors: Gebremedhin Negasi , Rotich Gideon K.
Published: June 2020

Plastic has been a dominant material for packaging in recent years but due to its nonbiodegradability, it is causing environmental pollution. Among the plastics used, low-density polyethylene is used abundantly. These plastics can be removed from the environment by recycling into useful products through reinforcing it with natural textile fibers into composite materials. Natural fiber-based composites are ecofriendly and low cost. This research is aimed at manufacturing composite wall tiles from recycled low-density polyethylene reinforced with pineapple leaf fibers (PALF). The PALF was extracted by the retting process followed by mechanical scratching and treated with 5% NaOH to improve the fiber-matrix interaction. The composites were manufactured by the melt-mixing method followed by compression molding. The effects of fiber length and fiber weight proportion on composite properties were investigated using tensile, flexural, impact, and water absorption tests. The study showed that the optimum fiber weight proportion and fiber length for the optimal properties of the composite were achieved at 30% fiber weight proportion and 30 mm fiber length. The maximum tensile strength of 1562 N/mm2, flexural strength of 454.9 N/mm2, and impact strength of 225.2 J/mm2 were obtained. Water absorption of the tiles increased with the increase in both the fiber weight proportion and the fiber length.