bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermo‐Hydro‐Mechanical Combined Effect Analysis Model for Early‐Age Concrete Bridges and Its Application
Authors: Li Shiwei , Yang Yongqing , Pu Qianhui , Wen Wangqing , Yan Aiguo
Published: September 2020

The early cracking of concrete beam bridges remains a concern in civil engineering. An analytical model considering the combined effect of thermo‐hydro‐mechanical processes forms the basis for assessing the cracking risk of girders during construction. Based on the equivalent hydration theory, the temperature and moisture conduction processes and the evolution of the mechanical properties of concrete were modeled as a function of the equivalent age. A coupling model for the temperature and moisture fields was established, and a theoretical framework for analyzing the thermo‐hydro‐mechanical combined effect was presented. Based on this, a numerical analysis method was proposed and implemented into ABAQUS; the results were validated with some typical tests. Finally, a long‐span prestressed concrete (PC) box girder bridge with balanced cantilever construction was taken as an example, and the causes of web cracking and its impact degree were analyzed. The results show that the rate of moisture conduction is significantly lower than the rate of temperature conduction; even for thin‐walled components, there exists a significant humidity gradient on the surface layer. The humidity‐induced shrinkage and restraint of the precast members are the main causes of web cracking.
Optimal Design of Bus Stop Locations Integrating Continuum Approximation and Discrete Models
Authors: Luo Xiaoling , Fan Wenbo , Jiang Yangsheng , Zhang Jun
Published: September 2020

Although transit stop location problem has been extensively studied, the two main categories of modeling methodologies, i.e., discrete models and continuum approximation (CA) ones, seem have little intersection. Both have strengths and weaknesses, respectively. This study intends to integrate them by taking the advantage of CA models’ parsimonious property and discrete models’ fine consideration of practical conditions. In doing so, we first employ the state-of-the-art CA models to yield the optimal design, which serves as the input to the next discrete model. Then, the stop location problem is formulated into a multivariable nonlinear minimization problem with a given number of stop location variables and location constraint. The interior-point algorithm is presented to find the optimal design that is ready for implementation. In numerical studies, the proposed model is applied to a variety of scenarios with respect to demand levels, spatial heterogeneity, and route length. The results demonstrate the consistent advantage of the proposed model in all scenarios as against its counterparts, i.e., two existing recipes that convert CA model-based solution into real design of stop locations. Lastly, a case study is presented using real data and practical constraints for the adjustment of a bus route in Chengdu (China). System cost saving of 15.79% is observed by before-and-after comparison.
In Situ Creep Model Testing for the Tunnel Anchor Foundation of Xingkang Suspension Bridge in Luding of China
Authors: Wen Lina , Cheng Qiangong , Cheng Qiang , Guo Xifeng , Zhang Bin
Published: September 2020

Due to the limitations of geography and geology, cast concrete tunnel anchors were used to provide counterforces for Xingkang Suspension Bridge foundation at the left bank of Daduhe River. In this study, the in situ creep tests were conducted on two model tunnel anchors at a scale of 1:10 near the real working anchor site. Thus, the long‐term deformation of the real working tunnel anchors installed at the bridge foundation could be determined from the creep test of model tunnel anchors. The creep tests were conducted under three different loads and lasted for 102.2 h, 167.5 h, and 189.4 h, respectively. The model anchor, the surrounding rock, and their interface were all monitored and measured during the creep testing. In addition, the numerical calculation, in which the Burger creep constitution was used for describing the surrounding rock and the Mohr–Coulomb criterion for describing the concrete anchor, was performed to further evaluate the long‐term stability of the real working tunnel anchors. The numerical calculations are in good agreement with the laboratory testing results, and the creep deformations of the anchor and the surrounding rock have the same order of magnitude. The results show that the tunnel anchor and surrounding rock of Xingkang Bridge are in a stable creep state under the three different loads.
Exploring Deep‐Rock Mechanics through Mechanical Analysis of Hard‐Rock In Situ Coring System
Authors: Li Jianan , Xie Heping , Chen Ling , Li Cong , He Zhiqiang
Published: September 2020

Exploration of deep‐rock mechanics has a significant influence on the techniques of mining and rock mechanics. Rock coring technique is the basic method for all rock mechanics study. With the increase of the drilling depth and increasing strength of the hard rock, how to obtain high‐quality rock core through various coring techniques is an eternal work. Here an innovative method is applied to design the new coring system to maximize the efficiency of operation. The stress conditions or parameters of rock core in the coring are analyzed, and the mechanism of the core with in situ stress is shown in this paper. The conflict of the core and coring tool chamber is proposed for the innovative design. The innovative design method is fulfilled by the theory of inventive problem solving (TRIZ). An improved coring system for the full‐length core with in situ stress was obtained with the solutions of improved coring mechanism, cutting mechanism, and spiral drill pipe.
Development and Evaluation of an iiPCR Assay for Salmonella and Shigella Detection on a Field-Deployable PCR System
Authors: Du Tian , Lin Ji-hong , Zhao Jun-hua , Wang Hai-bo , Mo Qiu-hua
Published: September 2020

Background. Salmonella and Shigella are often associated with fecal-oral transmission and cause large-scale outbreaks in centralized catering units and, therefore, should be frequently and strictly monitored, especially among food handlers. However, no specific and sensitive on-site detection method is available until now. Methods. In this study, an insulated isothermal PCR assay for the detection of Salmonella and Shigella on a field-deployable PCR system was developed. Specificity, sensitivity, reproducibility, and clinical accuracy of the assay were characterized and evaluated. Results. The insulated isothermal PCR assay could be completed within 58 minutes with minimal pretreatment needed. The assay was specific and with good reproducibility. The limit of detection was 103 CFU/mL and 101 CFU/mL for Salmonella and Shigella, respectively, which was comparable to multiplex real-time PCR. Mock on-site clinical evaluation results showed that the analytical sensitivity and specificity of the insulated isothermal PCR assay were 100% and 96.6%, while the positive predictive value and negative predictive value were 94.1% and 100%, respectively. Conclusion. Based on our results, we believe that the assay developed herein could serve as an alternative method for preliminary screening and provide a valuable platform for the on-site detection of Salmonella and Shigella, especially in resource-limited and developing countries.
Synthesis, Characterization, and Properties of Sulfonated Chitosan for Protein Adsorption
Authors: Zhang Xiaomin , Sun Jie
Published: September 2020

Chitosan sulfate was prepared and characterized as a new chromatography media for protein separation. The degree of sulfonation of chitosan could be well controlled and impacted under conditions in the synthesis process. The prepared chitosan sulfate shows improved binding capacity with proteins. Sulfonated chitosan shows improved ion-exchange adsorption properties with proteins, which could have good potential in protein purification.
Changes in Tinnitus by Cochlear Implantation: A Parametric Study of the Effect of Single-Electrode Stimulation
Authors: Kloostra Francka J.J. , de Kleine Emile , Free Rolien H. , Hofman Rutger , Van Dijk Pim
Published: September 2020

Introduction: While cochlear implantation may have a positive effect on tinnitus, it is not effective in reducing tinnitus in all patients. This may be due to different patients requiring different strategies of electrical stimulation in order to obtain a positive effect on tinnitus. It is, therefore, important to identify the most effective stimulation strategies to reduce tinnitus. The simplest possible strategy is stimulation by only one electrode. In this study, we investigated tinnitus suppression by electrical stimulation via a single electrode of the cochlear implant. Methods: We performed a listening experiment in 19 adult participants, who had received a unilateral cochlear implant (CI) because of severe bilateral hearing loss. All of these patients had indicated that they suffered from tinnitus. During a 300-s interval, patients listened to blocks of single-electrode stimulation and rated the loudness of the stimulus and any effects on their tinnitus. The 300-s interval included a block of single-electrode stimulation (duration 120 s). In consecutive intervals, the stimulus differed in its cochlear location (basal or apical), its pulse rate (720 or 725 Hz, 1,200 Hz, and 2,400 or 2,320 Hz), and amplitude (just above threshold or equivalent to moderate loudness). Thus, 2 × 3 × 2 = 12 stimulus conditions were tested in each participant, and each condition was presented only once. During the experiment, the participants promptly rated the loudness of the stimuli and the loudness of their tinnitus on a Visual Analogue Scale (10-point VAS). Results: Significantly more tinnitus reduction was observed with stimuli at a moderate intensity level (30%) compared to stimuli at near-threshold level (18%) (χ2 [1, N = 222] = 14.115, p < 0.01). No significant differences in tinnitus levels resulted from the different pulse rates and stimulation sites. Eight participants reported an increase of tinnitus loudness under at least one stimulus condition. Changes in tinnitus loudness were generally minor, and never exceeded 3 points on the VAS. The overall effect of cochlear implantation on tinnitus, that is, the effect with full-array stimulation, was not correlated with the effectiveness of the single-electrode stimulation on tinnitus. Conclusion: In conclusion, the effect of single-electrode stimulation on tinnitus is relatively insignificant in comparison to the effect of full-array stimulation. However, in some individual cases, sustained single-electrode stimulation may be beneficial for tinnitus management.
Postoperative Pain Protocol in Children after Selective Dorsal Rhizotomy
Authors: Hatef Jeffrey , Smith Luke G.F. , Veneziano Giorgio C. , Martin David P. , Bhalla Tarun , Leonard Jeffrey R.
Published: September 2020

Introduction: Selective dorsal rhizotomy (SDR) provides lasting relief of spasticity for children suffering from cerebral palsy, although controlling postoperative pain is challenging. Postoperatively, escalation of therapies to include a patient-controlled analgesia (PCA) pump and intensive care unit (ICU) admission is common. Objectives: We developed a multimodal pain management protocol that included intraoperative placement of an epidural catheter with continuous opioid administration. We present the 3-year results of protocol implementation. Methods: With institutional review board approval, all patients who were subjected to SDR at our institution were identified for review. Hourly pain scores were recorded. Adverse effects of medication, including desaturation, nausea/vomiting, and pruritus, were also noted. Comparisons were made between patients treated with PCA and those treated with multimodal pain control using t and χ2 tests as appropriate. Results: Thirty-nine patients undergoing the procedure with protocolized pain control (average age 6.8 years, 57% male) were compared to 7 PCA-treated controls (average age 6.6 years, 54% male). Pain control was satisfactory in both groups, with average pain scores of 1.5 in both groups on postoperative day 0, decreasing by postoperative day 3 to 1.1 in the PCA group and 0.5 in the protocol group. No patients under the protocol required ICU admission; all patients with PCA spent at least 1 day in the ICU. Desaturations were seen in 16 patients in the protocol group (41%), but none required ICU transfer. Treatment for pruritis was given to 57% of PCA patients and 15% of protocol patients. Treatment for nausea and vomiting was given to 100% of PCA patients and 51% of protocol patients. Medication requirements for the hospitalization were decreased from 1.1 to 0.28 doses per patient for pruritis, and from 3 to 1.1 doses per patient for nausea. Conclusions: Multimodal analgesia is an excellent alternative to PCA for postoperative pain after SDR. Actual analgesia is comparative to that of controls without the need for intensive care monitoring. Side effects of high-dose opiates were less frequent and required less medication. With the protocol, patients were safely treated outside the ICU.
Chest Computed Tomography Findings in Asymptomatic Patients with COVID-19
Authors: Chang Min Cheol , Lee Wonho , Hur Jian , Park Donghwi
Published: September 2020

Background: Little is known about the damage to the respiratory system in asymptomatic patients with coronavirus disease (COVID-19). Objective: Herein, we evaluate the findings of chest computed tomography (CT) and radiography in patients with COVID-19 who were asymptomatic. Methods: We retrospectively investigated patients with a confirmed diagnosis of COVID-19 but who did not show any symptoms. Among the 139 patients with COVID-19 who were hospitalized in Yeungnam University Hopistal in Daegu, South Korea, 10 (7.2%) were asymptomatic. Their chest CT and radiographic findings were analyzed. Results: In the results, all patients (100%) had ground-glass opacity (GGO) on chest CT. Further, the GGO lesions were predominantly distributed peripherally and posteriorly in all patients. In 9 (90%) patients, the GGO lesions were combined with reticular opacity. Air bronchogram due to bronchiolectasis surrounded by GGO was observed in 8 patients (80%). Additionally, the lung lesions were dominant on the right side in all patients. Conclusions: In conclusion, considering our results that the lung is affected in asymptomatic patients, it will be necessary to extend the indications of COVID-19 testing for effective management of COVID-19 during the pandemic.
Use of Azithromycin for the Prevention of Lung Injury in Mechanically Ventilated Preterm Neonates: A Randomized Controlled Trial
Authors: Nunes Cristiane R. , Procianoy Renato S. , Corso Andréa L. , Silveira Rita C.
Published: September 2020

Introduction: Macrolides have anti-inflammatory and immunomodulatory properties that give this class of antibiotics a role that differs from its classical use as an antibiotic, which opens new therapeutic possibilities. Objective: The aim of this study was to evaluate the anti-inflammatory effect of azithromycin in preventing mechanical ventilation (MV)-induced lung injury in very-low-birth-weight preterm neonates. Methods: This is a randomized, double-blind, placebo-controlled trial of preterm neonates who received invasive MV within 72 h of birth. Patients were randomized to receive intravenous azithromycin (at a dose of 10/mg/kg/day for 5 days) or placebo (0.9% saline) within 12 h of the start of MV. Two blood samples were collected (before and after intervention) for measurement of interleukins (ILs) and PCR for Ureaplasma. Patients were followed up throughout the hospital stay for the outcomes of death and broncho­pulmonary dysplasia defined as need for oxygen for a period of ≥28 days of life (registered at ClinicalTrials.gov, No. NCT03485703). Results: Forty patients were analyzed in the azithromycin group and 40 in the placebo group. Five days after the last dose, serum IL-2 and IL-8 levels dropped significantly in the azithromycin group. There was a significant reduction in the incidence of death and O2 dependency at 28 days/death in azithromycin-treated patients regardless of the detection of Ureaplasma in blood. Conclusions: Azithromycin has anti-inflammatory effects, with a decrease in cytokines after 5 days of use and a reduction in death and O2 dependency at 28 days/death in mechanically ventilated preterm neonates.
Splenic Abscess: An Unusual Presentation of COVID-19?
Authors: Al-Ozaibi Labib S. , Alshaikh Mohammed O. , Makhdoom Maahroo , Alzoabi Osama M. , Busharar Hajar A. , Keloth Tasnim R.
Published: September 2020

Most patients with coronavirus disease 2019 (COVID-19) present with respiratory symptoms that range from mild symptoms to severe illness leading to mortality. Some might be asymptomatic and others may present with unusual presentations. A 55-year-old male with a past history of ischemic stroke, ischemic heart disease, and type 2 diabetes mellitus presented with right-sided weakness and a history of abdominal pain, diarrhea, and fever. He tested positive for COVID-19. Computed tomography (CT) abdomen showed the presence of splenic abscess and small intraperitoneal gas indicating pneumoperitoneum. Laparotomy revealed ruptured splenic abscess and splenectomy was done. The patient continued to show features of severe sepsis with multiorgan failure and died on postoperative day 16. COVID-19 mainly affects the respiratory system but extrapulmonary affection has been reported. Direct invasion and damage to the organs by the virus could be the reason behind the development of the extrapulmonary manifestations.
Acquired Angioedema due to C1 Inhibitor Deficiency Preceding Splenic Marginal Zone Lymphoma: Further Insights from Clinical Practice
Authors: Ferriani Mariana Paes Leme , Trevisan-Neto Orlando , Costa Julia S. , Melo Janaina M.L. , Moreno Adriana S. , Dias Marina M. , Garibaldi Pedro M.M. , Pereira Gabriel C. , Chahud Fernando , Traina Fabiola , Arruda L. Karla
Published: September 2020

Background: Acquired angioedema due to C1 inhibitor deficiency (AAE-C1-INH) is a very rare disease. In clinical practice, it may be difficult to differentiate AAE-C1-INH from hereditary angioedema due to C1-INH deficiency (HAE-C1-INH). In both conditions, patients are at an increased risk of death from asphyxiation due to upper airway obstruction. The association of AAE-C1-INH with lymphoproliferative and autoimmune diseases, and with presence of anti-C1-INH antibodies has been well documented, and treatment of the underlying condition may result in complete remission of angioedema. Objectives: To discuss the clinical evaluation, diagnosis, and treatment outcomes of AAE-C1-INH in the context of the care of 2 patients with recurrent isolated angioedema. Methods: Two patients were followed up prospectively at our clinic. Measurements of C3, C4, C1-INH, and C1q levels were carried out by nephelometry, and the functional activity of C1-INH was determined by a chromogenic assay. Hematological investigation included morphological and immunophenotyping analysis of peripheral blood, bone marrow, and spleen histopathology. Sequencing of the 8 exons and adjacent intronic regions of the SERPING1 gene was performed using the Sanger method. Results: Two patients were diagnosed with AAE-C1-INH associated with splenic marginal zone lymphoma during follow-up. Conclusions: Close follow-up, including detailed clinical history, physical examination, and laboratory tests, of our patients with AAE-C1-INH was essential for the early diagnosis and successful treatment of the lymphoproliferative disease, leading to the resolution of the angioedema attacks.
Collapsing Glomerulopathy Affecting Native and Transplant Kidneys in Individuals with COVID-19
Authors: Noble Rebecca , Tan Mei Ying , McCulloch Thomas , Shantier Mohamed , Byrne Catherine , Hall Matthew , Jesky Mark
Published: September 2020

Since the emergency of novel coronavirus COVID-19 (SARS-CoV-2) in December 2019, infections have spread rapidly across the world. The reported incidence of acute kidney injury (AKI) in the context of COVID-19 is variable, and its mechanism is not well understood. Data are emerging about possible mechanisms of AKI including virus-induced cytopathic effect and cytokine storm-induced injury. To date, there have been few reports of kidney biopsy findings in the context of AKI in COVID-19 infection. This article describes 2 cases of collapsing glomerulopathy, 1 in a native kidney and, for the first time, 1 in a kidney transplant. Both individuals were black, and both presented without significant respiratory compromise. Indeed, the 2 patients we describe remained systemically well for the majority of their inpatient stay, which would support the hypothesis that for these patients, AKI was caused by a cytopathic viral effect, rather than that of a cytokine storm or acute tubular necrosis caused by prolonged hypovolaemia or the effect of medication known to exacerbate AKI. Here, we report 2 cases of AKI with collapsing glomerulopathy in COVID-19, one of which is in a kidney transplant recipient, not previously described elsewhere.
Primary Undifferentiated Pericardial Sarcoma after Radiоtherapy for Hodgkin Lymphoma
Authors: Glybochko Petr V. , Fomin Victor V. , Chichkova Natalia V. , Kogan Evgeniya A. , Svistunov Andrei A. , Komarov Roman N. , Syrkin Abram L.
Published: September 2020

Various types of sarcomas arise as a result of postradiation chronic fibrous pericarditis. A primary undifferentiated spindle cell pericardial sarcoma is a rare type of sarcoma after radiotherapy. The risk of sarcoma increases with time after treatment of cancer. A 55-year-old woman underwent successful radiation and chemotherapy for Hodgkin lymphoma 20 years ago. She was hospitalized with typical manifestations of severe heart failure. Echocardiography, сomputed tomography of the chest and magnetic resonance imaging scan of the heart detected neoplastic formations of the pericardium. A biopsy of the pericardium was performed. Histological, immunohistochemical, and genetic studies showed a primary undifferentiated spindle cell pericardial sarcoma (an extremely rare type of sarcoma).
Long-Term Prognostic Predictors of Esophageal Squamous Cell Carcinoma Potentially Indicated for Endoscopic Submucosal Dissection
Authors: Suzuki Tomohiko , Furukawa Kazuhiro , Funasaka Kohei , Ishikawa Eri , Sawada Tsunaki , Maeda Keiko , Yamamura Takeshi , Ishikawa Takuya , Ohno Eizaburo , Nakamura Masanao , Kawashima Hiroki , Miyahara Ryoji , Fujishiro Mitsuhiro
Published: September 2020

Introduction: Patients with esophageal squamous cell carcinoma (ESCC) have various comorbidities. Thus, it is necessary to determine the appropriateness of performing treatment based on the patient’s general condition. Aim: This study aimed to clarify the prognostic predictors of ESCC indicated for endoscopic submucosal dissection (ESD). Methods: This retrospective study enrolled 241 patients with superficial ESCC endoscopically diagnosed as ESD-indicated lesions at the Nagoya University Hospital between January 2007 and December 2017. We evaluated the 3- and 5-year overall survival (OS) rates and prognostic predictors, such as the Prognostic Nutritional Index (PNI), Charlson Comorbidity Index (CCI), Psoas Muscle Index, and Controlling Nutritional Status score. Furthermore, we created a score-based classification using the prognostic predictors identified by multivariate analysis, and the 3- and 5-year OS rates were compared among the calculated scores. Results: In the multivariate analysis, PNI < 45 (hazard ratio [HR]: 2.39; 95% confidence interval [CI]: 1.28–4.46; p = 0.006) and CCI ≥ 3 (HR: 4.42; 95% CI: 2.40–8.12; p < 0.001) were significantly associated with the OS. Based on the HR, 0 and 1 were assigned to PNI and 0, 2, and 4 were assigned to CCI, and the score classification of 0–5 points was created. The 3- and 5-year OS rates in patients with a score 3 were significantly higher than in those with scores 4 and 5. As a result of scoring, the prognosis was stratified; the 3- and 5-year OS rates in patients with scores 4 and 5, that is, CCI ≥ 6, were clearly low, at approximately 10%. Conclusions: CCI and PNI can be prognostic predictors of patients with superficial ESCC indicated for ESD. Observation without ESD might be an acceptable strategy among patients with CCI ≥ 6.
Comparison of the Functional Success of Fat Myringoplasty and Perifascial Areolar Tympanoplasty in Transcanal Endoscopic Ear Surgery
Authors: Ko Chien-An , Yang Chao-Hui , Wu Ching-Nung , Huang Pingche , Hwang Chung-Feng
Published: September 2020

Objectives:

We compared the functional outcomes of fat myringoplasty and areolar tympanoplasty through a small postauricular incision in patients who underwent transcanal endoscopic ear surgery (TEES).

Methods:

The study included patients who underwent myringoplasty or type I tympanoplasty using TEES in our Department of Otolaryngology between April 2016 and May 2019. The patients were divided into 2 groups according to the type of graft material used, which was selected based on the available amount of subcutaneous fat and the surgeon’s experience.

Results:

In total, 63 patients received fat tissue grafts (group A) and 77 received areolar tissue grafts (group B). The median operative time was significantly longer in group B (132 minutes) than in group A (65 minutes); perforations were significantly larger in group B than in group A (61.0% vs 29.7% of the eardrum surface). The postoperative air conduction threshold, air–bone gap, and speech reception threshold values were significantly lower than the preoperative values in both groups. The graft success rate did not significantly differ between groups A (96.8%, 61/63) and B (96.1%, 74/77). In group A, the perforation was > 35% of the eardrum surface in 27.0% (17/63) of the patients; the graft success rate was 100% (17/17). In the remaining 46 patients (perforation > 35%), the graft success rate was 95.7% (44/46); this difference was not statistically significant.

Conclusions:

Transcanal endoscopic ear surgery increases the usefulness of fat myringoplasty for the repair of perforations > 35% of the eardrum surface. Postauricular fatty and areolar tissues are suitable for this simple and rapid technique, which yields excellent outcomes.
Distributed sliding mode leader-following consensus controller for uncertain time-delay linear parameter-varying multiagent systems
Authors: Moradi Mohammad Amin , Safarinejadian Behrouz , Shafiei Mohammad Hossein
Published: September 2020

This study addresses the consensus problem of leader-following multiagent systems, whose dynamics are governed by time-delay linear parameter-varying models with norm-bounded uncertainties. At first, a delay-dependent sufficient condition concerned with the existence of a parameter-varying sliding surface is given in terms of linear matrix inequalities. Then, a robust consensus among the leader and followers is achieved via the distributed linear parameter-varying sliding mode control protocol. Conditions for closed-loop stability are also presented in the form of some theorems. Simulation results demonstrate the effectiveness of the proposed approach.
A nonlinear optimization shooting method for bifurcation tracking of nonlinear systems
Authors: Liao Haitao , Li Mengyu , Gao Ruxin
Published: September 2020

A continuation method for bifurcation tracking is presented based on the proposed optimization problem formulation which is designed to locate the bifurcation periodic solution. The bifurcation detection problem is formulated as a constrained optimization problem. The nonlinear constraints of the optimization problem are imposed on the shooting function and bifurcation conditions derived from the Floquet theory whereas the objective function associated with the pseudo-arclength correlation equation is devised to solution continuation. The proposed optimization formulation is integrated with the prediction–correction strategy to achieve bifurcation tracking. Two numerical examples about the Jeffcott rotor and the nonlinear tuned vibration absorber are illustrated to validate the effectiveness of the proposed methodology. Numerical results have demonstrated that the proposed method offers a convenient scheme to follow bifurcation periodic solution.
Features of a mobile health intervention to manage chronic obstructive pulmonary disease: a qualitative study
Authors: Alwashmi Meshari F. , Fitzpatrick Beverly , Davis Erin , Farrell Jamie , Gamble John-Michael , Hawboldt John
Published: September 2020

Background:

The use of mobile health (mHealth) interventions has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes. Further research is needed to determine which mHealth features are required to potentially enhance COPD self-management.

Aim:

The aim of this study was to explore the potential features of an mHealth intervention for COPD management with healthcare providers (HCPs) and patients with COPD. It could inform the development and successful implementation of mHealth interventions for COPD management.

Methods:

This was a qualitative study. We conducted semi-structured individual interviews with HCPs, including nurses, pharmacists and physicians who work directly with patients with COPD. Interviews were also conducted with a diverse sample of patients with COPD. Interview topics included demographics, mHealth usage, the potential use of medical devices and recommendations for features that would enhance an mHealth intervention for COPD management.

Results:

A total of 40 people, including nurses, physicians and pharmacists, participated. The main recommendations for the proposed mHealth intervention were categorised into two categories: patient interface and HCP interface. The prevalent features suggested for the patient interface include educating patients, collecting baseline data, collecting subjective data, collecting objective data via compatible medical devices, providing a digital action plan, allowing patients to track their progress, enabling family members to access the mHealth intervention, tailoring the features based on the patient’s unique needs, reminding patients about critical management tasks and rewarding patients for their positive behaviours. The most common features of the HCP interface include allowing HCPs to track their patients’ progress, allowing HCPs to communicate with their patients, educating HCPs and rewarding HCPs.

Conclusion:

This study identifies important potential features so that the most effective, efficient and feasible mHealth intervention can be developed to improve the management of COPD. The reviews of this paper are available via the supplemental material section.
Impact assessment of rural PPP MaaS pilots
Authors: Eckhardt Jenni , Lauhkonen Arttu , Aapaoja Aki
Published: September 2020

The purpose of this paper is to present the impact assessment results of Mobility as a Service pilots based on public-private collaboration. In the pilots, companies and local and regional stakeholders joined their expertise to experiment with different ways of organizing mobility services in rural areas. The pilots included demand-responsive transport and integrated transport of different user groups and combining trips that include customers paying themselves and those being publicly subsidized. In addition to the call centre service, a smartphone application was introduced. The impact assessment of these pilots spans individual/user, business/organizational and societal levels. The main findings include improved accessibility of transport services in rural areas and resource efficiency in terms of improved occupancy rates of vehicles, reduced driven kilometres and emissions, and cost savings for the public sector.
MAPK cascade gene family in Camellia sinensis: In-silico identification, expression profiles and regulatory network analysis
Authors: Chatterjee Archita , Paul Abhirup , Unnati G. Meher , Rajput Ruchika , Biswas Trisha , Kar Tamalika , Basak Srijita , Mishra Neelam , Pandey Ashutosh , Srivastava Anurag Prakash
Published: September 2020

Background

Mitogen Activated Protein Kinase (MAPK) cascade is a fundamental pathway in organisms for signal transduction. Though it is well characterized in various plants, there is no systematic study of this cascade in tea.

Result

In this study, 5 genes of Mitogen Activated Protein Kinase Kinase (MKK) and 16 genes of Mitogen Activated Protein Kinase (MPK) in Camellia sinensis were found through a genome-wide search taking Arabidopsis thaliana as the reference genome. Also, phylogenetic relationships along with structural analysis which includes gene structure, location as well as protein conserved motifs and domains, were systematically examined and further, predictions were validated by the results. The plant species taken for comparative study clearly displayed segmental duplication, which was a significant candidate for MAPK cascade expansion. Also, functional interaction was carried out in C. sinensis based on the orthologous genes in Arabidopsis. The expression profiles linked to various stress treatments revealed wide involvement of MAPK and MAPKK genes from Tea in response to various abiotic factors. In addition, the expression of these genes was analysed in various tissues.

Conclusion

This study provides the targets for further comprehensive identification, functional study, and also contributed for a better understanding of the MAPK cascade regulatory network in C. sinensis.
Identification of loci controlling mineral element concentration in soybean seeds
Authors: Malle Sidiki , Morrison Malcolm , Belzile François
Published: September 2020

Background

Mineral nutrients play a crucial role in the biochemical and physiological functions of biological systems. The enhancement of seed mineral content via genetic improvement is considered as the most promising and cost-effective approach compared alternative means for meeting the dietary needs. The overall objective of this study was to perform a GWAS of mineral content (Ca, K, P and S) in seeds of a core set of 137 soybean lines that are representative of the diversity of early maturing soybeans cultivated in Canada (maturity groups 000-II).

Results

This panel of 137 soybean lines was grown in five environments (in total) and the seed mineral content was measured using a portable x-ray fluorescence (XRF) spectrometer. The association analyses were carried out using three statistical models and a set of 2.2 million SNPs obtained from a combined dataset of genotyping-by-sequencing and whole-genome sequencing. Eight QTLs significantly associated with the Ca, K, P and S content were identified by at least two of the three statistical models used (in two environments) contributing each from 17 to 31% of the phenotypic variation. A strong reproducibility of the effect of seven out these eight QTLs was observed in three other environments. In total, three candidate genes were identified involved in transport and assimilation of these mineral elements.

Conclusions

There have been very few GWAS studies to identify QTLs associated with the mineral element content of soybean seeds. In addition to being new, the QTLs identified in this study and candidate genes will be useful for the genetic improvement of soybean nutritional quality through marker-assisted selection. Moreover, this study also provides details on the range of phenotypic variation encountered within the Canadian soybean germplasm.
Shear stress improves the endothelial progenitor cell function via the CXCR7/ERK pathway axis in the coronary artery disease cases
Authors: Zhou Hua , Tu Qiang , Zhang Yan , Xie Hua Qiang , Shuai Qing Yun , Huang Xiao Chuan , Fu Jie , Cao Zheng
Published: September 2020

Background

Dysfunction in the late Endothelial Progenitor Cells (EPCs) is responsible for endothelial repair in patients with Coronary Artery Disease (CAD), and the shear stress is beneficial for EPCs function. However, the impact of shear stress on the capacity of EPCs in CAD patients has not been elucidated yet. The C-X-C chemokine receptor 7/extracellular signal-regulated kinase (CXCR7)/(ERK) pathways are identified to regulate EPCs function in CAD patients. Here, we hypothesize that shear stress upregulates the CXCR7/ERK pathways, which restore the EPCs function in CAD patients.

Methods

The human Peripheral Blood Mononuclear Cells (PBMCs) were collected from healthy adults and CAD patients and then used for EPCs cultivation. The Lv-siRNA for human CXCR7 was transfected into induced EPCs isolated from the CAD patients. Meanwhile, the EPCs from CAD patients were subjected to shear stress generated by a biomimetic device. Next, the cell viability, migration, tube formation, and apoptosis were detected by CCK-8, Transwell assay, Matrigel, and flow cytometry, respectively. Also, the CXCR7/ERK pathways in human EPCs were analyzed by Western blotting and qRT-PCR.

Result

Compared to the EPCs collected from normal adults, the CAD patient-derived EPCs showed reduced in vitro vasculogenic capacity. Also, the level of CXCR7 in CAD patient-derived EPCs was significantly reduced compared to the EPCs of healthy subjects. Meanwhile, the extracellular signal-regulated kinase (ERK), which represents a CXCR7 downstream signaling pathway, had decreased phosphorylation level. The shear stress treatment augmented the CXCR7 expression and also elevated ERK phosphorylation, which is comparable to the up-regulation of CAD patient-derived EPCs function. Further, the small interfering RNA (siRNA)-mediated CXCR7 knockdown diminished the enhanced migration, adhesion, and tube formation capacity of shear stress treated CAD patient-derived EPCs.

Conclusion

Up-regulation of the CXCR7/ERK pathways by shear stress can be a promising new target in enhancing the vasculogenic ability of CAD patient-derived EPCs.
Weekly variation in markers of cardiometabolic health – the possible effect of weekend behavior – a cross-sectional study
Authors: Hansen Louise Sølund , Pedersen Marlene Rosager Lund , Tarp Jakob , Bugge Anna , Wedderkopp Niels , Møller Niels Christian
Published: September 2020

Background

Adolescents’ health-related behavior varies from weekday to weekend. Only few studies, however, have examined to which degree such variation will affect markers of cardiometabolic health. Therefore, the primary aim of this study is to examine if markers of cardiometabolic health differ between different days of the week in adolescents.

Methods

This cross-sectional school-based study included up to 581 participants, 11–17 years old. Markers of metabolic health were insulin, glucose, triglyceride, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and blood pressure. Linear mixed regression modelling was used to examine the cardiometabolic profile across weekdays.

Results

Significant declining trends were observed across the week in adolescents’ levels of cardiometabolic health markers. Lower levels of insulin (16.1%), glucose (2.6%) and triglyceride (24.7%) were observed on Fridays compared to Mondays (p ≤ 0.006). Gradual improvement in measurement profiles across weekdays was less apparent for HDL-C, LDL-C, systolic blood pressure and diastolic blood pressure (P ≥ 0.06). Analyses stratified by sex suggested a more noticeable pattern of gradual improvement across weekdays in boys than in girls.

Conclusion

Significantly lower levels of insulin, glucose and triglyceride were observed in adolescents on Fridays compared to Mondays. However, when sex specific analyses were performed significant profile variations were only observed across the week in boys. More research is needed to better understand which behavioral factors in particular seem to influence weekly variation in markers of cardiometabolic health - especially since such variation potentially will have an impact on how assessments of markers of cardiometabolic health optimally should be planned, standardized and carried out, both in research and in medical practice.
Endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm: a case report
Authors: Zeng Zhaoxiang , Li Zhenjiang , Zhao Yuxi , Liu Junjun , Feng Jiaxuan , Jing Zaiping , Feng Rui
Published: September 2020

Background

Infectious aortic aneurysm, defined as a focal dilation of an infectious arterial wall, is an uncommon life-threatening disease. Compared with open surgery, endovascular repair yields acceptable clinical outcomes. However, residual tissue infection may increase the risk of secondary intervention. Here, we present a successful case of endovascular repair combined with staged drainage for the treatment of infectious aortic aneurysm.

Case presentation

A 58-year-old man presented to hospital with a 3-day history of lower back pain radiating to the back associated with fever. The dynamic imaging characteristics revealed rapid progress of infectious abdominal aortic aneurysm with negative blood culture. The patient underwent endovascular repair and salmonella enteritidis was identified through drain culture.

Conclusions

Endovascular procedure and staged drainage can be feasible and effective option in selected cases.
A call to action for delirium research: Meta-analysis and regression of delirium associated mortality
Authors: Aung Thein May Zin , Pereira Jarett V. , Nitchingham Anita , Caplan Gideon A.
Published: September 2020

Background

Delirium is an extremely common hospital complication. No study to date has assessed whether a priori defined covariates; type of hospital setting and year of study publication, influence the relationship between delirium and mortality. This is also the first study to examine the longitudinal trend of delirium-associated mortality over recent decades, to analyse the trajectory of our efforts in combating this disease.

Methods

MEDLINE, EMBASE and PsycINFO, were searched from January 1981 to May 2018 for English-language primary articles. Rigorous title and abstract screen and full-text screen were conducted independently by two reviewers. This paper adhered to MOOSE guidelines. Data was extracted independently by one reviewer using standardised data-collection sheets, with a separate reviewer verifying for accuracy. The quality of included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Unadjusted effect sizes and event counts were analysed with a random effects model in primary meta-analysis and meta-regression, whereas a mixed effect model was used in secondary sub-group analysis. Mortality data at longest follow-up and cumulative mortality (hospital mortality combined with mortality at longest follow-up) data were analysed.

Results

As part of a larger project, 446 of 6790 articles were retrieved, including 71 studies that measured mortality. Our results demonstrate that elderly inpatients with delirium had significantly greater odds of mortality (OR 3.18 [95%CI: 2.73, 3.70]) compared to non-delirious controls. Patients with delirium in the ICU had the highest odds for mortality (OR: 7.09 [95%CI: 3.60, 14.0]); double the risk compared to the average. Curiously, despite advancements in delirium research, delirium associated in-hospital odds of mortality has not changed in 30 years.

Conclusion

This is the largest meta-analysis to confirm the association between delirium and mortality, in older (age ≥ 65) hospital inpatients.

The current meta-analysis highlights the significant odds of mortality after an episode of delirium, and these odds are much higher for ICU patients. However, in contrast to other medical conditions that have seen a decrease in associated mortality over the past few decades, delirium associated mortality remains unchanged. These findings underscore the urgent need for better delirium treatments.

PROSPERO Registration Number: CRD42018098627, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=98627
Poor self-rated health predicts the incidence of functional disability in elderly community dwellers in Japan: a prospective cohort study
Authors: Takahashi Shuko , Tanno Kozo , Yonekura Yuki , Ohsawa Masaki , Kuribayashi Toru , Ishibashi Yasuhiro , Omama Shinichi , Tanaka Fumitaka , Sasaki Ryohei , Tsubota-Utsugi Megumi , Takusari Eri , Koshiyama Makoto , Onoda Toshiyuki , Sakata Kiyomi , Itai Kazuyoshi , Okayama Akira ,   on behalf of the Iwate KENCO study group
Published: September 2020

Background

Although previous large population studies showed elderly with poor self-rated health (SRH) to be at a high risk of functional disability in Western countries, there have been few studies in which the association between SRH and functional disability was investigated in Japanese community dwellers. The association between SRH and functional disability, defined as certification of the long-term care insurance (LTCI) system, in Japanese elderly community dwellers was examined in this study.

Methods

A total of 10,690 individuals (39.5% men, mean age of 71.4 years) who were 65 years of age or more who did not have a history of cardiovascular disease or LTCI certification were followed in this prospective study for 10.5 years. SRH was classified into four categories: good, rather good, neither good nor poor, and poor. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) for the incidence of functional disability among the SRH groups for each sex.

Results

The number of individuals with functional disability was 3377. Men who rated poor for SRH scored significantly higher for functional disability (HR [95% confidence interval]: poor = 1.74 [1.42, 2.14]) while women who rated rather good, neither good nor poor, and poor scored significantly higher for functional disability (rather good =1.12 [1.00, 1.25], neither good nor poor = 1.29 [1.13, 1.48], poor = 1.92 [1.65, 2.24]: p for trend < 0.001 in both sexes).

Conclusion

Self-rated health, therefore, might be a useful predictor of functional disability in elderly people.