bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Self-Powered Dynamic System Using a Quasi-Z-Source Inverter-Based Piezoelectric Vibration Energy Harvester
Authors: Poh Wesley Qi Tong , Bin Mohamad Saifuddin Muhammad Ramadan , Naayagi Ramasamy Thaiyal
Published: February 2020

The use of quasi-Z-source inverters (qZSIs) for DC-DC power conversion applications has gained much recognition when dealing with grid-tied renewable energy resource integrations. This paper proposes a novel self-powered dynamic system (SPDS) involving a piezoelectric vibration energy harvester (PVEH) using qZSI to establish interoperability with a DC load rated at 16.15 mW. Based on uncertain output performances from a piezoelectric cantilever beam (CB), the qZSI-based PVEH serves as a dynamic voltage restoration unit that establishes load-following synchronisation. It uses a proportional-integral based boost controller (PI-based BC) to generate strategic ordering of shoot-through voltage amplification into pulse-width modulation (PWM) gating sequences. The SPDS was modelled using two software based on commercially available product specifications: (i) COMSOL Multiphysics to mechanically design and optimise a CB. (ii) PSCAD/EMTDC to electronically design and integrate the qZSI with the optimised CB, while functioning as a testbed to model the SPDS against arbitrary wind speed and structural vibration frequency data collected from an above-ground mass rapid transit (MRT) train station in Khatib, Singapore. The acquired simulation results have depicted desirable transient responses at respective sub-systems, procuring fast settling-time responses, negligible steady-state error, as well as high efficiencies of 94.07% and 91.64% for the CB and SPDS respectively.
Bandwidth Improvement of MMIC Single-Pole-Double-Throw Passive HEMT Switches with Radial Stubs in Impedance-Transformation Networks
Authors: Tsao Yi-Fan , Würfl Joachim , Hsu Heng-Tung
Published: February 2020

In this paper, we propose a new configuration for improving the isolation bandwidth of MMIC single-pole-double-throw (SPDT) passive high-electron-mobility transistor (HEMT) switches operating at millimeter frequency range. While the conventional configuration adopted open-stub loading for compensation of the off-state capacitance, radial stubs were introduced in our approach to improve the operational bandwidth of the SPDT switch. Implemented in 0.15 m GaAs pHEMT technology, the proposed configuration exhibited a measured insertion loss of less than 2.5 dB with better than 30 dB isolation level over the frequency range from 33 GHz to 44 GHz. In terms of the bandwidth of operation, the proposed configuration achieved a fractional bandwidth of 28.5% compared to that of 12.3% for the conventional approach. Such superior bandwidth performance is mainly attributed to the less frequency dependent nature of the radial stubs.
Computer Network Simulation with ns-3: A Systematic Literature Review
Authors: Campanile Lelio , Gribaudo Marco , Iacono Mauro , Marulli Fiammetta , Mastroianni Michele
Published: February 2020

Complexity of current computer networks, including e.g., local networks, large structured networks, wireless sensor networks, datacenter backbones, requires a thorough study to perform analysis and support design. Simulation is a tool of paramount importance to encompass all the different aspects that contribute to design quality and network performance (including as well energy issues, security management overheads, dependability), due to the fact that such complexity produces several interactions at all network layers that is not easily modellable with analytic approaches. In this systematic literature review we aim to analyze, basing our investigation on available literature, the adoption of a popular network simulator, namely ns-3, and its use in the scientific community. More in detail, we are interested in understanding what are the impacted application domains in which authors prefer ns-3 to other similar tools and how extensible it is in practice according to the experience of authors. The results of our analysis, which has been conducted by especially focusing on 128 papers published between 2009 to 2019, reveals that 10% of the evaluated papers were discarded because they represented informal literature; most of the studies presented comparisons among different network simulators, beyond ns-3 and conceptual studies related to performance assessment and validation and routing protocols. Only about 30% of considered studies present extensions of ns-3 in terms of new modules and only about 10% present effective case studies demonstrating the effectiveness of employing network simulator in real application, except conceptual and modeling studies.
Improved 2D Coprime Array Structure with the Difference and Sum Coarray Concept
Authors: Wang Guiyu , Fei Zesong , Ren Shiwei , Li Xiaoran
Published: February 2020

Recently, the difference and sum (diff-sum) coarray has attracted much attention in one-dimensional direction-of-arrival estimation for its high degrees-of-freedom (DOFs). In this paper, we utilize both the spatial information and the temporal information to construct the diff-sum coarray for planar sparse arrays. The diff-sum coarray contains both the difference coarray and the sum coarray, which provides much higher DOFs than the difference coarray alone. We take a planar coprime array consisting of two uniform square subarrays as the array model. To fully use the aperture-extending ability of the diff-sum coarray, we propose two novel configurations to improve the planar coprime array. The first configuration compresses the inter-element spacing of one subarray and results in a larger consecutive area in the coarray. The second configuration rearranges the two subarrays and introduces a proper separation between them, which can significantly reduce the redundancy of the diff-sum coarray and increase the DOFs. Besides, we derive the closed-form expressions of the central consecutive ranges in the coarrays of the proposed array configurations. Simulations verify the superiority of the proposed array configurations.
Early Detection of Diabetic Retinopathy Using PCA-Firefly Based Deep Learning Model
Authors: Gadekallu Thippa Reddy , Khare Neelu , Bhattacharya Sweta , Singh Saurabh , Maddikunta Praveen Kumar Reddy , Ra In-Ho , Alazab Mamoun
Published: February 2020

Diabetic Retinopathy is a major cause of vision loss and blindness affecting millions of people across the globe. Although there are established screening methods - fluorescein angiography and optical coherence tomography for detection of the disease but in majority of the cases, the patients remain ignorant and fail to undertake such tests at an appropriate time. The early detection of the disease plays an extremely important role in preventing vision loss which is the consequence of diabetes mellitus remaining untreated among patients for a prolonged time period. Various machine learning and deep learning approaches have been implemented on diabetic retinopathy dataset for classification and prediction of the disease but majority of them have neglected the aspect of data pre-processing and dimensionality reduction, leading to biased results. The dataset used in the present study is a diabetes retinopathy dataset collected from the UCI machine learning repository. At its inceptions, the raw dataset is normalized using the Standardscalar technique and then Principal Component Analysis (PCA) is used to extract the most significant features in the dataset. Further, Firefly algorithm is implemented for dimensionality reduction. This reduced dataset is fed into a Deep Neural Network Model for classification. The results generated from the model is evaluated against the prevalent machine learning models and the results justify the superiority of the proposed model in terms of Accuracy, Precision, Recall, Sensitivity and Specificity.
Combining GF-2 and Sentinel-2 Images to Detect Tree Mortality Caused by Red Turpentine Beetle during the Early Outbreak Stage in North China
Authors: Zhan Zhongyi , Yu Linfeng , Li Zhe , Ren Lili , Gao Bingtao , Wang Lixia , Luo Youqing
Published: February 2020

In recent years, the red turpentine beetle (RTB) (Dendroctonus valens LeConte) has invaded the northern regions of China. Due to the short invasion time, the outbreak of tree mortality corresponded to a low level of damage. Important information about tree mortality, provided by remote sensing at both single-tree and forest stand scale, is needed in forest management at the early stages of outbreak. In order to detect RTB-induced tree mortality at a single-tree scale, we evaluated the classification accuracies of Gaofen-2 (GF2) imagery at different spatial resolutions (1 and 4 m) using a pixel-based method. We also simultaneously applied an object-based method to 1 m pan-sharpened images. We used Sentinel-2 (S2) imagery with different resolutions (10 and 20 m) to detect RTB-induced tree mortality and compared their classification accuracies at a larger scale—the stand scale. Three kinds of machine learning algorithms—the classification and regression tree (CART), the random forest (RF), and the support vector machine (SVM)—were applied and compared in this study. The results showed that 1 m resolution GF2 images had the highest classification accuracy using the pixel-based method and SVM algorithm (overall accuracy = 77.7%). We found that the classification of three degrees of damage percentage within the S2 pixel (0%, <15%, and 15% < x < 50%) was not successful at a forest stand scale. However, 10 m resolution S2 images could acquire effective binary classification (<15%: overall accuracy = 74.9%; 15% < x < 50%: overall accuracy = 81.0%). Our results indicated that identifying tree mortality caused by RTB at a single-tree and forest stand scale was accomplished with the combination of GF2 and S2 images. Our results are very useful for the future exploration of the patterns of spatial and temporal changes in insect pest transmission at different spatial scales.
Towards Sustainable Forest Management in Central America: Review of Southern Pine Beetle (Dendroctonus frontalis Zimmermann) Outbreaks, Their Causes, and Solutions
Authors: Gomez Demian F. , Sathyapala Shiroma , Hulcr Jiri
Published: February 2020

Outbreaks of the southern pine beetle (SPB) Dendroctonus frontalis Zimmermann in Central America have had a devastating impact on pine forests. It remains unclear to what extent these outbreaks are caused by the beetle’s ecology, climate, and historical management practices. Using research data and experience accumulated in northern latitudes to guide management of forests in Central America is associated with great uncertainty, given the many unique features of the conifer forests in this region. The main recommendation from this review is that Central American bark beetle outbreaks need to be studied locally, and the local climate, biotic elements, and silvicultural history need to be considered. The key to reducing the impacts of SPB in Central America are local research and implementation of proactive management, in order to facilitate the establishment of forests more resilient to increasing environmental and anthropogenic pressures.
Acknowledgement to Reviewers of Fishes in 2019
Authors:   Fishes Editorial Office
Published: February 2020

Rigorous peer-review is the corner-stone of high-quality academic publishing [...]
Nitrogen Source Affects the Composition of Metabolites in Pepper (Capsicum annuum L.) and Regulates the Synthesis of Capsaicinoids through the GOGAT–GS Pathway
Authors: Zhang Jing , Lv Jian , Xie Jianming , Gan Yantai , Coulter Jeffrey A. , Yu Jihua , Li Jing , Wang Junwen , Zhang Xiaodan
Published: February 2020

Phytochemical analyses of pepper fruit metabolites have been reported; however, much less is known about the influence of different forms of nitrogen (N), which is critical for plant growth and fruit quality formation. The “Longjiao No. 5” variety (Capsicum annuum L.) grown in Northwestern China was profiled using liquid chromatography–mass spectrometry (LC–MS) coupled with multivariate data analysis to explore the composition of different metabolites in pericarp and placenta, and to investigate the effect of three ammonium (NH4+) to-nitrate (NO3−) ratios (0:100, 25:75, and 50:50). A total of 215 metabolites were obtained by qualitative analysis, where 31 metabolites were the major differential metabolite components of pepper fruits between placenta and pericarp, and 25 among N treatments. The addition of ammonium up-regulated carbohydrates, such as Î±-lactose and sucrose, as well as phenylalanine lyase (PAL) of placenta tissue. The supply of 25% NH4+–N and 75% NO3−–N exhibited a relatively higher levels of ascorbic acid in pericarp and amino acids, capsaicin, and dihydrocapsaicin in placenta, and led to higher fruit weight among the ammonium-to-nitrate ratios. The expression and activities of glutamic acid synthetase (GOGAT) and glutamine synthetase (GS) that are involved in ammonium assimilation were affected by adjusting the ammonium–N proportion, and they were significantly positively correlated with capsaicin, dihydrocapsaicin contents, capsaicinoid synthetase (CS), as well as the relative expression levels of genes related to capsaicinoid biosynthesis, such as acyltransferase 3 (AT3) and acyl-ACP thioesterase (FatA).
Growth Performance and Nutrient Composition of Mealworms (Tenebrio Molitor) Fed on Fresh Plant Materials-Supplemented Diets
Authors: Liu Changqi , Masri Jasmin , Perez Violet , Maya Cassandra , Zhao Jing
Published: February 2020

Mealworms (Tenebrio molitor) have a great potential to serve as a sustainable food source for humans due to their favorable nutrient profile and low environmental impact. Feed formulation and optimization are important for mealworm production. The objective of this study was to evaluate the effects of fresh plant materials-supplemented diets on the growth performance and nutritional value of mealworms. Mealworm larvae were grown on wheat bran or wheat bran enriched with carrot, orange, or red cabbage for four weeks. Larval and pupal survival, growth rate, pupating rate, duration of pupal stage, proximate composition, reducing power, metal chelating activity, and radical scavenging activity of the mealworms were analyzed. Dietary supplementation with fresh plant materials did not result in significant changes in mealworm survival, development, proximate composition, or antioxidant activities. However, mealworm larvae fed on carrot-, orange-, and red cabbage-supplemented diets had improved growth rates, and were 40%–46% heavier in week four than those fed on wheat bran only, indicating the supplementation resulted in an increased production efficiency of mealworm larvae. Our findings may help optimize the diet formulation for mealworm mass production.
The Effect of Bread Fortification with Whole Green Banana Flour on Its Physicochemical, Nutritional and In Vitro Digestibility
Authors: Amini Khoozani Amir , Kebede Biniam , Birch John , Bekhit Alaa El-Din Ahmed
Published: February 2020

The use of Whole Green Banana Flour (WGBF) in bread production may be a strategy to improve the nutritional profile of bread, but the extent of improvement may depend on the processing conditions of the flour. Therefore, WGBF was produced using two methods (freeze-drying and air-oven drying) and was used in bread-making. This study investigated the effect of flour type—FDF (WGBF produced by freeze-drying) and ODF (prepared by air-oven drying at 50 °C)—at fortification levels of 0% (control), 10%, 20%, and 30% on the fortified bread. A significant decrease in energy caloric value and an increase in moisture and fibre at >20% fortification level (p < 0.05) was noted. The ODF bread samples had a higher browning index compared to the control and the FDF samples. Addition of WGBF improved macro minerals (Mg, Ca, Na, K, and P) with a no significant change in micro minerals (Fe, Zn, and Mn). The use of FDF in bread resulted in a marked increase in resistant and slow digestible starch levels in F30 compared to ODF samples and their comparable fortification levels. The digestibility of the bread samples showed that WGBF can be used as an alternative functional ingredient to prepare bread with better nutritional value.
Bioactive Components in Fermented Foods and Food By-Products
Authors: Verardo Vito , Gómez-Caravaca Ana , Tabanelli Giulia
Published: February 2020

Food fermentation is one of the most ancient processes of food production that has historically been used to extend food shelf life and to enhance its organoleptic properties [...]
A Missense Variant Affecting the C-Terminal Tail of UNC93B1 in Dogs with Exfoliative Cutaneous Lupus Erythematosus (ECLE)
Authors: Leeb Tosso , Leuthard Fabienne , Jagannathan Vidhya , Kiener Sarah , Letko Anna , Roosje Petra , Welle Monika , Gailbreath Katherine , Cannon Andrea , Linek Monika , Banovic Frane , Olivry Thierry , White Stephen , Batcher Kevin , Bannasch Danika , Minor Katie , Mickelson James , Hytönen Marjo , Lohi Hannes , Mauldin Elizabeth , Casal Margret
Published: February 2020

Cutaneous lupus erythematosus (CLE) in humans encompasses multiple subtypes that exhibit a wide array of skin lesions and, in some cases, are associated with the development of systemic lupus erythematosus (SLE). We investigated dogs with exfoliative cutaneous lupus erythematosus (ECLE), a dog-specific form of chronic CLE that is inherited as a monogenic autosomal recessive trait. A genome-wide association study (GWAS) with 14 cases and 29 controls confirmed a previously published result that the causative variant maps to chromosome 18. Autozygosity mapping refined the ECLE locus to a 493 kb critical interval. Filtering of whole genome sequence data from two cases against 654 controls revealed a single private protein-changing variant in this critical interval, UNC93B1:c.1438C>A or p.Pro480Thr. The homozygous mutant genotype was exclusively observed in 23 ECLE affected German Shorthaired Pointers and an ECLE affected Vizsla, but absent from 845 controls. UNC93B1 is a transmembrane protein located in the endoplasmic reticulum and endolysosomes, which is required for correct trafficking of several Toll-like receptors (TLRs). The p.Pro480Thr variant is predicted to affect the C-terminal tail of the UNC93B1 that has recently been shown to restrict TLR7 mediated autoimmunity via an interaction with syndecan binding protein (SDCBP). The functional knowledge on UNC93B1 strongly suggests that p.Pro480Thr is causing ECLE in dogs. These dogs therefore represent an interesting spontaneous model for human lupus erythematosus. Our results warrant further investigations of whether genetic variants affecting the C-terminus of UNC93B1 might be involved in specific subsets of CLE or SLE cases in humans and other species.
A Comparative Transcriptome Analysis of Volvariella volvacea Identified the Candidate Genes Involved in Fast Growth at the Mycelial Growth Stage
Authors: Liu Ming , Yu Ting , Singh Puneet Kumar , Liu Qinjian , Liu Hao , Zhu Qingfeng , Xiao Zitian , Xu Jiang , Peng Yangyang , Fu Shiyu , Chen Shicheng , He Huanqing
Published: February 2020

The edible straw mushroom, Volvariella volvacea, is one of the most important cultivated mushrooms in tropical and sub-tropical regions. Strain improvement for V. volvacea is difficult because of the unknown mechanisms involved in its growth regulation and substrate utilization. A comparative physiological and transcriptomic study was conducted between two commercially available straw mushroom strains (v9 and v26) to explore their fast-growth regulation mechanism(s). The physiological study showed that V. volvacea v9 had a shorter growth cycle and higher biological efficiency (4% higher) than that in v26. At least 14,556 unigenes were obtained from the four cDNA libraries (two replicates per strain). Among them, the expression of 1597 unigenes was up-regulated while 1352 were down-regulated. Four heat-shock proteins were highly expressed in v9, showing that v9 has the better ability to handle stresses and/or environmental changes. Moreover, up to 14 putative transporter genes were expressed at a higher level in v9 than those in v26, implying that v9 has a better ability to transport nutrients or export xenobiotics efficiently. Our report allows to identify the candidate genes involved in the fast growth requirement of V. volvacea, which represents a valuable resource for strain improvement in this commercially important edible mushroom.
Altered Hippocampal Epigenetic Regulation Underlying Reduced Cognitive Development in Response to Early Life Environmental Insults
Authors: Schachtschneider Kyle M. , Welge Michael E. , Auvil Loretta S. , Chaki Sulalita , Rund Laurie A. , Madsen Ole , Elmore Monica R.P. , Johnson Rodney W. , Groenen Martien A.M. , Schook Lawrence B.
Published: February 2020

The hippocampus is involved in learning and memory and undergoes significant growth and maturation during the neonatal period. Environmental insults during this developmental timeframe can have lasting effects on brain structure and function. This study assessed hippocampal DNA methylation and gene transcription from two independent studies reporting reduced cognitive development stemming from early life environmental insults (iron deficiency and porcine reproductive and respiratory syndrome virus (PRRSv) infection) using porcine biomedical models. In total, 420 differentially expressed genes (DEGs) were identified between the reduced cognition and control groups, including genes involved in neurodevelopment and function. Gene ontology (GO) terms enriched for DEGs were associated with immune responses, angiogenesis, and cellular development. In addition, 116 differentially methylated regions (DMRs) were identified, which overlapped 125 genes. While no GO terms were enriched for genes overlapping DMRs, many of these genes are known to be involved in neurodevelopment and function, angiogenesis, and immunity. The observed altered methylation and expression of genes involved in neurological function suggest reduced cognition in response to early life environmental insults is due to altered cholinergic signaling and calcium regulation. Finally, two DMRs overlapped with two DEGs, VWF and LRRC32, which are associated with blood brain barrier permeability and regulatory T-cell activation, respectively. These results support the role of altered hippocampal DNA methylation and gene expression in early life environmentally-induced reductions in cognitive development across independent studies.
Circulatory miR-133b and miR-21 as Novel Biomarkers in Early Prediction and Diagnosis of Coronary Artery Disease
Authors: Kumar Dinesh , Narang Rajiv , Sreenivas Vishnubhatla , Rastogi Vandana , Bhatia Jagriti , Saluja Daman , Srivastava Kamna
Published: February 2020

While coronary artery disease (CAD) has become a major threat worldwide, the timely biomarker-based early diagnosis of CAD remains a major unmet clinical challenge. We aimed towards assessing the level of circulatory microRNAs as candidates of novel biomarkers in patients with CAD. A total of 147 subjects were recruited which includes 78 subjects with angiographically proven CAD, 15 pre-atherosclerotic normal coronary artery (NCA) subjects and 54 healthy individuals. Quantitative real-time PCR assays were performed. MiR-133b was downregulated by 4.6 fold (p < 0.0001) whereas miR-21 was upregulated by ~2 fold (p < 0.0001) in plasma samples of CAD patients. Importantly, both the miRNAs showed association with disease severity as miR-133b was downregulated by 8.45 fold in acute coronary syndrome (ACS), 3.38 fold in Stable angina (SA) and 2.08 fold in NCA. MiR-21 was upregulated by 2.46 fold in ACS, 1.90 fold in SA and 1.12 fold in NCA. Moreover, miR-133b could significantly differentiate subjects with ST-elevation myocardial infarction (STEMI) from Non-STEMI. Area under the curve (AUC) for miR-133b was 0.80 with >75.6% sensitivity and specificity, AUC for miR-21 was 0.79 with >69.4% sensitivity and specificity. Our results suggest that miR-133b and miR-21 could be possible candidates of novel biomarkers in early prediction of CAD.
The LCORL Locus Is under Selection in Large-Sized Pakistani Goat Breeds
Authors: Saif Rashid , Henkel Jan , Jagannathan Vidhya , Drögemüller Cord , Flury Christine , Leeb Tosso
Published: February 2020

Goat domestication and human selection for valued traits have formed diverse breeds with characteristic phenotypes. This process led to the fixation of causative genetic variants controlling breed-specific traits within regions of reduced genetic diversity—so-called “selection signatures”. We previously reported an analysis of selection signatures based on pooled whole-genome sequencing data of 20 goat breeds and bezoar goats. In the present study, we reanalyzed the data and focused on a subset of eight Pakistani goat breeds (Angora, Barbari, Beetal, Dera Din Panah, Kamori, Nachi, Pahari, Teddy). We identified 749 selection signatures based on reduced heterozygosity in these breeds. A search for signatures that are shared across large-sized goat breeds revealed that five medium-to-large-sized Pakistani goat breeds had a common selection signature on chromosome 6 in a region harboring the LCORL gene, which has been shown to modulate height or body size in several mammalian species. Fine-mapping of the region confirmed that all five goat breeds with the selection signature were nearly fixed for the same haplotype in a ~191 kb region spanning positions 37,747,447–37,938,449. From the pool sequencing data, we identified a frame-shifting single base insertion into an isoform-specific exon of LCORL as a potential candidate causal variant mediating the size-increasing effect. If this preliminary result can be confirmed in independent replication studies, genotyping of this variant might be used to improve breeding programs and the selection for stature in goats.
Pirates and Publicity: The Making and Unmaking of Early Modern Pirates in English and Scottish Popular Print
Authors: Macfarlane C. Alasdair
Published: February 2020

This essay contrasts scholarship on printed authority within buccaneer ethnographies, contemporary apologetics for colonial enterprise, and the role of publicity in the delineation of piracy within print to ask: ‘when is a pirate not a pirate?’. Beginning with the ethnographies relating to the buccaneers’ crossing of the Isthmus of Darien during the ‘Pacific Adventure’ (1679–1682), this paper describes how the buccaneers escaped prosecution through their literary materials and became socially rehabilitated as credible explorers. Drawing on materials which highlight the diverse readings of piracy within the different ‘news-cultures’ and maritime traditions which existed in the Atlantic archipelago, this paper develops an argument for a ‘popular’ conception and interpretation of piracy within publicity and periodical print which reflects its utility within competing political and maritime enterprises. Using contrasting examples of the negotiation and renegotiation of what constituted ‘piracy’ within the promotion of the attempted colonisation of the Isthmus of Darien by the Company of Scotland (1696–1700), and the literary campaign which surrounded the trial of the crew of the Worcester for piracy in 1705, this essay argues for the role of ‘public opinion’ and popular print culture in the making and unmaking of pirates in early modern anglophone print.
Psychosexual Functioning Outcome Testing after Hypospadias Repair
Authors: Majstorovic Marko , Bizic Marta , Nikolic Dejan , Stojanovic Borko , Bencic Marko , Joksic Ivana , Djordjevic Miroslav
Published: February 2020

Self-confidence plays an important role in both genders’ sexual functioning. Lack of genital self-esteem may have negative effects on psychosexual development, especially in males, where deviations from a standardized normal penile appearance can lead to inhibitions in entering into sexual relationships. The aim of our study was to evaluate the informativeness of studied domains of the Global Sexual Functioning (GSF) questionnaire and sexual functioning of patients surgically treated in childhood for different types of hypospadias. We evaluated 63 males with hypospadias and 60 healthy age- and gender-matched controls. The GSF questionnaire was used to estimate psychosexual function as a long-term follow-up after the surgical correction of hypospadias in the patient and control groups. Sexual activity (p = 0.017), arousal (p = 0.033) and orgasmic abilities (p = 0.002) values were significantly increased in patients. Strong correlation was noticed between sexual activity and sexual desire (R = 0.872); arousal and sexual desire (R = 0.753), as well as orgasmic and erectile abilities (R = 0.769). Different domains of psychosexual functioning in the patient group correlated with each other to various degrees, resulting in a heterogeneous expression of psychosexual dysfunctions, implicating the necessity of a personalized treatment approach.
Syphilis Notifications and the Triggering Processes for Vertical Transmission: A Cross-Sectional Study
Authors: de Oliveira Samara Isabela Maia , de Oliveira Saraiva Cecília Olívia Paraguai , de França Débora Feitosa , Ferreira Júnior Marcos Antônio , de Melo Lima Libna Helen , de Souza Nilba Lima
Published: February 2020

Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student’s and Fisher’s tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem.
Impact of Urbanization on PM2.5-Related Health and Economic Loss in China 338 Cities
Authors: Diao Beidi , Ding Lei , Zhang Qiong , Na Junli , Cheng Jinhua
Published: February 2020

According to the requirements of the Healthy China Program, reasonable assessment of residents’ health risks and economic loss caused by urban air pollution is of great significance for environmental health policy planning. Based on the data of PM2.5 concentration, population density, and urbanization level of 338 Chinese cities in the year of 2015, the epidemiological relative risk (RR) was adopted to estimate the negative health effects caused by exposure to PM2.5. Meanwhile, the Value of Statistical Life (VSL) and Cost of Illness (COI) methods were used to calculate economic loss. The results show that PM2.5 pollution remains serious in 2015, which brings about many people suffering from all kinds of fearful health problems especially premature death and related diseases. The mortality and morbidity increase dramatically, and the total direct economic loss related to PM2.5 pollution in 2015 was 1.846 trillion yuan, accounting for 2.73% of total annual GDP. In addition, there was a strong correlation between urbanization level and health risks as well as economic loss, which implies that people who live in highly urbanized cities may face more severe health and economic losses. Furthermore, 338 cities were divided into four categories based on urbanization level and economic loss, of which the key areas (type D) were the regions where an increase in monitoring and governance is most needed. In the process of urbanization, policy makers should pay more attention to health costs and regional differentiated management, as well as promote the construction of healthy cities more widely.
Dynamic Evolution of the Ecological Carrying Capacity of Poverty-Stricken Karst Counties Based on Ecological Footprints: A Case Study in Northwestern Guangxi, China
Authors: Shi Shana , Hu Baoqing , Yan Yan , Li Xiaoqing , Zhou Kaichun , Tang Chuanyong , Xie Binggeng
Published: February 2020

The karst area in northwestern Guangxi is poor, underdeveloped, and ecologically fragile. It is experiencing rocky desertification, which creates challenges that are more severe than those of other regional ecological environments. In this paper, the ecological footprint (EF) model is used to analyze the ecological carrying capacity (EC) in northwestern Guangxi from 1995 to 2015, and the differences in karst counties with different poverty levels are discussed. The results show that (1) since 1995, the EC of northwestern Guangxi has continued to decrease, the EF has continued to increase, the ecological deficit (ED) has been expanding, and the status of the region has been unsustainable for a long time. (2) The evolutionary patterns, EF and EC of karst counties with different poverty levels are different. The county with the lowest poverty rate has the fastest growth rate of the per capita EF. The county with the largest proportion of karst area has the lowest EC. (3) It is recommended that different types of counties take different measures, including strengthening ecological environment protection, carrying out rocky desertification control and ecological resettlement projects, and reducing energy consumption. This study can provide information for the sustainable development of the karst region and provide decision support for regional poverty alleviation.
Poor Sleep Is a Risk Factor for Low-Back Pain among Healthcare Workers: Prospective Cohort Study
Authors: Vinstrup Jonas , Jakobsen Markus D. , Andersen Lars L.
Published: February 2020

This study aimed to investigate the association between poor sleep and risk of low-back pain (LBP) in healthcare workers. Using a prospective cohort design with 1-year follow-up, a total of 1955 healthcare workers (60% nurses) from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health, and working environment. Associations between sleep scores (0–100) at baseline and LBP intensity (0–10) at follow-up were modelled using cumulative logistic regression accounting for clustering at the department level and adjusted for lifestyle and psychosocial confounders. In the full population of healthcare workers, 43.9% and 24.4% experienced moderate and poor sleep, respectively. In the fully adjusted model with good sleep as reference, moderate, and poor sleep increased the risk of LBP at follow-up, with odds ratios (OR’s) of 1.66 (95% confidence interval (CI) 1.35–2.04) and 2.05 (95% CI 1.57–2.69), respectively. Three sensitivity analyses including healthcare workers free from LBP, nurses, and nurses free from LBP at baseline, respectively, yielded similar results. In conclusion, poor sleep constitutes a potent risk factor for LBP among healthcare workers. The presented results provide strong incentives to evaluate and weigh current prevention policies against an updated biopsychosocial framework.
Sleep Disturbances Rate among Medical and Allied Health Professions Students in Iran: Implications from a Systematic Review and Meta-Analysis of the Literature
Authors: Khaksarian Mojtaba , Behzadifar Masoud , Behzadifar Meysam , Jahanpanah Firuzeh , Guglielmi Ottavia , Garbarino Sergio , Lanteri Paola , Re Tania Simona , Zerbetto Riccardo , Maldonado Briegas Juan José , Riccò Matteo , Bragazzi Nicola Luigi
Published: February 2020

Medicine and healthcare professions are prestigious and valued careers and, at the same time, demanding, challenging, and arduous jobs. Medical and allied health professions students, experiencing a stressful academic and clinical workload, may suffer from sleep disturbances. In Iran, several studies have been conducted to explore the prevalence rate among medical and healthcare professions students. The aim of this systematic review and meta-analysis was to quantitatively and rigorously summarize the existing scholarly literature, providing the decision- and policy-makers and educators with an updated, evidence-based synthesis. Only studies utilizing a reliable psychometric instrument, such as the Pittsburgh sleep quality index (PSQI), were included, in order to have comparable measurements and estimates. Seventeen investigations were retained in the present systematic review and meta-analysis, totaling a sample of 3586 students. Studies were conducted between 2008 and 2018 and reported an overall rate of sleep disturbances of 58% (95% confidence interval or CI 45–70). No evidence of publication bias could be found, but formal analyses on determinants of sleep disturbances could not be run due to the dearth of information that could be extracted from studies. Poor sleep is highly prevalent among Iranian medical and healthcare professions students. Based on the limitations of the present study, high-quality investigations are urgently needed to better capture the determinants of poor sleep quality among medical and healthcare professions students, given the importance and the implications of such a topic.
The Clustering of mApoE Anti-Amyloidogenic Peptide on Nanoparticle Surface Does Not Alter Its Performance in Controlling Beta-Amyloid Aggregation
Authors: Corti Roberta , Cox Alysia , Cassina Valeria , Nardo Luca , Salerno Domenico , Marrano Claudia Adriana , Missana Natalia , Andreozzi Patrizia , Silva Paulo Jacob , Stellacci Francesco , Dal Magro Roberta , Re Francesca , Mantegazza Francesco
Published: February 2020

The deposition of amyloid-β (Aβ) plaques in the brain is a significant pathological signature of Alzheimer’s disease, correlating with synaptic dysfunction and neurodegeneration. Several compounds, peptides, or drugs have been designed to redirect or stop Aβ aggregation. Among them, the trideca-peptide CWG-LRKLRKRLLR (mApoE), which is derived from the receptor binding sequence of apolipoprotein E, is effectively able to inhibit Aβ aggregation and to promote fibril disaggregation. Taking advantage of Atomic Force Microscopy (AFM) imaging and fluorescence techniques, we investigate if the clustering of mApoE on gold nanoparticles (AuNP) surface may affect its performance in controlling Aβ aggregation/disaggregation processes. The results showed that the ability of free mApoE to destroy preformed Aβ fibrils or to hinder the Aβ aggregation process is preserved after its clustering on AuNP. This allows the possibility to design multifunctional drug delivery systems with clustering of anti-amyloidogenic molecules on any NP surface without affecting their performance in controlling Aβ aggregation processes.
Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals
Authors: Masson Walter , Huerín Melina , Lobo Lorenzo Martin , Masson Gerardo , Molinero Graciela , Nemec Mariano , Boccadoro Mariela , Romero Cinthia , Micali Gabriel , Siniawski Daniel
Published: February 2020

Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals, and recommendations for the use of lipid-lowering drugs. The objectives of this work were to describe the lipid-lowering treatment prescribed for patients with diabetes and to determine the percentage of patients that achieved the lipid goals recommended by the 2019 ESC/EASD Guidelines on Diabetes in real and simulated scenarios. Methods: A multicenter, cross-sectional study was performed. Subjects >18 years with type 2 diabetes were included. The recommendations of the 2019 ESC/EASD Guidelines were followed. The real and simulated (ideal setting using adequate doses of statins ± ezetimibe) scenarios were analyzed. Results: Overall, 528 patients were included. In total, 62.5% of patients received statins (17.1% high intensity). Most patients were stratified as “very high risk” (54.2%) or “high risk” (43.4%). Only 13.3% achieved the double lipid goal (LDL-C and non-HDL-C goals according to the risk categories). In the simulation analysis, the proportion of subjects that did not reach the therapeutic objective decreased in all risk strata, although a considerable proportion of subjects persisted outside the target. Conclusion: The difficulty of achieving lipid goals in diabetic patients was considerable when applying the new guidelines. The situation would improve if we optimized treatment, but the prescription of new lipid-lowering drugs could be limited by their high cost.
Markov State Modelling of Disease Courses and Mortality Risks of Patients with Community-Acquired Pneumonia
Authors: Przybilla Jens , Ahnert Peter , Bogatsch Holger , Bloos Frank , Brunkhorst Frank M. ,   SepNet Critical Care Trials Group,   PROGRESS study group, Bauer Michael , Loeffler Markus , Witzenrath Martin , Suttorp Norbert , Scholz Markus
Published: February 2020

Community-acquired pneumonia (CAP) is one of the most frequent infectious diseases worldwide, with high lethality. Risk evaluation is well established at hospital admission, and re-evaluation is advised for patients at higher risk. However, severe disease courses may develop from all levels of severity. We propose a stochastic continuous-time Markov model describing daily development of time courses of CAP severity. Disease states were defined based on the Sequential Organ Failure Assessment (SOFA) score. Model calibration was based on longitudinal data from 2838 patients with a primary diagnosis of CAP from four clinical studies (PROGRESS, MAXSEP, SISPCT, VISEP). We categorized CAP severity into five disease states and estimated transition probabilities for CAP progression between these states and corresponding sojourn times. Good agreement between model predictions and clinical data was observed. Time courses of mortality were correctly predicted for up to 28 days, including validation with patient data not used for model calibration. We conclude that CAP disease course follows a Markov process, suggesting the necessity of daily monitoring and re-evaluation of patient’s risk. Our model can be used for regular updates of risk assessments of patients and could improve the design of clinical trials by estimating transition rates for different risk groups.
Therapeutic Options for the Treatment of Interstitial Lung Disease Related to Connective Tissue Diseases. A Narrative Review
Authors: Vacchi Caterina , Sebastiani Marco , Cassone Giulia , Cerri Stefania , Della Casa Giovanni , Salvarani Carlo , Manfredi Andreina
Published: February 2020

Interstitial lung disease (ILD) is one of the most serious pulmonary complications of connective tissue diseases (CTDs) and it is characterized by a deep impact on morbidity and mortality. Due to the poor knowledge of CTD-ILD’s natural history and due to the difficulties related to design of randomized control trials, there is a lack of prospective data about the prevalence, follow-up, and therapeutic efficacy. For these reasons, the choice of therapy for CTD-ILD is currently very challenging and still largely based on experts’ opinion. Treatment is often based on steroids and conventional immunosuppressive drugs, but the recent publication of the encouraging results of the INBUILD trial has highlighted a possible effective and safe use of antifibrotic drugs as a new therapeutic option for these subjects. Aim of this review is to summarize the available data and recent advances about therapeutic strategies for ILD in the context of various CTD, such as systemic sclerosis, idiopathic inflammatory myopathy and Sjogren syndrome, systemic lupus erythematosus, mixed connective tissue disease and undifferentiated connective tissue disease, and interstitial pneumonia with autoimmune features, focusing also on ongoing clinical trials.
Cardiovascular and Lung Involvement in Patients with Autoimmune Pancreatitis
Authors: Nikolic Sara , Brehmer Katharina , Panic Nikola , Valente Roberto , Löhr J.-Matthias , Vujasinovic Miroslav
Published: February 2020

Introduction: Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated disease characterised pathologically by the infiltration of IgG4-bearing plasma cells into the involved organs. Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis with a heavy lymphocytic infiltration and two distinct histopathological subtypes, namely: lymphoplasmacytic sclerosing pancreatitis (AIP type 1) and idiopathic duct-centric pancreatitis (AIP type 2). Lung involvement and aortic involvement have been reported in 12% and 9% of patients with systemic IgG4-RD, respectively. In series including patients with AIP, both lung and aortic involvement were described in 2% of the patients. Most of the epidemiological data come from Japan, and there is a lack of information from Europe, especially the Scandinavian countries. Patients and methods: We performed a single-centre retrospective study on a prospectively collected cohort of patients diagnosed with AIP at the Department for Digestive Diseases at Karolinska University Hospital in Stockholm, Sweden, from 2004 to 2019. Demographic and clinical data were collected from the medical charts. Results: One hundred and thirty-three patients with AIP were analysed. Six patients were excluded because they lacked some of the clinical data relevant to the study. Demographic and clinical features of 127 patients were presented. There were 98 patients with AIP type 1-35 (35.7%) female and 63 (64.3%) male, with a mean age of 55.4 ± 18.2. Among them, 15 (15.3%) patients had lung and/or cardiovascular involvement-11 (11.2%) patients had lung involvement, 10 (10.2%) patients had cardiovascular involvement (six patients had both). Most of them (67.0%) had never smoked. The mean follow-up time of the patients with AIP type 1 was 49 months. Conclusions: Lung and/or cardiovascular involvement were diagnosed in 15 (15.3%) patients in our historical cohort of patients with AIP type 1. Most of the lung involvement was presented in the form of nodular lesions in the lungs, non-specific infiltrates, “ground-glass” appearance with pleura thickening, and effusion. Aortic involvement was a major form of vascular involvement in patients with AIP, as in previous published studies on patients with IgG4-RD.
Skeletal and Respiratory Muscle Dysfunctions in Pulmonary Arterial Hypertension
Authors: Riou Marianne , Pizzimenti Mégane , Enache Irina , Charloux Anne , Canuet Mathieu , Andres Emmanuel , Talha Samy , Meyer Alain , Geny Bernard
Published: February 2020

Pulmonary arterial hypertension (PAH) is a rare disease, which leads to the progressive loss and remodeling of the pulmonary vessels, right heart failure, and death. Different clinical presentations can be responsible for such a bad prognosis disease and the underlying mechanisms still need to be further examined. Importantly, skeletal and respiratory muscle abnormalities largely contribute to the decreased quality of life and exercise intolerance observed in patients with PAH. At the systemic level, impaired oxygen supply through reduced cardiac output and respiratory muscle dysfunctions, which potentially result in hypoxemia, is associated with altered muscles vascularization, inflammation, enhanced catabolic pathways, and impaired oxygen use through mitochondrial dysfunctions that are likely participate in PAH-related myopathy. Sharing new insights into the pathological mechanisms of PAH might help stimulate specific research areas, improving the treatment and quality of life of PAH patients. Indeed, many of these muscular impairments are reversible, strongly supporting the development of effective preventive and/or therapeutic approaches, including mitochondrial protection and exercise training.