bluuebunny/crossref_metadata_2025 huggingface dataset:
Enumerative numerical solution for optimal control using treatment and vaccination for an SIS epidemic model
Authors: Mbatumutima Vianney , Thron Christopher , Todjihounde Leonard
Published: December 2019

Optimal control problems in mathematical epidemiology are often solved by Hamiltonian methods. However, these methods require conditions on the problem to guarantee that they give global solutions. Because of the improved computational power of modern computers, numerical approximate solutions that systematically try a large number of possibilities have become practical. In this paper we give an efficient implementation of an enumerative numerical solution method for an optimal control problem, which applies to cases where standard methods cannot guarantee global optimality. We demonstrate the method on a model where vaccination and treatment are used to control the level of prevalence of an infectious disease. We describe the solution algorithm in detail, and verify the method with simulations. We verify that the enumerative numerical method produces solutions that are locally optimal.
Parameter Identification and Sensor Configuration in Tip Timing for Asynchronous Vibration of a Deformed Blade With Finite Element Method Simulated Data Verification
Authors: Zhang Xiaojie , Wang Yanrong , Jiang Xianghua , Gao Shimin
Published: December 2019

Blade tip timing (BTT) measurement has been used to measure the vibration of turbomachinery blades in recent years. People researches focus on the development of processing methods. Newly developed BTT processing methods are usually tested by numerical simulations. Because blades will deform when loaded, the detected points by sensors relative to the blade tip will deviate from their expected positions. A novel simulated BTT model is proposed to identify the movement of the detected points. Finite element method (FEM) is used, and the blade tip profile is discretized into series of segments, each of which is composed of adjacent nodes from the blade tip grid to avoid the error possibly caused by coarse girds. There are two factors which will deviate the detected points from their initial positions: static deformation and vibration. This method is validated by BTT datasets from three different simulations. In addition, an improved sine fitting method and a displacement modification method are proposed to process the deceptive signal of the detected point. The effect of the sensor configuration on the parameter identification is also studied. The result shows that when the static point cannot be determined, it would be better if the sensor could be mounted at a place where it is far away from the nodal line and the static deformation there is small.
Inverse Optimal Stabilization of Dynamical Systems by Wiener Processes
Authors: Do K. D.
Published: December 2019

This paper formulates and solves new problems of inverse optimal stabilization and inverse optimal stabilization with gain assignment for nonlinear systems by Wiener processes. First, a theorem is developed to design inverse optimal stabilizers (i.e., covariance matrix multiplied by variance of Wiener processes), where it does not require to solve a Hamilton–Jacobi–Belman equation. Second, another theorem is developed to design inverse optimal stabilizers with gain assignment for nonlinear systems perturbed by both nonvanishing deterministic and stochastic (Wiener processes) disturbances without having to solve a Hamilton–Jacobi–Isaacs equation.
Welding, Brazing and Fusing Qualifications
Authors: Swezy John P. , Feldstein Joel G.
Published: December 2019

This chapter covers the qualification of welding, brazing, and plastic fusing procedures and the qualification of individuals performing these procedures as required by the Construction Codes of the ASME Boiler and Pressure Vessel and Piping Codes. It first traces the history of Section IX, outlines the organization of the Section, and reviews the scope of weld processes that Section IX addresses. Section IX contains rules for the qualification of the several weld processes such as oxyfuel welding, shielded metal arc welding, submerged arc welding, gas metal arc welding, gas tungsten arc welding, and plasma arc, among others. The chapter then describes the classification of ASME base materials as given in Section IX. It explains the general requirements for both the welding procedure and welder performance qualification as well as the variables applicable to the welding procedure and welder performance qualification. The chapter also discusses the requirements to perform Charpy V-notch impact testing of the weld procedure qualification. It outlines the requisites for conducting the following testing and examination methods for groove weld and pressure-retaining fillet weld procedure qualification: tension test, guided-bend test, visual examination, volumetric examination, macroexamination, and fracture test. The qualification rules for two special weld processes, corrosion-resistant weld metal overlay and hardfacing overlay, are also explained. General requirements for brazing procedure and brazer performance qualification and the variables applicable to brazing procedure and brazer performance qualification are subsequently addressed. Finally, the chapter summarizes the general requirements for fusing procedure and fusing machine operator performance qualifications and identifies the variables applicable to fusing procedure and fusing machine operator performance qualification.
Part 2, Section II—Materials and Specifications
Authors: Upitis Elmar , Moen Richard A. , Carpenter Marvin L. , Newell William , Grubb John F. , Sutherlin Richard C. , Henry Jeffrey , Chaudouet Anne
Published: December 2019

This chapter presents various specifications for the materials used in the construction of boilers. The first section of this chapter traces the chronological evolution of materials and associated technologies, from the need for materials to accommodate riveted construction to the acceptance of fusion welding as a fabrication process. Included in this discussion are the application of advanced materials, the revisions to the basis for setting allowable stress values, and the acceptance of Material Specifications other than those approved by ASTM. The next two sections discuss Code Section II, Part A–Ferrous Material Specifications and Part B–Nonferrous Material Specifications. The discussion covers the following: Guideline on the approval of new materials under the ASME Boiler and Pressure Vessel (BPV) Code; Submittal of Technical Inquiries to the Boiler and Pressure Vessel Committee; and Guidelines on Multiple Marking of Materials. The fourth section provides the basis for the Specifications and Standards covered by Section II, Part C–Specification for Welding Rods, Electrodes, and Filler Metals, and their relations to the ANSI/AWS specifications. Included in the discussion are the electrode classification system, material descriptions, welding material applications, welding material procurement, and filler metal certification. The fifth section reviews important aspects of Section II, Part D–Properties. The discussion covers the properties of ferrous and nonferrous alloys used in the design of components for the BPV and Nuclear Construction Codes. The final section discusses Section II, Part A and Part B—International Material Specifications. ASME Section II includes rules for acceptance of material specifications of recognized National or International organizations other than ASTM. The section also discusses the process of adoption of the Committee for Standardization specifications in Europe with consequences on the corresponding ASME specifications.

History

Dennis Rahoi, Marvin L. Carpenter and Domenic A. Canonico were the original authors of this chapter. The second and third editions were updated by Marvin L. Carpenter, Elmar Upitis and Richard A. Moen. The fourth edition was updated by Elmar Upitis, Marvin L. Carpenter, John F. Grubb, Richard C. Sutherlin, Jeffrey Henry, C. W. Rowley and Anne Chaudoulet. The fifth edition was updated by Richard C. Sutherlin, Jeffrey Henry, and Anne Chaudoulet The current online edition was updated by Anne Chaudouet, Elmar Upitis and John Grubb.
Spectral ellipsometry of monolayer transition metal dichalcogenides: Analysis of excitonic peaks in dispersion
Authors: Ermolaev Georgy A. , Yakubovsky Dmitry I. , Stebunov Yury V. , Arsenin Aleksey V. , Volkov Valentyn S.
Published: December 2019

Optical constants of monolayers MoS2 and WS2 were measured by spectroscopic ellipsometry in the spectral range 365–1700 nm. Analysis of ellipsometry spectra was carried out, taking into account the excitonic nature of dispersion. In the considered wavelength range, excitons originate from different interband transitions. As a result, they can be described via Tauc–Lorentz oscillators, one for each exciton. The scalability and universality of such an approach could be applied for the extended wavelength range and to the other transition metal dichalcogenides.
Application of a B-spline model dielectric function to infrared spectroscopic ellipsometry data analysis
Authors: Mohrmann Joel , Tiwald Thomas E. , Hale Jeffrey S. , Hilfiker James N. , Martin Andrew C.
Published: December 2019

The flexibility of the Kramers–Kronig-consistent basis spline (B-spline) function provides advantages over traditional physics-based oscillator functions for analyzing infrared spectroscopic ellipsometry data. Oscillator functions require that the user identify the spectral location of every absorption, choose the correct oscillator line shape, and choose the correct number of oscillators (which can be difficult for organic films that have many overlapping absorption peaks). The user must also choose starting parameters sufficiently close to the final values so that the regression fit converges. Weak absorptions can be difficult to identify when they overlap with strong absorption features, or they can be obscured when there are large interference oscillations in the spectroscopic ellipsometry data. The B-spline function’s flexibility allows the user to model the infrared, dielectric-function line shape for any material, and it requires far less user input and judgment to obtain the dielectric function of a material. The user must simply define the spacing of control nodes, which can usually be obtained from a reference dielectric function or by a preliminary fit to a spectral region where the material is transparent. A “wavelength-range-expansion” fit can then be used to obtain the dielectric function for the remaining spectral range.
Bismuth vanadate photoanodes for water splitting deposited by radio frequency plasma reactive co-sputtering
Authors: Pedroni Matteo , Chiarello Gian Luca , Haghshenas Niloofar , Canetti Maurizio , Ripamonti Dario , Selli Elena , Vassallo Espedito
Published: December 2019

Photoactive bismuth vanadate (BiVO4) thin coatings were deposited on fluorine-doped tin oxide glass by plasma reactive sputtering from Bi2O3 and vanadium (V) radio frequency (RF) powered targets. The films were characterized by x-ray diffraction, scanning electron microscopy, energy dispersion spectroscopy, and UV-vis spectroscopy. The effects that the power density supplied to the Bi2O3 target, the post-annealing treatment, and the film thickness have on the structural features and on the photoelectrochemical (PEC) performances of the so obtained BiVO4 film-based photoelectrodes were investigated. Their PEC performance in water splitting was evaluated in a three-electrode cell by both incident photon to current efficiency and linear sweep voltammetry measurements under AM 1.5 G simulated solar light irradiation. A monoclinic phase of BiVO4, which is more photoactive than the tetragonal BiVO4 phase, was obtained by optimizing the power density supplied to the Bi2O3 target, i.e., by tuning the Bi:V:O atomic ratio. The best PEC performance was obtained for a stoichiometric 1:1 Bi:V atomic ratio, attained with 20 W power supplied to the Bi2O3 target and 300 W power supplied to the vanadium target, and an optimal 200 nm thickness of the BiVO4 film, with a 0.65 mA/cm2 photocurrent density attained at 1.23 V versus standard calomel electrode, under simulated solar light. These results show the suitability of plasma reactive sputtering with two RF powered electrodes for the deposition of BiVO4 photoanodes for water splitting.
Signaling from mTOR to eIF2α mediates cell migration in response to the chemotherapeutic doxorubicin
Authors: Harvey Robert F. , Pöyry Tuija A. A. , Stoneley Mark , Willis Anne E.
Published: December 2019

Doxorubicin-induced DNA damage promotes cancer cell migration downstream of eIF2α phosphorylation.
Genetic diversity affects the nanoscale membrane organization and signaling of natural killer cell receptors
Authors: Kennedy Philippa R. , Barthen Charlotte , Williamson David J. , Pitkeathly William T. E. , Hazime Khodor S. , Cumming Joshua , Stacey Kevin B. , Hilton Hugo G. , Carrington Mary , Parham Peter , Davis Daniel M.
Published: December 2019

The abundance and clustering patterns of inhibitory receptors on natural killer cells are genetically encoded.
Long-Term Compassionate Use of Cefiderocol To Treat Chronic Osteomyelitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae in a Pediatric Patient
Authors: Alamarat Zain I. , Babic Jessica , Tran Truc T. , Wootton Susan H. , Dinh An Q. , Miller William R. , Hanson Blake , Wanger Audrey , Gary Joshua L. , Arias Cesar A. , Pérez Norma
Published: December 2019

We report a 15 year-old Nigerian adolescent male with chronic osteomyelitis caused by an extensively drug-resistant (XDR)
Pseudomonas aeruginosa
strain of sequence type 773 (ST773) carrying
bla
NDM-1
and an extended spectrum β-lactamase (ESBL)-producing
Klebsiella pneumoniae
strain. The patient developed neurological side effects in the form of circumoral paresthesia with polymyxin B and asymptomatic elevation of transaminases with aztreonam (used in combination with ceftazidime-avibactam).
VNRX-5133 (Taniborbactam), a Broad-Spectrum Inhibitor of Serine- and Metallo-β-Lactamases, Restores Activity of Cefepime in
Enterobacterales
and Pseudomonas aeruginosa
Authors: Hamrick Jodie C. , Docquier Jean-Denis , Uehara Tsuyoshi , Myers Cullen L. , Six David A. , Chatwin Cassandra L. , John Kaitlyn J. , Vernacchio Salvador F. , Cusick Susan M. , Trout Robert E. L. , Pozzi Cecilia , De Luca Filomena , Benvenuti Manuela , Mangani Stefano , Liu Bin , Jackson Randy W. , Moeck Greg , Xerri Luigi , Burns Christopher J. , Pevear Daniel C. , Daigle Denis M.
Published: December 2019

As shifts in the epidemiology of β-lactamase-mediated resistance continue, carbapenem-resistant
Enterobacterales
(CRE) and carbapenem-resistant
Pseudomonas aeruginosa
(CRPA) are the most urgent threats.
Ecological and Technical Mechanisms for Cross-Reaction of Human Fecal Indicators with Animal Hosts
Authors: Feng Shuchen , Ahmed Warish , McLellan Sandra L.
Published: December 2019

Identifying human sources of fecal pollution is critical to remediate sanitation concerns. Large financial investments are required to address these concerns; therefore, a high level of confidence in testing results is needed. Human fecal marker genes validated in this study showed high specificity in both sequencing data and qPCR results. Human marker sequences were rarely found in individual animals, and in most cases, the animals had atypical microbial communities. Sequencing also revealed the presence of closely related organisms that could account for nonspecific amplification in certain assays. Both the true cross-reactions and the nonspecific amplification had low signals well below
E. coli
or
Enterococcus
levels and likely would not impact the assay’s ability to reliably detect human fecal pollution. No animal source had multiple human/sewage marker genes present; therefore, using a combination of marker genes would increase the confidence of human fecal pollution detection.
PA0335, a Gene Encoding Histidinol Phosphate Phosphatase, Mediates Histidine Auxotrophy in
Pseudomonas aeruginosa
Authors: Wang Yulu , Wang Liyue , Zhang Jian , Duan Xintong , Feng Yuqi , Wang Shiwei , Shen Lixin
Published: December 2019

Histidine is a common amino acid in proteins. Because it plays critical roles in bacterial metabolism, its biosynthetic pathway in many bacteria has been elucidated. However, the pathway remains unclear in
Pseudomonas aeruginosa
, an important opportunistic pathogen in clinical settings; in particular, there is scant knowledge about histidinol-phosphate phosphatase (Hol-Pase), which has a complex origin and evolution. In this study,
P. aeruginosa
Hol-Pase was identified and characterized. Furthermore, the roles of all other predicted genes involved in histidine biosynthesis were examined. Our results illustrate the histidine synthesis pathway of
P. aeruginosa
. The knowledge obtained from this study may help in developing strategies to control
P. aeruginosa
-related infections. In addition, some enzymes of the histidine synthesis pathway from
P. aeruginosa
might be used as elements of histidine synthetic biology in other industrial microorganisms.
Clostridioides difficile Infection Induces an Inferior IgG Response to That Induced by Immunization and Is Associated with a Lack of T Follicular Helper Cell and Memory B Cell Expansion
Authors: Amadou Amani Souwelimatou , Shadid Tyler , Ballard Jimmy D. , Lang Mark L.
Published: December 2019

The intracellularly active bacterial toxin TcdB is a major
Clostridioides difficile
virulence factor that contributes to inflammation and tissue damage during disease. Immunization with an inactive TcdB fragment prevents
C. difficile
infection (CDI)-associated pathology. The protective immune response against inactive TcdB involves development of antigen-specific memory B cells and long-lived plasma cells that encode TcdB-neutralizing antibodies. Unlike the response to inactive TcdB, very little is known about the host humoral immune response to
C. difficile
and TcdB during primary and recurrent infection.
Impact of a Rapid Blood Culture Diagnostic Test in a Children's Hospital Depends on Gram-Positive versus Gram-Negative Organism and Day versus Night Shift
Authors: Juttukonda Lillian J. , Katz Sophie , Gillon Jessica , Schmitz Jonathon , Banerjee Ritu
Published: December 2019

Rapid diagnostic tests (RDTs) for bloodstream infections (BSIs) decrease the time to organism identification and resistance detection. RDTs are associated with early deescalation of therapy for Gram-positive BSIs. However, it is less clear how RDTs influence antibiotic management for Gram-negative BSIs and whether RDT results are acted on during off-hours. We performed a single-center, retrospective review of children with BSI and Verigene (VG) testing at a children’s hospital. Of the 301 positive cultures included in the study (196 Gram-positive, 44 Gram-negative, 32 polymicrobial, and 29 non-VG targets), the VG result had potential to impact antibiotic selection in 171 cases; among these, antibiotic changes occurred in 119 (70%) cases.
Analysis of paediatric long-term ventilation incidents in the community
Authors: Nawaz Rasanat Fatima , Page Bethan , Harrop Emily , Vincent Charles A
Published: December 2019

Aim

To describe the nature and causes of reported patient safety incidents relating to care in the community for children dependent on long-term ventilation with the further aim of improving safety.

Methods

We undertook an analysis of patient safety incident data relating to long-term ventilation in the community using incident reports from England and Wales’ National Reporting and Learning System occurring between January 2013 and December 2017. Manual screening by two authors identified 220 incidents which met the inclusion criteria. The free text for each report was descriptively analysed to identify the problems in the delivery of care, the contributory factors and the patient outcome.

Results

Common problems in the delivery of care included issues with faulty equipment and the availability of equipment, and concerns around staff competency. There was a clearly stated harm to the child in 89 incidents (40%). Contributory factors included staff shortages, out of hours care, and issues with packaging and instructions for equipment.

Conclusions

This study identifies a range of problems relating to long-term ventilation in the community, some of which raise serious safety concerns. The provision of services to support children on long-term ventilation and their families needs to improve. Priorities include training of staff, maintenance and availability of equipment, support for families and coordination of care.
Impact of radiological diagnostics in the survivor of disseminated Fournier gangrene patient with septic pulmonary embolism
Authors: Khan Adeena , Sultan Mamoona , Ul Haq Usman , Shahid Habib Syed
Published: December 2019

A 51-year-old diabetic man diagnosed with prostatic abscess underwent its drainage twice. Following surgery he developed fever and right-sided painless visual loss due to endophthalmitis. To rule out its endogenous source CT scan was done which showed multisystem aetiology and complications. His pelvic CT and CT cystogram revealed postsurgical urethral injury along with urinary extravasation, perineal and pelvic soft tissues air densities with fat stranding ascribed to Fournier gangrene, air in distended urinary bladder due to emphysematous cystitis and right common iliac vein air containing septic thrombus. CT chest spotted bilateral multiple septic pulmonary emboli. These radiological findings were promptly handled by uro-surgical team followed by alliance with other relevant departments. With hasty surgical drainage/debridement, urological restoration of urinary obstruction, aggressive broad spectrum antibiotics, anticoagulation and radiological follow-ups the patient withstood multisystem lethal complications and come up with excellent outcome except evisceration.
Successful emergency management of a bleeding tracheoinnominate fistula
Authors: Donaldson Lachlan , Raper Raymond
Published: December 2019

In this case, we describe a novel approach to achieving temporary haemostasis in acute massive haemorrhage from a bleeding tracheoinnominate fistula. We report the case of a 42-year-old man admitted to hospital after suffering 80% body surface area burns. Thirty days following the percutaneous insertion of a tracheostomy, spontaneous massive haemorrhage occurred via the tracheostomy stoma, the tracheostomy tube and the mouth. After hyperinflation of the tracheostomy cuff which controlled airway contamination, effective tamponade was achieved using a hyperinflated balloon on a Foley catheter that was introduced by direct laryngoscopy into the upper larynx above the tracheotomy stoma. This provided temporary control of the bleeding until definitive management through ligation of the innominate artery via median sternotomy.
Oral focal mucinosis of the mandible in an adolescent patient
Authors: Cho Jason J , Shupak Raymond P , Michaels Caroline
Published: December 2019

Oral focal mucinosis (OFM) is the rare oral manifestation of cutaneous focal mucinosis. It is a diagnosis made histopathologically, as OFM remains clinically similar to other more common oral lesions, and radiographs do not provide any diagnostic information. This case is a report of a teenage female with left mandibular involvement of an elevated, rounded, asymptomatic, mucosa-coloured lesion in the facial and lingual gingiva between her left first and second mandibular molars. The cause was unclear, although the patient stated that she may have sustained a laceration in that area several months prior. An incisional biopsy revealed histopathological findings consistent with OFM, and complete surgical excision of the lesion was performed under a general anaesthetic, with no signs of recurrence for 2 months. The histological, clinical and accepted treatment methods on OFM will be discussed. Clinicians, including those serving paediatric populations, should consider OFM in their differential diagnoses when evaluating gingival lesions.
Severe hyperandrogenism due to ovarian hyperthecosis in a young woman
Authors: Goyal Alpesh , Malhotra Rakhi , Kulshrestha Vidushi , Kachhawa Garima
Published: December 2019

Hyperandrogenism is a relatively common clinical problem. However, severe hyperandrogenism causing virilisation is rare. A 27-year-old woman presented with generalised hirsutism, clitoromegaly, breast atrophy and secondary amenorrhoea. She had serum testosterone levels elevated to the adult male range. Administration of gonadotropin-releasing hormone (GnRH) analogue resulted in >50% suppression of serum testosterone which was suggestive of luteinising hormone-dependent ovarian hyperandrogenism. Imaging studies of abdomen and pelvis were normal, and ovarian venous sampling failed to show a gradient between the two sides. A presumptive diagnosis of ovarian hyperthecosis was, therefore, considered. Medical treatment with GnRH analogue and combined oral contraceptive pills was initiated to which an excellent clinical and biochemical response was noted. This case highlights a rare presentation of ovarian hyperthecosis in a young woman with severe hyperandrogenism mimicking a virilising neoplasm.
Q fever—the superstition of avoiding the word “quiet” as a coping mechanism: randomised controlled non-inferiority trial
Authors: Brookfield Charlotte R , Phillips Patrick P J , Shorten Robert J
Published: December 2019

Objective

To determine the validity of the superstition that utterance of the word “quiet” in a clinical setting increases workload.

Design

Prospective randomised controlled non-inferiority study.

Setting

Microbiology department of a large teaching hospital in Lancashire, UK.

Participants

Two members of the medical microbiology team carried out the duty work on any given week day and an on-call team member on any weekend day. 29 days were assigned in which staff were to say “Today will be a quiet day” and 32 days were assigned in which staff were to refrain from saying the word “quiet” in any context.

Interventions

Each day was randomly allocated to either saying “Today will be a quiet day” (intervention group) or refraining from saying the word “quiet” (control group) in any context.

Main outcome measures

The primary outcome was mean overall workload: a composite of number of clinically related telephone calls, clinically significant results, or validated results processed by the duty medical microbiology team during a 24 hour period referred to collectively as “clinical episodes.” A difference of 30 clinical episodes was considered as the margin of non-inferiority. Secondary outcomes included the individual components of the primary outcome.

Results

Workload was measured each day over a 61 day period (1 May to 30 June 2019). A mean 139.0 clinical episodes occurred on control days compared with 144.9 on days when the experimental intervention was uttered, a difference of 5.9 (95% confidence interval−12.9 to 24.7). The upper bound was less than the specified margin of 30, providing evidence for non-inferiority. No evidence of a difference in workload was found between interventions with any of the four components, whether considering unadjusted or adjusted analyses, or looking at the subgroups of week days or weekends.

Conclusions

The study findings refute the long held superstition that utterance of the word “quiet” impacts on clinical workload, and therefore it should not be avoided. In the era of considerable staff shortages and increased work related stress, doctors should look to other methods to increase resilience and protect their wellbeing and mental health.

Trial registration

Lancashire Teaching Hospitals NHS Foundation Trust’s research department SE-259.
Cross-sectional study of the association between long working hours and pre-diabetes: 2010-2017 Korea national health and nutrition examination survey
Authors: Baek Yunseng , Kim Minseok , Kim Gyu Ri , Park Eun-Cheol
Published: December 2019

Objective

Long working hours have been shown to raise the risk of various health outcomes. However, epidemiological evidence has shown inconsistent result in relation to type 2 diabetes mellitus (T2DM) and the association between long working hours and pre-diabetes among non-diabetic adults remains largely unexplored. We thus aimed to investigate whether long working hours were linked with pre-diabetes as determined by glycated haemoglobin (HbA1c) level.

Design

Cross-sectional survey.

Participants

This study included 6324 men and 4001 women without diabetes from the 2010 to 2017 Korean National Health and Nutrition Examination Survey.

Primary outcome measures

The study outcome of interest was pre-diabetes, defined as HbA1c values 5.7% to 6.4%

Results

Logistic regression was performed to obtain the ORs for pre-diabetes according to categories of work hour (40 hours/week, 41 to 52 hours/week, >52 hours/week), after adjusting for relevant covariates. Of the 10 325 eligible participants, 2261 (34.4%) men and 1317 (31.0%) women had pre-diabetes. No statistically significant relationship was found for women. In men, extended working hours (>52 hours per week) was associated with an increased likelihood of pre-diabetes, after adjustment for age, educational attainment, monthly household income, lifestyle related factors, perceived stress, family history of diabetes, hypertension, hypercholesterolaemia and other covariates (adjusted OR=1.22; 95% CI 1.03 to 1.46). In the subgroup analysis by occupational categories, the association was only apparent among men in blue-collar worker groups.

Conclusion

Extended working hours were significantly related to pre-diabetes in men, with no statistically significant association observed for women. Further subgroup analysis by occupational categories revealed that the increased odds of pre-diabetes associated with long working hours was only apparent among male workers of blue-collar occupations and shift workers.
Impact of repeated simulation on learning curve characteristics of residents exposed to rare life threatening situations
Authors: E J Sree Kumar , Purva Makani , Chander M Sarat , Parameswari Aruna
Published: December 2019

Background

Little is known about the learning curve characteristics of residents undertaking simulation-based education. It is important to understand the time for acquisition and decay of knowledge and skills needed to manage rare and difficult clinical situations.

Method

Ten anaesthesiology residents underwent simulation-based education to manage a cannot intubate cannot ventilate scenario during general anaesthesia for caesarean section. Their performance was measured using an assessment tool and debriefed by two experienced anaesthesiologists. The parameters against which the performance was judged were grouped into preoperative assessment, preoperative patient care, equipment availability, induction sequence, communication and adherence to airway algorithm protocol. The scenario was repeated at 6 and 12 months thereafter. The residents’ acquisition of knowledge, technical and non-technical skills were assessed and compared at baseline, 6 months and end of 12 months.

Result

The skills of preoperative assessment, preoperative care and communication quickly improved but the specific skill of managing a difficult airway as measured by adherence to an airway algorithm required more than 6 months (CI at 6 vs 12 months: −3.4 to –0.81, p=0.016). The skills of preoperative assessment and preoperative care improved to a higher level quickly and were retained at this improved level. Communication (CI at 0 vs 6 months: −3.78 to −0.22, p=0.045 and at 6 vs 12 months : −3.39 to −1.49, p=0.007) and difficult airway management skill were slower to improve but continued to do so over the 12 months. The compliance to machine check was more gradual and showed an improvement at 12 months.

Conclusion

Our study is unique in analysing the learning curve characteristics of different components of a failed obstetric airway management skill. Repeated simulations over a longer period of time help in better reinforcement, retention of knowledge, recapitulation and implementation of technical and non-technical skills.
Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double-blind, placebo-controlled study
Authors: El-Salhy Magdy , Hatlebakk Jan Gunnar , Gilja Odd Helge , Bråthen Kristoffersen Anja , Hausken Trygve
Published: December 2019

Objective

Faecal microbiota transplantation (FMT) from healthy donors to patients with irritable bowel syndrome (IBS) has been attempted in two previous double-blind, placebo-controlled studies. While one of those studies found improvement of the IBS symptoms, the other found no effect. The present study was conducted to clarify these contradictory findings.

Design

This randomised, double-blind, placebo-controlled study randomised 165 patients with IBS to placebo (own faeces), 30 g FMT or 60 g FMT at a ratio of 1:1:1. The material for FMT was obtained from one healthy, well-characterised donor, frozen and administered via gastroscope. The primary outcome was a reduction in the IBS symptoms at 3 months after FMT (response). A response was defined as a decrease of 50 or more points in the total IBS symptom score. The secondary outcome was a reduction in the dysbiosis index (DI) and a change in the intestinal bacterial profile, analysed by 16S rRNA gene sequencing, at 1 month following FMT.

Results

Responses occurred in 23.6%, 76.9% (p<0.0001) and 89.1% (p<00.0001) of the patients who received placebo, 30 g FMT and 60 g FMT, respectively. These were accompanied by significant improvements in fatigue and the quality of life in patients who received FMT. The intestinal bacterial profiles changed also significantly in the groups received FMT. The FMT adverse events were mild self-limiting gastrointestinal symptoms.

Conclusions

FMT is an effective treatment for patients with IBS. Utilising a well-defined donor with a normal DI and favourable specific microbial signature is essential for successful FMT. The response to FMT increases with the dose.

Trial registration

www.clinicaltrials.gov(NCT03822299) andwww.cristin.no(ID657402).
Circulating microRNA after autologous bone marrow mononuclear cell (BM-MNC) injection in patients with ischemic stroke
Authors: Mancha Fernando , Escudero-Martinez Irene , Zapata-Arriaza Elena , Vega-Salvatierra Angela , Cabezas Juan Antonio , Lebrato Lucia , Pardo Blanca , De-La-Torre Javier , Zapata Montserrat , Escamilla Virginia , Calderón-Cabrera Cristina , Martín-Sánchez Jesús , Valverde Roberto , Aguera-Morales Eduardo , Herrera Inmaculada , Delgado Fernando , Gamero Miguel Ángel , Pérez-Sánchez Soledad , Moya Miguel , Espinosa Raúl , Ortega-Quintanilla Joaquín , Gutierrez-Jarrin Isabel , González-García Alejandro , Montaner Joan , Moniche Francisco
Published: December 2019

Previous studies have shown the potential of microRNAs (miRNA) in the pathological process of stroke and functional recovery. Bone marrow mononuclear cell (BM-MNC) transplantation improves recovery in experimental models of ischemic stroke that might be related with miRNA modifications. However, its effect on circulating miRNA has not been described in patients with stroke. We aimed to evaluate the circulating levels of miRNAs after autologous BM-MNC transplantation in patients with stroke. We investigate the pattern of miRNA-133b and miRNA-34a expression in patients with ischemic stroke included in a multicenter randomized controlled phase IIb trial ( http://www.clinicaltrials.gov ; unique identifier: NCT02178657). Patients were randomized to 2 different doses of autologous intra-arterial BM-MNC injection (2×106/kg or 5×106/kg) or control group within the first 7 days after stroke onset. We evaluate plasma concentration of miRNA-113b and miRNA-34a at inclusion and 4, 7, and 90 days after treatment. Thirteen cases (8 with 2×106/kg BM-MNC dose and 5 with 5×106/kg dose) and 11 controls (BM-MNC non-treated) were consecutively included. Mean age was 64.1±12.3 with a mean National Institutes of Health Stroke Scale score at inclusion of 14.5. Basal levels of miRNA were similar in both groups. miR-34a-5p and miR-133b showed different expression patterns. There was a significant dose-dependent increase of miRNA-34a levels 4 days after BM-MNC injection (fold change 3.7, p<0.001), whereas miRNA-133b showed a significant increase in the low-dose BM-MNC group at 90 days. Intra-arterial BM-MNC transplantation in patients with ischemic stroke seems to modulate early circulating miRNA-34a levels, which have been related to precursor cell migration in stroke and smaller infarct volumes.
Prescribing medical cannabis: ethical considerations for primary care providers
Authors: Glickman Aaron , Sisti Dominic
Published: December 2019

Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, these ethical considerations are extensions of well-established principles of beneficence and nonmaleficence, which indicate that providers should recommend cannabis only for conditions that have the strongest evidence base. Additionally, the contested status of cannabis in American culture raises specific issues related to shared decision-making and patient education, as well as continuing clinical education.
Use of cadavers to train surgeons: what are the ethical issues?
Authors: James Hannah
Published: December 2019

This is an invited submission from the Editor-in-Chief as the introductory piece for an ‘Ethics Roundtable’. This piece will include invited commentaries from experts in surgical education, medical ethics, law and the prospective body donor perspective.
Sensory attributes of e-cigarette flavours and nicotine as mediators of interproduct differences in appeal among young adults
Authors: Leventhal Adam , Cho Junhan , Barrington-Trimis Jessica , Pang Raina , Schiff Sara , Kirkpatrick Matthew
Published: December 2019

Objective

To estimate the extent to which specific sensory attributes, for example, smoothness, mediate differences in electronic cigarette (e-cigarette) appeal between products in non-tobacco versus tobacco flavours and varying nicotine content in young adults.

Method

E-cigarette users (n=100; aged 18–34 years) administered standardised two-puff e-cigarette doses of different products varying in a flavour (fruit, menthol, tobacco) × nicotine (nicotine-containing (6 mg/mL freebase), nicotine-free) within-subject design. Participants rated sensory attributes (sweetness, bitterness, smoothness and harshness) and appeal on 100-unit visual analogue scales after administering each product. Sensory ratings were tested as simultaneous mediators of flavour, nicotine and flavour × nicotine effects on appeal.

Results

Appeal preferences for fruit versus tobacco flavours were mediated by sweetness-enhancing (βindirect=0.092), smoothness-enhancing (βindirect=0.045) and bitterness-reducing (βindirect=0.072) effects of fruit flavours. Appeal preferences for menthol versus tobacco flavours were mediated by menthol’s smoothness-enhancing (βindirect=0.039) and bitterness-reducing (βindirect=0.034) effects. Lower appeal of nicotine-containing versus nicotine-free products was mediated by nicotine’s sweetness-reducing (βindirect=–0.036), smoothness-reducing (βindirect=–0.156) and bitterness-increasing (βindirect=0.045) effects. Flavour × nicotine interaction effects on appeal were explained by menthol-related suppression of nicotine’s bitterness-enhancing and sweetness-reducing mediation pathways and fruit-related suppression of nicotine’s bitterness-enhancing mediation pathway. Harshness did not mediate appeal after adjusting for other sensory attributes.

Conclusion

Bitterness and smoothness may be cross-cutting mediators of interproduct variation in the effects of types of non-tobacco flavours and nicotine on e-cigarette appeal in young adults. Sweetness may also mediate appeal-enhancing effects of fruit and appeal-reducing effects of nicotine. Non-tobacco flavours may suppress appeal-reducing effects of nicotine in e-cigarettes through attenuation of nicotine’s aversive taste attributes.
Observational constraint on interacting Tsallis holographic dark energy in logarithmic Brans–Dicke theory
Authors: Aditya Y. , Mandal Sanjay , Sahoo P. K. , Reddy D. R. K.
Published: December 2019

In this paper, we investigate the dark energy phenomenon by studying the Tsallis holographic dark energy within the framework of Brans–Dicke (BD) scalar–tensor theory of gravity (Brans and Dicke in Phys. Rev. 124:925, 1961). In this context, we choose the BD scalar field $$\phi $$ϕ as a logarithmic function of the average scale factor a(t) and Hubble horizon as the IR cutoff ($$L=H^{-1}$$L=H-1). We reconstruct two cases of non-interacting and interacting fluid (dark sectors of cosmos) scenario. The physical behavior of the models are discussed with the help of graphical representation to explore the accelerated expansion of the universe. Moreover, the stability of the models are checked through squared sound speed $$v_s^2$$vs2. The well-known cosmological plane i.e., $$\omega _{de}-\omega ^{\prime }_{de}$$ωde-ωde′ is constructed for our models. We also include comparison of our findings of these dynamical parameters with observational constraints. It is also quite interesting to mention here that the results of deceleration, equation of state parameters and $$\omega _{de}-\omega ^{\prime }_{de}$$ωde-ωde′ plane coincide with the modern observational data.
Rational soliton solutions of the nonlocal nonlinear Schrödinger equation by the KP reduction method
Authors: Wang Donghua , Huang Yehui , Yong Xuelin , Zhang Jinping
Published: December 2019

In this paper, we present the construction of the rational solutions to the nonlocal nonlinear Schrödinger equation by the bilinear method and KP reduction method. The solutions are given in determinant form, the first- and second-order rational solutions are analyzed for their dynamic behaviors.
Enhancement of acoustic absorption of a rigidly backed poroelastic plate with periodic elliptic inclusions
Authors: Zhang Hongbo , Liu Bilong
Published: December 2019

Perfect acoustic absorption is an important issue for a lot of applications. In this paper, a rigidly backed poroelastic plate with periodic elliptic inclusions is proposed to achieve perfect acoustic absorption at low frequencies by using the finite element method (FEM) with the porous material considered as fluid and solid materials. The absorption of the acoustic energy in such a composite plate resulting from viscous and thermal losses is enhanced by the resonances of the inclusions and energy trapping between the upper part of the poroelastic plate and the inclusion at low frequencies. The influence of the geometry, the incidence angle and the material properties on the absorption coefficient are investigated in detail. Our results show that increasing the major axis of the inclusion, the first absorption peak is pushed to lower frequencies and its value is first increased upto one and then it is decreased. The major axis is the most important parameter to tune the absorption peak, when the thickness is not changed. Once the major axis is determined, perfect acoustic absorption persists even if other parameters are changed. The reported results pave the way for the design of absorption devices which could be used to solve the major issue of noise control.
Solitons and complexitons to the (2 + 1)-dimensional Heisenberg ferromagnetic spin chain model
Authors: Aliyu Aliyu Isa , Li Yongjin , Inc Mustafa , Baleanu Dumitru , Alshomrani Ali S.
Published: December 2019

This paper investigates the ([Formula: see text])-dimensional Heisenberg ferromagnetic spin chain (HMF) model. The model describes the nonlinear spin dynamics of HMF. By adopting the modified [Formula: see text]-Expansion and projective Riccati equation methods, we report the dark, combined dark-bright and envelope optical solitons, complexitons singular solutions of the equation along with the conditions that must be satisfied for solitons to exist. The physical structure of the obtained solutions are shown by graphic illustration in order to give a better understanding on the dynamics of optical solitons.
A FRACTAL SCALING LAW BETWEEN TORTUOSITY AND POROSITY IN POROUS MEDIA
Authors: XU PENG , ZHANG LIPEI , RAO BINQI , QIU SHUXIA , SHEN YUQING , WANG MIN
Published: December 2019

Hydraulic tortuosity is one of the key parameters for evaluating effective transport properties of natural and artificial porous media. A pore-scale model is developed for fluid flow through porous media based on fractal geometry, and a novel analytical tortuosity–porosity correlation is presented. Numerical simulations are also performed on two-dimensional Sierpinski carpet model. The proposed fractal model is validated by comparison with numerical results and available experimental data. Results show that hydraulic tortuosity depends on both statistical and morphological characteristics of porous media. The exponents for the scaling law between tortuosity and porosity depend on pore size distribution and tortuous fractal dimension. It has been found that hydraulic tortuosity indicates evident anisotropy for asymmetrical particle arrangements under the same statistical characteristics of porous media. The present work may be helpful to understand the transport mechanisms of porous materials and provide guidelines for the development of oil and gas reservoir, water resource and chemical engineering, etc.
TWO-POINT RESISTANCES IN SAILBOAT FRACTAL NETWORKS
Authors: ZHU JIALI , TIAN LI , FAN JIAQI , XI LIFENG
Published: December 2019

The two-point resistance of fractal network has been studied extensively by mathematicians and physicists. In this paper, for a class of self-similar networks named sailboat networks, we obtain a recursive algorithm for computing resistance between any two nodes, using elimination principle, substitution principle and local sum rules on effective resistance.
MULTIFRACTAL DETRENDED CROSS-CORRELATION ANALYSIS OF HIGH-FREQUENCY STOCK SERIES BASED ON ENSEMBLE EMPIRICAL MODE DECOMPOSITION
Authors: GU DANLEI , HUANG JINGJING
Published: December 2019

We used the multifractal detrended cross-correlation analysis (MFDCCA) method based on ensemble empirical mode decomposition (EEMD) to study the 5-min high-frequency data of two Chinese stocks and two US stocks. Using EEMD method to decompose the original high-frequency stock data can effectively reduce the interference of noise on the series, which helps to reveal the internal characteristics of the stock system and extract more accurate and rich information. We first conducted a cross-correlation test and cross-correlation coefficient analysis on the reconstructed stock data of two groups, and found that there is a cross-correlations between them. Then we used the EEMD-based MFDCCA method to analyze the cross-correlation between the data and found that there are significant cross-correlations between DJI and NASDAQ and between SSEC and SZSE. The cross-correlation of the two Chinese stocks is stronger than that of the two US stocks. The MFDCCA results of the comparison of the original series with the reconstructed series after decomposition by the EEMD method show that the reconstructed series can display more internal details of the multifractal cross-correlation metrics compared with the original series.