bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective study of the utility of pre-induction tests as predictors of attrition in infantry recruits
Authors: Fleischmann Chen , Yanovich Ran , Eliyahu Uri , Milgrom Charles , Gez Hadar , Heled Yuval , Finestone Aharon S
Published: November 2020

BackgroundSoldiers in modern armies perform tasks that are increasingly technologically dependent. Training them to obtain necessary technological skills is both complex and expensive. Personnel attrition is costly and can affect military readiness. The purpose of this study was to examine the utility of pre-induction tests as a predictor of attrition in the first year of infantry training.Methods303 infantry recruits participated in the study. Before beginning military service their health profile was determined and they were given a Quality Group score, which is determined by psycho-technical tests, a personal interview and the quality of their education. Recruits were screened shortly following induction using a battery of tests including questionnaires, anthropometrics, functional movement screening (FMS), upper and lower quarter Y balance tests, dynamic tests, and followed by orthopaedists and their unit doctors for orthopaedic injuries and problems during the first year of training.Results165/303 (54.5%) recruits were diagnosed with injury or pain during the course of their first year of training. 46 recruits (15.1%) did not complete their first year of service as combatants and 18 (5.9%) were discharged from service. On multivariable analysis for attrition, protective factors were higher Quality Group scores (OR 0.78, CI 0.69-0.89) and recruits diagnosed with orthopaedic injuries or musculoskeletal pain (OR 0.21 CI 0.09-0.50). Pain in the balance test performed at the beginning of training was a risk factor (OR 3.39, CI 1.47-7.79). These factors together are only responsible for 15.4% of infantry attrition according to partial eta squared analysis. ConclusionsThe three variables found by multivariable analysis to be associated with infantry attrition in this study together are responsible for 15.4% of the attrition. Measuring these variables would seem to be most valuable in armies in which the number of candidates for a specific infantry unit greatly exceeds the number of positions. The IDF approach of trying to keep attriters within the Army in non-combatant roles and not discharging them from service is a way to manage the problem of infantry attrition. Trial RegistrationProspectively registered on clinicaltrials.gov, registration number NCT02091713
SNRPB is a Mediator for Cellular Response to Cisplatin in Non-Small-Cell Lung Cancer
Authors: Liu Nianli , Chen Aoxing , Feng Ning , Liu Xiaochen , Zhang Longzhen
Published: November 2020

Background: Our previous study has demonstrated that small nuclear ribonucleoprotein polypeptides B And B’ (SNRPB) is highly expressed in non-small-cell lung cancer (NSCLC) and functions as an oncogene. However, whether SNRPB contributes to cisplatin resistance in NSCLC is still unknown. This study aimed to explore how SNRPB regulates the effect of cisplatin in NSCLC.Methods: In this study, cell counting kit-8 (CCK-8) and flow cytometry assays were performed to examine cell survival, cell cycle and apoptosis in NSCLC cells upon cisplatin treatment. Western blotting assays were used to examine the cell cycle and apoptosis-related protein expression. The effects of SNRPB on cisplatin-mediated tumor inhibition was measured via a xenograft tumor model in nude mouse.Results: SNRPB negatively regulates cisplatin resistance in NSCLC cells. Knocking out of SNRPB could significantly decrease cisplatin-induced cell growth inhibition, cell cycle arrest and apoptosis in H1299 cells. However, enforced expression of SNRPB in H460 cells can markedly promote cisplatin-induced cell growth inhibition, cell cycle arrest and apoptosis. Our results also indicate that overexpression of SNRPB enhances the inhibitory effects of cisplatin on H460 cell-mediated xenograft tumors.Conclusion: Our results suggest that SNRPB may be a prediction marker for NSCLC patients in response to cisplatin-based chemotherapy.
Evaluation of Genetic Stability in Olive Callus-induced and Meristem-induced Shoots using Flow Cytometry and Amplified Fragment Length Polymorphism Techniques
Authors: Mirzaei Leila , Yadollahi Abbas , Kermani Maryam Jafarkhani , Naderpour Masoud , Zeinanloo Ali Asghar , Farsi Maryam , Davoodi Dariush
Published: November 2020

BackgroundIn vitro culture of olive, as an economically valuable tree, has fundamentally genotype-dependant low micropropagation rate which need to be improved in already established cultivars, while needing to be struggled in firstly considered cultivars. Various plant tissue culture media, planting systems and growth factors were evaluated in two promissing Iranian olive cultivars ˈAminˈ and ˈMeshkatˈ plus a commercial Spanish cultivar ˈArbequinaˈ. ResultsThe results showed that in ˈAminˈ cultivar MS enriched with zeatin (4 mg/L), in ˈArbequinaˈ cultivar OM enriched with zeatin (1 mg/L) and in ˈMeshkatˈ cultivar OM and MS enriched with zeatin (2 mg/L) produced reasonably healthier in vitro plantlets. The results indicated that using Periodical Mini Bioreactor (PMB) system in the presence of VS medium in ˈAminˈ cultivar resulted in growth indicies amelioration compared to semi-solid media. Regarding carbon sources and light intensities, mannitol and 2000 cd·sr·m-² greatly enhancedˈArbequinaˈ growth indices. The genetic stability of callus induced shoots (CIS) was compared with meristem induced shoots (MIS) using Amplified Fragment Length Polymorphism (AFLP) marker and flow cytometery (FCM). The results revealed that 2C DNA value assessed by partec FCM was mostly depended on the cultivars rather than the origin of generation -callus or meristem-. The AFLP results also showed that the cultivars were classified regardless of the micropropagation origin (CIS or MIS), except for ˈArbequinaˈ. However, ˈArbequinaˈ CIS and MIS still had 62- 80% of genetic similarity with three other categories and the highest resemblance (97%) was seen with MIS of ˈAminˈ cultivar. ConclusionsBriefly,olive in vitro propagation optimization co-produced large volume and percent of calli resulting in more undesired indirect organogenesis. True to typeness of CIS was assessed showing that no changes in DNA amount occurred. Nonetheless, in phylogenetic analysis cultivars were clustered separately even some discrepancies were seen in ˈArbequinaˈ MIS and CIS, however, ˈAminˈ and ˈMeshkatˈ cultivars were more stable in clustering.
Correlation Between Antimicrobial Resistance and Biofilm Formation Capability Among Klebsiella Pneumoniae Strains Isolated From Hospitalized Patients in Iran
Authors: Shadkam Shadi , Goli Hamid Reza , Mirzaei Bahman , Gholami Mehrdad , Ahanjan Mohammad
Published: November 2020

BackgroundKlebsiella pneumoniae (K. pneumoniae) is a common cause of nosocomial infections. Antibiotic resistance and ability to form biofilm, as two key virulence factors of K. pneumoniae, involved in persistent of the infections. The purpose of this study is to investigate the correlation between antimicrobial resistance and biofilm formation capability among K. pneumoniae strains isolated from hospitalized patients in Iran.MethodsOver a 10-month period, a total of 100 non-duplicate K. pneumoniae strains were collected. Antibiotic susceptibility test was determined by Kirby-Bauer disk diffusion method according to CLSI. Biofilm formation was assessed by tissue culture plate method. Finally, polymerase chain reaction was conducted to detect four families of carbapenemase: blaIMP, blaVIM, blaNDM, blaOXA-48, biofilm formation associated genes; treC, wza, luxS and K. pneumoniae confirming gene; rpoB.ResultsMost of the isolates were resistant to co-trimoxazole (52%), cefotaxime (51%), cefepime (43%), and ceftriaxone (43%). Among all the 100 isolates, 67 were multidrug-resistant (MDR), and 11 were extensively drug-resistant (XDR). The prevalence of the blaVIM, blaIMP, blaNDM, and blaOXA-48 genes were 7%, 11%, 5%, and 28%, respectively. Among these isolates, 25% formed fully established biofilms, 19% were categorized as moderately biofilm-producing, 31% formed weak biofilms, and 25% were non-biofilm-producers. Molecular distribution of biofilm formation genes revealed that 98%, 96%, and 34% of the isolates carried luxS, treC, and wza genes, respectively. ConclusionThe rise of antibiotic resistance among biofilm-producer strains, demonstrating a serious alarm about limited treatment options in hospital setting. Also, fundamental actions and introduction of novel strategies for controlling of K. pneumoniae biofilm-related infections is essential.
Primary Yolk Sac Tumor of the Endometrium-----A Case Report and Literature Review
Authors: Ge Huijuan , Bi Rui
Published: November 2020

BackgroundPrimary yolk sac tumor (YST) of the endometrium is extremely rare. We report a case of endometrial YST and review the literature to provide a comprehensive understanding of the diagnosis and management of primary YST of the endometrium.Methods A 43-year-old woman with primary YST of the endometrium is described. We summarize the clinical characteristics, treatments and prognosis of the case reported herein and 29 cases from the literature.ResultsIn a total of 30 primary endometrial YSTs, the average patient age was 52 years (range, 24-87 y). The mean tumor size was 6.94 cm (range 1.3-19.0 cm). Increasing serum levels of AFP were observed in all but one patient. Stage I was more common (12/30, 40%), followed by stages II (5/30, 17%), III (6/30, 20%) and IV (7/30, 23%). Of all 30 patients, 17 (57%) had pure endometrial YST, and 13 (43%) had a concomitant somatic neoplasm representing between <10% and 90% of the tumor, of which endometrial adenocarcinoma was the most common. Patients with pure YST were younger than those with concomitant somatic tumors (ranging from 24-68 years, mean 44.41 years vs. range 28-87 years, mean 61.92 years, P=0.008). Endometrial YSTs with somatic neoplasms had a poorer prognosis than pure YSTs.ConclusionPrimary YST of the endometrium is an extremely rare disease. Surgery combined with adjuvant chemotherapy is the most effective treatment. A late stage and combined somatic components may indicate a poor prognosis.
Cortical Circuit Dysfunction in a Mouse Model of Alpha-synucleinopathy in Vivo
Authors: Blumenstock Sonja , Sun Fanfan , Marinkovic Petar , Sgobio Carmelo , Liebscher Sabine , Herms Jochen
Published: November 2020

Considerable fluctuations in cognitive performance and eventual dementia are an important characteristic of alpha-synucleinopathies, such as Parkinson’s disease (PD) and Lewy Body dementia (LBD) and are linked to cortical dysfunction. The presence of misfolded and aggregated alpha-synuclein (a-syn) in the cerebral cortex of patients has been suggested to play a crucial role in this process. However, the consequences of a-syn accumulation on the function of cortical networks at cellular resolution in vivo are largely unknown. Here we used the striatal seeding model in wildtype mice in order to induce robust a-synuclein pathology in the cerebral cortex. 9 months after a single intrastriatal injection of a-syn preformed fibrils, we performed in vivo two-photon calcium imaging in awake mice. We observed profound alterations of the function of layer 2/3 cortical neurons in somatosensory cortex (S1), as witnessed by an enhanced response to whisking and increased synchrony, accompanied by a decrease in baseline Ca2+ levels. Stereological analyses revealed a reduction in GAD67-positive inhibitory cells in S1 in PFF-injected brains. These findings point to a disturbed excitation/inhibition balance as an important driver of circuit dysfunction in alpha-synucleinopathies, which may underly cognitive changes in these diseases.
DNAJB6 Suppresses Alpha-synuclein Induced Pathology in an Animal Model of Parkinson’s Disease
Authors: Arkan Sertan , Ljungberg Mårten , Kirik Deniz , Hansen Christian
Published: November 2020

Background: α-synuclein (α-syn) aggregation can lead to degeneration of dopaminergic neurons in the substantia nigra pars compacta ( SNpc ) as invariably observed in patients with Parkinson’s Disease (PD). The co-chaperone DNAJB6 has previously been found to be expressed at higher levels in PD patients than in control subjects and was also found in Lewy bodies. Our previous experiments showed that knock out of DNAJB6 induced α-syn aggregation in cellular level. However, effects of overexpression of DNAJB6 against α-syn aggregation remains to be investigated. Methods: we used to α-syn CFP/YFP HEK293 FRET cell line to investigate the effects of overexpression of DNAJB6 in cellular level. α-syn aggregation was induced by transfection α-syn preformed fibrils (PPF), then was measured FRET analysis. We proceeded to investigate if DNAJB6b can impair α-syn aggregation and toxicity in an animal model and used adeno associated vira (AAV6) designed to overexpress of human wt α-syn, GFP-DNAJB6 or GFP in rats. These vectors were injected into the SNpc of the rats, unilaterally. Rats injected with vira to express α-syn along with GFP in the SNpc where compared to rats expressing α-syn and GFP-DNAJB6. We evaluated motor functions, dopaminergic cell death, phosphorylated α-syn in SNpc and axonal degeneration in striatum. Results : We show that DNAJB6 prevent α-syn aggregation induced by α-syn PFF’s, in a cell culture model. Also, we observed α-syn overexpression caused dopaminergic cell death and that this was strongly reduced by co-expression of DNAJB6b. In addition, the lesion caused by α-syn overexpression resulted in behavior deficits, which increased over time as seen in stepping test, which was rescued by co-expression of DNAJB6b. Moreover, we observed an increase in serine 129 (S129) phosphorylated α-syn in SNpc of rats overexpressing α-syn, that was lowered by DNAJB6 co-expression. Conclusion : We here demonstrate for the first time that DNAJB6 is a strong suppressor of α-syn aggregation in cells and in animals and that this results in a suppression of dopaminergic cell death and PD related motor deficits in an animal model of PD. Keywords: Protein homeostasis, Parkinson`s Disease, Alpha-synuclein, Adeno Associated Virus, DNAJB6, Heat Shock Protein 70
Prevalence of Depression and its Impact on Quality of Life among Frontline Otorhinolaryngology Nurses During the COVID-19 Pandemic in China: A National Survey
Authors: Tian Zi-Rong , xie xiaomeng , Li Xiu-Ya , Li Yue , Zhang Qinge , Zhao Yan-Jie , Cheung Teris , Ungvari Gabor S. , An Feng-Rong , Xiang Yu-Tao
Published: November 2020

Objective: Exposure to the coronavirus disease 2019 (COVID-19) was associated with high risk of mental health problems among frontline nurses. This study examined the prevalence of depressive symptoms (depression hereafter) and its impact on quality of life (QOL) among otorhinolaryngology (ENT) nurses during the COVID-19 pandemic in China.Methods: A national online study was conducted between March 15 and March 20, 2020. Depression and QOL were assessed using standardized instruments.Results: A total of 1,757 participants were recruited. The prevalence of depression was 33.75% (95% CI: 31.59%-35.97%). Results emerging from multiple logistic regression analysis showed that direct care of COVID-19 patients (OR: 1.440, 95% CI: 1.031–2.012, P= 0.032), and current smoker (OR: 3.143, 95% CI: 1.020–9.690, P = 0.046) were significantly associated with depression. After controlling for covariates, ENT nurses with depression had a lower overall QOL compared to those without (F (1, 1757) =536.80, P<0.001).Conclusions: Depression was common among ENT nurses during the COVID-19 pandemic in China. Considering the negative impact of depression on QOL and care quality, regular screening for depression should be conducted among ENT nurses and timely treatments should be provided for those in need.
Preoperative Carbohydrate Load and Intraoperative Goal-Directed Fluid Therapy for Elderly Patients Undergoing Open Gastrointestinal Operation: A Prospective Randomized Controlled Trial
Authors: Liu Xia , Zhang Peng , Liu MengXue , Ma JunLi , Wei XinChuan , Fan Dan
Published: November 2020

Background: At present it remains uncertain as to whether carbohydrate (200 ml) loaded 2 hours before anesthesia induction combined with intraoperative goal-directed fluid therapy (GDFT) is beneficial to elderly patients undergoing gastrointestinal operations. As such, a randomized controlled trial was designed to evaluate the relative impact of perioperative fluid optimisation versus conventional fluid therapy (CFT) on clinical outcomes in elderly patients following gastrointestinal surgery.Methods: A total of 120 elderly patients undergoing gastrointestinal surgery were randomized into a CFT group (n = 60) with traditional methods of fasting and water-deprivation, and a GDFT group (n = 60) with carbohydrate (200 ml) load 2 hours before anesthesia induction. The CFT group underwent routine monitoring during surgery, however, the GDFT group was conducted by a Vigileo/FloTrac monitor with cardiac index (CI), stroke volume variation (SVV), and mean arterial pressure (MAP). For all patients, demographic information, intraoperative parameters and postoperative outcomes were recorded.Results: Patients in the GDFT group were administered less crystalloid fluid (1111 ± 442.9 ml vs 1411 ± 412.6 ml; p = 0.000) and produced less urine output (200 ml [150-300] vs 400 ml [290-500]; p = 0.000) relative to patients in the CFT group. Moreover, GDFT was associated with a shorter average time to first flatus (55 ± 13.9 hours vs 65 ± 22.6 hours; p = 0.004) and oral intake (72 ± 17.4 hours vs 85 ± 27.5 hours; p = 0.002), as well as a reduction in the rate of postoperative complications (14 (25.5%) vs 27(47.4%) patients; p = 0.016). However, postoperative hospitalization or hospitalization expenses were similar between groups.Conclusions: Focused on elderly patients undergoing open gastrointestinal surgery, we found perioperative fluid optimisation may be associated with improvement of bowel function and a lower incidence of postoperative complications. Trial registration: ChiCTR, ChiCTR1800018227. Registered 6 September 2018 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=29899
Fabrication of Micro/Nanofibrous Scaffolds using a Robotic Manipulator and Their Application for Tissue Engineering
Authors: Shynkarenko Andrii , Azulay Dekel , Hauzerova Sarka , Klapstova Andrea , Moucka Michal , Jencova Vera , Lukas David
Published: November 2020

Background: Nanofibrous materials currently find a wide range of medical and bioengineering applications including tissue-engineering scaffolds, sutures, and wound dressings. Recently, production of nanofibrous materials via Electrospinning has played a dominant role in this area. Here we introduce an alternative method, which we call the drawing method, which allows us to produce individual micro and nanofibers and to position them precisely into a two-dimensional network. Results: The creation of such nano or micro fibrous networks is enabled thanks to a special arm-like robotic manipulator that we have designed, including its control system software. In this work we produced and tested microfibrous scaffolds of precise geometry made of two different biodegradable polymers: Polycaprolactone and Polylactide – Polycaprolactone copolymer. The microfibrous networks produced thereby were analyzed using a scanning electronic microscope and tested in vitro for cell adhesion and proliferation. The crystallinity of the resulting manufactured polymeric structures was evaluated using differential scanning calorimetry. Conclusions: The mechanical drawing of individual microfibers presented in this article is a promising method to produce precisely oriented nano and microfibrous structures for technical as well as bioengineering applications. Our results indicate that the mechanical drawing of microfibers expands the possibilities for the preparation of tissue engineering scaffolds. Therefore, we believe that the range of applications of mechanical fiber drawing may soon expand.
Serum Lipid, Total Bile Acid and Total Bilirubin Levels are the Risk Factors of Gallstones
Authors: Zeng Dehui , Wu Heming , Huang Qingyan , Zeng Anxiang , Yu Zhikang , Zhong Zhixiong
Published: November 2020

Background: The risk factors for gallstones among the population in the Meizhou area remains unclear.Methods: A total of 816 gallstone disease patients and 818 control participants was included in the study. Serum lipid levels of all participants were measured. Information recorded included age, sex, and gallstone disease risk factors.Results: Of the 1,634 enrolled individuals, with ages between 13 and 101 years, 727 were males and 907 females. The differences in serum TG (P<0.001), LDL-C (P=0.043), TBA (P<0.001), and T-BIL (P<0.001) levels between patients and controls were statistically significant. There were no statistically significant differences in age, percentage of ever drinker, the percentage of ever smokers, the prevalence of hypertension, prevalence of diabetes mellitus, serum levels of TC, HDL-C, Apo-A1, Apo-B, and Apo-A1/Apo-B between the patients and controls. There were statistically significant differences in the frequencies of gallstones in common bile duct (χ2=13.909, P<0.001), and intrahepatic bile ducts (χ2=8.289, P=0.004) between male and female patients. There were no statistically significant differences in the prevalence of the different gallstones sizes between male and female patients. Serum TBA (P<0.001) and T-BIL (P<0.001) levels in patients with gallstones in common bile duct higher than gallstones in gall bladder and intrahepatic bile ducts patients. Logistic regression analysis indicated that participants with high TG, LDL-C, TBA, and T-BIL had a significantly higher risk of gallstone disease.Conclusions: In general, high serum levels of TG, LDL-C, TBA, and T-BIL are the main risk factors for gallstone formation in the Meizhou area.
Investigating the Role of Transcription Factors TWIST1, TWIST2 and PPARγ in the Progression of Nonalcoholic Steatohepatitis
Authors: Zhang Yanmei , Ge Xiaoxiao , Li Yongqing , Lu Sumei , Ma Wanshan
Published: November 2020

Background: To investigate the role that transcription factors TWIST1, TWIST2 and PPARγ play in nonalcoholic steatohepatitis progression. Methods: The protein levels of TWIST1, TWIST2 and PPARγ were determined in the serum of NAFLD patients and healthy controls by ELISA. An in vivo model for fatty liver was established by feeding C57BL/6J mice a high fat diet (HFD). An in vitro model of steatosis was established by treating LO-2 cells with oleic acid (OA). RNA sequencing was performed on the untreated and OA treated LO-2 cells followed by TWIST1, TWIST2 and PPARγ gene mRNA levels analysis, Gene Ontology (GO) enrichment and pathway analysis. Results: The TWIST2 serum protein levels decreased significantly in all fatty liver groups (P<0.05) while TWIST1 varied. TWIST2 tended to be lower in mice fed a HFD and was significantly lower at 3 months. Similarly, in our in vitro model, TWIST2 protein level was down significantly at 48 and 72 hours after OA treatment. RNA sequencing of the LO-2 cells showed an approximately 2.3-fold decrease in TWIST2, with TWIST1 and PPARγ no obvious change. The PPAR signaling pathway was enriched with 4 genes up regulated in OA treated cells (P=0.0018). IL-17 and TNF signaling pathways were enriched in OA treated cells. Conclusions: Our results provide evidence that TWIST2 and PPARγ are important in NAFLD and shed light on a potential mechanism of steatosis.
Burden of non-communicable diseases in Cyprus, 1990 - 2017: findings from the Global Burden of Disease 2017 study
Authors: Charalampous Periklis , Pallari Elena , Tyrovolas Stefanos , Middleton Nicos , Economou Mary , Devleesschauwer Brecht , Haagsma Juanita A.
Published: November 2020

Background: Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs) is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes. Methods: We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage of change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change. Results: In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders. Conclusion: Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.
Which symptoms pose the highest risk in patients calling for an ambulance? A population-based cohort study from Denmark
Authors: Ibsen Stine , Lindskou Tim Alex , Nickel Christian H. , Kløjgård Torben , Christensen Erika Frischknecht , Søvsø Morten Breinholt
Published: November 2020

Background Emergency medical service patients are a vulnerable population and the risk of mortality is considerable. In Denmark, healthcare professionals receive 112-emergency calls and assess the main reason for calling. The main aim was to investigate which of these reasons, i.e. which symptoms or mechanism of injury, contributed to short-term risk of death. Secondary aim was to study 1-30 day-mortality for each symptom/ injury.Methods Historic population-based cohort study of emergency medical service patients calling 112 in the North Denmark Region between 01.01.2016–31.12.2018. We defined 1-day mortality as death on the same or the following day. The frequency of each symptom and cumulative number of deaths on day 1 and 30 together with 1- and 30-day mortality for each symptom/mechanism of injury is presented in proportions. Poisson regression with robust variance estimation was used to estimate incident rates (IR) of mortality with 95% confidence intervals (CI), crude and age and sex adjusted, mortality rates on day 1 per 100,000 person-year in the population.Results The five most frequent reasons for calling 112 were “chest pain” (15.9%), “unclear problem” (11.9%), “accidents” (11.2%), “possible stroke” (10.9%), and “breathing difficulties” (8.3%). Four of these contributed to the highest numbers of deaths: “breathing difficulties” (17.2%), “unclear problem” (13.2%), “possible stroke” (8.7%), and “chest pain” (4.7%), all exceeded by “unconscious adult – possible cardiac arrest” (25.3%). Age and sex adjusted IR per 100,000 person-year was 3.65 (CI 3.01-4.44) for “unconscious adult – possible cardiac arrest” followed by “breathing difficulties” (0.45, CI 0.37-0.54), “unclear problem”(0.30, CI 0.11-0.17), “possible stroke”(0.13 , CI 0.11-0.17) and “chest pain”(0.07, CI 0.05-0.09). Conclusion In terms of risk of death on the same day and the day after the 112-call, “unconscious adult/possible cardiac arrest” was the most deadly symptom, about eight times more deadly than “breathing difficulties”, 12 times more deadly than “unclear problem”, 28 times more deadly than “possible stroke”, and 52 times more deadly than “chest pain”. “Breathing difficulties” and “unclear problem” as presented when calling 112 are among the top three contributing to short term deaths when calling 112, exceeding both stroke symptoms and chest pain.
Colonic Mucormycosis Causing Massive Lower Gastrointestinal Bleeding: A Case Report
Authors: Chiang Ting-Hsuan , Lee Yi-Wei , Tan Jui-Hsiang , Kao Chih-Chin , Chang Chun-Chao , Fang Kuan- chieh
Published: November 2020

BackgroundLower gastrointestinal bleeding (LGIB) is very common in the hospital setting. Most bleedings stop spontaneously, but rare infectious causes of LGIB may lead to rapid and serious complications if left untreated.Case PresentationWe described a young man with poorly controlled Type I Diabetes Mellitus and chronic alcohol abuse who presented with acute altered mental status. During his hospitalization for treatment of diabetic ketoacidosis, acute renal failure, and sepsis, he suddenly developed massive hematochezia of 1500ml. Colonoscopy was done and a deep ulcer covered with mucus with peripheral elevation was noted at the transverse colon. Biopsy of the ulcer later revealed nonpigmented, wide (5-20 µm in diameter), thin-walled, ribbon-like hyphae with few septations and right-angle branching suggestive of mucormycosis demonstrated by Periodic acid–Schiff stain. He received two months of antifungal treatment. Follow up colonoscopy post-treatment was normal with no ulcer visualized.ConclusionsEarly diagnosis and treatment of gastrointestinal (GI) mucormycosis infection is critical but can be challenging, especially in the setting of massive hematochezia. Therefore, clinical awareness for immunocompromised patients and prompt antifungal prophylaxis in cases with high suspicion of infection are essential.
Model Dimension Reduction and Nonlinear Analysis of the Sprag Clutch-flexible Rotor System Considering Local Nonlinearity
Authors: Huang Chuang , Zhao Yongqiang , Jin Guanghu
Published: November 2020

In order to study the influence of local nonlinear factors such as bearing clearance and Hertzian contact on the nonlinear behavior of the sprag clutch-rotor system during high-speed steady-state engaging, a nonlinear force model of rolling bearing considering radial clearance and Hertzian contact is established. Regarding the inner and outer rotors as substructures, the fixed interface modal synthesis method is used to reduce the dimension of the substructure model, and the nonlinear dimension reduction model of the sprag clutch-flexible rotor system (SC-FRS) is obtained. To improve computational efficiency, the Newmark method combined with the fixed interface synthesis method is presented to calculate the system response. The response results of the reduced model with a different number of dominant modes and the unreduced model are compared, and the number of reserved dominant modes of the inner and outer rotors is selected based on the calculation efficiency and accuracy. The effect of the radial clearance of different bearings on the nonlinear vibration response and the dynamic load of the inter-shaft bearing is discussed. It is found that the sensitivity of different radial clearances to the system's amplitude-frequency response is different, and the amplitude jump and the frequency hysteresis appear at the resonance peak.
Optimization Transmission Efficiency with Driver Intention for Automotive Continuously Variable Transmission Under Slip Mode
Authors: Han Ling , Zhang Hui , Fang Ruoyu , Liu Hongxiang
Published: November 2020

This study proposes and experimentally validates an optimal integrated system to control the automotive continuously variable transmission (CVT) to achieve its expected transmission efficiency range. The control system framework consists of top and bottom layers. In the top layer, a driving intention recognition system is designed on the basis of fuzzy control strategy to determine the relationship between the driver intention and CVT target ratio at the corresponding time. In the bottom layer, a new slip state dynamic equation is obtained considering slip characteristics and its related constraints, and a clamping force bench is established. Innovatively, a joint controller based on model predictive control (MPC) is designed taking internal combustion engine torque and slip between the metal belt and pulley as optimization dual targets . A cycle is attained by solving the optimization target to achieve optimum engine torque and the input slip in real-time . Moreover, the new controller provides good robustness. Finally, performance is tested by actual CVT vehicles. Results show that compared with traditional control, the proposed control improves vehicle transmission efficiency by approximately 9.12%–9.35% with high accuracy.
Vortex Simulation of Two Cylinders in Tandem Using Overlapping Grid System
Authors: Wardhana Wisnu , Wardhana Ede , Soetardjo Meitha
Published: November 2020

To give a considerable time reduction in the calculation of the vortex velocity and in the CPU time, discrete vortex modelling of flows using overlapping grid system for two tandem cylinders is carried out. This simple and time efficient method gives a better scatter of surface vorticity as the vortices around the body are now calculated on grid point. This research is to simulate the loading on structural elements of the structures due to their interaction with anodes or with other members. To show the flow phenomena and interactions involved, the in-line and transverse force coefficients are presented. The comparison of the results with experimental and numerical results and the range for good results is presented.
Joint Binary Response Modeling for Childhood Comorbidity in Ethiopia
Authors: Bokoro Tesfaye Abera , Gebresilasie Habtamu Kiros
Published: November 2020

Background: Childhood diarrhea and Acute Respiratory Infection (ARI) are some of the diseases that share common risk factors in tropical developing regions. The objective of the study was to identify risk factors of childhood diarrhea and ARI among children age under-five years old based on 2016 Ethiopian Demographic and Health Survey data.Methods: A joint binary response model that accommodates the interdependence between the two diseases was employed. Results: We found a common odds ratio value (4.30) greater than unity, describing a positive association between the two childhood diseases. Thereby, employing a joint model to assess the potential factors for diarrhea and acute respiratory infection (ARI) was reasonable. Moreover, it was identified that standard errors of the parameter estimates in the joint response model were smaller compared to the corresponding standard errors of the separate models.Conclusion: In the joint model, explanatory variables such as residence, vaccination, mother’s education, and antenatal care visits during pregnancy were found statistically significant risk factors for diarrhea, whereas residence, number of children ever born, vaccination, mother’s education, and wealth index were statistically significant risk factors for childhood Acute Respiratory Infection. The two correlated dichotomous response variables that is, diarrhea and ARI were affected together significantly by the risk factors such as residence, vaccination, and mother’s education.
Explaining better hearing in Norway: A comparison of two HUNT cohorts 20 years apart
Authors: Engdahl Bo , Stigum Hein , Aarhus Lisa
Published: November 2020

Background The hearing function at a given age seems to have improved in more recent born cohorts in industrialized countries. But the reasons for the improvement have not yet been explained. Methods We investigated the extent to which better hearing in Norway is attributed to modifiable risk factors by using representative demographic and audiometric data from two cohorts of the Nord-Trøndelag Health Study, HUNT2 (1996-1998) and HUNT4 (2017-2019). We estimated natural indirect effects using causal inference methods in order to assess whether cohort improvement in hearing thresholds (HTs) was mediated by occupational noise exposure, recurrent ear infections, smoking and education. Results The improvement in HTs from HUNT2 to HUNT4 was 2.8 and 3.0 dB at low respectively high frequencies. Together all risk factors mediated this improvement by 0.8 dB (95% CI 0.7-0.9) and 0.8 dB (95% CI 0.7-0.9) respectively, corresponding to mediated proportions of 27 and 28 percent. Substantial mediation was specifically found for occupational noise in men and recurrent ear infections in women (mediated proportions of 11 and 17 percent at high frequencies, respectively).Conclusions Increased education, less occupational noise exposure, ear infections and smoking contributed considerably to better hearing in Norway the last two decades.
In-Situ Study of Electrochemical Migration of Tin in The Presence of Bromide Ion
Authors: Lee Ee Lynn , Haseeb A. S. M. A. , Basirun Wan Jeffrey , Wong Yew Hoong , Sabri Mohd Faizul Mohd , Low Boon Yew
Published: November 2020

The miniaturization of electronic devices and the consequent decrease in the distance between conductive lines have increased the risk of short circuit failure due to electrochemical migration (ECM). The presence of ionic contaminants in the devices can accelerate the ECM process. This work systematically investigates the ECM of tin (Sn) in the presence of bromide ions (Br−) in the range of 10-6 M to 1.0 M. Water drop test (WDT) was conducted in the two-probe semiconductor characterization system under an optical microscope for in-situ observations. Anodic polarization test (APT) was carried out to study the correlation between corrosion properties of Sn and its ECM behaviour. The products of ECM were characterized by scanning electron microscope coupled with an energy dispersive X-rays spectrometer (SEM/ EDX) and X-ray photoelectron spectrometer (XPS). The results confirm that the rate of anodic dissolution of Sn monotonously increases with Br− concentration. However, the probability of ECM failure follows a normal distribution initially, but later increases with the Br− concentration. The main products of the ECM reactions are identified as Sn dendrites and tin hydroxide precipitates. The mechanism of the ECM process of Sn in the presence of Br− is also suggested.
Optimization of Air Traffic Management Efficiency Based on Deep Learning Enriched by the Long Short-term Memory(LSTM) and Extreme Learning Machine(ELM)
Authors: Aghdam Mahdi Yousefzadeh , Kamel Seyed Reza , Chabok Seyed Javad Mahdavi , khairabadi maryam
Published: November 2020

Air traffic management refers to the activities required for the efficient and safe management of the national air system (NAS) for each country. This concept has been widely assessed due to its complexity and sensitivity for the beneficiaries, including passengers, airlines, regulatory agencies, and other organizations. To date, various methods (e.g., statistical and fuzzy techniques) and data mining algorithms (e.g., neural network) have been used to solve the issues of air traffic management (ATM) and delay the minimization problems. However, each of these techniques has some disadvantages, such as overlooking the data, computational complexities, and uncertainty. The present study aimed to increase ATM efficiency using the deep learning approach. The main research objective was to propose a deep learning model with the application of a long short-term memory-based deep learning model in order to increase the predictive accuracy in short daily and long-term annual windows by enhancing deep learning (two-dimensional). In addition, the deep model output was transferred to the extreme learning machine fast learning deep neural machine in order to calculate the estimated time of arrival real-time based on other similar input data, including the NAS data, bureau of transportation statistics system, and automatic dependent surveillance-broadcast system. The final results indicated the increased accuracy of ATM compared to other studies.
CaReAl: Capturing Read Alignments in a BAM file Rapidly and Conveniently
Authors: Park Yoomi , Seo Heewon , Yoo Kyunghun , Kim Ju Han
Published: November 2020

Some of the variants detected by high-throughput sequencing (HTS) is often not reproducible. To minimize the technical-induced artifacts, secondary experimental validation is required but this step is unnecessarily slow and expensive. Thus, developing a rapid and ease to use visualization tool is necessary to systematically review the statuses of sequence read alignments. Here, we developed a high-performance alignment capturing tool, CaReAl, for visualizing the read-alignment status of nucleotide sequences and associated genome features. CaReAl is optimized for the systematic exploration of regions of interest by visualizing full-depth read-alignment statuses in a set of PNG files. CaReAl was 7.5 times faster than IGV ‘snapshot’, the only stand-alone tool which provides automated snapshot of sequence reads. This rapid user-programmable capturing tool is useful for obtaining read-level data for evaluating variant calls and detecting technical biases. The multithreading and sequential wide-genome-range-capturing functionalities of CaReAl aid the efficient manual review and evaluation of genome sequence alignments and variant calls. CaReAl is a rapid and convenient tool for capturing aligned reads in BAM. CaReAl will facilitate the acquisition of highly curated data for obtaining reliable analytic results.
Circulating Chemokine Levels and the Development of Allergic Phenotypes from Infancy to Adolescence: A Population-Based Birth Cohort Study
Authors: Huoman Johanna , Haider Sadia , Simpson Angela , Murray Clare S , Custovic Adnan , Jenmalm Maria C
Published: November 2020

Background: Chemokines are important mediators in immune cell recruitment, contributing to allergy development. However, extensive studies of chemokines in the circulation in relation to the presence and development of allergic diseases remain scarce.Objective: To investigate associations of circulating allergy-related chemokines with development of asthma and sensitisation cross-sectionally and longitudinally in a population-based cohort. Methods: The chemokines CCL17, CCL22, CXCL10, CXCL11 and CCL18 were measured in plasma samples from children in a population-based birth cohort. Samples were available from cord blood at birth (n=376) and age 1 (n=195) and 8 years (n=334). Cross-sectional and longitudinal association analyses were performed in relation to asthma and allergic sensitisation, as well as allergic phenotype clusters previously derived using machine learning in the same study population.Results: In children with asthma and/or allergic sensitisation, CCL18 levels at ages 1 and/or 8 were consistently elevated. In a longitudinal model which included information on asthma from 4 time-points (ages 5, 8, 11 and 16 years), we observed a significant association between increasing levels of CCL18 at age 1 year and a higher risk of asthma from early school age to adolescence (OR=2.9, 95% CI 1.1-7.6, p=0.028). We observed similar associations in longitudinal models for allergic sensitisation. Asthma later in life was preceded by increased CXCL10 levels after birth, and decreased CXCL11 levels at birth. Conclusion: Elevated CCL18 levels throughout childhood foreshadow the development of asthma and allergic sensitisation. The Th1-associated chemokines CXCL10 and CXCL11 were also associated with development of both outcomes, with differential temporal effects.
Combination of Nephrolepis Exaltata - Hibiscus Rosa Sinensis Herbal Mask Protect The Sinonasal Immune System and Increase Lung Function of Motorcycle Taxi Drivers
Authors: Prasetyo Awal , Sabila Aulia Arinindya , Dairiyanti Anugraheni , Aufa Muhammad Hanif , Antari Arlita Leniseptaria , Sadhana Udadi , Miranti Ika Pawitra , Kristina Tri Nur
Published: November 2020

Background:Combination of Nephrolepis exaltata - Hibiscus rosa sinensis (NEHRS) herbal mask proved to decrease nasal mucociliary transport time, increase sinonasal IgA and lung function in textile industry workers. Its protection effect on motorcycle taxi drivers exposed to acute motor vehicle exhaust pollutants has not been proven. The study aimed to demonstrate the protective effect of using NEHRS herbal mask both in the sinonasal immune system and lung function.Methods:This research was non-blinded randomized control trial with pre-post test design. Thirty two motorcycle taxi drivers were randomly assigned into three groups; positive control (n=11) using regular medical mask, negative control (n=10) using nonwoven cloth mask, and intervention group using NEHRS herbal mask (n = 11). Nasal wash was taken by ENT specialist, and the level of sinonasal IgA and IL-6 was reading by ELISA. Pulmonary function parameters were performed using the MAS-1-A spirometer, Data were analyzed with Wilcoxon, Paired t-test, Mann Whitney and One-way ANOVAResults: Sinonasal IgA level were significant decrease in all groups, respectively; intervention 16.31 ± 3.38; control (+)16.24 ± 2.62; control (-)15.28 ± 2.50. The IL-6 level also decrease in all groups in significantly difference (p=0.031), the delta were; intervention -6.92 ± 8.61; control (+) -10.23 ± 7.65; control (-)-8.56 ± 4.37. A significant increased of FEV1 (p=0,005) and PEF (p = 0,005) in the intervention group, but nearly significant of FVC (p=0,053), as well as in control (+); FVC (p=0,017), FEV1 (p=0,005), PEF (p<0,001), and control negatif; FVC (p=0,046), FEV1 (p=0,010), PEF (p=0,005). The test for difference of increasing FVC (p=0,652), FEV1 (p=0,696) and PEF (p=0,670) between all groups not significantly different.Conclusions: NEHRS Herbal mask that worn by motorcycle taxi drivers for 2 weeks decreased IgA and IL-6 sinonasal levels, as well as increased FVC, FEV1, and PEF.
What kind of man gets depressed after having a baby?
Authors: Hambidge Sarah , Cowell Amy , Arden-Close Emily , Mayers Andrew
Published: November 2020

Background: To date, information and support has been focused on mothers, with evidence that healthcare professionals overlook fathers’ mental health, and that fathers receive little or no support for themselves during the perinatal period. However, recently, fathers’ mental health has become an area of interest. Methods: This study explored the support fathers receive for their own mental health during the perinatal period. A qualitative questionnaire was distributed on social media networks and completed by twenty-nine fathers. Results: Thematic analysis produced three main themes: Factors Influencing Fathers’ Mental Health, Consequences of Poor Mental Health in Fathers and Solutions to Improve Fathers’ Mental Health. Conclusions: The findings from this study highlighted important implications about fathers’ mental health and the need to support them more effectively. Fathers’ reluctance to seek support and the limited support available need to be addressed. Fathers in this study perceived that perinatal health professionals view ‘mothers as the priority’. It is clear that health professionals need more training on how to recognise that fathers are also important and need support for their mental health.