bluuebunny/crossref_metadata_2025 huggingface dataset:
Creating and Implementing an Effective and Deterrent National Cyber Security Strategy
Authors: Senol Mustafa , Karacuha Ertugrul
Published: June 2020

This paper presents a new national cyber security strategy (NCSS) covering the deterrence perspective from creation to implementation. With the aim of responding to and ensuring cyber security effectively, studies on which pathways should be followed and what methods should be used to develop, create, and implement a NCSS are being conducted in Turkey, as in all countries. In this context, by explaining the importance of cyber power, the need for cyber power to be considered as one of the elements of national power and the importance of providing security against cyber attacks with deterrence by cyber power are discussed, while a new and integrated approach for the creation and implementation of a NCSS and an authoritarian organizational structure responsible for this strategy is proposed. It can be concluded that the proposed effective and deterrent NCSS model and approaches might help to efficiently and effectively handle these issues for better management, control, and auditing for cyber security issues; provide new concepts for cyber security issues supported by cyber power and deterrence on this issue in the world; introduce integrated approach to cyber security strategies and policies on the stages of developing and implementing a NCSS; bring a number of issues to support cyber security and defence in different perspectives; and achieve a high degree of success, especially in terms of effectiveness and existing deterrence strategies and action plans of basic structure, with the proposed approach. Finally, it is expected that the proposed strategy, steps, and suggestions might help to improve cyber security issues and national strategies in near future to secure national assessment more than ever with a powerful concept of deterrence. In addition, this approach, which has been put forward for effective implementation of cyber security by ensuring better management, control, and supervision, can be easily used by all other countries.
Determinants of Complete Immunization Coverage among Children Aged 11-24 Months in Somalia
Authors: Jama Abdinasir Abdullahi
Published: June 2020

Background. The general coverage of vaccination means the percentage of children in world who received the recommended vaccines and has existed over the past few years continued the same. Aim. The aim of this study was to determine the factors associated with complete immunization coverage among children aged 11-24 months in Somalia. Method. This was a descriptive cross-sectional study conducted in Galkayo hospital in Mudug region Somalia. Systematic random sampling was carried out in to recruit 357 children between 24 and 11 ages. Well-structured questionnaires were filled by participants who gave their consent. Data were analyzed using the statistical package for social sciences version 21. Descriptive statistics such as means, standard deviation, proportions, and range were used to summarize the data. Inferential statistics were used to test for association between the dependent variable and independent variables using the chi-square with the level of significance set at 5%. Result. The age of the respondents was between 11 and 24 with a mean age of the 7.71 with standard deviation ±5.87, the level of education of the mother (p=0.0001), the place of delivery of the baby (p=0.0001), and the distance of the participants to health facility (p=0.026533) were statistically significantly associated with immunization coverage. Final the full immunization coverage in Somalia is 20%. Conclusion. The study is recommended to the government to increase the level of education of the mother; also, the study is recommended to increase the hospital delivery that may increase the immunization coverage in Somalia.
Effect of B2O3 Content on the Sintering Basic Characteristics of Mixed Ore Powder of Vanadium-Titanium Magnetite and Hematite
Authors: Liu Hao , Zhang Ke , Ling Qingfeng , Qin Yuelin
Published: June 2020

The sintering basic characteristics of iron ore play a key role in the process of sintering. In this study, the effects of B2O3 on the assimilation characteristics, softening temperature, fluidity of liquid phase, compressive strength of bonding phase, and microstructure of the mixed fine powder of hematite and vanadium-titanium magnetite (H-VTM) are studied. Results show that B2O3 content from 0%–5% (wt%) could improve the assimilation characteristics of the H-VTM and increase the amount of the liquid phase. The liquidity of the bonding phase index (LBPI) of the H-VTM increases from 3.7 to 24.2. When B2O3 content exceeds 2%, the diameter of the pore in the H-VTM sintered samples enlarges. However, the compressive strength gradually decreases. Boron and calcium-magnesium-aluminium elements are abundant in the bonding phase, which can reduce the formation of calcium silicate and perovskite in H-VTM sintered samples.
Use of Student Evaluation of Teaching (SET) Survey to Evaluate Effectiveness of Teaching in a Leadership Course among Dental Students over Three Years
Authors: Nazir Muhammad , Al-Ansari Asim , AlKhalifa Khalifa , Gaffar Balgis , AlHumaid Jehan
Published: June 2020

Leadership courses are being increasingly integrated into dental curricula. The study aimed to assess the validity and reliability of student evaluation of teaching (SET) instrument among dental students and to evaluate the effectiveness of teaching in a new leadership course over a period of three years. This cross-sectional study was conducted on fourth-year undergraduate dental students (N = 260) who took a practice management course over three consecutive years from 2014 to 2016. A 29-item SET questionnaire was administered among students who were willing to participate in the study. Out of 260 students, 185 returned completed surveys and the response rate was 71.15%. Factor analysis (principal component analysis) showed the validity of four dimensions of the SET instrument. Total variance explained by four dimensions was 62.80%. Cronbach’s alpha for the instrument was 0.95 and each dimension had fairly high internal consistency (>0.80). Treating students with respect (94%), accepting different viewpoints of students (94.1%), being flexible/open-minded (92.5%), and preparedness in the course (91.9%) were the most common effective teaching traits. Over the period of three years, 16 items showed improvement in teaching and there was a significant improvement in four items (P<0.05). In conclusion, it was found that SET is a valid instrument to evaluate the effectiveness of teaching in nonclinical courses in dentistry. This instrument should be used longitudinally to compare the effectiveness of teaching.
3D High‐Frequency Ultrasound Imaging of Cartilage‐Bone Interface Compared with Micro‐CT
Authors: Huang Yanping , Chan Choi Han , Zhou Guangquan , Zheng Yongping , Yan Chun Hoi , Wen Chunyi
Published: June 2020

Cartilage‐bone interface (CBI) is a complex structure which bears important information in pathophysiology of osteoarthritis (OA). While high‐frequency ultrasound (US) has been widely used for the investigation of articular cartilage, 3D imaging of CBI using US is less commonly reported in this field. Here, we adopted a 3D high‐frequency ultrasound imaging approach specifically for the investigation of CBI in human knee samples. Fifteen osteochondral disks from the tibial plateau of seven OA patients were prepared in vitro and scanned using both high‐frequency US and micro‐CT imaging. The 3D morphology of the tidemark was reconstructed and compared using an image registration approach between the two imaging modalities. Results showed that the 3D tidemark could be well registered between the two imaging methods with a mean surface discrepancy of 33.2 ± 9.9 μm. Quantitative surface waviness/roughness parameter analysis showed significant correlations between the two imaging modalities. An intensity projected en face imaging was proposed to probe characteristic details of the CBI such as its perforations. This study provided evidence for the 3D high‐frequency ultrasound as a nonionizing radiation imaging tool potentially useful to evaluate the change of CBI in basic research of join diseases including OA.
Effect of Laryngeal Mask Air Way Insertion versus Endotracheal Intubation over Hemodynamic Responses in Pediatrics Patient Who Underwent Ophthalmic Surgery at Menelik II Hospital, Addis Ababa: A Prospective Observational Study Design
Authors: Obsa Mohammed Suleiman , Sholla Azeb Lencha , Baraki Betelhem Girma , Welde Getahun Dendir , Gelgelu Temesgen Bati , Kuruche Melese Meleku
Published: June 2020

Background. The airway of an anesthetized child is usually maintained with an endotracheal tube or laryngeal mask airway. However, both are related with some level of pressor response which may be risky in several groups of patient.Methods. An institutional-based prospective observational study design was employed. A systematic random sampling technique was used to select study participants. Data were entered into Epi info version 7 and transported to SPSS version 20 for analysis. Normality of the data was checked using Shapiro–Wilk tests. An independentttest was used to determine the mean differences between the two groups while the paired samplettest was used to determine the mean differences within the groups. Apvalue of less than 0.05 was used as a cut-off point for the presence of association.Results. The changes in systolic and diastolic blood pressure were returned to baseline values at five and three minutes in both groups, respectively. However, the changes in the heart rate and mean arterial pressure returned to baseline values in five minutes in the ETT group and three minutes in the LMA group. At baseline, the difference in systolic blood pressure between the two groups was not statistically significant (p=0.328).Conclusions. A significant hemodynamic pressor response was observed after the insertion of both LMA and ETT groups. However, the LMA group has less hemodynamic change as compared to the ETT group. Therefore, the practice of LMA insertion was strongly recommended.
Medical Liability of Residents in Taiwan Criminal Court: An Analysis of Closed Malpractice Cases
Authors: Wu Kuan-Han , Chuang Po-Chun , Su Chih-Min , Cheng Fu-Jen , Wu Chien-Hung , Chen Fu-Cheng , Huang Yii-Ting
Published: June 2020

Objective. By analyzing closed criminal malpractice claims involving resident physicians, we aimed to clarify the characteristics of litigations and examine the litigious errors leading to guilty verdicts. Design. A retrospective descriptive study. Setting/Study Participants. The verdicts pertaining to physicians recorded on the national database of the Taiwan justice system were reviewed. Main Outcome Measures. The characteristics of litigations were documented. Negligence and guilty verdicts were further analyzed to identify litigious errors. Results. Between January 1, 2000, and December 31, 2014, from a total of 436 closed criminal malpractice cases, 40 included resident physicians. Five (12.5%) cases received guilty verdicts with mean imprisonment sentences of 5.4 ± 4.1 months. An average of 77.2 months was required for the final adjudication, and surgery residents were involved most frequently (38.9%). Attending physicians were codefendants in 82.5% of cases and were declared guilty in 60% of them. Sepsis (37.5%) was the most common disease in the 40 cases examined, followed by operation/procedure complications (25%). Performance errors (70%) were more than twice as common than diagnostic errors (30%), but the percentage of guilty verdicts in performance error cases was much lower (7.1% vs. 25%). Four negligence cases received nonguilty verdicts, which were mostly due to lack of causation. Conclusion. Closed criminal malpractice cases involving residents took on average 6.22 years to conclude. Performance errors accounted for 70% of cases, with treatment of sepsis and operation/procedure complications predominant. To reduce medicolegal risk, residents should learn experiences from analyzing malpractice cases to avoid similar litigious pitfalls.
Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know?
Authors: Herath R. P. , Patabendige M. , Rashid M. , Wijesinghe P. S.
Published: June 2020

Introduction. Nonpuerperal uterine inversion (NPUI) is a rare clinical problem with diagnostic and surgical challenges. The objective of our study was to review the literature on NPUI and describe causative pathologies, diagnosis, and different surgical options available for treatment.Materials and Methods. A comprehensive literature review was carried out on MEDLINE and Google Scholar databases to look for NPUI using the term “non-puerperal uterine inversion,” and further went through the cross-references of the published articles. Data are published case reports from 1911 to September 2018. Of the 153 published cases, 133 reports had adequate details of surgery for analysis. These reports were analyzed, concerning the clinical presentation, methods of diagnosis, and surgical treatment.Results. Mean age of the women was 46.3 years (standard deviation: 18,N = 153). Leiomyoma remained the commonest (56.2%) aetiology. While malignancies contributed to 32.02% of cases, 9.2% were idiopathic. High degree of clinical suspicion and identification of unique features on ultrasonography and magnetic resonance imaging enable prompt diagnosis. In cases of uncertainty, laparoscopy or biopsy of the mass was used to confirm the diagnosis. Hysterectomy or repositioning and repair of the uterus are the only treatment options available. The surgical methods implemented were analyzed in three aspects: route of surgical access, method of repositioning, and final surgical procedure undertaken. The majority (48.8%) had only abdominal access, while 27.1% had both abdominal and vaginal access. Haultain procedure was the most useful procedure for reposition (18.0%) of the uterus. The majority (39.7%) required abdominal hysterectomy with or without debulking of the tumour abdominally, while 15.0% had uterine repair after repositioning. We reviewed the different surgical techniques and described and proposed a treatment algorithm.Conclusions. Fibroids were the commonest cause for NPUI. Malignancies accounted for one-third of cases. A combined abdominal and vaginal approach, followed by hysterectomy or repair after repositioning, seems to be better for nonmalignant cases.
Improvement of Endothelial Dysfunction of Berberine in Atherosclerotic Mice and Mechanism Exploring through TMT-Based Proteomics
Authors: Tan Wangxiao , Wang Yu , Wang Kaiyue , Wang Siwei , Liu Jinghua , Qin Xiaoyan , Dai Yongna , Wang Xiaoying , Gao Xiumei
Published: June 2020

Atherosclerosis is a multifactorial vascular disease triggered by disordered lipid metabolism, characterized by chronic inflammatory injury, and initiated by endothelial dysfunction. Berberine is the main active alkaloid of the herbal medicineCoptidis Rhizoma(Huanglian). Notably, berberine has been shown to have beneficial effects against atherosclerosis. However, the mechanisms of berberine in preventing atherosclerosis are still unclear. This study is aimed at investigating the effects and mechanisms of berberine in protecting the aorta and ameliorating atherosclerosis in apolipoprotein E-deficient (ApoE-/-) mice. Here, we demonstrated that berberine reduced serum lipid levels, antagonized hepatic lipid accumulation, improved intima-media thickening, and alleviated atherosclerotic lesions in ApoE-/-mice fed a western-type diet for 12 weeks. Meanwhile, berberine reduced aortic reactive oxygen species (ROS) generation and reduced the serum levels of malondialdehyde (MDA), oxidized low-density lipoprotein (ox-LDL), and interleukin-6 (IL-6). In aortic ring assay, berberine restored aortic endothelium-dependent vasodilatation in vivo and in vitro. Furthermore, 4,956 proteins were identified by proteomic analysis, and 199 differentially expressed proteins regulated by berberine were found to be involved in many biological pathways, such as mitochondrial dysfunction, fatty acidβ-oxidation I, and FXR/RXR activation. Summarily, these data suggested that berberine ameliorates endothelial dysfunction and protects against atherosclerosis, and thus may be a promising therapeutic candidate for atherosclerosis.
Permeability Experiment of Fractured Rock with Rough Surfaces under Different Stress Conditions
Authors: Zhou Zilong , Zhang Jing , Cai Xin , Wang Shanyong , Du Xueming , Zang Haizhi
Published: June 2020

To investigate the permeability changes and the mechanisms of fractured rock under dynamic and static stresses produced by earthquakes, permeability experiments on fractured rock with rough surfaces under axial dynamic and static stresses were conducted on the MTS815 Rock Mechanics Testing System. Surface asperity was investigated by scanning the specimen surfaces before and after testing. The results show that the roughness of fracture surface has a great influence on the permeability when the axial displacement is not enough to cause the fracture rock to slip. Moreover, the rougher fracture surface leads to severer surface damage as indicated by the more gouge productions. The accumulation of gouge materials on larger roughness fracture surfaces causes a slow drop in permeability. The fracture surfaces experience larger degradations, but it has small weights of gouge materials on fracture surface after testing under axial dynamic stress. The reason is that the gouge material transport and mobilization tend to occur in process of dynamic loading. Therefore, the permeability drops of axial dynamic stress are larger than those of axial static stress.
A Novel 3D Reconstruction Algorithm of Motion-Blurred CT Image
Authors: Jing Zhang , Qiang Guo , Fang Han , Zhan-Li Li , Hong-An Li , Yu Sun
Published: June 2020

The majority of medical workers are eager to obtain realistic and real-time CT 3D reconstruction results. However, autonomous or involuntary motion of patients can cause blurring of CT images. For the 3D reconstruction scene of motion-blurred CT image, this paper consists of two parts: firstly, a GAN image translation network deblurring algorithm is proposed to remove blurred results. This algorithm adopts the clear image to supervise the training process of the blurred image, which creates solutions that are close to the clear image. Secondly, this paper proposes a Marching Cubes (MC) algorithm based on the fusion of golden section and isosurface direction smooth (GI-MC) for 3D reconstruction of CT images. The golden section algorithm is used to calculate the equivalent points and normal vectors, which reduces the calculation numbers from four to one. The isosurface direction smooth algorithm computes the mean value of the normal vector, so as to smooth the direction of all triangular patches in spatial arrangement. The experimental results show that for different blurred angle and blurred amplitude, comparing the results of the Shannon entropy ratio and peak signal-to-noise ratio, our GAN image translation network deblurring algorithm has better restoration than other algorithms. Furthermore, for different types of liver patients, the reconstruction accuracy of our GI-MC algorithm is 9.9%, 7.7%, and 3.9% higher than that of the traditional MC algorithm, Li’s algorithm, and Pratomo’s algorithm, respectively.
Prevalence and Pattern of Road Traffic Accidents among Commercial Motorcyclists in the Central Tongu District, Ghana
Authors: Konlan Kennedy Diema , Doat Abdul Razak , Mohammed Iddrisu , Amoah Roberta Mensima , Saah Joel Afram , Konlan Kennedy Dodam , Abdulai Juliana Asibi
Published: June 2020

Background. The World Health Organisation estimates that 1.35 million people die as a result of road traffic crashes. Motorcycles as a means of transport are increasingly becoming the preferred and easiest means of transportation for most people in developing countries despite the associated risk. This study determined the prevalence and pattern of motorcycle crashes in Adidome among commercial motorcyclists. Methods. A descriptive, cross-sectional study design was used as 114 commercial motorcyclists were recruited to respond to a pretested research questionnaire in the Adidome district of the Volta Region. Data were analyzed using SPSS, version 22.0. Data were presented as simple descriptive statistics. A chi-square relationship was determined using the demographic variables, and the history of accident at a 95% confidence interval with 0.05 was considered as statistically significant. Results. The prevalence of road traffic crashes at Adidome was 64.0%. Motorcyclists (74.0%) were reported to have been involved in crashes in the past one year prior to the study. Motorcyclists attributed the last accident to excessive speeding (31.5%) and bad roads (23.3%), this accident as a result of colliding with another motorcycle (50.7%), and slippery surfaces (24.7%). The majority (63.0%) of the respondents had an accident once. The consumption of alcohol was associated with the occurrence of an accident as 34.2% occurred among cyclists who drank alcohol, compared with 29.8% who did not (p<0.05). Conclusion. There should be strict implementation of current road traffic regulations of Ghana by the MTTD of the Ghana Police Service, and penalties should be awarded against anybody caught riding a motorcycle under the influence of alcohol. Helmet and other protective devices must be made compulsory for motorcycle riders to prevent injuries, especially head injuries, if an accident occurs.
A Multidisciplinary Capstone Design Project to Satisfy ABET Student Outcomes
Authors: Meah Kala , Hake Donald , Wilkerson Stephen Drew
Published: June 2020

This paper presents a multidisciplinary open-ended capstone design project where students designed, built, and test drove a Formula Society of Automatic Engineers (FSAE) electric vehicle. The capstone team included students from computer, electrical, and mechanical engineering programs. Each student worked in on a subteam, namely, mechanical design, drivetrain, supervisory control and data acquisition, and battery management system. A thorough description of each subsystem is provided herein. Software architecture, system integration, and field test results are also reviewed. Team organization, faculty and industry involvement, and assessment of student outcomes are provided. This paper details the approach of building a bridge between academia and engineering practices. This paper also documents a process where undergraduate students research and master multiple technology areas and then apply them to the project’s focus. ABET student outcomes 1–7 were used to design and assess the course. Peer-to-peer rating and ranking are presented as an assessment tool for the multidisciplinary nature of the project.
The Golgi: Keeping It Unapologetically Basic
Authors: Ward Nathan P. , DeNicola Gina M.
Published: June 2020

Tumor cells maintain a reverse pH gradient relative to normal cells, conferring cell-intrinsic and cell-extrinsic benefits that sustain tumor growth. In this issue of Cancer Discovery, Galenkamp and colleagues reveal that NHE7 mediates acidification of the trans-Golgi network in pancreatic ductal adenocarcinoma, which is critical for the maintenance of cytosolic pH and consequently tumor growth.

See related article by Galenkamp et al., p. 822.
Chemotherapy and Tumor Evolution Shape Pancreatic Cancer Recurrence after Resection
Authors: Bednar Filip , Pasca di Magliano Marina
Published: June 2020

Most patients with pancreatic cancer who undergo curative resection and systemic chemotherapy still relapse with local or systemic recurrence. In this issue, Sakamoto and colleagues use advanced genomic tools to investigate the evolutionary origins of pancreatic cancer recurrence and discover an increased mutational burden that might be promoted by therapeutic intervention and might provide an opportunity for therapeutic intervention.

See related article by Sakamoto et al., p. 792.
Modest Sodium Reduction Increases Circulating Short-Chain Fatty Acids in Untreated Hypertensives
Authors: Chen Li , He Feng J. , Dong Yanbin , Huang Ying , Wang Changqiong , Harshfield Gregory A. , Zhu Haidong
Published: June 2020

High-sodium diet may modulate the gut microbiome. Given the circulating short-chain fatty acids (SCFAs) are microbial in origin, we tested the hypothesis that the modest sodium reduction would alter circulating SCFA concentrations among untreated hypertensives, and the changes would be associated with reduced blood pressure and improved cardiovascular phenotypes. A total of 145 participants (42% blacks, 19% Asian, and 34% females) were included from a randomized, double-blind, placebo-controlled cross-over trial of sodium reduction with slow sodium or placebo tablets, each for 6 weeks. Targeted circulating SCFA profiling was performed in paired serum samples, which were collected at the end of each period, so as all outcome measures. Sodium reduction increased all 8 SCFAs, among which the increases in 2-methylbutyrate, butyrate, hexanoate, isobutyrate, and valerate were statistically significant (
P
s<0.05). Also, increased SCFAs were associated with decreased blood pressure and improved arterial compliance. There were significant sex differences of SCFAs in response to sodium reduction (
P
s<0.05). When stratified by sex, the increases in butyrate, hexanoate, isobutyrate, isovalerate, and valerate were significant in females only (
P
s<0.05), not in males (
P
s>0.05). In females, changes in isobutyrate, isovalerate, and 2-methylbutyrate were inversely associated with reduced blood pressures (
P
s<0.05). Increased valerate was associated with decreased carotid-femoral pulse wave velocity (
P
=0.040). Our results show that dietary sodium reduction increases circulating SCFAs, supporting that dietary sodium may influence the gut microbiome in humans. There is a sex difference in SCFA response to sodium reduction. Moreover, increased SCFAs are associated with decreased blood pressures and improved arterial compliance.

Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00152074.
NOX4/H
2
O
2
/mTORC1 Pathway in Salt-Induced Hypertension and Kidney Injury
Authors: Kumar Vikash , Kurth Theresa , Zheleznova Nadezhda N. , Yang Chun , Cowley Allen W.
Published: June 2020

We have reported that a high-salt (4.0% NaCl) dietary intake activates mTORC1 and inhibition of this pathway with rapamycin blunts the chronic phase of salt-induced hypertension and renal injury in Dahl salt-sensitive (SS) rats. In SS rats, high-salt intake is known to increase the renal production of H
2
O
2
by NOX4, the most abundant NOX isoform in the kidney, and the global knockout of NOX4 blunts salt-sensitivity in these rats. Here, we explored the hypothesis that elevations of H
2
O
2
by NOX4 in high-salt fed SS rat stimulate mTORC1 for the full development of salt-induced hypertension and renal injury. Our in vitro studies found that H
2
O
2
activates mTORC1 independent of PI3K/AKT and AMPK pathways. To determine the in vivo relevance of NOX4/H
2
O
2
/mTORC1 in the salt-induced hypertension, SS-
Nox4
knockout (SS

Nox4
−/−

) rats were daily administrated with vehicle/rapamycin fed a high-salt diet for 21 days. Rapamycin treatment of SS
Nox4−/−
rats had shown no augmented effect on the salt-induced hypertension nor upon indices of renal injury. Significant reductions of renal T lymphocyte and macrophage together with inhibition of cell proliferation were observed in rapamycin treated rats suggesting a role of mTORC1 independent of NOX4 in the proliferation of immune cell. Given the direct activation of mTORC1 by H
2
O
2
and absence of any further protection from salt-induced hypertension in rapamycin-treated SS

Nox4
−/−

rats, we conclude that NOX4-H
2
O
2
is a major upstream activator of mTORC1 that contributes importantly to salt-induced hypertension and renal injury in the SS rat model.
COVID-19
Authors: Verdecchia Paolo , Cavallini Claudio , Spanevello Antonio , Angeli Fabio
Published: June 2020

Diffuse pulmonary inflammation, endothelial inflammation, and enhanced thrombosis are cardinal features of coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2. These features are reminiscent of several adverse reactions triggered by angiotensin II and opposed by angiotensin
1-7
, in many experimental models. Severe acute respiratory syndrome coronavirus 2 binds to ACE2 (angiotensin-converting enzyme 2) receptors and entries into the cell through the fusion of its membrane with that of the cell. Hence, it downregulates these receptors. The loss of ACE2 receptor activity from the external site of the membrane will lead to less angiotensin II inactivation and less generation of antiotensin
1-7
. In various experimental models of lung injury, the imbalance between angiotensin II overactivity and of antiotensin
1-7
deficiency triggered inflammation, thrombosis, and other adverse reactions. In COVID-19, such imbalance could play an important role in influencing the clinical picture and outcome of the disease. According to this line of thinking, some therapeutic approaches including recombinant ACE2, exogenous angiotensin
1-7
, and angiotensin receptor blockers seem particularly promising and are being actively tested.
Synergistic Effects of Moderate Therapeutic Hypothermia and Levosimendan on Cardiac Function and Survival After Asphyxia‐Induced Cardiac Arrest in Rats
Authors: Wang Chih‐Hung , Chang Wei‐Tien , Tsai Min‐Shan , Huang Chien‐Hua , Chen Wen‐Jone
Published: June 2020

Background

This study investigated whether levosimendan, an inotropic calcium sensitizer, when combined with moderate therapeutic hypothermia, may exert synergistic benefits on post–cardiac arrest myocardial dysfunction and improve outcomes.

Methods and Results

After 9.5‐minute asphyxia‐induced cardiac arrest and resuscitation, 48 rats were randomized equally into 4 groups following return of spontaneous circulation (ROSC), including normothermia, hypothermia, normothermia–levosimendan, and hypothermia–levosimendan groups. For the normothermia group, the target temperature was 37°C while for the hypothermia group, the target temperature was 32°C, both of which were to be maintained for 4 hours after ROSC. Levosimendan was administered after ROSC with a loading dose of 10 μg/kg and then infused at 0.1 μg/kg per min for 4 hours. In the hypothermia–levosimendan group, left ventricular systolic function and cardiac output increased significantly, whereas the heart rate and systemic vascular resistance decreased significantly compared with the normothermia group. Also, the concentrations of interleukin 1β at 4 hours post‐ROSC and the production of NO between 1 hour and 4 hours post‐ROSC were reduced significantly in the hypothermia–levosimendan group compared with the normothermia group. The 72‐hour post‐ROSC survival and neurological recovery were also significantly better in the hypothermia–levosimendan group compared with the normothermia group (survival, 100% versus 50%, χ
2
test,
P
=0.006).

Conclusions

Compared with normothermia, only combined moderate therapeutic hypothermia and levosimendan treatment could consistently improve post–cardiac arrest myocardial dysfunction and decrease the release of pro‐inflammatory molecules, thereby improving survival and neurological outcomes. These findings suggest synergistic benefits between moderate therapeutic hypothermia and levosimendan.
Trouble Brewing: The North Korean Famine of 1954–1955 and Soviet Attitudes toward North Korea
Authors: Lankov Andrei
Published: June 2020

This article, based on newly available materials from the former Soviet archives, deals with the famine that struck a large part of the North Korean countryside in the winter of 1954–1955. The famine was related to the policies of crash industrialization and collectivization favored by Kim Il-sung—or at least, this is how many contemporaries, including Soviet diplomats, saw it. The famine, mentioned only once in openly available publications of the period, sparked political instability and prompted the urgent delivery of food assistance from the USSR and China. Soviet leaders, seeing the famine as another sign of the dangerous trends of Kim Il-Sung's policies, gave Pyongyang strong “advice,” demanding a moderation of policies and partial halt of the collectivization drive. The “advice” was followed, but the entire confrontation contributed to the further buildup of tensions between Moscow and Kim Il-Sung.
The Creation of the American Republic at Fifty
Authors: McConville Brendan J.
Published: June 2020

Jonathan Gienapp, Stanford University, and Brendan McConville, Boston University reflect on the historiographic and scholarly contributions of Gordon Wood's The Creation of the American Republic.
Authorship and Unity of the Classical Arabic Poem through the Lens of Collaborative Composition
Authors: Naaman Erez
Published: June 2020

When a classical Arabic poem lacked a noticeable degree of thematic coherence and formal structure, it was at risk of foreign intervention aiming to improve it. Who was recognized in such a case as the author of the poem and on which grounds? This article looks at the interrelated questions of the poem’s unity and its authorship through the lens of collaborative poetry that was practiced by completing verse composed in the past. It presents an analysis of poetic collaboration cases from the second/eighth century to the Ayyubid era, and discusses different practical approaches of poets to authorship questions related to the earlier source poem and their own later completion. In the third/ninth century, as an expansive reservoir of ancient and modern poems became increasingly available, we occasionally notice the marks of plagiary, rather than forgery, on collaborative poems of this type. At the same time, and based on this very expansion, kinds of legitimate poetic influence can be detected in the completions of the later poets. Remarkably, poetic intervention did not cease and the poem conceptually did not achieve an inviolable status, when the scholars replaced the transmitters as the authorities on poetry around the third/ninth century and throughout the period under study. Nevertheless, the cultural domain for reshaping earlier verse changed, and the repertoire of poetry considered as “fair game” for this practice was narrowed down based on quality considerations.
The Impact of Early Recognition and Treatment of Systemic Hypertension on Reducing Blood Pressure: The Hypertension and Vascular Evaluation Program
Authors: Min Jungwon , Griffis Heather M. , Mendoza Melodee , Tam Vicky , Kaplinski Michelle , Kogon Amy J. , Hanson Hannah , Meyers Kevin E. , Natarajan Shobha S.
Published: June 2020

This study aimed to evaluate the effect of an outpatient systemic hypertension program and associated factors with attending recommended follow-up visit. All visits were tracked in the program, 2011 to 2018. We examined patient characteristics by follow-up status and changes in systolic blood pressure (SBP) and the risk of hypertension in follow-up patients using a mixed-effects regression model. Among 310 patients with first visits, 113 patients returned for a follow-up visit. Patients who did not attend a follow-up were older and less likely to have a severe chronic condition or a family history of hypertension than followed-up patients. The risk of hypertension was significantly reduced by the number of follow-up visits (odds ratio = 0.53, 95% confidence interval = 0.31-0.92). Adolescent SBP and body mass index percentiles decreased with more follow-up visits. As the risk of hypertension is significantly reduced with follow-up visits, additional effort should be made to improve the likelihood of follow-up attendance.
Out-of-Place and In-Place Policing: An Examination of Traffic Stops in Racially Segregated Philadelphia
Authors: Hannon Lance , Neal Malik , Gustafson Alex R.
Published: June 2020

It is commonly argued that Black people may be more likely to be stopped by the police in majority White neighborhoods due to a natural tendency to first observe and then scrutinize that which seems out of the ordinary. Anecdotal evidence of police officers appearing equally drawn to White people in predominantly Black neighborhoods is sometimes presented to suggest that the phenomenon is race neutral. Motivated by such narratives, we examine the extent to which Black versus White racial categorization encourages police scrutiny in out-of-place and in-place contexts. Applying the veil-of-darkness and vehicle search threshold tests, we find that in place or out of place, being seen as White is always an advantage in Philadelphia.
Distributed Leadership Globally: The Interactive Nature of Principal and Teacher Leadership in 32 Countries
Authors: Printy Susan , Liu Yan
Published: June 2020

Purpose: This study provides cross-country evidence regarding the extent to which distributed leadership operates in schools globally and offers preliminary insights about country education policies that explain the reported distributed leadership results. The researchers also investigate the relationship between principals’ reports of distributed leadership and teachers’ reports of the school culture, demonstrating the alignment of principal and teacher perspectives of distributed leadership. The conceptual framework highlights the interaction between leaders in varied situations characterized by leadership functions and country contexts. Research Design: Researchers use both principal and teacher surveys from the 2013 TALIS. In the first analytical stage, latent measures using confirmative factor analysis capture the extent to which principals and teachers were responsible for each of the three leadership functions; scatterplots explore distribution of interactive leadership, and further explanation is offered by document analysis of country policy profiles. In the second stage, the research uses hierarchical linear models for the effect of distributed leadership, specifically principal leadership, teacher leadership, and interactive leadership, on school culture for each country, synthesizing country results with meta-analysis. Findings: Distributed leadership varies by leadership function and appears to be influenced by country education policy. Teachers report that their school culture is conducive to distributed leadership when, in fact, they have the opportunity to lead. Conclusions: Findings add global evidence that country context is an important part of the situation for distributed leadership. The patterns of distributed leadership by function invite further research within each country, particularly to examine the influence of educational policy.
Neighborhood Walkability and Crime: Does the Relationship Vary by Crime Type?
Authors: Lee Narae , Contreras Christopher
Published: June 2020

We draw on theoretical insights from criminology in using the Walk Score index to analyze walkability’s relationship to spatial crime patterns on Los Angeles city blocks. Results from our first set of negative binomial regression models show that walkability had an especially strong linear effect on robbery rates: a 24% increase in the robbery rate accompanied a 10-point increase in Walk Score on a block, controlling for the effects of local businesses and sociodemographic characteristics. Our second set of models reveals that walkability exerted variable nonlinear influences on spatial crime patterns. Our final set of models suggests that the walkability–crime relationship might depend on neighborhood social organization: When walkability is high, low-income blocks might experience sharp rises in rates of predatory violence as compared with more advantaged blocks. This research highlights the importance of considering the mechanisms involved in walkability’s impact on the spatial distribution of individual crime types.
Improving Reciprocal Conversation and Social Preference of Children With Autism
Authors: Yuan Chengan , Chen Liqi
Published: June 2020

Individuals with autism spectrum disorders (ASD) often have difficulties initiating and maintaining reciprocal conversations with others. In this study, we examined if an interdependent group contingency would improve reciprocal conversation of children with ASD when they were paired as conversational partners. We also assessed children’s social preference through their choices between spending time with their peers or by themselves. In a multiple-baseline design, we found that the group contingency immediately produced independent reciprocal conversational responses, sustained conversational exchanges, and increased preference for peers across all participants. Improvements were further maintained even after the group contingency was removed and novel peers were introduced.
Intravenous Antibiotic Susceptibility for Urinary Tract Infection Prior to Emergency Department Discharge
Authors: Rewitzer Stacey , Montgomery Josie , Zepeski Anne , Finer Lexie , Faine Brett A.
Published: June 2020

Background

Urinary tract infection (UTI) is a common infectious disease managed in the emergency department (ED). Patients may be initially treated with an intravenous (IV) antibiotic and subsequently discharged with an oral antibiotic regimen.

Objective

The purpose of this study was to determine whether the current Infectious Diseases Society of America guideline recommendation for an initial dose of long-acting IV antibiotic for treatment of UTI when the prevalence of fluoroquinolone resistance exceeds 10% improves the likelihood of providing in vitro susceptibility to the isolated uropathogen.

Methods

This was a retrospective study of patients in ED presenting between May 2009 and August 2018 who received treatment for UTI. The primary outcome was susceptibility of uropathogen to the IV antibiotic administered. Secondary outcomes included susceptibility to the oral antibiotic regimen prescribed at discharge, repeat health care visit within 30 days related to UTI follow-up, adverse events (AEs) associated with antibiotic use, and identification of risk factors associated with pathogen resistance.

Results

A total of 255 patients were included for analysis. Of these patients, 230 (90.2%) had pathogens susceptible to the administered IV antibiotic. The oral regimen susceptibility was 81.6% with 29 patients returning for UTI follow-up and 4 patients reporting AEs related to antibiotic use. Men and long-term care facility residents were more likely to have resistant uropathogens.

Conclusion

Administration of a long-acting IV antibiotic for treatment of UTI prior to ED discharge is recommended when the fluoroquinolone resistance rate exceeds 10% to improve in vitro susceptibility coverage.
Model-free active input–output feedback linearization of a single-link flexible joint manipulator: An improved active disturbance rejection control approach
Authors: Abdul-Adheem Wameedh Riyadh , Ibraheem Ibraheem Kasim , Humaidi Amjad J , Azar Ahmad Taher
Published: June 2020

Traditional input–output feedback linearization requires full knowledge of system dynamics and assumes no disturbance at the input channel and no system’s uncertainties. In this paper, a model-free active input–output feedback linearization technique based on an improved active disturbance rejection control paradigm is proposed to design feedback linearization control law for a generalized nonlinear system with a known relative degree. The linearization control law is composed of a scaled generalized disturbance estimated by an improved nonlinear extended state observer with saturation-like behavior and the nominal control signal produced by an improved nonlinear state error feedback. The proposed active input–output feedback linearization cancels in real-time fashion the generalized disturbances which represent all the unwanted dynamics, exogenous disturbances, and system uncertainties and transforms the system into a chain of integrators up to the relative degree of the system, which is the only information required about the nonlinear system. Stability analysis has been conducted based on the Lyapunov functions and revealed the convergence of the improved nonlinear extended state observer and the asymptotic stability of the closed-loop system. Verification of the outcomes has been achieved by applying the proposed active input–output feedback linearization technique on the single-link flexible joint manipulator. The simulations results validated the effectiveness of the proposed active input–output feedback linearization tool based on improved active disturbance rejection control as compared to the conventional active disturbance rejection control–based active input–output feedback linearization and the traditional input–output feedback linearization techniques.
Research on the impact of home country patent level on outward foreign direct investment: Empirical analysis via equal part linear regression model and Grey Computing
Authors: Zhu Yuanbing , Chen Xueying , Wang Gang , Zhong Zuchang , Zhuang Meier
Published: June 2020

From the practice of developed countries, countries with higher patent applications and PCT patent applications (such as the United States, China, Japan, the United Kingdom, Germany, etc.) have relatively higher outward foreign direct investment, and the actual data of provinces in China also show that with the improvement of the patent level in various provinces and cities, the intensity of outward foreign direct investment in each province and city has also increased. At present, there are relatively few research data and the research method is relatively single. Therefore, collecting panel data on China’s 31 provinces from 2003 to 2016, this paper conducts an empirical analysis on the influence of patent level on outward foreign direct investment via analytical method of equal part linear regression and Grey Computing. By comparing analysis results with the model and the results with conventional linear regression model, the difference of different regression models is observed. Furthermore, the impact of China’s patent level on China’s inter-provincial outward foreign direct investment is further analyzed.
Analysis of pumped hydroelectric energy storage for large-scale wind energy integration
Authors: Carew Nick , Warnock William , Bayindir Ramazan , Hossain Eklas , Rakin Adnan Siraj
Published: June 2020

Renewable energy sources are becoming a popular choice of energy, due to their sundry advantages and more convenient environmental impacts. Wind certainly emerges as one of the most plausible energy sources in modern power generation. However, large-scale wind energy is associated with fluctuations in voltage and power due to its intermittent nature. The proposed pumped hydroelectric energy storage system offers one of the best solutions in solving this problem. It is shown that large-scale integration of wind energy becomes more feasible and efficient when a proper energy storage system is added to achieve appropriate energy charging or discharging. Upon comparing the potential of different storage systems, pumped hydroelectric energy storage is found to be highly promising for wind integration. In order to demonstrate the behavior of the integrated system with respect to time constant and to verify the feasibility of the energy storage in different case studies, simulations are performed in Matlab/Simulink. This work would open new doors toward the investigation of large-scale wind power integration. It is also expected that pumped hydroelectric energy storage would become a possible alternative for energy reserves for large-scale wind power applications.