bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulsed Impingement Turbine Cooling and Its Effect on the Efficiency of Gas Turbines With Pressure Gain Combustion
Authors: Neumann Nicolai , Berthold Arne , Haucke Frank , Peitsch Dieter , Stathopoulos Panagiotis
Published: March 2021

Performance improvements of conventional gas turbines are becoming increasingly difficult and costly to achieve. Pressure gain combustion (PGC) has emerged as a promising technology in this respect, due to the higher thermal efficiency of the respective ideal gas turbine cycle. Previous cycle analyses considering turbine cooling methods have shown that the application of pressure gain combustion may require more turbine cooling air. This has a direct impact on the cycle efficiency and reduces the possible efficiency gain that can potentially be harvested from the new combustion technology. Novel cooling techniques could unlock an existing potential for a further increase in efficiency. Such a novel turbine cooling approach is the application of pulsed impingement jets inside the turbine blades. In the first part of this paper, results of pulsed impingement cooling experiments on a curved plate are presented. The potential of this novel cooling approach to increase the convective heat transfer in the inner side of turbine blades is quantified. The second part of this paper presents a gas turbine cycle analysis where the improved cooling approach is incorporated in the cooling air calculation. The effect of pulsed impingement cooling on the overall cycle efficiency is shown for both Joule and PGC cycles. In contrast to the authors’ anticipation, the results suggest that for relevant thermodynamic cycles pulsed impingement cooling increases the thermal efficiency of Joule cycles more significantly than it does in the case of PGC cycles. Thermal efficiency improvements of 1.0 p.p. for pure convective cooling and 0.5 p.p. for combined convective and film with TBC are observed for Joule cycles. But just up to 0.5 p.p. for pure convective cooling and 0.3 p.p. for combined convective and film cooling with TBC are recorded for PGC cycles.
Selective chemical vapor deposition of HfB2 on Al2O3 over SiO2 and the acceleration of nucleation on SiO2 by pretreatment with Hf[N(CH3)2]4
Authors: Zhang Zhejun V. , Liu Sumeng , Girolami Gregory S. , Abelson John R.
Published: March 2021

We show that growth of the metallic ceramic HfB2 by CVD from Hf(BH4)4 at 220 °C is inherently selective on Al2O3 over SiO2: a 10.4-nm film grows on Al2O3 in 16 min, whereas only 0.07 nm of HfB2 grows on SiO2 in 18 min. Nucleation occurs on both SiO2 and Al2O3; however, the Al2O3 surface has a much higher density of nuclei such that HfB2 islands quickly coalesce to form continuous films, followed by steady-state growth of HfB2. On SiO2, nucleation is sparse and coalescence of the islands takes much longer; as a result, the overall growth rate is slower. Sparse nucleation on SiO2 also leads to a rough layer with a broad height distribution function: for a deposit containing 1.6 × 1015 Hf atoms/cm2 (equivalent to a bulk thickness of 0.5 nm for HfB2), the rms roughness is 3.8 nm on SiO2 but only 1.3 nm on Al2O3. The difference in the formation rate of nuclei (and thus the area density of nuclei) is attributed to the different acid-base character of hydroxyl groups on these oxide surfaces. We also found that, when growth on SiO2 is desired, the surface can be modified by exposure to tetrakis(dimethylamido)hafnium, which adsorbs to saturation at ∼1 monolayer. Subsequent exposure of this pretreated surface leads to an increased density of HfB2 nuclei, a reduced coalescence time, and a smaller roughness of the resulting surface from 3.8 to 1.7 nm. By contrast, a similar pretreatment on Al2O3 has little effect on the roughness of subsequently grown HfB2 films, which are already relatively smooth when grown on untreated alumina surfaces.
Effect of Mongolian warm acupuncture on the gene expression profile of rats with insomnia
Authors: A Gula , Li Xian , Su Budao , Lian Hua , Bao Manjie , Liang Yabin , Chen Yingsong , Jia Yongfeng , Bao Lidao , Su Xiulan
Published: March 2021

Background:

The mechanism of Mongolian warm acupuncture (MWA) for the treatment of insomnia has not been previously reported.

Objective:

To investigate the effect of MWA on gene expression profile in the p-chlorophenylalanine (PCPA)-induced rat model of insomnia.

Methods

A rat model of insomnia was established and the animals were divided into five groups: control, PCPA (untreated), PCPA+estazolam, PCPA+MA (manual acupuncture), and PCPA+MWA. The rats were euthanased at 7 days after treatment, and hypothalamic tissue was harvested to extract total RNA for the analysis of gene expression profile. Micro-array and Partek Genomics Suite analysis system were used to analyse differential expression of genes between groups. Furthermore, ingenuity pathways analysis was used to analyse the main regulators.

Results:

After treatment, in rats with improved sleep, micro-array data from the follow-up phase compared with baseline showed that MWA down-regulated 11 genes compared with the control group and 16 genes compared with the PCPA group. Six genes were selected following the micro-array detection to perform quantitative polymerase chain reaction (qPCR) verification, and the results showed that the coincidence rate was up to 90%, which verified the reliability of the microarray results. Compared with the PCPA group, transcription levels of Egr 1, Btg2 and BDNF in the PCPA+MWA group were up-regulated (P<0.05).

Conclusion:

In combination, the findings of this study suggests that MWA is efficacious at improving sleep in an experimental rat model of insomnia.
Effects of electroacupuncture on functional indices and pS6 expression following acute sciatic nerve crush injury in rats
Authors: Zeng Linghuan , Cen Ying , Chen Junjie , Lei Lei , Zhang Lei , Qin Xiaohui , Gao Xinchang , Wang Ya , Zeng Chuanxiu
Published: March 2021

Objective:

The aim of this study was to investigate the effect of electroacupuncture (EA) on recovery from acute sciatic nerve crush injury and the expression of pS6 in rats.

Methods:

A total of 108 adult male Sprague–Dawley rats were randomly divided into control, model, EA and EA+rapamycin (EA+Rapa) groups. 28 rats were allocated to undergo measurement of sciatic functional index (SFI); one rat in the EA+Rapa group was unsuccessfully modelled and excluded because of an anaesthetic problem. The remaining 80 rats were allocated to undergo Western blot detection of S6 ribosomal protein (pS6, ser240/244). The model was created by mechanical clamping of the sciatic nerve stem. EA stimulation at GB30 and ST36 for 15 min separately was applied once daily for rats in the EA and EA+Rapa groups. For rats in the EA+Rapa group, rapamycin, a mammalian target of rapamycin (mTor) pathway inhibitor, was injected intramuscularly (1 mg/kg/day) near the site of crush injury in the sciatic nerve and an equivalent amount of dimethyl sulfoxide was injected in the other three groups every other day. After treatment for 7, 14, 28 and 42 days post-operation, the SFI of 27 rats was obtained to evaluate recovery of motor function and five rats from each group per stage were used for Western blot detection of pS6.

Results:

The SFI values showed that EA could significantly promote recovery of the injured sciatic nerve but rapamycin hindered the therapeutic effect of EA. Moreover, immunoblotting indicated that EA improved the expression of pS6 in the area of the sciatic nerve crush injury and local injection of rapamycin near the injured sciatic nerve decreased its expression. The pS6 level correlated with the extent of recovery of the injury.

Conclusions:

This study indicated that EA may activate the mTOR signalling pathway to enhance expression of pS6 and facilitate recovery following sciatic nerve crush injury.
Acupuncture combined with swallowing training for poststroke dysphagia: a meta-analysis of randomised controlled trials
Authors: Li Ling Xin , Deng Kai
Published: March 2021

Objective:

This meta-analysis aimed to assess the efficacy and safety of the combination of acupuncture with swallowing training for poststroke dysphagia.

Method:

Nine electronic databases (including PubMed and China National Knowledge Infrastructure) were searched from their inception through June 2016. Seventeen studies were included in this meta-analysis. Data on 1479 eligible patients were extracted, and the relative risk (RR) and standard mean difference (SMD) with 95% CI for the effective rate (ER), swallowing function assessment (SFA), individual activity (IA), eg., modified Barthel Index (MBI) and quality of life (QOL) were evaluated.

Results:

The pooled ER (RR 1.26, 95% CI 1.19 to 1.34, P<0.001, 14 studies) and SFA (SMD 1.06, 95% CI 0.79 to 1.32, P<0.001, five studies) suggested that combination therapy yielded a significantly higher ER and improved the SFA scores to a greater degree than swallowing training alone in patients with poststroke dysphagia. The pooled QOL score (SMD 1.06; 95% CI −0.04 to 2.17, P=0.06, two studies) did not differ between groups. The MBI data (SMD 1.47, 95% CI 1.07 to 1.87, P<0.001, one study) showed significant improvement in IA. Some evidence of publication bias was observed for the ER, although the trim-and-fill analysis and fail-safe number indicated no influence of publication bias on its pooled effect size. There was no evidence of publication bias of any other outcome measures.

Conclusion:

This study showed that acupuncture combined with swallowing training may improve the ER, swallowing function and activities of daily life of patients with poststroke dysphagia compared with conventional swallowing training alone.
Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis
Authors: Zhang Qing , Gong Jing , Dong Haoxu , Xu Shabei , Wang Wei , Huang Guangying
Published: March 2021

Objective:

To evaluate evidence for the efficacy of acupuncture for chronic fatigue syndrome (CFS).

Methods:

Randomized controlled trials (RCTs) comparing acupuncture with sham acupuncture, other interventions that may have a therapeutic effect, or no intervention, for the treatment of CFS, were searched for in the following databases up to March 2018: Pubmed; Embase; the Cochrane Library; Web of Science; Wanfang database; China National Knowledge Infrastructure (CNKI); Chinese Biomedicine (CBM) database; and VIP database. Risk of bias was determined using the Cochrane tool. Meta-analyses were performed using RevMan V.5.3 software. The GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) was adopted for levels of evidence.

Results:

Sixteen studies with 1346 subjects were included. Most studies had low methodological quality. Meta-analyses showed a favourable effect of acupuncture on overall response rate compared with sham acupuncture (four studies, 281 participants, RR=2.08, 95% CI 1.4 to 3.1, I2=64%, low certainty) and Chinese herbal medicine (three studies, 290 participants, RR=1.17, 95% CI 1.07 to 1.29, I2=0%, low certainty). Acupuncture also appeared to significantly reduce fatigue severity measured by Chalder’s Fatigue Scale and the Fatigue Severity Scale compared with other types of control.

Conclusion:

Our review indicated that acupuncture was more effective than sham acupuncture and other interventions (Chinese herbal medicine, mainly), but no firm conclusion could be reached owing to limited data, poor quality and potentially exaggerated effect size evaluation. Further large, rigorously designed and reported RCTs are required.
Gestational age on trajectories of social competence difficulties into adolescence
Authors: Hosozawa Mariko , Cable Noriko , Kelly Yvonne , Sacker Amanda
Published: March 2021

Objectives

To examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on these trajectories.

Design

Nationally representative population-based birth cohort (UK Millennium Cohort Study).

Participants

15 821 children born in 2000–2002.

Outcome measures

SCDs (derived from peer and prosocial subscales of Strengths and Difficulties Questionnaire) were assessed by parent report when the participants were aged 3, 5, 7, 11 and 14 years. Maternal psychological distress was self-rated using Rutter Malaise Inventory when the children were 9 months of age. Data were modelled using latent growth curve analysis.

Results

Developmental trajectories of SCDs were U-shaped in all groups. Very preterm (VP) children (<32 weeks, n=173) showed pronounced difficulties throughout, with the coefficient difference from the full term at age 14 being 0.94 (95% CI 0.23 to 1.66, equivalent to 0.32 SD of the population average SCDs). Moderate-to-late preterm children (32–36 weeks, n=1130) and early-term children (37–38 weeks, n=3232) showed greater difficulties compared with the full-term peers around age 7 years, which resolved by age 14 years (b=0.20, 95% CI –0.05 to 0.44; b=0.03, 95% CI –0.12 to 0.17, respectively). Maternal psychological distress during infancy mediated 20% of the aforementioned association at age 14 years for the VP.

Conclusion

There was a dose–response association between gestational age and the trajectories of SCDs. Monitoring and providing support on social development throughout childhood and adolescence and treating early maternal psychological distress may help children who were born earlier than ideal, particularly those born VP.
Ophthalmic anterior segment metastasis masquerading as uveitis
Authors: Nguyen Quang Le , Reynolds Samuel Benjamin , Piri Niloofar , Rivas Perez Hiram L
Published: March 2021

Ocular malignancies are rare, with many cancers of the eye being the result of metastases, the most common of which result from primary tumours of breast, lung and gastrointestinal tract. Diagnosis is often made at a late stage in the disease course, leading to poorer outcomes. Disease-directed therapy in the presence of ocular metastases varies based on the primary tumour and patient performance status but generally involves systemic treatment, either with chemotherapy or involved-field radiation. We herein present an interesting case of ocular malignancy with neuroendocrine small cell features of pulmonary origin in a patient with no prior oncological history. Meticulous ophthalmic examination led to the diagnosis of small cell lung carcinoma with anterior segment metastasis. The patient underwent six cycles of systemic chemotherapy with a favourable response, resulting in improvement in vision and regression of the ocular lesion.
Systemic lupus erythematosus multiorgan flare with quiescent serologic markers
Authors: Gile Jennifer Jane , Sara Jaskanwal Deep Singh , Mueller Michael R
Published: March 2021

Systemic lupus erythematosus (SLE) can affect almost every organ with differing degrees of severity. Typically, SLE activity is associated with hypocomplimentaemia and elevated double-stranded DNA (dsDNA) levels. We describe a case of a severe multiorgan lupus flare including lupus cerebritis, autoimmune haemolytic anaemia, lupus nephritis and lupus myopericarditis with normal complement and dsDNA levels. This highlights the importance of understanding the heterogeneous nature of SLE flares.
Granulomatosis with polyangiitis presenting as pancreatic disease
Authors: Tao Jessie Jia , Agarwal Arnav , Cuperfain Ari Benjamin , Pagnoux Christian
Published: March 2021

Granulomatosis with polyangiitis (GPA) is a rare necrotising small vessel vasculitis typically associated with oronasal, pulmonary and renal manifestations. Pancreatic disease is an exceedingly rare initial presentation and is associated with delayed diagnosis and rapid progression. We discuss a 66-year-old woman presenting with epigastric pain, elevated lipase and radiographic evidence of focal pancreatitis. She had no relevant medical history and no lithiasis seen on imaging. Pertinent findings include strawberry gingivitis, positive proteinase-antineutrophil cytoplasm antibody (98% specificity) and focal nodular parenchymal lung lesions on CT chest—all of which are consistent with a diagnosis of GPA. She was promptly started on high-dose steroids which resulted in significant clinical and biochemical improvement. Cyclophosphamide was added once biopsy confirmed the absence of malignancy. In order to optimise the clinical outcomes of GPA, physicians must keep a wide differential and high index of suspicion in the setting of unexplained pancreatitis with systemic features.
High flow oxygen and risk of mortality in patients with a suspected acute coronary syndrome: pragmatic, cluster randomised, crossover trial
Authors: Stewart Ralph A H , Jones Peter , Dicker Bridget , Jiang Yannan , Smith Tony , Swain Andrew , Kerr Andrew , Scott Tony , Smyth David , Ranchord Anil , Edmond John , Than Martin , Webster Mark , White Harvey D , Devlin Gerard
Published: March 2021

Objective

To determine the association between high flow supplementary oxygen and 30 day mortality in patients presenting with a suspected acute coronary syndrome (ACS).

Design

Pragmatic, cluster randomised, crossover trial.

Setting

Four geographical regions in New Zealand.

Participants

40 872 patients with suspected or confirmed ACS included in the All New Zealand Acute Coronary Syndrome Quality Improvement registry or ambulance ACS pathway during the study periods. 20 304 patients were managed using the high oxygen protocol and 20 568 were managed using the low oxygen protocol. Final diagnosis of ST elevation myocardial infarction (STEMI) and non-STEMI were determined from the registry and ICD-10 discharge codes.

Interventions

The four geographical regions were randomly allocated to each of two oxygen protocols in six month blocks over two years. The high oxygen protocol recommended oxygen at 6-8 L/min by face mask for ischaemic symptoms or electrocardiographic changes, irrespective of the transcapillary oxygen saturation (SpO
2
). The low oxygen protocol recommended oxygen only if SpO
2
was less than 90%, with a target SpO
2
of less than 95%.

Main outcome measure

30 day all cause mortality determined from linkage to administrative data.

Results

Personal and clinical characteristics of patients managed under both oxygen protocols were well matched. For patients with suspected ACS, 30 day mortality for the high and low oxygen groups was 613 (3.0%) and 642 (3.1%), respectively (odds ratio 0.97, 95% confidence interval 0.86 to 1.08). For 4159 (10%) patients with STEMI, 30 day mortality for the high and low oxygen groups was 8.8% (n=178) and 10.6% (n=225), respectively (0.81, 0.66 to 1.00) and for 10 218 (25%) patients with non-STEMI was 3.6% (n=187) and 3.5% (n=176), respectively (1.05, 0.85 to 1.29).

Conclusion

In a large patient cohort presenting with suspected ACS, high flow oxygen was not associated with an increase or decrease in 30 day mortality.

Trial registration

ANZ Clinical Trials ACTRN12616000461493.
Safety climate as a predictor of work ability problems in blue-collar workers: prospective cohort study
Authors: Brandt Mikkel , Sundstrup Emil , Andersen Lars L , Wilstrup Ninna Maria , Ajslev Jeppe Z N
Published: March 2021

Objectives

To evaluate whether safety climate items would be predictive of future physical and mental work ability among blue-collar workers.

Methods

Blue-collar workers (n=3822) from the Danish Work Environment and Health study replied to questions on safety climate, physical and mental work ability, and health in 2012 and 2014. Using multivariate logistic regression, we estimated the association of number of safety climate items (0–5) in 2012 with physical and mental work ability in 2014. Potential confounders included sex, age, socioeconomic class, occupational group, lifestyle (smoking habits and body mass index) and previous accidents.

Results

In the fully adjusted model, workers reporting two and three or more safety
climate problems (reference: 0) had higher risk for reduced physical work
ability at follow-up (OR 1.29 [95% CI 1.03 to 1.61]
and OR 1.52 [95% CI 1.27 to 1.84], respectively).
Similar outcomes were observed for mental work ability. Using number of safety
climate items as a continuous variable, a doseresponse
association existed both for physical and mental work ability (trend-test <0.0001).

Conclusion

A dose–response association between the number of safety climate items at baseline and lower physical and mental work ability was detected after 2 years. Safety climate items should be highly prioritised in blue-collar companies.
How many medications do doctors in primary care use? An observational study of the DU90% indicator in primary care in England
Authors: Chiedozie Chiamaka , Murphy Mark E , Fahey Tom , Moriarty Frank
Published: March 2021

Aim

To apply the drug utilisation 90% (DU90%) indicator (the number of unique drugs which makes up 90% of a doctor’s prescribing) to general practitioner (GP) practices prescribing in England to examine time trends, practice-level variation, and relationships with practice characteristics, prescribing costs and low-value prescribing.

Study design

Retrospective cohort study.

Setting

Primary care in England, using publicly available prescribing data available from the National Health Service (NHS) digital platform for 2013–2017.

Participants

All general practices in England (n=7620).

Primary and secondary outcome measures

The DU90% was calculated on an annual basis for each practice based on medication British National Formulary codes. Low-value prescribing was defined using NHS 2017 guidance (including lidocaine plasters, liothyronine, omega-3 supplements). Descriptive statistics were generated per year on time trends and practice-level variation in the DU90%. Multilevel linear regression was used to examine the practice characteristics (relating to staff, patients and deprivation of the practice area).

Results

Among 7620 practices, mean DU90% ranged from 130.0 to 131.0 across study years, and regarding variation between practices, there was a 1.4-fold difference between the lowest and highest 5% of practices. A range of medications were included in the DU90% of virtually all practices, including atorvastatin, levothyroxine, omeprazole, ramipril, amlodipine, simvastatin and aspirin. A higher volume of prescribing was associated with a lower DU90%, while having more patients, higher proportions of patients who are women or aged ≥45 years, higher number of GPs working in the practice and being in a more deprived area were associated with a higher DU90%. Practices in higher quintiles of DU90% had higher levels of low-priority prescribing and prescribing costs.

Conclusion

GP practices typically use 130 different medications in the bulk of their prescribing. Higher DU90% was associated with higher levels of low-priority prescribing and prescribing costs. Increasing use of personal formularies may enhance prescribing quality and reduce costs.
Systematic review of prediction models for pulmonary tuberculosis treatment outcomes in adults
Authors: Peetluk Lauren S. , Ridolfi Felipe M. , Rebeiro Peter F. , Liu Dandan , Rolla Valeria C , Sterling Timothy R.
Published: March 2021

Objective

To systematically review and critically evaluate prediction models developed to predict tuberculosis (TB) treatment outcomes among adults with pulmonary TB.

Design

Systematic review.

Data sources

PubMed, Embase, Web of Science and Google Scholar were searched for studies published from 1 January 1995 to 9 January 2020.

Study selection and data extraction

Studies that developed a model to predict pulmonary TB treatment outcomes were included. Study screening, data extraction and quality assessment were conducted independently by two reviewers. Study quality was evaluated using the Prediction model Risk Of Bias Assessment Tool. Data were synthesised with narrative review and in tables and figures.

Results

14 739 articles were identified, 536 underwent full-text review and 33 studies presenting 37 prediction models were included. Model outcomes included death (n=16, 43%), treatment failure (n=6, 16%), default (n=6, 16%) or a composite outcome (n=9, 25%). Most models (n=30, 81%) measured discrimination (median c-statistic=0.75; IQR: 0.68–0.84), and 17 (46%) reported calibration, often the Hosmer-Lemeshow test (n=13). Nineteen (51%) models were internally validated, and six (16%) were externally validated. Eighteen (54%) studies mentioned missing data, and of those, half (n=9) used complete case analysis. The most common predictors included age, sex, extrapulmonary TB, body mass index, chest X-ray results, previous TB and HIV. Risk of bias varied across studies, but all studies had high risk of bias in their analysis.

Conclusions

TB outcome prediction models are heterogeneous with disparate outcome definitions, predictors and methodology. We do not recommend applying any in clinical settings without external validation, and encourage future researchers adhere to guidelines for developing and reporting of prediction models.

Trial registration

The study was registered on the international prospective register of systematic reviews PROSPERO (CRD42020155782)
Unresectable malignant obstructive jaundice: a 2-year experience of EUS-guided biliary drainage
Authors: Staroń Robert , Rzucidło Mateusz , Macierzanka Adam , Krawczyk Marcin , Gutkowski Krzysztof , Krupa Lukasz
Published: March 2021

Objectives

Endoscopic biliary drainage is a first-line treatment in patients with unresectable malignant biliary obstruction. In most cases the drainage is conducted using endoscopic retrograde cholangiopancreatography (ERCP). Percutaneous transhepatic biliary drainage or endosonography-guided biliary drainage (EUS-BD) represents therapeutic options after unsuccessful ERCP. Here we report on 2 years experience in the management of patients diagnosed with malignant biliary obstruction using EUS-BD.

Methods

Retrospective data were collected on patients who underwent EUS-BD due to malignant biliary obstruction at our centre between April 2016 and April 2018. Only patients who had two unsuccessful attempts of ERCP prior to EUS-BD were included. We analysed the technical success (ie, creation of anastomosis and successful placement of a stent) and complication rate of EUS-BD, and monitored changes in serum bilirubin and liver function tests after 2 days, and at least 2 weeks, following the procedure.

Results

Screening of 1781 ERCP procedures performed in our department during the inclusion period led to the identification of 31 patients (18 women, age range 51–92 years, 58% with pancreatic cancer) who fulfilled the inclusion criteria. Hepaticogastrostomy and choledochoduodenostomy were performed in 12 and 19 patients, respectively. The technical success rate was 97% and the complication rate was 12.9%. EUS-BD resulted in a significant decrease in serum bilirubin (p<0.01).

Conclusions

EUS-BD represents a reasonable therapeutic option after unsuccessful ERCP in patients with malignant biliary obstruction. Possible complications have to be kept in mind and this procedure should be performed at centres experienced in ERCP and EUS.
Efficacy and safety of sufentanil sublingual tablet system in postoperative pain management: a systematic review and meta-analysis
Authors: Thangaraju Pugazhenthan , Varthya Shoban Babu , Venkatesan Sajitha , Tamilselvan Thangaraju , Singh Surjit
Published: March 2021

Background

Sufentanil sublingual tablet system (SSTS) is a recently approved formulation for postoperative pain management that has become popular due to its pharmacokinetic properties such as good bioavailability, rapid attainment of equilibrium and elimination without any metabolites, along with its pharmacodynamic properties such as rapid onset and effective pain reduction. It is also relatively well tolerated by patients.

Objective

This is a quantitative analysis of the efficacy and safety of SSTS in patients with moderate to severe postoperative pain.

Design

This is a systematic review and meta-analysis. Databases such as Cochrane Library, MEDLINE and EMBASE were searched for eligible articles.

Settings

Randomised controlled trials published after 2000 in English language and which assessed at least one of the outcome measures of interest with pain intensity difference between 12 hours and a maximum of 96 hours.

Participants

Adults with moderate to severe postoperative pain and taking SSTS for pain management.

Methods

Data were analysed using Review Manager (RevMan) V.5.3. Risk of bias (RoB) assessment was done using RoB-2 scale, and overall grading of evidence of each outcome was done using GRADEpro Guideline Development Tool.

Results

Analysis of SSTS versus control indicates a statistically significant reduction in summed pain intensity difference at 12 hours (mean difference (MD)=−12.33 (95% CI −15.5 to −9.17), p<0.00001), summed pain intensity difference at 48 hours (MD=−43.57 (95% CI −58.65 to −28.48), p<0.00001), time-weighted total pain relief over 12 hours (MD=−4.77 (95% CI −6.28 to −3.27), p<0.00001) and pain intensity difference (MD=–0.73 (95% CI −1.00 to −0.46), p<0.00001) with SSTS, alongside high quality of evidence. Success of treatment as assessed by Patient Global Assessment (OR=4.01 (95% CI 2.74 to 5.89), p<0.00001) and Healthcare Professional Global Assessment (OR=4.46 (95% CI 3.03 to 6.56), p<0.00001) scoring at 72 hours was observed in a significantly high number of individuals using SSTS, with high quality of evidence. There was no difference in adverse events except for dizziness (RR=1.90, 95% CI 1.02 to 3.52). There was a significantly higher number of total adverse events in orthopaedic surgery in the SSTS group than in the comparator.

Conclusion

SSTS is effective in postoperative pain management in patients with moderate to severe pain. It also has good tolerability and high patient satisfaction.

PROSPERO registration number

CRD42018115458.
Glioma patient-reported outcomes: patients and clinicians
Authors: Peeters Marthe , Ottenheijm Germaine , Bienfait Paul , Eekers Daniëlle , Gijtenbeek Anja , Hanse Monique , Koekkoek Johan , van Leeuwen Leonie , Tijssen Cees , Dirven Linda , Taphoorn Martin
Published: March 2021

Introduction

Routine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed.

Objective

This study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients.

Methods

Semistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included.

Results

Twenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper.

Conclusion

This study shows that routine assessment of PROs is desired by patients, proxies and HCP’s in neuro-oncological care in Dutch hospitals.
Considerations for treatment duration in responders to immune checkpoint inhibitors
Authors: Marron Thomas U , Ryan Aideen E , Reddy Sangeetha M , Kaczanowska Sabina , Younis Rania H , Thakkar Dipti , Zhang Jiajia , Bartkowiak Todd , Howard Rachel , Anderson Kristin G , Olson Daniel , Naqash Abdul Rafeh , Patel Ravi B , Sachdev Esha , Rodriguez-Ruiz Maria E , Sheffer Michal , Church Sarah , Fuhrman Christopher , Overacre-Delgoffe Abigail , Nguyen Rosa , Florou Vaia , Thaxton Jessica E , Aggen David H , Guerriero Jennifer L
Published: March 2021

Immune checkpoint inhibitors (ICIs) have improved overall survival for cancer patients, however, optimal duration of ICI therapy has yet to be defined. Given ICIs were first used to treat patients with metastatic melanoma, a condition that at the time was incurable, little attention was initially paid to how much therapy would be needed for a durable response. As the early immunotherapy trials have matured past 10 years, a significant per cent of patients have demonstrated durable responses; it is now time to determine whether patients have been overtreated, and if durable remissions can still be achieved with less therapy, limiting the physical and financial toxicity associated with years of treatment. Well-designed trials are needed to identify optimal duration of therapy, and to define biomarkers to predict who would benefit from shorter courses of immunotherapy. Here, we outline key questions related to health, financial and societal toxicities of over treating with ICI and present four unique clinical trials aimed at exposing criteria for early cessation of ICI. Taken together, there is a serious liability to overtreating patients with ICI and future work is warranted to determine when it is safe to stop ICI.
COPD discharge bundle and pulmonary rehabilitation referral and uptake following hospitalisation for acute exacerbation of COPD
Authors: Barker Ruth E , Kon Samantha SC , Clarke Stuart F , Wenneberg Jenni , Nolan Claire M , Patel Suhani , Walsh Jessica A , Polgar Oliver , Maddocks Matthew , Farquhar Morag , Hopkinson Nicholas S , Bell Derek , Wedzicha Jadwiga A , Man William D-C.
Published: March 2021

Pulmonary rehabilitation (PR) following hospitalisations for acute exacerbation of COPD (AECOPD) is associated with improved exercise capacity and quality of life, and reduced readmissions. However, referral for, and uptake of, post-hospitalisation PR are low. In this prospective cohort study of 291 consecutive hospitalisations for AECOPD, COPD discharge bundles delivered by PR practitioners compared with non-PR practitioners were associated with increased PR referral (60% vs 12%, p<0.001; adjusted OR: 14.46, 95% CI: 5.28 to 39.57) and uptake (40% vs 32%, p=0.001; adjusted OR: 8.60, 95% CI: 2.51 to 29.50). Closer integration between hospital and PR services may increase post-hospitalisation PR referral and uptake.
Exact Solutions of Linear Buckling for a Class of FGM Columns with Varying Cross-Section
Authors: Fabiani Marco , Mentrasti Lando
Published: March 2021

This paper deals with the linear buckling problem for inhomogeneous Euler–Bernoulli column having both mechanical and geometrical properties variable along its length. Four classes of longitudinally functionally graded material columns with variable cross-sections are considered. The solutions of the relevant differential equations are obtained in terms of both hypergeometric functions and elementary functions. The normalized buckling loads are computed for five typical boundary conditions and they are validated by a comparison with approximate numerical results available in literature. The proposed formulation may provide a further benchmark for the accuracy assessment of numerical and approximated solutions.
Defining relations and Gröbner–Shirshov bases of Poisson algebras as of conformal modules
Authors: Kolesnikov P. S. , Panasenko A. S.
Published: March 2021

We study the relation between Poisson algebras and representations of Lie conformal algebras. We establish a Gröbner–Shirshov basis theory framework for modules over associative conformal algebras and apply this technique to Poisson algebras considered as conformal modules over appropriate associative conformal envelopes of current Lie conformal algebras. As a result, we obtain a setting for the calculation of a Gröbner–Shirshov basis in a Poisson algebra.
On the lengths of group algebras of finite abelian groups in the semi-simple case
Authors: Guterman Alexander , Markova Olga , Khrystik Mikhail
Published: March 2021

In this paper we solve the problem of finding the length of group algebras of arbitrary finite abelian groups in the case when the characteristic of the ground field does not divide the order of the group. We show that these group algebras have maximal possible lengths for infinite fields and sufficiently large finite fields since they are one-generated. In case of small fields we prove that the length is bounded from above by a logarithmic function of the order of the group.
On the Extensions of LM-Fuzzy Topologies
Authors: Vivek S. , Mathew Sunil C.
Published: March 2021

This paper analyzes and modifies the concepts of degree of regularity and degree of normality introduced by Shi in 2011. Also the authors introduce extensions of [Formula: see text]-fuzzy topological spaces and explore the link between the associated [Formula: see text]-topologies of a given space and its extensions. Further, the effect of extensions on the degree of regularity and degree of normality of an [Formula: see text]-fts has been investigated.
Virtual Screening of Citrus Flavonoid Tangeretin: A Promising Pharmacological Tool for the Treatment and Prevention of Zika fever and COVID-19
Authors: Rocha Matheus Nunes da , Alves Daniela Ribeiro , Marinho Marcia Machado , Morais Selene Maia de , Marinho Emmanuel Silva
Published: March 2021

It is of great importance for the pharmaceutical industry to find therapeutic substances extracted from natural sources, which are abundant, obtained with low costs and presenting the antiviral potential for the treatment of Zika virus (ZIKV) and COVID-19. Tangeretin (TAN) is a citrus polymethoxyflavone from Citrus reticulata peel oil with known antiviral activities, whose physico-chemical properties are not reported. The present study aimed to investigate by a theoretical screening of electronic, structural properties and pharmacodynamic and pharmacokinetic parameters that characterize TAN as a therapeutic drug in the treatment and prevention of zika fever and COVID-19. The molecule reached its minimum energy-forming state of [Formula: see text]795.85747[Formula: see text]kJ/mol and the HOMO and LUMO boundary orbitals reactivity descriptors suggest that the compound is stable and does not tend to be reactive in intermolecular interactions. The ligand connects to the NS1 ZIKV receptor with strong H-bond interactions, also connects with the NS5 ZIKV receptor in a competitive effect with the SAM inhibitor and acts in a supplementary effect with the N3 inhibitor and the BRT drug in the Mpro SARS-CoV-2 receptor. The properties of ADMET shows that the compound suffers few amounts of drug alterations because it inhibits the metabolic enzymes CYP2C9 and CYP3A4 and penetrates the central nervous system, without accumulation of drug residues in the blood or in the lumen in the gastrointestinal tract, without risk of toxicity to the patient. With the results obtained, it is possible to identify TAN as a promising pharmacological tool for the treatment and prevention of Zika fever and COVID-19.
Tracking Prototethyan assembly felsic magmatic suites in southern Yunnan (SW China): evidence for an Early Ordovician–Early Silurian arc–back-arc system
Authors: Liu Guichun , Chen Guangyan , Santosh M. , Qian Xin , Sun Zaibo , Zi Jian-Wei , Zhao Tianyu , Feng Qinglai , Ma Shen
Published: March 2021

Early Paleozoic trondhjemites, gneissic granites and alkali granites in southern Yunnan preserve important records of the tectonic evolution of the Prototethyan Ocean and regional correlations. Zircon ages suggest that these granitoids were emplaced from 476 to 436 Ma. The trondhjemites are characterized by high Na
2
O and low K
2
O contents, with
ε
Nd
(
t
) values of −1.9 to −3.5 and
ε
Hf
(
t
) values of −2.8 to +3.9. The trondhjemites were derived from an amphibolite source with a juvenile mafic component. The gneissic granites belong to the metaluminous low-K calc-alkaline series with an
ε
Nd
(
t
) value of −6.2 and
ε
Hf
(
t
) values of −5.0 to −0.4. The alkali granites belong to the high-K calc-alkaline series and yield
ε
Nd
(
t
) values of −10.1 to −10.7 and
ε
Hf
(
t
) values of −7.9 to −2.3. The gneissic granites were derived from an ‘ancient' lower mafic crust, whereas the alkali granites were derived from a meta-sedimentary source. These granitoids were formed during the subduction of the Prototethyan Ocean beneath the Simao Block and can be compared with similar igneous rocks from the Truong Son and Tam Ky-Phuoc Son zones in southern Laos. Our study, along with Early Paleozoic igneous suites from southern Laos, central Vietnam and the Malay Peninsula, suggests an arc–back-arc system along the northern margin of Gondwana.

Supplementary material:
Tables of zircon U–Pb and in-situ Hf and geochemical data are available at
https://doi.org/10.6084/m9.figshare.c.5322386
Biobjective Optimization-Based Frequency Regulation of Power Grids with High-Participated Renewable Energy and Energy Storage Systems
Authors: He Tingyi , Li Shengnan , Wu Shuijun , Li Chuangzhi , Xu Biao
Published: March 2021

Large-scale renewable energy sources connected to the grid bring new problems and challenges to the automatic generation control (AGC) of the power system. In order to improve the dynamic response performance of AGC, a biobjective of complementary control (BOCC) with high-participation of energy storage resources (ESRs) is established, with the minimization of total power deviation and the minimization of regulation mileage payment. To address this problem, the strength Pareto evolutionary algorithm is employed to quickly acquire a high-quality Pareto front for BOCC. Based on the entropy weight method (EWM), grey target decision-making theory is designed to choose a compromise dispatch scheme that takes both of the operating economy and power quality into account. At last, an extended two-area load frequency control (LFC) model with seven AGC units is taken to verify the effectiveness and the performance of the proposed method.
Estimation of Daily Suspended Sediment Load Using a Novel Hybrid Support Vector Regression Model Incorporated with Observer‐Teacher‐Learner‐Based Optimization Method
Authors: Doroudi Siyamak , Sharafati Ahmad , Mohajeri Seyed Hossein
Published: March 2021

Predicting suspended sediment load (SSL) in water resource management requires efficient and reliable predicted models. This study considers the support vector regression (SVR) method to predict daily suspended sediment load. Since the SVR has unknown parameters, the observer‐teacher‐learner‐based Optimization (OTLBO) method is integrated with the SVR model to provide a novel hybrid predictive model. The SVR combined with the genetic algorithm (SVR‐GA) is used as an alternative model. To explore the performance and application of the proposed models, five input combinations of rainfall and discharge data of Cham Siah River catchment are provided. The predictive models are assessed using various numerical and visual indicators. The results indicate that the SVR‐OTLBO model offers a higher prediction performance than other models employed in the current study. Specifically, SVR‐OTLBO model offers highest Pearson correlation coefficient (R = 0.9768), Willmott’s Index (WI = 0.9812), ratio of performance to IQ (RPIQ = 0.9201), and modified index of agreement (md = 0.7411) and the lowest relative root mean square error (RRMSE = 0.5371) in comparison with SVR‐GA (R = 0.9704, WI = 0.9794, RPIQ = 0.8521, and md = 0.7323, 0.5617) and SVR (R = 0.9501, WI = 0.9734, RPIQ = 0.3229, md = 0.4338, and RRMSE = 1.0829) models, respectively.
Granulocyte-Macrophage Colony-Stimulating Factor-Activated Neutrophils Express B7-H4 That Correlates with Gastric Cancer Progression and Poor Patient Survival
Authors: Shan Zhi-guo , Yan Zong-bao , Peng Liu-sheng , Cheng Ping , Teng Yong-sheng , Mao Fang-yuan , Fan Kun , Zhuang Yuan , Zhao Yong-liang
Published: March 2021

Neutrophils are prominent components of gastric cancer (GC) tumors and exhibit distinct phenotypes in GC environment. However, the phenotype, regulation, and clinical relevance of neutrophils in human GC are presently unknown. Here, immunohistochemistry, real-time PCR, and flow cytometry analyses were performed to examine levels and phenotype of neutrophils in samples from 41 patients with GC, and also isolated, stimulated, and/or cultured neutrophils for in vitro regulation assays. Finally, we performed Kaplan-Meier plots for overall survival by using the log-rank test to evaluate the clinical relevance of neutrophils and their subsets. In our study, neutrophils in tumor tissues were significantly higher than those in nontumor tissues and were positively associated with tumor progression but negatively correlated with GC patient survival. Most intratumoral neutrophils showed an activated CD54+ phenotype and expressed high-level immunosuppressive molecule B7-H4. Tumor tissue culture supernatants from GC patients induced neutrophils to express CD54 and B7-H4 in both time-dependent and dose-dependent manners. Locally enriched CD54+ neutrophils and B7-H4+ neutrophils positively correlated with increased granulocyte-macrophage colony-stimulating factor (GM-CSF) detection ex vivo, and in vitro GM-CSF induced the expression of CD54 and B7-H4 on neutrophils in a time-dependent and dose-dependent manner. Moreover, GC tumor-derived GM-CSF activated neutrophils and induced neutrophil B7-H4 expression via Janus kinase (JAK)-signal transducer and activator of transcription 3 (STAT3) signaling pathway activation. Furthermore, higher intratumoral B7-H4+ neutrophil percentage/number was found in GC patients with advanced tumor node metastasis stage and reduced overall survival following surgery. Our results illuminate a novel regulating mechanism of B7-H4 expression on tumor-activated neutrophils in GC, suggesting that functional inhibition of these novel GM-CSF-B7-H4 pathways may be a suitable therapeutic strategy to treat the immune tolerance feature of GC.