bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in the Age of Diagnosis for Cardiovascular Disease and Its Risk Factors Among US Adults: Trends From 2008 to 2017, the Medical Expenditure Panel Survey
Authors: Okunrintemi Victor , Tibuakuu Martin , Virani Salim S. , Sperling Laurence S. , Volgman Annabelle Santos , Gulati Martha , Cho Leslie , Leucker Thorsten M. , Blumenthal Roger S. , Michos Erin D.
Published: November 2020

Background

Sex differences in the trends for control of cardiovascular disease (CVD) risk factors have been described, but temporal trends in the age at which CVD and its risk factors are diagnosed and sex‐specific differences in these trends are unknown.

Methods and Results

We used the Medical Expenditure Panel Survey 2008 to 2017, a nationally representative sample of the US population. Individuals ≥18 years, with a diagnosis of hypercholesterolemia, hypertension, coronary heart disease, or stroke, and who reported the age when these conditions were diagnosed, were included. We included 100 709 participants (50.2% women), representing 91.9 million US adults with above conditions. For coronary heart disease and hypercholesterolemia, mean age at diagnosis was 1.06 and 0.92 years older for women, compared with men, respectively (both
P
<0.001). For stroke, mean age at diagnosis for women was 1.20 years younger than men (
P
<0.001). The mean age at diagnosis of CVD risk factors became younger over time, with steeper declines among women (annual decrease, hypercholesterolemia [women, 0.31 years; men 0.24 years] and hypertension [women, 0.23 years; men, 0.20 years];
P
<0.001). Coronary heart disease was not statistically significant. For stroke, while age at diagnosis decreased by 0.19 years annually for women (
P
=0.03), it increased by 0.22 years for men (
P
=0.02).

Conclusions

The trend in decreasing age at diagnosis for CVD and its risk factors in the United States appears to be more pronounced among women. While earlier identification of CVD risk factors may provide opportunity to initiate preventive treatment, younger age at diagnosis of CVD highlights the need for the prevention of CVD earlier in life, and sex‐specific interventions may be needed.
Left Atrial Appendage Thrombus Detected During Hyperacute Stroke Imaging Is Associated With Atrial Fibrillation
Authors: Senadeera Sajith C. , Palmer David G. , Keenan Ross , Beharry James , Yuh Lim Jen , Hurrell Michael A. , Mouthaan Paul , Fink John N. , Wilson Duncan , Lim Anthony , Wu Teddy Y.
Published: November 2020

Background and Purpose:

Left atrial appendage (LAA) is the likely embolic source in atrial fibrillation (AF)–related cardioembolic strokes. We sought to determine the prevalence of LAA thrombus on hyperacute stroke imaging and its association with AF.

Methods:

We retrospectively examined the clinical and radiological features of patients assessed through the hyperacute stroke imaging pathway over a 12-month period at Christchurch Hospital. The LAA was included in the computed tomography angiogram scan-range as part of the multimodal imaging protocol. Two radiological readers blinded to clinical information independently assessed for the presence of LAA thrombus. The association between AF and LAA thrombus was determined by multivariable logistic regression analysis.

Results:

Of 303 patients included in the analysis, the overall prevalence of LAA thrombus was 6.6% and 14.9% in patients with known AF. Patients with LAA thrombus were older (85 versus 75 years,
P
<0.01), more commonly had known or newly diagnosed AF (75% versus 30%,
P
<0.01) and heart failure (30% versus 8%,
P
=0.01), and was associated with intracranial large vessel occlusion (65% versus 39%,
P
=0.02). In the multivariable model, AF (odds ratio, 3.71 [95% CI, 1.25–11.01]
P
=0.02) was independently associated with LAA thrombus after adjusting for age and congestive heart failure. Interrater reliability was moderate (kappa=0.56).

Conclusions:

LAA thrombus is a potential radiological marker of AF and can be assessed as a part of hyperacute stroke imaging.
Microglial Calcium Waves During the Hyperacute Phase of Ischemic Stroke
Authors: Liu Lei , Kearns Kathryn N. , Eli Ilyas , Sharifi Khadijeh A. , Soldozy Sauson , Carlson Elizabeth W. , Scott Kyle W. , Sluzewski M. Filip , Acton Scott T. , Stauderman Kenneth A. , Kalani M. Yashar S. , Park Min , Tvrdik Petr
Published: November 2020

Background and Purpose:

Ischemic injury triggers multiple pathological responses in the brain tissue, including spreading depolarizations across the cerebral cortex (cortical spreading depolarizations [CSD]). Microglia have been recently shown to play a significant role in the propagation of CSD. However, the intracellular responses of myeloid cells during ischemic stroke have not been investigated.

Methods:

We have studied intracellular calcium activity in cortical microglia in the stroke model of the middle cerebral artery occlusion, using the murine Polr2a-based and Cre-dependent GCaMP5 and tdTomato reporter (PC::G5-tdT). High-speed 2-photon microscopy through cranial windows was employed to record signals from genetically encoded indicators of calcium. Inflammatory stimuli and pharmacological inhibition were used to modulate microglial calcium responses in the somatosensory cortex.

Results:

In vivo imaging revealed periodical calcium activity in microglia during the hyperacute phase of ischemic stroke. This activity was more frequent during the first 6 hours after occlusion, but the amplitudes of calcium transients became larger at later time points. Consistent with CSD nature of these events, we reproducibly triggered comparable calcium transients with microinjections of potassium chloride (KCl) into adjacent cortical areas. Furthermore, lipopolysaccharide-induced peripheral inflammation, mimicking sterile inflammation during ischemic stroke, produced significantly greater microglial calcium transients during CSD. Finally, in vivo pharmacological analysis with CRAC (calcium release-activated channel) inhibitor CM-EX-137 demonstrated that CSD-associated microglial calcium transients after KCl microinjections are mediated at least in part by the CRAC mechanism.

Conclusions:

Our findings demonstrate that microglia participate in ischemic brain injury via previously undetected mechanisms, which may provide new avenues for therapeutic interventions.
Separable Influences of Reward on Visual Processing and Choice
Authors: Soltani Alireza , Rakhshan Mohsen , Schafer Robert J. , Burrows Brittany E. , Moore Tirin
Published: November 2020

Primate vision is characterized by constant, sequential processing and selection of visual targets to fixate. Although expected reward is known to influence both processing and selection of visual targets, similarities and differences between these effects remain unclear mainly because they have been measured in separate tasks. Using a novel paradigm, we simultaneously measured the effects of reward outcomes and expected reward on target selection and sensitivity to visual motion in monkeys. Monkeys freely chose between two visual targets and received a juice reward with varying probability for eye movements made to either of them. Targets were stationary apertures of drifting gratings, causing the end points of eye movements to these targets to be systematically biased in the direction of motion. We used this motion-induced bias as a measure of sensitivity to visual motion on each trial. We then performed different analyses to explore effects of objective and subjective reward values on choice and sensitivity to visual motion to find similarities and differences between reward effects on these two processes. Specifically, we used different reinforcement learning models to fit choice behavior and estimate subjective reward values based on the integration of reward outcomes over multiple trials. Moreover, to compare the effects of subjective reward value on choice and sensitivity to motion directly, we considered correlations between each of these variables and integrated reward outcomes on a wide range of timescales. We found that, in addition to choice, sensitivity to visual motion was also influenced by subjective reward value, although the motion was irrelevant for receiving reward. Unlike choice, however, sensitivity to visual motion was not affected by objective measures of reward value. Moreover, choice was determined by the difference in subjective reward values of the two options, whereas sensitivity to motion was influenced by the sum of values. Finally, models that best predicted visual processing and choice used sets of estimated reward values based on different types of reward integration and timescales. Together, our results demonstrate separable influences of reward on visual processing and choice, and point to the presence of multiple brain circuits for the integration of reward outcomes.
Attractiveness in the Eyes: A Possibility of Positive Loop between Transient Pupil Constriction and Facial Attraction
Authors: Liao Hsin-I , Kashino Makio , Shimojo Shinsuke
Published: November 2020

Contrary to the long-held belief of a close linkage between pupil dilation and attractiveness, we found an early and transient pupil constriction response when participants viewed an attractive face (and the effect of luminance/contrast was controlled). While human participants were making an attractiveness judgment on faces, their pupil constricted more for the more attractive (as-to-be-rated) faces. Further experiments showed that the effect of pupil constriction to attractiveness judgment extended to intrinsically esthetic visual objects such as natural scene images (as well as faces) but not to line-drawing geometric figures. When participants were asked to judge the roundness of faces, pupil constriction still correlated with their attractiveness but not the roundness rating score, indicating the automaticity of the pupil constriction to attractiveness. When pupillary responses were manipulated implicitly by relative background luminance changes (from the prestimulus screen), the facial attractiveness ratings were in accordance with the amount of pupil constriction, which could not be explained solely by simultaneous or sequential luminance contrast. The overall results suggest that pupil constriction not only reflects but, as a part of self-monitoring and attribution mechanisms, also possibly contributes to facial attractiveness implicitly.
New species of black corals (Cnidaria:Anthozoa: Antipatharia) from deep-sea seamounts and ridges in the North Pacific
Authors: OPRESKO DENNIS M. , WAGNER DANIEL
Published: November 2020

Three new species of antipatharian corals are described from deep-sea (677–2,821 m) seamounts and ridges in the North Pacific, including Antipathes sylospongia, Alternatipathes venusta, and Umbellapathes litocrada. Most of the material for these descriptions was collected on expeditions aboard NOAA Ship Okeanos Explorer that were undertaken as part of the Campaign to Address Pacific Monument Science, Technology, and Ocean Needs (CAPSTONE). One of the main goals of CAPSTONE was to characterize the deep-sea fauna in protected waters of the U.S. Pacific, as well as in the Prime Crust Zone, the area with the highest known concentration of commercially valuable deep-sea minerals in the Pacific. Species descriptions and distribution data are supplemented with in situ photo records, including those from deep-sea exploration programs that have operated in the North Pacific in addition to CAPSTONE, namely the Hawaii Undersea Research Laboratory (HURL), the Ocean Exploration Trust (OET), and the Monterey Bay Aquarium Research Institute (MBARI).
Tropical Pacific Decadal Variability and ENSO Precursor in CMIP5 Models
Authors: Zhao Yingying , Di Lorenzo Emanuele , Sun Daoxun , Stevenson Samantha
Published: November 2020

Observational analyses suggest that a significant fraction of the tropical Pacific decadal variability (TPDV) (~60%–70%) is energized by the combined action of extratropical precursors of El Niño–Southern Oscillation (ENSO) originating from the North and South Pacific. Specifically, the growth and decay of the basin-scale TPDV pattern (time scale = ~1.5–2 years) is linked to the following sequence: ENSO precursors (extratropics, growth phase) → ENSO (tropics, peak phase) → ENSO successors (extratropics, decay phase) resulting from ENSO teleconnections. This sequence of teleconnections is an important physical basis for Pacific climate predictability. Here we examine the TPDV and its connection to extratropical dynamics in 20 models from phase 5 of the Coupled Model Intercomparison Project (CMIP). We find that most models (~80%) can simulate the observed spatial pattern (R > 0.6) and frequency characteristics of the TPDV. In 12 models, more than 65% of the basinwide Pacific decadal variability (PDV) originates from TPDV, which is comparable with observations (~70%). However, despite reproducing the basic spatial and temporal statistics, models underestimate the influence of the North and South Pacific ENSO precursors to the TPDV, and most of the models’ TPDV originates in the tropics. Only 35%–40% of the models reproduce the observed extratropical ENSO precursor patterns (R > 0.5). Models with a better representation of the ENSO precursors show 1) better basin-scale signatures of TPDV and 2) stronger ENSO teleconnections from/to the tropics that are consistent with observations. These results suggest that better representation of ENSO precursor dynamics in CMIP may lead to improved Pacific decadal variability dynamics and predictability.
Representation of Climate in Reanalyses: An Intercomparison for Europe and North America
Authors: Keller Jan D. , Wahl Sabrina
Published: November 2020

AbstracT

Atmospheric reanalysis datasets are a major tool to assess climate and its variability for past decades in a broad spectrum of applications. Nowadays, global reanalysis systems are available in third- and fourth-generation versions. They benefit from continuous improvements of numerical models and data assimilation schemes thus utilizing a growing number of observing systems. In the past decade, global reanalyses have been complemented by several regional reanalyses with enhanced horizontal resolution and appropriate model physics. Due to the considerable technical overhead associated with the comparison of reanalyses, it is difficult for users to identify an optimal dataset for their needs. Therefore, this study strives to provide a comprehensive intercomparison of the representation of climate in various reanalyses. The study compares four global reanalyses and three regional reanalyses over Europe and North America with in situ observations. The focus lies on the representation of near-surface temperature and precipitation expressed through various climate indices. The comparison shows that performances of the different reanalyses vary considerably depending on the parameter(s) of interest, the region, and the type of aggregation. The main findings are that regional reanalyses provide added value especially with regard to precipitation. While ECMWF’s newest reanalysis ERA5 is in better agreement with observations compared to the other global reanalyses for most climate indices over Europe, it is still outperformed by its predecessor ERA-Interim over North America. To support users in identifying an appropriate reanalysis for their needs, the study is complemented by comprehensive supplemental material.
Lrp6 Dynamic Expression in Tooth Development and Mutations in Oligodontia
Authors: Yu M. , Fan Z. , Wong S.W. , Sun K. , Zhang L. , Liu H. , Feng H. , Liu Y. , Han D.
Published: November 2020

Genes associated with the WNT pathway play an important role in the etiology of tooth agenesis. Low-density lipoprotein receptor–related protein 6 encoding gene ( LRP6) is a recently defined gene that is associated with autosomal dominant inherited tooth agenesis. Here, we aimed to identify novel LRP6 mutations in patients with tooth agenesis and investigate the significance of Lrp6 during tooth development. Using whole-exome sequencing, we identified 4 novel LRP6 heterozygous mutations (c.2292G>A, c.195dup, c.1095dup, and c.1681C>T) in 4 of 77 oligodontia patients. Notably, a patient who carried a nonsense LRP6 mutation (c.2292G>A; p.W764*) presented a hypohidrotic ectodermal dysplasia phenotype. Preliminary functional studies, including bioinformatics analysis and TOP-/FOP-flash reporter assays, demonstrated that the activation of WNT/β-catenin signaling was compromised as a consequence of LRP6 mutations. RNAscope in situ hybridization revealed dynamic and special changes of Lrp6 expression during murine tooth development from E11.5 to E16.5. It was noteworthy that Lrp6 was specifically expressed in the epithelium at E11.5 to E13.5 but was expressed in both dental epithelium and dental papilla from E14.5 and persisted in both tissues at later stages. Our study broadens the mutation spectrum of human tooth agenesis and is the first to identify a LRP6 mutation in patients with hypohidrotic ectodermal dysplasia and reveal the dynamic expression pattern of Lrp6 during tooth development. Information from this study is conducive to understanding the functional significance of Lrp6 on the biological process of tooth development.
Emotional Responses of Neonatal Intensive Care Nurses to Neonatal Death
Authors: Köktürk Dalcalı Berna , Can Şeyda , Durgun Hanife
Published: November 2020

The study was planned as a descriptive qualitative study to determine the emotional responses of neonatal intensive care nurses to work in the neonatal unit and to neonatal deaths. The sample of the study consisted of 7 nurses who work at the neonatal intensive care unit since data saturation was achieved. The data were collected using the “Semi-Structured In-Depth Interview Guide for Nurses”. The data were analyzed using the content analysis method. Following codes were reached as a result of the study: ‘happiness-sadness’, ‘professional satisfaction-exhaustion’, ‘empathy’, ‘responsibility-guilt’, ‘hope-despair’ under the theme of being a nurse at neonatal unit’; ‘unforgettable first loss’, ‘professionalism in intervention-and then: sadness, ‘mature-premature difference’, ‘difficulty in giving hurtful news-inability to associate with death’ and ‘attachment-burnout’ under the theme of experiencing neonatal loss.It was seen that nurses’ emotions about working at neonatal intensive care unit were generally positive; however, these emotions changed to negative after neonate’s relapsing and death.
Comparison of pre- and post-hemodialysis PHQ-9 depression scores in patients with end-stage renal disease: A cross-sectional study
Authors: AlAwwa Izzat , Ibrahim Sarah , Obeid Ahmad , Alfraihat Nadeen , Al-Hindi Reham , Jallad Shatha , Al-Awwa Ahmad
Published: November 2020

Objectives

An overlap between the somatic symptoms of depression and those of uremia seen in end-stage renal disease (ESRD) patients may affect the diagnosis of depression. This study aims to evaluate the effect of hemodialysis on the diagnosis of depression among patients on maintenance hemodialysis as dialysis diminishes the uremic symptoms, and to compare depression scores before and after dialysis.

Methods

This was a cross-sectional analytic study conducted from November 2018 through April 2019, in three tertiary hospitals. Consenting participants aged 18 years or older, who had received hemodialysis for at least three months were included. The Patient Health Questionnaire (PHQ-9) tool was used to collect patients’ data and to identify symptoms of depression Pre- and post-hemodialysis. Depression scores were compared using the paired sample Wilcoxon rank test or the McNemar test, where appropriate.

Results

Overall, 163 participants were enrolled in the study. The average age of the participants was 56.5 years old, whereas 44.8% were females. The prevalence of depressive symptoms before hemodialysis was 48.5%, with prevalence of mild, moderate and moderately severe of 34.4%, 11.7% and 2.5%, respectively. On the other hand, the prevalence of depressive symptoms after hemodialysis was 46.6% with 36.8%, 9.2% and 0.6% of the participants reporting mild, moderate and moderately severe symptoms, respectively. We found no significant difference in depression scores before and after dialysis (p-values > 0.05).

Conclusion

Our study supports the fact that the prevalence of depression is high among patients with ESRD on maintenance hemodialysis. We didn’t find a significant difference in depression scores among hemodialysis patients before and after dialysis, with negligible effect of uremic symptoms on the diagnosis of depression. We suggest adopting routine screening of depression among this high-risk group of patients.
The Application of Machine Learning to a General Risk–Need Assessment Instrument in the Prediction of Criminal Recidivism
Authors: Ghasemi Mehdi , Anvari Daniel , Atapour Mahshid , Stephen wormith J. , Stockdale Keira C. , Spiteri Raymond J.
Published: November 2020

The Level of Service/Case Management Inventory (LS/CMI) is one of the most frequently used tools to assess criminogenic risk–need in justice-involved individuals. Meta-analytic research demonstrates strong predictive accuracy for various recidivism outcomes. In this exploratory study, we applied machine learning (ML) algorithms (decision trees, random forests, and support vector machines) to a data set with nearly 100,000 LS/CMI administrations to provincial corrections clientele in Ontario, Canada, and approximately 3 years follow-up. The overall accuracies and areas under the receiver operating characteristic curve (AUCs) were comparable, although ML outperformed LS/CMI in terms of predictive accuracy for the middle scores where it is hardest to predict the recidivism outcome. Moreover, ML improved the AUCs for individual scores to near 0.60, from 0.50 for the LS/CMI, indicating that ML also improves the ability to rank individuals according to their probability of recidivating. Potential considerations, applications, and future directions are discussed.
Successful secukinumab treatment of erythrodermic psoriasis and psoriatic arthritis concomitant with severe noninfectious uveitis: a case report
Authors: Lu Jiajing , Tang Suwei , Yu Ning , Yi Xuemei , Li Ying
Published: November 2020

Uveitis is considered a relatively rare but serious ocular complication of psoriasis. We report the first successful treatment of severe noninfectious uveitis with secukinumab in a 70-year-old woman with erythrodermic psoriasis and psoriatic arthritis. Anti-tumor necrosis factor (TNF) agents were administered for 5 years for the treatment of erythrodermic psoriasis and psoriatic arthritis. Although the symptoms improved, she later developed noninfectious uveitis, resulting in a sharp decline in vision. After switching to secukinumab, her vision slightly improved, her skin lesions subsided, and her joint symptoms were relieved. Given the rarity of psoriasis combined with uveitis, it is unclear whether uveitis is related to anti-TNF therapy. In addition, the selection of effective biological agents for the treatment of uveitis remains a challenge and requires extensive clinical experience.
On optimal stress for shaft–hub connections (polygon connections)
Authors: Pedersen Niels Leergaard
Published: November 2020

In machine elements many different methods for connecting shaft and hub are specified in different standards. A not so common shaft–hub connection is the polygon profile as specified in DIN 32711 (P3G) and DIN 32712 (P4C). This type of connection is an alternative to key or spline connections. The practical point of the connection is the easy assembly and disassembly, but as for all shaft–hub connections the drawback is the high stress leading to a limited strength of these connections. The polygon connection design is to some extent due to an old production method, i.e. it is not design/optimized for reducing the maximum stress. In the present paper it is shown how the connection strength can be improved significantly by the use of shape optimization. The focus here is both on the highest contact stress (compression) but also on the largest tensile stress. Overall reduction in the stress in the order of 20% to 40% is found relative to standard design.
Using Wi-Fi Signals from Mobile Devices to Determine Characteristics of Pedestrian Behavior in Public Spaces
Authors: Šimara Eva , Kilnarová Pavla , Palacký Jiří , Vašut Radka
Published: November 2020

This paper presents an investigation into automated data collection, applied to pedestrians in public spaces. Three case studies conducted in Brno, Czech Republic, a typical, medium-sized city in Central Europe, were used to determine the accuracy of the proposed method. Data were recorded in two ways: (i) automated data collection, using a data logger constructed on the principle of a minicomputer to measure the intensity of Wi-Fi signals from mobile devices; and (ii) in situ observation. Data from in situ observation provided a basis for the comparison and verification of corresponding values from the automated data collection. The research framework of the paper comprises the determination of exact values for optimum characterization of pedestrian behavior in a given locality, taking into consideration conventions from previously published works: (i) the number of pedestrians ( N); (ii) speed ( u); (iii) flow ( q); and (iv) density ( k). The results of this study confirm that as the density of the street network increases, the accuracy of the data collected by the digital method decreases significantly. These findings indicate that the method is more suitable for projects focused on identifying major trends or shifts in pedestrian preferences when navigating city centers than for projects that require exact counts in specific locations at a given time.
Pet Medications: A Tail of Caution
Authors: Nguyen Tammy T. , Kirkwood Craig F. , Reilly Denise , Lee Danyae , Coggin Christy
Published: November 2020

Purpose:

A case report of pet medications appearing along with the patient’s medications (pet owner) in the external medication history list of the electronic medical record (EMR).

Case Presentation:

A 67-year-old female presented to the emergency department for altered mental status. A medication history was performed by the pharmacist in an attempt to identify possible etiologies of the patient’s clinical status. An external prescription refill report from the EMR included 2 medications that could not be confirmed by the family as the patient’s: phenobarbital 50 mg twice daily and zonisamide 200 mg every 12 hours. The patient’s pharmacy identified that the prescriptions were pet medications registered under the patient’s name and date of birth for the state’s prescription monitoring program.

Conclusion:

A lack of standardization between pet identifiers in community pharmacy databases and state Board of Pharmacy regulations for prescription monitoring programs, has led to the association of pet medications with their human owners in the EMR. Patient medication histories should always be verified and validated utilizing patient/patient family interviews and prescription refill histories. Utilization of pharmacists to identify and scrutinize inconsistencies can reduce medication errors that could occur during medication history or reconciliation.
Clinical Response and Cost-Savings Associated With Generic Fluticasone Propionate/Salmeterol Multidose, Dry-Powder Inhaler in Asthma Patients Managed in an Ambulatory Care Practice Setting
Authors: McCarthy Patrick , Iliadis Tanya , Zaiken Kathy
Published: November 2020

Background:

Fluticasone propionate/salmeterol multidose, dry powder inhaler (MDPI) was the first and only authorized generic inhaled corticosteroid/long-acting beta agonist (ICS/LABA) combination inhaler at the time of this study. This offers the potential for significant prescription cost-savings for both patients and accountable care organizations. The objective of the study was to demonstrate patients’ clinical response to generic fluticasone propionate/salmeterol MDPI when switched from one of its brand name competitors.

Methods:

The study was approved by the Institutional Review Board at MCPHS University. This was a prospective chart review of a large, multi-center ambulatory care organization in the Greater Boston area. Patients 12 years of age or older who were switched from a brand-name ICS/LABA inhaler to the generic fluticasone/salmeterol MDPI were included in the study. The primary endpoint was worsened asthma control requiring a change in therapy, oral corticosteroid therapy, or hospitalization at or before 12 weeks after the inhaler was switched.

Results:

In total, 203 patients met inclusion criteria. Of those 203 patients, 35 had a change in therapy due to worsened asthma control (17.2% of patients, 95% CI 12.0% to 22.4%) within 12 weeks. Total projected yearly prescription cost-savings for patients who were switched and remained on the generic inhaler was $581,628.

Conclusion:

Eighty-three percent of patients maintained appropriate asthma control after switching from a brand ICS/LABA inhaler to the generic fluticasone/salmeterol MDPI for 12 weeks. Switching to the generic inhaler resulted in significant prescription cost-savings for the accountable care organization.
Mathematical modelling and model predictive controller design of a quad tiltrotor UAV
Authors: Liao Jingxian , Song Xiaodong
Published: November 2020

A novel convertible unmanned aerial vehicle (UAV) with four tiltable rotors and a tandem-wing system has been developed. Considering the aerodynamic effect caused by the rotor-induced velocity, a mathematical model that contains the traditional free airstream analysis and rotor-induced effect analysis is proposed, from which the precise equilibrium point of the control inputs and states can be derived. Moreover, a control allocation algorithm is designed to provide the mapping relationship between traditional input variables and specific input variables of the UAV, so that the complicated mathematical model can be linearized for the design of model predictive control (MPC) system. In order to handle the control input constraints of the UAV system, an MPC system is applied for the trajectory tracking during the cruising phase. The simulation results demonstrate that the proposed model predictive control system has stability, accuracy without a random disturbance and quick response capabilities with a random disturbance during cruising trajectory tracking, which are in high demand for the quick UAV flight system.
An octahedral stress-based fracture criterion for hyperelastic materials
Authors: Hamdi A , Boulenouar A , Benseddiq N
Published: November 2020

No uniﬁed stress-based criterion exists, in the literature, for predicting the rupture of hyperelastic materials subjected to mutiaxial loading paths. This paper aims to establish a generalized rupture criterion under plane stress loading for elastomers. First, the experimental set up, at breaking, including various loading modes, is briefly described and commented. It consists of uniaxial tests, biaxial tests and pure shear tests, performed on different rubbers. The used vulcanizate and thermoplastic rubber materials are a Natural Rubber (NR), a Styrene Butadiene Rubber (SBR), a Polyurethane (PU) and a Thermoplastic elastomer (TPE). Then, we have investigated a new theoretical approach, based upon the principal stresses, to establish a failure criterion under quasi-static loadings. Thus, we have proposed a new analytical model expressed as a function of octahedral stresses. Quite good agreement is highlighted when comparing the ultimate stresses, at break, between the experimental data and the prediction of the proposed criteria using our rubber-like materials.
Effect of heat generation and thermal radiation on heat transfer in porous enclosure having t-shape inner geometry
Authors: Srinivasa Rao Pentyala , Kumar Anil
Published: November 2020

The numerical investigation of steady two-dimensional free convection is conducted to analyze the thermal radiation and viscous dissipation effects on heat transfer characteristics in fluid saturated T-shape porous hollow enclosure. The nonlinear partial differential equations in terms of stream function, using Darcy’s law and Boussinesq approximation, are solved numerically using finite difference scheme based on Gauss-Seidel approach. The results of this analysis discussed for the wide range of pertinent parameters such as radiation parameter ([Formula: see text]), viscous dissipation parameter ([Formula: see text]) and Rayleigh number ([Formula: see text]) in terms of local and average heat flow rate, streamlines and isotherms. The obtained results show that the average heat flow rate is enhanced with radiation parameter and reduced with viscous dissipation parameter. The results are graphically depicted to show the implications of the pertinent parameters in heat and flow field inside the hollow porous enclosure.
Mesenchymal Stromal Cells Attenuate Infection-Induced Acute Respiratory Distress Syndrome in Animal Experiments: A Meta-Analysis
Authors: Fengyun Wang , LiXin Zhou , Xinhua Qiang , Bin Fang
Published: November 2020

Mesenchymal stromal cell (MSC) therapy is a potential therapy for treating acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), which was widely studied in the last decade. The purpose of our meta-analysis was to investigate the efficacy of MSCs for simulated infection-induced ALI/ARDS in animal trials. PubMed and EMBASE were searched to screen relevant preclinical trials with a prespecified search strategy. 57 studies met the inclusion criteria and were included in our study. Our meta-analysis showed that MSCs can reduce the lung injury score of ALI caused by lipopolysaccharide or bacteria (standardized mean difference (SMD) = −2.97, 95% CI [−3.64 to −2.30], P < 0.00001) and improve the animals’ survival (odds ratio = 3.64, 95% CI [2.55 to 5.19], P < 0.00001). Our study discovered that MSCs can reduce the wet weight to dry weight ratio of the lung (SMD = −2.58, 95% CI [−3.24 to −1.91], P < 0.00001). The proportion of the alveolar sac in the MSC group was higher than that in the control group (SMD = 1.68, 95% CI [1.22 to 2.13], P < 0.00001). Moreover, our study detected that MSCs can downregulate the levels of proinflammatory factors such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in the lung and it can upregulate the level of anti-inflammatory factor IL-10. MSCs were also found to reduce the level of neutrophils and total protein in bronchoalveolar lavage fluid, decrease myeloperoxidase (MPO) activity in the lung, and improve lung compliance. MSC therapy may be a promising treatment for ALI/ARDS since it may mitigate the severity of lung injury, modulate the immune balance, and ameliorate the permeability of lung vessels in ALI/ARDS, thus facilitating lung regeneration and repair.
Foreign Capital, Natural Resource Rents and Financial Development: A New Approach
Authors: Shahbaz Muhammad , Aboutorabi Mohammad Ali , Yazdi Farzaneh Ahmadian
Published: November 2020

This article explores the impact of financial development on the ‘natural resources rents–foreign capital accumulation nexus’ in selected natural resource–rich countries during 1970Q1–2016Q4. In doing so, we propose a new approach by applying the autoregressive distributed lag (ARDL) rolling regression technique for our empirical purpose. The results show that financial development has a positive and significant effect on the way natural resource rents affect foreign capital in the case of Australia, Chile, Ecuador, Egypt and Peru in both the short run and the long run. We achieve the same results in the case of Colombia and Iran too, but just in the long run. Also, short-term and long-term negative effects of financial development on the rents–foreign capital nexus are witnessed just in the case of Algeria. We provide some empirical evidence for further robustness of our findings. Finally, we suggest that there is a necessity for the development of the financial system in natural resource–rich countries to reach higher levels of foreign capital, which has a crucial role in their economic growth.
Cognition and Alertness in Medical Students: Effects of a Single Night of Partial Sleep Deprivation
Authors: Mishra Priyadarshini , Panigrahi Madhuri , Ankit D.
Published: November 2020

Background:

Partial sleep deprivation is common among young adults today. Though multiple studies have stressed on the benefits of having a good sleep, medical students often compromise their sleep due to academic targets and stress. This can lead to changes in attention and cognition. The effects of acute partial sleep deprivation of a single night have been studied less and studies in the past in Indian context have shown controversial results that reaction time is decreased following acute partial sleep deprivation.

Purpose:

The purpose of the study was to evaluate the effects of a single night of partial sleep deprivation on the cognitive status and alertness of medical students in the Indian context and to find out the change in auditory event-related potential (AERP) and psychomotor vigilance of medical students following a single night of partial sleep deprivation.

Methods:

The study was a before–after experimental trial conducted among 20 medical student volunteers of a tertiary care hospital of eastern India. Baseline psychomotor vigilance task measured by unprepared serial reaction time, and AERP measured by P300, were assessed at baseline (after normal sleep) and after four hours of sleep deprivation (intervention).

Results:

It was seen that median RT had increased from 320.4 ms to 337.6 ms after acute partial sleep deprivation ( P < .001). P300 and lapses ( P < .05) were also found to increase significantly ( P < .05), while there was significant decrease in correctness ( P < .01).

Conclusion:

The study concluded that cognition is affected, including alertness and latency, following partial sleep deprivation even for a single night and contradicted earlier results of Indian studies stating variable effect on psychomotor vigilance.
Structural Transformation, Profit and Cost: What Drive(s) Mission Drift in Indian Microfinance?
Authors: Pati A. P.
Published: November 2020

During the recent past, all over the globe, many privately managed microfinance institutions (MFIs) have transformed into professionally managed companies, which has brought the mission drift discussion to the forefront. Along this line, over the last decade, the Indian counterparts also have changed their positions and moved towards commercialisation of their business. Keeping transformation in the background, this article tries to capture the mission of drift magnitude and its dimensions and to identify the drivers of drift. With the help of empirical data, it is observed that there is a significant percentage of institutions falling under the drifted category. Many of those that are new and sustainable are found to have drifted from their mission. A noticeable change in their capital structure in India, with a strong tilt towards financial sustainability among the regulated and professionally managed category, is being observed. Among the capital structure variables, the influence of capital assets ratio (CAR) on mission drift is found significant. Though the profit motive is not established, the increasing pressure to remain financially viable because of a higher level of equity infusion forces MFIs to drift further from their mission.
Cytobrushing of the oral mucosa as a possible tool for early detection of testudinid herpesvirus in Horsfield’s tortoises with nonspecific clinical signs
Authors: Vetere Alessandro , Bertocchi Mara , Pelizzone Igor , La Cauza Giuseppe F. , Denti Laura , Bigliardi Enrico , Di Ianni Francesco
Published: November 2020

Forty-five Horsfield’s tortoises ( Testudo horsfieldii; syn. Agrionemys horfieldii, Russian tortoise) belonging to different owners had decreased appetite and respiratory issues. Twenty-nine tortoises had epiphora, dyspnea, and white necrotic diphtheroid oral plaques (group G1). Ten of the remaining 16 tortoises had serious dehydration, appetite disorder, and depression (G2). The last 6 tortoises had only decreased appetite and moderate conjunctival discharge (G3). During the physical examination of all 45 tortoises, a cytologic sample and an oral swab for herpesvirus and Mycoplasma agassizii PCR testing were taken. In 20 of 29 specimens from G1, in 8 of 16 from G2, and 0 of 6 from G3, the cytologic exam revealed intranuclear acidophilic inclusion bodies, multinucleate cellular syncytia, and further abnormalities caused by herpesviral infection. Moreover, all 45 tested subjects were found to be positive for testudinid herpesvirus 1; 2 were positive for M. agassizii. This prospective study suggests that Horsfield’s tortoises with such signs would benefit from this screening procedure, given that it was effective in a significant proportion of infected and symptomatic animals, and no negative effects were seen.
Implementing a Protocol to Address Risk for Burnout Among Mental Health Professionals
Authors: Via Kamala D. , Oliver Joann S. , Shannon Donna
Published: November 2020

BACKGROUND:

The magnitude for potential burnout is enormous. The Centers for Disease Control and Prevention, Center for Addiction and Mental Health, and Substance Abuse and Mental Health Services Administration reported diagnoses of psychiatric and substance use disorders are at an all-time high for physicians, psychiatrists, nurses, social workers, and psychologists.

OBJECTIVE:

Reduce the potential for burnout among outpatient mental health clinicians and staff.

METHOD:

Develop an agency wellness protocol utilizing evidence-based interventions to reduce the potential for clinician and staff burnout.

RESULTS:

Survey data indicated low to moderate levels of burnout and depersonalization. Staff and clinician recommendations provided during feedback sessions were incorporated with evidence-based interventions to establish a wellness protocol.

CONCLUSION:

Implementing evidence-based interventions in a wellness protocol may reduce the potential for clinician and staff burnout.
Using Evidence: A Nursing Assessment Protocol for Acute Geropsychiatric Patients
Authors: Corn Ashley Sechrist , Sevy-Majers Joan , Tyson R. Lee
Published: November 2020

Introduction:

The Centers for Disease Control and Prevention estimates that approximately 20% of the United States population lives with at least one mental health issue. The most common mental illnesses affecting older Americans include anxiety, cognitive, and mood disorders. These patients may exhibit behaviors indicating agitation or anxiety during necessary hospital stays that warrant de-escalation techniques and appropriate medications to help manage emergent symptoms.

Aims:

This quality improvement intervention was intended to demonstrate enhancement of the nursing assessment and reassessment of patients demonstrating symptoms of agitation and anxiety requiring intervention.

Methods:

Assessment of the established nursing practice demonstrated compromised patient safety and led to planning and implementation of a new practice standard that incorporated an evidence-based tool. Nurses utilized a protocol that employed the Pittsburgh Agitation Scale to augment documentation of the nursing assessment for patients exhibiting symptoms of marked anxiety and agitation.

Results:

Following a 3-month trial, chart audits were completed to assess results of the protocol’s implementation. Significant improvement was noted in the nursing assessment process as evidenced in required documentation of nursing assessment and reassessment including use of the protocol.

Conclusions:

Implementing standards to guide nursing care can support both patient safety and professional practice.
Concrete Evidence: Infrastructure Challenges and the COVID-19 Pandemic
Authors: Miller Robert A. , Klouda Nolan , Fisk Jonathan M.
Published: November 2020

The COVID pandemic has forced governments to reimagine their revenue sources and spending priorities as well as how they balance meeting increasing public health demands with other pressing challenges. As the challenges to local economies have grown, policymakers at all levels of government have debated how best to restore confidence in the economy while mitigating the pandemic’s economic fallout. One such example is the Federal Government’s CARES legislation, which covers expenses related to COVID mitigation and response for state and local governments. This short commentary examines the experiences of Anchorage, Alaska and Reno, Nevada and offers a ‘lessons learned’ on how best to stimulate growth while protecting citizens’ health.
The Utility of Novel Urinary Biomarkers in Mice for Drug Development Studies
Authors: Adedeji Adeyemi O. , Gu Yi-Zhong , Pourmohamad Tony , Kanerva Justin , Chen Yafei , Atabakhsh Elnaz , Tackett Michael R. , Chen Feifei , Bhatt Bhavana , Gury Thierry , Dorchies Olivier , Sonee Manisha , Morgan Michelle , Burkey Jennifer , Gautier Jean-Charles , McDuffie James E.
Published: November 2020

Novel urinary protein biomarkers have recently been identified and qualified in rats for the early detection of renal injury in drug development studies. However, there are few reports on the utility of these renal biomarkers in mice, another important and widely used preclinical animal species for drug development studies. The purpose of this study was to assess the value of these recently qualified biomarkers for the early detection of drug-induced kidney injury (DIKI) in different strains of mice using multiple assay panels. To this end, we evaluated biomarker response to kidney injury induced by several nephrotoxic agents including amphotericin B, compound X, and compound Y. Several of the biomarkers were shown to be sensitive to DIKI in mice. When measured, urinary albumin and neutrophil gelatinase-associated lipocalin were highly sensitive to renal tubular injury, regardless of the assay platforms, mouse strain, and nephrotoxic agents. Depending on the type of renal tubular injury, kidney injury molecule-1 was also highly sensitive, regardless of the assay platforms and mouse strain. Osteopontin and cystatin C were modestly to highly sensitive to renal tubular injury, but the assay type and/or the mouse strain should be considered before using these biomarkers. Calbindin D28 was highly sensitive to injury to the distal nephron in mice. To our knowledge, this is the first report that demonstrates the utility of novel urinary biomarkers evaluated across multiple assay platforms and nephrotoxicants in different mice strains with DIKI. These results will help drug developers make informed decisions when selecting urinary biomarkers for monitoring DIKI in mice for toxicology studies.