bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary passport: a service evaluation study of a standardised web-based procedure logbook to aid specialist respiratory training and appraisal
Authors: Cheng Andrew , Saba Tarek , Duncan Tracy , Grundy Seamus , Evison Matthew
Published: November 2020

Introduction

The pulmonary passport (PP) is a secure web-based procedural logbook for specialist respiratory trainees with enhanced functionality that includes automated analysis to provide key performance metrics and in-platform interactions with supervisors.

Methods

This service evaluation study used preimplementation and postimplementation online surveys in both trainees and supervisors along with analysis of recorded data within the PP to evaluate the impact of this service on data capture, training, appraisal and quality assurance.

Results

From August 2017 to August 2019, 69/73 (95%) specialist respiratory trainees eligible to use the PP across two UK health education deaneries registered with the system and logged 7352 procedures. 3105 thoracic ultrasound procedures identified 2145 pleural effusions and resulted in 1253 pleural procedures of which 96% were successful. 4% of ultrasounds required referral to a more expert sonographer. Iatrogenic bleeding and pneumothorax both occurred in ≤1% of all pleural procedures. 1909 basic diagnostic bronchoscopies were recorded including 1236 bronchial washes, 328 brushes and 221 endobronchial biopsies where definite tumour was identified (biopsy sensitivity 74%). Preimplementation and postimplementation survey data confirmed the PP had increased the consistency of logging procedures by trainees, the depth of data captured, the review of procedural performance metrics in appraisal and the frequency of formal supervisor feedback.

Discussion

In this regional project, the implementation of a web-based procedural logbook has been feasible with excellent uptake and has enhanced procedural recording, supervision and appraisal. Furthermore, it provides unprecedented quality assurance at an individual trainee, trust and deanery level and has a number of potential wider applications in the future.
Improving postoperative mobilisation rates in patients undergoing elective major hepatopancreatobiliary surgery
Authors: Tang Jun Han , Wang Bei , Chow Jie Ling Jaclyn , Joseph Priscilla M , Chan Jia Ying , Abdul Rahman Nursharazilla , Low Yi Hui , Tan Yen Pin , Shelat Vishalkumar G
Published: November 2020

Background

Early mobilisation reduces postoperative complications such as pneumonia, deep vein thrombosis and hospital length of stay. Many authors have reported poor compliance with early mobilisation within Enhanced Recovery After Surgery initiatives.

Objectives

The primary objective was to increase postoperative day (POD) 2 mobilisation rate from 23% to 75% in patients undergoing elective major hepatopancreatobiliary (HPB) surgery within 6 months.

Methods

We report a multidisciplinary team clinical practice improvement project (CPIP) to improve postoperative mobilisation of patients undergoing elective major HPB surgery. We identified the common barriers to mobilisation and analysed using the fishbone or cause-and-effect diagram and Pareto chart. A series of Plan–Do–Study–Act cycles followed this. We tracked the rate of early mobilisation and mean distance walked. In the post hoc analysis, we examined the potential cost savings based on reduced hospital length of stay.

Results

Mobilisation rate on POD 2 following elective major HPB surgery improved from 23% to 78.9%, and this sustained at 6 months after the CPIP. Wound pain was the most common reason for failure to ambulate on POD 2. Hospital length of stay reduced from a median of 8 days to 6 days with an estimated cost saving of S$2228 per hospital stay.

Conclusion

Multidisciplinary quality improvement intervention effort resulted in an improved POD 2 mobilisation rate for patients who underwent elective major HPB surgery. This observed outcome was sustained at 6 months after completion of the CPIP with potential cost savings.
Strategic organisational skills predict surgical training success
Authors: James Osian Penri , Robinson David Bryan Thomas , Hopkins Luke , Bowman Chris , Powell Arfon , Brown Chris , Hemington-Gorse Sarah , Egan Richard John , Lewis Wyn G
Published: November 2020

Introduction

Surgical career progression is determined by examination success and Annual Review of Competence Progression (ARCP) outcome, yet data on organisational skills are sparse. This study aimed to determine whether organisational skills related to Core Surgical Training (CST) outcome. Primary outcome measures include operative experience, publications, examination success (Membership of the Royal College of Surgeons or the Diploma in Otolaryngology—Head and Neck Surgery (MRCS/DO-HNS)) and ARCP outcome.

Methods

The study was conducted prospectively at three consecutive CST induction boot camps (2017–2019) providing clinical and simulation training for 125 trainees. Arrival time at course registration was the selected surrogate for organisational skills. Trainees were advised to arrive promptly at 8:45 for registration and that the course would start at 9:00. Trainee arrival times were grouped as follows: early (before 8:45), on time (8:45–8:59am) or late (after 9:00). Arrival times were compared with primary outcome measures.

Setting

Health Education and Improvement Wales' School of Surgery, UK.

Results

Median arrival time was 8:53 (range 7:55–10:03), with 29 trainees (23.2%) arriving early, 63 (50.4%) on-time and 33 (26.4%) late. Arrival time was associated with operative experience (early vs late; 206 vs 164 cases, p=0.012), publication (63.2% vs 18.5%, p=0.005), MRCS/DO-HNS success (44.8% vs 15.2%, p=0.029), ARCP outcome (86.2% vs 60.6% Outcome 1, p=0.053), but not National Training Number success (60.0% vs 53.3%, p=0.772).

Conclusions

Better-prepared trainees achieved 25% more operative experience, were four-fold more likely to publish and pass MRCS, which aligned with consistent desirable ARCP outcome. Timely arrival at training events represents a skills-composite of travel planning and is a useful marker of strategic organisational skills.
The relationship of iodine value with pork carcass weight and composition
Authors: Zhou Z.Y. , Wormsbecher L. , Roehrig C. , Smetanin M. , Bohrer B.M.
Published: November 2020

This study examined the relationship of iodine value (IV) with carcass weight, fat depth, muscle depth, and predicted lean yield from 37 488 pork carcasses. Five IV categories were formed, which were defined as low (<64.99), medium-low (65.00–69.99), medium (70.00–74.99), medium-high (75.00–79.99), and high (>80.00). Correlation analysis indicated IV was weakly correlated (r ≤ 0.26; P < 0.05) with all carcass traits; however, the categorical analysis revealed that greater IV was associated with heavier weight and leaner carcasses. Segregation systems of pork carcasses based on IV should consider the relationships of IV with other carcass parameters before implementation.
Reconciling civil liberties and public health in the response to COVID-19
Authors: Flood Colleen M. , MacDonnell Vanessa , Thomas Bryan , Wilson Kumanan
Published: November 2020

The COVID-19 pandemic has highlighted the challenges governments face in balancing civil liberties against the exigencies of public health amid the chaos of a public health emergency. Current and emerging pandemic response strategies may engage diverse rights grounded in civil liberties, including mobility rights, freedom of assembly, freedom of religion, and the right to liberty and security of the person. As traditionally conceived, the discourses of civil rights and public health rest on opposite assumptions about the burden of proof. In the discourse of civil and political rights of the sort guaranteed under the Canadian Charter of Rights and Freedoms, the onus rests on government to show that any limitation on rights is justified. By contrast, public health discourse centers on the precautionary principle, which holds that intrusive measures may be taken—lockdowns, for example—even in the absence of complete evidence of the benefits of the intervention or of the nature of the risk. In this article, we argue that the two principles are not so oppositional in practice. In testing for proportionality, courts recognize the need to defer to governments on complex policy matters, especially where the interests of vulnerable populations are at stake. For their part, public health experts have incorporated ideas of proportionality in their evolving understanding of the precautionary principle. Synthesizing these perspectives, we emphasize the importance of policy agility in the COVID-19 response, ensuring that measures taken are continually supported by the best evidence and continually recalibrated to avoid unnecessary interference with civil liberties.
Homogeneous Higgs and co-Higgs bundles on Hermitian symmetric spaces
Authors: Biswas Indranil , Rayan Steven
Published: November 2020

We define homogeneous principal Higgs and co-Higgs bundles over irreducible Hermitian symmetric spaces of compact type. We provide a classification for each type of object up to isomorphism, which in each case can be interpreted as defining a moduli space.
Robustness paradox of attack behavior induced by cascading failures: The larger the attack, the more vulnerable the network?
Authors: Wang Jianwei , Guo Yuxin , Kai Wei
Published: November 2020

The robustness of complex networks responding to attacks has long been the focus of network science researching. Nonetheless, the precious studies mostly focus on network performance when facing malicious attacks and random failures while rarely pay attention to the influences of scales of attacking. It is wondering if it is an actual fact that the network is more fragile when attacking scale is exacerbated. In this paper, we are committed to exploring the influences related to the very factor of attacking scale from the perspective of cascading failure problem of dynamic network theory. We construct the model with a regular ranking edge deletion method by simulating attacking scale with [Formula: see text] and [Formula: see text] is denoted as attacked edge number. To be specific, we rank the edges according to initial distributed loads and delete edges in the ranked list, and subsequently observe the changes of robustness in the networks, including BA scale-free network, WS small-world network and several real traffic networks. During the process, an unusual counterintuitive phenomenon captures our attention that the network damages caused by attacks do not always grow with the increase of attacked edges number. We specifically demonstrate and analyze this abnormal cascading propagation phenomenon, ascribing this paradox to the dynamics of the load and the connections of the network structure. Our work may offer a new angle on better controlling the spread of cascading failure and remind the importance of effectively protecting networks from underlying dangers.
Kinky breathers, multi-peak and multi-wave soliton solutions for the nonlinear propagation of Kundu–Eckhaus dynamical model
Authors: El-Rashidy K. , Seadawy Aly R.
Published: November 2020

The multi-wave solutions for nonlinear Kundu–Eckhaus (KE) equation are obtained using logarithmic transformation and symbolic computation using the function method. Three-wave method, double exponential and homoclinic breather approach are used to get these solutions. We study the conflict between our results and considerably-known results and state that the solutions reached here are new. By specifying the suitable values for the parameter, the drawings of the solutions obtained are shown in this paper.
Fast Locking Time Biquadratic Band-Pass Filter Utilizing Nonlinear Sliding-Mode Controller
Authors: Mitić Darko , Jovanović Goran , Stojčev Mile , Antić Dragan
Published: November 2020

This paper considers design procedure of fast locking time self-tuning [Formula: see text] biquadratic band-pass filter with nonlinear sliding mode control. A sliding mode controller is building block of the phase control loop (PCL) involved to push central frequency to reach input signal frequency very fast, approximately 100–200[Formula: see text]ns. The sliding mode controller is realized by using a tunable delay line, enabling optimal filter locking time for different input signal frequencies. The filter possesses low sensitivity to component discrepancy and is applied as a selective amplifier. The 0.13[Formula: see text][Formula: see text]m SiGe BiCMOS technology has been utilized for design and verification of the presented filter. This filter has central frequency up to 220[Formula: see text]MHz, quality factor [Formula: see text] and 25[Formula: see text]dB gain.
The stability analysis of brane-induced gravity with quintessence field on the brane with a Gaussian potential
Authors: Ravanpak A. , Fadakar G. F.
Published: November 2020

In this paper, we consider a normal branch of the DGP cosmological model with a quintessence scalar field on the brane as the dark energy component. Using the dynamical system approach, we study the stability properties of the model. We find that [Formula: see text], as one of our new dimensionless variables which is defined in terms of the quintessence potential, has a crucial role in the history of the universe. We divide our discussion into two parts: a constant [Formula: see text] and a varying [Formula: see text]. In the case of a constant [Formula: see text] we calculate all the critical points of the model even those at infinity and then assume all of them as instantaneous critical points in the varying [Formula: see text] situation which is the main part of this paper. We find that the effect of the extra dimension in such a model is independent of the value of [Formula: see text]. Then, we consider a Gaussian potential for which [Formula: see text] is not constant but varies from zero to infinity. We discuss the evolution of the dynamical variables of the model and conclude that their asymptotic behaviors follow the trajectories of the moving critical points. Also, we find two different possible fates for the universe. In one of them, it could experience an accelerated expansion, but then enters a decelerating phase and finally reaches a stable matter-dominated solution. In the other scenario, the universe could approach the matter-dominated critical point without experiencing any accelerated expansion. We argue that the first scenario is more compatible with observations.
EFFECTS OF WHOLE-BODY VIBRATION ON MUSCLE STRENGTH, BALANCE AND FUNCTIONAL MOBILITY IN PATIENTS WITH MULTIPLE SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alam Mohd Mukhtar , Khan Abid Ali , Farooq Mohd
Published: November 2020

Multiple sclerosis (MS) is a type of degenerative syndrome that causes impaired physical function, decreased walking, imbalance, spasticity, sensory impairment, muscle weakness, fatigue, and demyelination of the central nervous system. The purpose of this review was to critically examine available studies on the efficacy of whole-body vibration (WBV) in patients with MS during rehabilitation training to increase strength, balance, and functional mobility. An organized literature search was performed on databases from various sources, including PubMed, MEDLINE, CINAHL, and EMBASE, to identify relevant randomized clinical trials (RCTs). Eight studies were finally selected based on exclusion and inclusion criteria. Attempts were made to identify factors affecting the improvement in muscle strength, balance, and functional mobility in MS patients as a result of WBV. A meta-analysis was performed if two or more studies measured the same outcome of interest. The meta-analysis found that the WBV intervention showed significant improvement over control groups in Body Balance Score (BBS) (MD = [Formula: see text]2.86, 95%CI = [Formula: see text]5.29 [Formula: see text] 0.43; [Formula: see text], [Formula: see text], heterogeneity ([Formula: see text]%). In addition, walking endurance (6MWT) favored control groups over WBV intervention (MD [Formula: see text], 95%CI [Formula: see text][Formula: see text] 99.41; [Formula: see text] = 2.97, [Formula: see text]). Timed-Up-and-Go Test (TUG) and Expanded Disability Status Scale (EDSS) ([Formula: see text]) had no significant effect on WBV. Restoration of balance and functional mobility appeared to respond better to WBV with additional exercise protocols compared to WBV alone. Although there is evidence of an overall effect of WBV on strength and some measures of balance and mobility, its impact remains inconclusive. Therefore, more robust RCTs examining exposure to WBV on balance and functional mobility in patients with MS are warranted.
DESIGN STRATEGY OF THREE-DIMENSIONAL PRINTED CAGES TO REDUCE IMPACT-INDUCED DEBRIS ALONG THE LOAD-TRANSFERRING PATH
Authors: Lin Shang-Chih , Hsu Yu-Pao , Yu Ching-Hsiao , Chen Chun-Ming , Chen Po-Quang
Published: November 2020

Peri-implant debris certainly lead to osteolysis, necrosis, pseudotumor formation, tissue granulation, fibrous capsule contractions, and even implant failure. For the three-dimensional (3D) printed cage, impaction during cage insertion is one of the most potential sources of fracture debris. A finite-element study was carried out to reduce the impact-induced debris of the 3D-printed cage. This study focused on the design strategy of solid and cellular structures along the load-transferring path. Using the finite-element method, the cellular structure of the transforaminal lumbar interbody fusion (TLIF) cage was systematically modified in the following four variations: a noncellular cage (NC), a fully cellular (FC) cage, a solid cage with a cellular structure in the middle concave (MC) zone, and a strengthened cage (SC) in the MC zone. Three comparison indices were considered: the stresses at the cage-instrument interfaces, in the MC zone, and along the specific load-transferring path. The NC and FC were the least and most highly stressed variations at the cage-instrument interfaces and in the MC zone, respectively. Along the entirely load-transferring path, the FC was still the most highly stressed variation. It showed a higher risk of stress fracture for the FC cage. For the MC and SC, the MC zone was consistently more stressed than the directly impacted zone. The further strengthened design of the SC had a lower peak stress (approximately 29.2%) in the MC zone compared with the MC. Prior to 3D printing, the load-transferring path from the cage-instrument interfaces to the cage-tissue interfaces should be determined. The cage-instrument interfaces should be printed as a solid structure to avoid impact-induced fracture. The other stress-concentrated zones should be cautiously designed to optimize the coexistence strategy of the solid and cellular structures.
OSTEOIMMUNOLOGICAL IMPLICATIONS IN REGENERATIVE MEDICINE: CROSS-TALK BETWEEN MESENCHYMAL STEM CELLS AND IMMUNE CELLS
Authors: Davis Alden , Guldberg Robert E. , Samsonraj Rebekah M.
Published: November 2020

Bone fractures are one of the most common orthopedic cases, yet strategies to resolve excessive inflammation and non-unions still lack satisfactory treatment methods owing to the complex fracture microenvironment, as well as the interactions between the plethora of cell types involved. Fracture is a highly inflammatory process which involves the recruitment of various immune cells which in turn release various cytokines and growth factors to perpetuate inflammation and eventually healing resolution. Osteoimmunology is an interdisciplinary field investigating the extensive interactions between the immune system and skeletal system. Mesenchymal stem cells (MSCs) are resident in almost every adult tissue and are responsible for initiating reparative cascades in the event of injury. A key aspect of MSCs is their role as trophic mediators, secreting a milieu of signaling as well as immunomodulatory cytokines that play important roles in tissue regeneration. This paracrine signaling polarizes macrophages into their anti-inflammatory M2 phenotype, activates osteoblasts, inhibits osteoclasts, as well as suppresses conventional T cell proliferation and promotes regulatory T cell (Treg) proliferation. MSCs have been shown to resolve inflammation whilst also supporting osteogenesis; for these reasons, they are considered promising candidates for cellular therapies to treat musculoskeletal pathologies. Through pretreatment and genetic modifications, MSCs can be predisposed to release specific molecules that can modulate the microenvironment and regulate the activity of the immune system towards enhancing bone repair. By understanding the cross-talk between MSCs and the immune system in bone physiology, more targeted therapies directed towards specific cells and discrete signaling molecules become possible that may allow for expedited healing and improved standard of care in orthopedics. In this review, we discuss the interplay between immune cells and MSCs and the potential ways to harness this cross-talk to improve regenerative medicine strategies.
Effect of Aspirin and Statins on Pulmonary Function and Inflammation in Patients with AECOPD
Authors: Duan Guangqing , Lv Kaixuan , Lyu Juncheng , Tian Na , Zhang Lichun , Liu Qi , Wang Mengjie , Sun Shiyu , Yu Jielun , Guo Guifang , Tan Wei , Yang Nana
Published: November 2020

Background: The influence of coronary atherosclerosis and related treatment drugs on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) development requires in-depth study. The study investigated the effect of coronary artery calcification (CAC) and drugs for CAC on the development of AECOPD.

Methods: This retrospective clinical study recruited subjects with AECOPD from May 2017 to May 2019. All subjects performed spirometry and coronary computed tomography (CT), and were divided into three groups according to whether coronary CT revealed CAC and whether they had received oral aspirin and statins: AECOPD group, AECOPD[Formula: see text]CAC nonmedication and AECOPD[Formula: see text]CAC medication. The t-test and nonparametric test were used for analyzing the lung function, arterial blood gas, routine blood and lipid between groups.

Results: Compared with the AECOPD group, Lym% were significantly higher ([Formula: see text]) in both the AECOPD[Formula: see text]CAC nonmedication and the AECOPD[Formula: see text]CAC medication. The AECOPD[Formula: see text]CAC medication group also had significantly higher PaO2 ([Formula: see text]). WBC, Neu, and Neu% in the AECOPD[Formula: see text]CAC medication group were significantly lower ([Formula: see text]) compared to the AECOPD group.

Conclusions: Aspirin and statins for the treatment of cardiovascular diseases may be linked to improving lung function, normalizing blood gas levels, and reducing inflammation in patients with AECOPD and CAC. Further, randomized controlled trials are needed to explore this topic.
Miniaturized Traveling-Wave Thermoacoustic Refrigerator Driven by Loudspeaker: Numerical Design
Authors: Mahmood Oday S. , Karim Abdul Mun’em A. , Yahya Samir Gh. , Azzawi Itimad D. J.
Published: November 2020

Ordinary refrigeration systems such as vapor-compression refrigerators are the commonly used devices in industry, mostly for their high efficiencies. However, they make a significant contribution to the depletion of Ozone and global warming due to their operational refrigerants. Hence, thermoacoustic refrigeration can be a great alternative candidate which uses inert gases such as air, helium and nitrogen as the primary refrigerant. Thermoacoustic refrigerators convert the acoustic power (sound waves) into a thermal effect (cooling power). Thermoacoustics can be counted as a new technology that has a strong potential toward the development of the thermal applications. This study aims to design and fabricate miniaturized traveling wave thermoacoustic refrigerator which can be driven by an ordinary loudspeaker. The optimized numerical design of the refrigerator shows an overall efficiency (cooling power over input electricity) of nearly 66% at a temperature difference of 25[Formula: see text]K (between cold and ambient heat exchangers). The maximum estimated cooling power is 65[Formula: see text]W at coefficient of performance (COP) of 2.65.
Ion Channel Function and Electrical Excitability in the Zona Glomerulosa: A Network Perspective on Aldosterone Regulation
Authors: Barrett Paula Q. , Guagliardo Nick A. , Bayliss Douglas A.
Published: November 2020

Aldosterone excess is a pathogenic factor in many hypertensive disorders. The discovery of numerous somatic and germline mutations in ion channels in primary hyperaldosteronism underscores the importance of plasma membrane conductances in determining the activation state of zona glomerulosa (zG) cells. Electrophysiological recordings describe an electrically quiescent behavior for dispersed zG cells. Yet, emerging data indicate that in native rosette structures in situ, zG cells are electrically excitable, generating slow periodic voltage spikes and coordinated bursts of Ca2+oscillations. We revisit data to understand how a multitude of conductances may underlie voltage/Ca2+oscillations, recognizing that zG layer self-renewal and cell heterogeneity may complicate this task. We review recent data to understand rosette architecture and apply maxims derived from computational network modeling to understand rosette function. The challenge going forward is to uncover how the rosette orchestrates the behavior of a functional network of conditional oscillators to control zG layer performance and aldosterone secretion.
Discovery of Quality Markers in Hugan Qingzhi Formula by Integrating a Lipid‐Lowering Bioassay with UHPLC‐QQQ‐MS/MS
Authors: He Fan , Xiao Chun-Xin , Wang Can-Jian , Liang Jie , Cheng Qi-Qing , Zhang Li , Zhou Ben-Jie , Zhou Hua
Published: November 2020

Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease. The Hugan Qingzhi formula (HGQZ) has been proven effective in treating NAFLD through clinical and pharmacological mechanism studies. A screening study of the chemical components was carried out to better control the quality of this formula. Current research has combined biological activity assessment with chemical analysis to screen and identify the bioactive compounds in HGQZ for use as potential quality markers (Q‐markers) to control the quality of this herbal product. The HGQZ extracted by three different solvents was evaluated in a free fatty acid‐induced hepatic steatosis LO2 cell model. Simultaneously, the twelve major chemical constituents of these extracts were quantitatively measured by ultrahigh‐performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC‐QQQ‐MS/MS). Extraction with 50% ethanol showed the most potent lipid‐lowering effect in steatosis LO2 cells and the highest extraction rate of major chemical constituents. Correlation analysis was used to establish the relationship between the biological activities and chemical characteristics of these extracts. The results showed that the contents of typhaneoside, hyperoside, isoquercitrin, isorhamnetin‐3‐O‐neohesperidoside, notoginsenoside R1, and alisol B 23‐acetate were positively correlated to the lipid‐lowering effect. The subsequent bioassay confirmed that typhaneoside, isoquercitrin, and alisol B 23‐acetate played the role of reducing the lipid effect. In conclusion, 50% of ethanol extraction produced the most active extract of HGQZ. Typhaneoside, isoquercitrin, and alisol B 23‐acetate could be considered potential Q‐markers for the quality control of HGQZ.
Anti-Tyro3 IgG Associates with Disease Activity and Reduces Efferocytosis of Macrophages in New-Onset Systemic Lupus Erythematosus
Authors: Zhou Zhuochao , Xu Aining , Teng Jialin , Wang Fan , Tan Yun , Liu Honglei , Cheng Xiaobing , Su Yutong , Shi Hui , Hu Qiongyi , Chi Huihui , Li Jian , Hou Jiaqi , Sun Yue , Yang Chengde , Ye Junna
Published: November 2020

Background. Systemic lupus erythematosus (SLE) is a disease characterized by the production of a large number of autoantibodies. Defected phagocytosis of macrophage plays an important role in innate immunity in the pathogenesis of SLE. Tyro3 is a receptor responsible for the recognition of apoptotic cells during efferocytosis by macrophages. To investigate the role of Tyro3 receptor in macrophages’ efferocytosis of apoptotic cells in SLE, we aimed to reveal the clinical relevance and impact of Tyro3 autoantibody on SLE. Methods. The serum levels of IgG-type autoantibody against Tyro3 receptor were detected in new-onset, treatment-naïve SLE patients (

n
=
70

), rheumatoid arthritis (RA) (

n
=
24

), primary Sjögren’s Syndrome (pSS) (

n
=
21

), and healthy controls (HCs) (

n
=
70

) using enzyme-linked immunosorbent assay (ELISA). The effects of purified Tyro3 autoantibody from SLE patients on the efferocytosis of human monocyte-derived macrophages were measured by flow cytometry and immunofluorescence. Results. The serum levels of IgG-type autoantibody against Tyro3 receptor were significantly elevated in patients with SLE compared to RA, pSS, and HCs (all

p
<
0.0001

). The levels of anti-Tyro3 IgG were positively associated with the SLE disease activity index (SLEDAI) score (

r
=
0.254

,

p
=
0.034

), erythrocyte sedimentation rate (ESR) (

r
=
0.430

,

p
<
0.001

), C-reactive protein (CRP) (

r
=
0.246

,

p
=
0.049

), and immunoglobulin G (IgG) (

r
=
0.408

,

p
=
0.001

) and negatively associated with haemoglobin (Hb) (

r
=
−
0.294

,

p
=
0.014

). ROC curves illustrated that the anti-Tyro3 antibody could differentiate patients with SLE from HCs. Furthermore, flow cytometry and immunofluorescence demonstrated that purified anti-Tyro3 IgG inhibited the efferocytosis of macrophages (

p
=
0.004

and 0.044, respectively) compared with unconjugated human IgG. Conclusions. These observations indicated that autoantibody against Tyro3 was associated with disease activity and could impair efferocytosis of macrophages. It might be a potential novel disease biomarker and might be involved in the pathogenesis of SLE.
Using the Robson Classification to Explain the Fluctuations in Cesarean Section
Authors: Cammu H. , Martens E. , Van Maele G.
Published: November 2020

Purpose. As the rate of cesarean sections (CS) continues to rise in Flanders (northern part of Belgium), it is important to understand the reasons behind this evolution and to find ways to achieve appropriate CS rates. For this analysis, we categorized CS changes between 1992 and 2016, applying the Robson 10-Group Classification System (TGCS). We also applied the TGCS to analyze the information of the only clinics where between 2008 and 2016, the absolute CS rate had fallen by more than two percent. Methods. This paper is based on a population-based cross-sectional study. Robson’s TGCS was used to analyze CS rates for the years 1992, 2000, 2008, and 2016, using the Flemish population-based birth register. Results. Between 1992 and 2016, the overall CS rate increased from 11.8% in 1992 to 20.9% in 2016. The major contributors to that increase were (a) single, cephalic nulliparous women, at term in spontaneous labor (Robson group 1); (b) single, cephalic nulliparous women, at term in induced labor or CS before labor (group 2); and (c) multiparous women with single cephalic at term pregnancy with history of CS (group 5). In the subgroup of the seven clinics where the collective CS rate had decreased from 23.2% in 2008 to 19.3% in 2016, the main contributors to this decrease were Robson groups 1 and 2. Conclusions. The CS increase in Flanders between 1992 and 2016 is mainly the result of the absolute CS increase in the childbirth of nulliparous women with a single cephalic baby at term in spontaneous or induced labor and in women with a single cephalic presentation at term and a previous CS. Further research in these aforementioned groups is needed to identify the real reasons for the CS increase.
The Effect of Lavender (Lavandula stoechas L.) on Reducing Labor Pain: A Systematic Review and Meta‐Analysis
Authors: Kazeminia Mohsen , Abdi Alireza , Vaisi-Raygani Aliakbar , Jalali Rostam , Shohaimi Shamarina , Daneshkhah Alireza , Salari Nader , Mohammadi Masoud
Published: November 2020

Background. Labor pain is one of the most severe pains, which most of women experience. By using novel supportive methods, the labor pain can be reduced, which makes this event pleasant and delightful. Several original studies have been conducted in regard to the effect of lavender on reducing labor pain, whose results are controversial. One of the applications of meta‐analysis studies is to respond to these hypotheses and remove controversies; therefore, this study aimed to determine the effect of lavender on labor pain in Iran by using meta‐analysis. Methods. In this study, to find published articles electronically from 2006 to 2019, the published articles in national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane Library, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) were used. Heterogenic index between studies was determined by Cochrane test (Q)c and I2. Due to heterogeneity, the random effects model was used to estimate standardize difference of the mean score of lavender test in order to assess the labor pain between intervention and control group. Results. In this meta‐analysis and systematic review, finally 13 eligible articles met the inclusion criteria of the study. The sample size from original studies enrolled in the meta‐analysis entered in the intervention group was 794 individuals and in the control group was 795 individuals. Mean score for pain in the control group was 7.2 ± 0.42 and in the intervention group was 5.4 ± 0.58 and this difference was statistically significant (p ≤ 0.001). Conclusion. The results of this study showed that lavender can reduce labor pain, which can be considered by health policy makers and gynecologists.
Development of Cooperative Controller for Dual-Motor Independent Drive Electric Tractor
Authors: Liu Mengnan , Wei Chuiquan , Xu Liyou
Published: November 2020

This paper proposes a control strategy of dual-motor independent drive electric tractor with cooperative control power take-off (PTO) and driving systems by investigating its structural characteristics to meet the field operation requirements. In the following operation mode, the vehicle speed is taken as the input signal, and the PTO motor speed is followed by the vehicle speed at a proportional ratio. Four different principles of collaborative control strategy-based stability control, namely, general closed-loop, conventional PID, adaptive fuzzy PID, and fuzzy neural network adaptive PID controls, are proposed to meet the requirements during speed change. Hardware design is divided into modules in accordance with circuit function. Software design is divided into application layer and underlying software, where the application software realizes the control strategy of the entire machine. The underlying software is based on the hardware driver of MC9S12XEP100 that connects the application layer software and hardware. A hardware-in-the-loop test platform based on dSPACE/DS1007 is built to test the function of the collaborative controller. Results show that the stabilization time of fuzzy neural network adaptive PID control is 0.024 s. Compared with the three other control modes, the settling time decreases by 0.256, 0.034, and 0.028, respectively, and the overshoot decreases to 1.6%. Root locus analysis results show that the stability of the system is the best. Under the entire machine cooperative operation mode hardware in the loop test, the PTO motor maintains the fixed target speed under the fixed speed output mode, and the PTO speed in the following mode has a good follow-up to the vehicle speed. The controller realizes the control of the power output shaft to cut between the following and standard speeds. It also meets the requirement of cooperative control in the operation of dual-motor independent drive electric tractor.
A Robust Beat-to-Beat Artifact Detection Algorithm for Pulse Wave
Authors: Hu Qihan , Deng Xintao , Liu Xin , Wang Aiguo , Yang Cuiwei
Published: November 2020

With the rise of the concept of smart cities and healthcare, artificial intelligence helps people pay increasing attention to the health of themselves. People can wear a variety of wearable devices to monitor their physiological conditions. The pulse wave is a kind of physiological signal which is widely applied in the physiological monitoring system. However, the pulse wave is susceptible to artifacts, which prevents its popularization. In this work, we propose a novel beat-to-beat artifact detection algorithm, which performs pulse wave segmentation based on wavelet transform and then detects artifacts beat by beat based on the decision list. We verified our method on data acquired from different databases and compared with experts’ annotations. The segmentation algorithm achieved an accuracy of 96.13%. When it is applied to detect main peaks, the performance achieved an accuracy of 99.11%. After the previous segmentation algorithm, the artifact detection algorithm can detect beat-to-beat pulse waves and artifacts with an accuracy of 98.11%. The result indicated that the proposed method is robust for pulse waves of different patterns and could effectively detect the artifact without the complex algorithm. In summary, our proposed algorithm is capable of annotating pulse waves of various patterns and determining pulse wave quality. Since our method is developed and evaluated on the transmission-mode PPG data, it is more suitable for the devices and applications inside the hospitals instead of reflectance-mode PPG.
Meta-Analysis of 11 Heterogeneous Studies regarding Dipeptidyl Peptidase 4 Inhibitor Add-On Therapy for Type 2 Diabetes Mellitus Patients Treated with Insulin
Authors: Shibuki Katsuya , Shimada Shuji , Aoyama Takao
Published: November 2020

Background. Several clinical trials have addressed the therapeutic strategy of adding dipeptidyl peptidase 4 (DPP-4) inhibitors to the treatment of type 2 diabetes mellitus (DM) inadequately controlled by insulin therapy. However, there is a high degree of heterogeneity in these studies, and the cause of which has not been identified. Methods. We conducted a meta-analysis of randomized controlled trials, which compared the efficacy and safety of adding DPP-4 inhibitors or placebo to insulin therapy; the level of hemoglobin A1c (HbA1c) in the patients was >7.0%, and the duration of treatment was ≥8 weeks. We focused on the mean changes in HbA1c from the baseline (ΔHbA1c) and the incidence of hypoglycemia. We assumed that five baseline parameters (HbA1c, fasting blood glucose, body mass index (BMI), duration of type 2 DM, and duration of treatment) could affect ΔHbA1c. Regarding the incidence of hypoglycemia, we suspected that the heterogeneity was caused by differences in the definition of hypoglycemia among the studies. Results. Data obtained from 11 studies (

n
=
4654

patients) were included in the analysis. The mean ΔHbA1c between the DPP-4 inhibitor and placebo groups was -0.61% (95% confidence interval (CI): -0.74 to -0.48,

I

2

=
73.4
%

). There was substantial heterogeneity among the 11 studies, but 74.1% of this variability was explained by the difference in BMI. The odds ratio for the incidence of hypoglycemia was 1.02 (95% CI: 0.74 to 1.42,

I

2

=
63.8
%

), with substantial heterogeneity due to differences in the definition of hypoglycemia among the studies. There was no apparent effect of publication bias. Conclusions. The addition of DPP-4 inhibitors to insulin therapy for adult patients with type 2 DM can significantly reduce HbA1c levels without increasing the occurrence of hypoglycemia. BMI and hypoglycemia definition could explain the heterogeneity in the clinical trials. This trial is registered with PROSPERO #CRD42016035994.
New Method for Calculating the Settlement of Single Pile and Pile Group in Soft Soil Area
Authors: Xu Jingjing , Xu Xu , Yao Wenjuan
Published: November 2020

This paper fits the τ‐z curve of a single pile by mathematical methods. Based on the one‐dimensional similarity of the τ‐z curves, the τ‐z curves of single pile under different loads are derived. It studies the distribution of the axial force of a single pile by taking the self‐weight of the pile and the pile‐end resistance ratio into account and establishes the calculated equation of settlement for single pile. The mutual reinforcing effect between the piles is fully considered, and the settlement of each foundation pile in the pile group is deduced in use of shear displacement method. The example analysis shows that the axial force distribution of single pile considering the self‐weight and the pile‐end resistance ratio is in good agreement with the experimental data. The settlement error of a single pile calculated by the traditional method is 18.52% compared with measured value. When the self‐weight and end resistance ratio are not considered, the error reaches 2.26%. However, the error could reduce to 1.64% when they are taken into consideration. It has a good applicability to calculate the settlement of pile group through the τ‐z curves of single pile. Also, it can better forecast the settlement behavior of the pile group under similar conditions.
Systematic Investigation of mRNA N6-Methyladenosine Machinery in Primary Prostate Cancer
Authors: Jiang Mei , Lu Yali , Duan Dongxia , Wang Hongxiang , Man Gaoya , Kang Ching , Abulimiti Kesaier , Li Yao
Published: November 2020

Background. Appreciable findings have pointed out pivotal roles of N6-methyladenosine (m6A) machinery in cancer onset and progression. However, limited efforts have been directed towards relevant research in the prostate cancer area. Methods. A PubMed search was conducted to acquire components of the mRNA m6A machinery. Multiomics integration was performed to systematically investigate the mRNA m6A machinery in primary prostate cancer. Furthermore, RNA interference assays of two prognostic m6A readers EIF3D and HNRNPA2B1 were conducted to explore m6A dependence of their functions in prostate cancer cell proliferation and migration. Results. A total of 41 mRNA m6A regulators have been identified to date. A small degree of copy number aberrations and an extremely low frequency of somatic mutations were observed in the regulators across prostate tumors. Enrichment of CpG sites and extensive changes of DNA methylation in the m6A machinery were also found. Impact of copy number variation on m6A regulator expression was stronger than that of DNA methylation disturbance. Furthermore, our study identified a set of m6A regulators related to clinical features and/or survival which were largely m6A-binding proteins. The translation initiation factor subunit EIF3D and the splicing factor HNRNPA2B1 can be independent prognostic factors which may contribute to retardation and promotion of cancer progression, respectively, through affecting cancer-related processes such as cell cycle. Moreover, in vitro assays demonstrated that m6A impacted the EIF3D and HNRNPA2B1 roles in proliferation and migration of prostate cancer cells. Conclusions. Our report systematically described molecular features of the mRNA m6A machinery and their potential roles in primary prostate cancer. Knowledge gained from this work may pave the way for further studies on the m6A system in prostate cancer.
Torsional Vibration Attenuation Characteristics and Stiffness Identification of Flexible Coupling in Vehicle Power Train
Authors: Fu Shengping , Luo Ning , Huang Hanlin , Zhou Yuhang , Ming Wei
Published: November 2020

Flexible coupling is one of the crucial components for vibration attenuation used in vehicle power train. Vibration attenuation characteristics and stiffness identification of flexible coupling are profoundly studied aiming at one vehicle power train. Firstly, the dynamics model of each crucial transmission component in power train is constructed. And the torsional vibration model of power train is established according to the concentrated mass method. The effects of coupling stiffness on vibration responses of power train are thoroughly analyzed based on system concentrated mass dynamics model. Secondly, the sensitivities of natural frequency and main forced vibration response parameters are calculated. The coupling stiffness is proved to be a sensitive parameter. Finally, taking the Geislinger coupling as an example, the damping and stiffness characteristics are acquired according to the parameter identification method based on the quantity of test data. The results provide the theory basis for the dynamics optimization of power train.
sEMG-Based Neural Network Prediction Model Selection of Gesture Fatigue and Dataset Optimization
Authors: Ma Fujun , Song Fanghao , Liu Yan , Niu Jiahui
Published: November 2020

The fatigue energy consumption of independent gestures can be obtained by calculating the power spectrum of surface electromyography (sEMG) signals. The existing research studies focus on the fatigue of independent gestures, while the research studies on integrated gestures are few. However, the actual gesture operation mode is usually integrated by multiple independent gestures, so the fatigue degree of integrated gestures can be predicted by training neural network of independent gestures. Three natural gestures including browsing information, playing games, and typing are divided into nine independent gestures in this paper, and the predicted model is established and trained by calculating the energy consumption of independent gestures. The artificial neural networks (ANNs) including backpropagation (BP) neural network, recurrent neural network (RNN), and long short-term memory (LSTM) are used to predict the fatigue of gesture. The support vector machine (SVM) is used to assist verification. Mean square error (MSE), root mean square error (RMSE), and mean absolute error (MAE) are utilized to evaluate the optimal prediction model. Furthermore, the different datasets of the processed sEMG signal and its decomposed wavelet coefficients are trained, respectively, and the changes of error functions of them are compared. The experimental results show that LSTM model is more suitable for gesture fatigue prediction. The processed sEMG signals are appropriate for using as the training set the fatigue degree of one-handed gesture. It is better to use wavelet decomposition coefficients as datasets to predict the high-dimensional sEMG signals of two-handed gestures. The experimental results can be applied to predict the fatigue degree of complex human-machine interactive gestures, help to avoid unreasonable gestures, and improve the user’s interactive experience.
Wound Botulism Caused by Botulinum Neurotoxin Type A in a Chronic Parenteral Drug Abuser
Authors: Awsare Sohun , Chirikian David , Lui Forshing
Published: November 2020

Botulism is an acute paralytic disease caused by botulinum neurotoxin (BoNT)-mediated inhibition of neurosignaling at the neuromuscular junction. BoNTs are produced by gram positive, anaerobic, spore-forming bacteria from the genus Clostridium,most commonly Clostridium botulinum. Over the last decade, a previously uncommon form of botulism, wound botulism, has increased in prevalence possibly due to the rise in parenteral drug abuse. A 53-year-old patient with a history of drug abuse presents to a rural emergency department with rapidly progressing lower extremity weakness over the past few days. He reports a recent heroin injection into right buttock and diffuse skin-popping scarring was observed throughout. The patient was treated with heptavalent botulinum antitoxin obtained from the Center for Disease Control and Prevention (CDC). A right thigh abscess culture was positive for Clostridium tertium, a left hip abscess culture was positive for methicillin-susceptible Staphylococcus aureus (MSSA), and blood culture confirmed multi-microbial bacteremia caused by Staphylococcus epidermidis and Streptococcus mitis. Serum analysis was positive for BoNT type A from a suspected concurrent Clostridium botulinum infection as C. tertium is not known to produce BoNT type A. This case report highlights the importance of early antitoxin treatment for patients with suspected wound botulism.