bluuebunny/crossref_metadata_2025 huggingface dataset:
Tolerability of statin-based management of patients with a history of statin-associated muscle symptoms: protocol for a systematic review
Authors: Villoz Fanny , Lyko Christina , Del Giovane Cinzia , Rodondi Nicolas , Blum Manuel R
Published: August 2021

Introduction

Statin-associated muscle symptoms (SAMSs) are a major clinical issue in the primary and secondary prevention of cardiovascular events. Current guidelines advise various approaches mainly based on expert opinion. We will lead a systematic review and meta-analysis to explore the tolerability and acceptability and effectiveness of statin-based therapy management of patients with a history of SAMS. We aim to provide evidence on the tolerability and different strategies of statin-based management of patients with a history of SAMS.

Methods and analysis

We will conduct a systematic review of randomised controlled trials (RCTs) and non-randomised studies with a control group. We will search in Data sources MEDLINE, EMBASE, Cochrane Central Register of Controlled Clinical Trials, Scopus, Clinicaltrials.gov and Proquest from inception until April 2021. Two independent reviewers will carry out the study selection based on eligibility criteria. We will extract data following a standard data collection form. The reviewers will use the Cochrane Collaboration’s tools and Newcastle-Ottawa Scale to appraise the study risk of bias. Our primary outcome will be tolerability and our secondary outcomes will be acceptability and effectiveness. We will conduct a qualitative analysis of all included studies. In addition, if sufficient and homogeneous data are available, we will conduct quantitative analysis. We will synthesise dichotomous data using OR with 95% CI and continuous outcomes by using mean difference or standardised mean difference (with 95% CI). We will determine heterogeneity visually with forest plots and quantitatively with I2and Q-test. We will summarise the confidence in the quantitative estimate by using Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

As a systematic review of literature without collection of new clinical data, there will be no requirement for ethical approval. We will disseminate findings through peer-reviewed publications.

PROSPERO registration number

CRD42020202619.
Strengthening sepsis care at a tertiary care teaching hospital in New Delhi, India
Authors: Malhotra Charu , Kumar Akshay , Sahu Ankit Kumar , Ramaswami Akshaya , Bhoi Sanjeev , Aggarwal Praveen , Lodha Rakesh , Kapil Arti , Vaid Sonali , Joshi Nitesh
Published: August 2021

Introduction

Failure of early identification of sepsis in the emergency department (ED) leads to significant delays in antibiotic administration which adversely affects patient outcomes.

Aim

The primary objective of our Quality Improvement (QI) project was to reduce the door-to-antibiotic time (DTAT) by 30% from the preintervention in patients with suspected sepsis. Secondary objectives were to increase the blood culture collection rate by 30% from preintervention, investigate the predictors of improving DTAT and study the effect of these interventions on 24-hour in-hospital mortality.

Methods

This QI project was conducted in the ED of a tertiary care teaching hospital of North India; the ED receives approximately 400 patients per day. Adult patients with suspected sepsis presenting to our ED were included in the study, between January 2019 and December 2020. The study was divided into three phases; preintervention phase (100 patients), intervention phase (100 patients) and postintervention phase (93 patients). DTAT and blood cultures prior to antibiotic administration was recorded for all patients. Blood culture yield and 24-hour in-hospital mortality were also recorded using standard data templates. Change ideas planned by the Sepsis QI Team were implemented after conducting plan-do-study-act cycles.

Results

The median DTAT reduced from 155 min in preintervention phase to 78 min in postintervention phase. Drawing of blood cultures prior to antibiotic administration improved by 67%. Application of novel screening tool at triage was found to be an independent predictor of reduced DTAT.

Conclusion

Our QI project identified the existing lacunae in implementation of the sepsis bundle which were dealt with in a stepwise manner. The sepsis screening tool and on-site training improved care of patients with sepsis. A similar approach can be used to deal with complex quality issues in other high-volume low-resource settings.
Ensuring administration of first dose of antibiotics within the golden hour of management in neonates with sepsis
Authors: Ray Somosri , Sundaram Venkataseshan , Dutta Sourabh , Kumar Praveen
Published: August 2021

Administration of first dose of antibiotics within the golden hour in infants with sepsis is critical. Delays can increase mortality. During our observations as part of antibiotic stewardship programme in inborn neonatal unit, we found a significant delay in the administration of first dose of antibiotics from the decision time. We set up a quality improvement team to improve the proportion of neonates with sepsis, who received first dose of antibiotics within 1 hour of decision, from 0% to 80% over 2 months.

We included inborn neonates requiring initiation or upgradation of antibiotics for a diagnosis of sepsis, from 1 May to 30 November 2018. We assessed the root causes behind delayed administration and found the lack of immediate availability of blood culture bottles, lack of awareness and busy clinical area as the major contributors to the delays in first dose. Various change ideas like ensuring prior availability of blood culture bottles, sensitising nursing staff and resident doctors, utilisation of hospital attendants and sharing responsibility of drawing culture between team members were tested through plan–do–study–act (PDSA) cycles.

The proportion of neonates receiving first dose of antibiotics within 1 hour increased from 0% to 91% over the study period and was sustained at 92% after 6 months. There was a significant reduction in median (IQR) time interval between decision and first dose from 120 (100–290) to 45 (30–60) min (p<0.001) and after 6 months, it further decreased to 30 (30–45) min. We achieved significant improvement in administration of first dose of antibiotics within 1 hour of decision, by using system analysis and testing change ideas in sequential PDSA cycles.
Use of point of care quality improvement methodology to improve newborn care, immediately after birth, at a tertiary care teaching hospital, in a resource constraint setting
Authors: Sachan Ravi , Srivastava Himsweta , Srivastava Sushil , Behera Sanjeeta , Agrawal Promilla , Gomber Sunil
Published: August 2021

After birth, separation of mothers and newborn is a common practice in many hospitals in our country. After delivery, we take the normal newborn to the radiant warmer in the resuscitation area for routine care. This was the existing process of care at our hospital. The frontline delivery team undertook quality improvement initiative to understand and document factors creating challenges in delivering evidence-based practice of providing immediate skin-to-skin care (SSC), delayed cord clamp (DCC) and early breast feeding within 1 hour of birth. Some of the barriers identified were early newborn mother separation and late transfer of mother from delivery room to the observation area. Additionally, there was a challenge of high delivery load with variation in understanding and provision of SSC and drying on mother’s abdomen. These made sustenance of improved care practices difficult. Using the Plan-Do-Study-Act (PDSA) approach some successful change ideas tested were pre-delivery counselling, avoiding separation of mother and newborn at birth by providing SSC and continuing it in the post-delivery observation area and getting family member’s help in first breast feed. The delivery team adapted these successful change ideas by multiple iterations, group discussions and feedback. This resulted in improved and sustained compliance of pre-delivery counselling, SSC, DCC and initiating breast feed within 1 hour, from minimal compliance to a median compliance of 51%, 56%, 59% and 61%, respectively, over 36 months period. We undertook this quality improvement initiative at Delhi (India) at a tertiary care teaching hospital. The implementation of WHO recommended evidence-based practices benefitted more than 10 000 mother–newborn dyads annually over 2 years, using Point of Care Quality Improvement method. Implementation of evidence-based practice is possible in challenging situations using PDSA approach. The resultant contextualised processes are convenient and have better success at sustainability.
Institution of an antibiotic stewardship programme for rationalising antibiotic usage: a quality improvement project in the NICU of a public teaching hospital in rural central India
Authors: Jain Manish , Bang Akash , Meshram Payal , Gawande Prachi , Kawhale Karuna , Kamble Pushpanjali , Deotale Vijayshri , Datta Vikram , Dhanireddy Ramasubbareddy
Published: August 2021

Antibiotic misuse is the most common cause of antimicrobial resistance—a globally declared emergency. This necessitates the introduction of rational antibiotic usage management policy. The paediatrics department of a public teaching hospital with around 500 neonatal intensive care unit (NICU) admissions annually revealed 75% of NICU admission exposure to any antibiotics. The aim was to institute antibiotic stewardship programme (ASP) to optimise antibiotic usage from existing 75% to 40% in a 6-month period through a quality improvement (QI) project.A root cause analysis using fishbone diagram was performed to identify the possible reasons for the high antibiotic usage. Six Plan-Do-Study-Act cycles were conducted to implement the protocols for usage of antibiotics for well-defined indications; active laboratory engagement to decrease the turnaround time for blood culture results; a hard stop to all antibiotic orders after 72 hours; streamlining of antibiotic usage; strengthening universal aseptic practices; and confidence building of staff. The outcomes monitored were antibiotic exposure rates, average number of antibiotic days in all NICU admissions, sepsis rates and mortality.Institution of ASP had significantly reduced antibiotic exposure in NICU admissions, that is, from 75% in March to 41% in August 2018. Median (IQR) antibiotic days per infant in NICU went down from 3 to 0 (0–6). The per cent of NICU admission with culture-positive sepsis and all-cause mortality rate in NICU declined from 18% to 11.56% and 25% to 16%, respectively, over these 6 months.Thus, ASP for rationalising antibiotic usage was successfully instituted in NICU of a rural medical college in central India through QI, without any adverse effect on sepsis and mortality.
Integrative metabolomic characterisation identifies altered portal vein serum metabolome contributing to human hepatocellular carcinoma
Authors: Liu Jinkai , Geng Wei , Sun Hanyong , Liu Changan , Huang Fan , Cao Jie , Xia Lei , Zhao Hongchuan , Zhai Jianning , Li Qing , Zhang Xiang , Kuang Ming , Shen Shunli , Xia Qiang , Wong Vincent Wai-Sun , Yu Jun
Published: August 2021

Objective

Altered metabolites are important for the tumourigenicity of hepatocellular carcinoma (HCC). We performed integrative metabolomics analysis of the metabolites changes in portal venous blood and in comparison with the metabolites changes in liver tissues and stool samples of HCC patients and healthy liver donors.

Design

Serum (portal and central vein), liver tissue (HCC tumour and adjacent non-tumour, normal liver) and stool samples were collected from 102 subjects (52 HCC patients and 50 healthy controls) in the discovery cohort; and 100 subjects (50 HCC patients and 50 healthy controls) in an independent validation cohort. Untargeted metabolomic profiling was performed using high-performance liquid chromatography-mass spectrometry. The function of candidate metabolites was validated in hepatocyte cell lines.

Results

Detailed metabolomic evaluation showed distinct clusters of metabolites in serum, liver tissue and stool samples from patients with HCC and control individuals (p<0.001). HCC patients had significantly higher levels of portal vein serum and HCC tissue metabolites of DL-3-phenyllactic acid, L-tryptophan, glycocholic acid and 1-methylnicotinamide than healthy controls, which were associated with impaired liver function and poor survival. On the other hand, HCC patients had lower levels of linoleic acid and phenol in portal vein and stool samples than healthy controls. Linoleic acid and phenol significantly inhibited HCC proliferation, inferring their anti-HCC function as protective metabolites.

Conclusions

The integrative metabolome analysis of serum, tissue and stool metabolites revealed unreported metabolic alterations in HCC patients. In portal vein, we identified elevated and depleted metabolites signifying that they might play a role in HCC development.
Pine fresh: the cultural and medical context of pine scent in relation to health—from the forest to the home
Authors: Hickman Clare
Published: August 2021

Pine is a familiar scent in domestic cleaning products, but how often do we relate it to its origins as an odour emanating from a tree? This article takes a sensory history approach to trace the late 19th century and early 20th century use of the pine forest as a therapeutic space, via the tuberculosis sanatoria to the use of pine scent in domestic disinfectant. By focusing on pine as experienced in this period as a microhistorical subject, this methodology will in turn allow for a detailed consideration of how historical context, and in particular medical conceptions and health concerns, can influence the creation of cultural memory. By following the trajectory of pine from its place in the forest to a commercial product used in the home, this will allow for an investigation at the intersection of environmental and medical histories and provide a framework for the consideration of the relationship of place to senses associated with concepts of health and well-being. As interest grows in the development of more effective sensory settings, in particular within healthcare, it also highlights the importance of considering the roles both cultural and personal memory play in response to various sensory stimuli.
Bycatch reduction in the deep-water shrimp (Pandalus borealis) trawl fishery by increasing codend mesh openness
Authors: Jacques Nadine , Pettersen Hermann , Cerbule Kristine , Herrmann Bent , Ingólfsson Ólafur Arnar , Sistiaga Manu , Larsen Roger B. , Brinkhof Jesse , Grimaldo Eduardo , Brčić Jure , Lilleng Dagfinn
Published: August 2021

In most trawl fisheries, drag forces tend to close the meshes in large areas of diamond mesh codends, negatively affecting their selective potential. In the Barents Sea deep-water shrimp (Pandalus borealis) trawl fishery, selectivity is based on a sorting grid followed by a diamond mesh codend. However, the retention of juvenile fish as well as undersized shrimp is still a problem. In this study, we estimated the effect of applying different codend modifications, each aimed at affecting codend mesh openness and thereby selectivity. Changing from a 4-panel to a 2-panel construction of the codend did not affect size selectivity. Shortening the lastridge ropes of a 4-panel codend by 20% resulted in minor reductions for juvenile fish bycatch, but a 45% reduction of undersized shrimp was observed. Target-size catches of shrimp were nearly unaffected. When the codend mesh circumference was reduced while simultaneously shortening the lastridge ropes, the effect on catch efficiency for shrimp or juvenile fish bycatch was marginal compared to a 4-panel codend design with shortened lastridge ropes.
Nested sampling for materials
Authors: Pártay Livia B. , Csányi Gábor , Bernstein Noam
Published: August 2021

We review the materials science applications of the nested sampling (NS) method, which was originally conceived for calculating the evidence in Bayesian inference. We describe how NS can be adapted to sample the potential energy surface (PES) of atomistic systems, providing a straightforward approximation for the partition function and allowing the evaluation of thermodynamic variables at arbitrary temperatures. After an overview of the basic method, we describe a number of extensions, including using variable cells for constant pressure sampling, the semi-grand-canonical approach for multicomponent systems, parallelizing the algorithm, and visualizing the results. We cover the range of materials applications of NS from the past decade, from exploring the PES of Lennard–Jones clusters to that of multicomponent condensed phase systems. We highlight examples how the information gained via NS promotes the understanding of materials properties through a novel way of visualizing the PES, identifying thermodynamically relevant basins, and calculating the entire pressure–temperature(–composition) phase diagram.

Graphic abstract
Four-lepton production in gluon fusion at NLO matched to parton showers
Authors: Alioli Simone , Ravasio Silvia Ferrario , Lindert Jonas M. , Röntsch Raoul
Published: August 2021

We present a calculation of the next-to-leading order (NLO) QCD corrections to gluon-induced electroweak gauge boson pair production, $$gg \rightarrow ZZ$$

g
g
→
Z
Z

and $$gg \rightarrow W^+W^-$$

g
g
→

W
+

W
-

, matched to the   parton shower in the approach. The calculation consistently incorporates the continuum background, the Higgs-mediated $$gg\rightarrow H^* \rightarrow VV$$

g
g
→

H
∗

→
V
V

process, and their interference. We consider leptonic decay modes of the vector bosons and retain offshell and non-resonant contributions. The processes considered are loop-induced at leading order and thus contain two-loop virtual contributions as well as loop-squared real contributions. Parton-shower effects are found to be marginal in inclusive observables and quite sizeable in observables that are exclusive in additional jet radiation. The Monte Carlo generator presented here allows for realistic experimental effects to be incorporated in state-of-the-art precision analyses of diboson production and of the Higgs boson in the offshell regime.
Energy-induced resonance synchronization in neural circuits
Authors: Huang Pengfei , Guo Yeye , Ren Guodong , Ma Jun
Published: August 2021

Biological neurons can be approached by using some functional neural circuits, and the biophysical mechanism for signal processing can be explained. Chemical stimulus can adjust the intracellular and extracellular ions concentration, and thus the channel current can be regulated to trigger appropriate firing modes in the neural activities. A physical stimulus often injects kinds of energy, and the energy can be encoded in the components for generating a certain channel current. The energy driving on the cell can be effective to enhance the pumping of ions and mode transition is induced. Based on a simple neural circuit exposed to the external magnetic field, the mode selection is investigated to explore the biophysical mechanism of energy absorption by applying periodic, and stochastic magnetic fields, respectively. The external field energy is encoded in the induction coil of the neural circuit, and the channel current is induced. Two identical neural circuits are exposed to the same magnetic field and the synchronization approach is investigated without synapse coupling. It is found that two neurons in periodic firings can be synchronized under the same periodic or noise-like magnetic field even applying different initials, while intermittent phase lock is induced between two chaotic neurons. Stochastic variation in the external magnetic field can induce noisy induced electromotive force (IEF) and the firing mode is regulated effectively. When both noisy IEF and periodic stimulus are applied, synchronization stability between periodic neurons with initials diversity is enhanced while synchronization approach between chaotic neurons becomes difficult. In addition, the Hamilton energy in each neuron can keep pace with another neuron when complete synchronization is stabilized within a finite transient period. These results provide new insights to know the energy encoding mechanism in neural circuits and neurons exposed to external magnetic field.
Deep Learning-Based Energy Disaggregation and On/Off Detection of Household Appliances
Authors: Jiang Jie , Kong Qiuqiang , Plumbley Mark D. , Gilbert Nigel , Hoogendoorn Mark , Roijers Diederik M.
Published: August 2021

Energy disaggregation, a.k.a. Non-Intrusive Load Monitoring, aims to separate the energy consumption of individual appliances from the readings of a mains power meter measuring the total energy consumption of, e.g., a whole house. Energy consumption of individual appliances can be useful in many applications, e.g., providing appliance-level feedback to the end users to help them understand their energy consumption and ultimately save energy. Recently, with the availability of large-scale energy consumption datasets, various neural network models such as convolutional neural networks and recurrent neural networks have been investigated to solve the energy disaggregation problem. Neural network models can learn complex patterns from large amounts of data and have been shown to outperform the traditional machine learning methods such as variants of hidden Markov models. However, current neural network methods for energy disaggregation are either computational expensive or are not capable of handling long-term dependencies. In this article, we investigate the application of the recently developed WaveNet models for the task of energy disaggregation. Based on a real-world energy dataset collected from 20 households over 2 years, we show that WaveNet models outperforms the state-of-the-art deep learning methods proposed in the literature for energy disaggregation in terms of both error measures and computational cost. On the basis of energy disaggregation, we then investigate the performance of two deep-learning based frameworks for the task of on/off detection which aims at estimating whether an appliance is in operation or not. The first framework obtains the on/off states of an appliance by binarising the predictions of a regression model trained for energy disaggregation, while the second framework obtains the on/off states of an appliance by directly training a binary classifier with binarised energy readings of the appliance serving as the target values. Based on the same dataset, we show that for the task of on/off detection the second framework, i.e., directly training a binary classifier, achieves better performance in terms of F1 score.
Imaging Infection Across Scales of Size: From Whole Animals to Single Molecules
Authors: Skaar Eric P.
Published: August 2021

Infectious diseases are a leading cause of global morbidity and mortality, and the threat of infectious diseases to human health is steadily increasing as new diseases emerge, existing diseases reemerge, and antimicrobial resistance expands. The application of imaging technology to the study of infection biology has the potential to uncover new factors that are critical to the outcome of host-pathogen interactions and to lead to innovations in diagnosis and treatment of infectious diseases. This article reviews current and future opportunities for the application of imaging to the study of infectious diseases, with a particular focus on the power of imaging objects across a broad range of sizes to expand the utility of these approaches.
In Vivo Analyses of Osteogenic Activity and Bone Regeneration Capacity of Demineralized Freeze-Dried Bovine Bone Xenograft: A Potential Candidate for Alveolar Bone Fillers
Authors: Kamadjaja David Buntoro , Abidin Zefry Zainal , Diana Riska , Kharis Ikhram , Mira Sumarta Ni Putu , Amir Muhammad Subhan , Rizqiawan Andra , Danudiningrat Coen Pramono , Nakamura Norifumi
Published: August 2021

Background. Deproteinized bovine bone mineral (DBBM) particle is the commonly used bone graft substitute in implant surgery which is mainly osteoconductive and has very slow degradation. Demineralized freeze-dried bovine bone xenograft (DFDBBX) particle is being developed as a novel xenogeneic bone filler. Objectives. The study aimed to analyze osteogenic activity and bone-forming capacity of DFDBBX particles compared to DBBM particles in alveolar bone defects in rabbit mandibles models. Material and Methods. This study investigated bone defects whether filled with DBBM particles or DFDBBX particles or left unfilled in 30 rabbit mandibles. Specimens were processed for histology, immunohistochemistry, and micro-CT scanning. Statistical difference was set at a

p

value < 0.05. Results. The quantitative assessment showed a significantly lower number of osteoclasts and a higher number of osteoblasts in the DFDBBX group compared to the DBBM group in 2 and 4 weeks (

p
<
0.05

). Immunostaining analyses showed significantly higher expression of RUNX2, collagen type I, alkaline phosphatase, and osteocalcin in the DFDBBX group compared to the DBBM group in 2 and 4 weeks. Bone healing score in the DFDBBX group was comparable to the DBBM group. Micro-CT presented no significant difference in the volume percentage of the mineralized tissue in the DBBM and DFDBBX groups in spite of the different healing patterns in both groups. Conclusion. DFDBBX particles induced higher osteoblastic activities than DBBM particles at the early stage of healing. Meanwhile, the capacity of bone formation in DFDBBX particles was comparable with DBBM particles at the later stage of healing. Considering the limitation of this study, the results presented DFDBBX particles as potential bone filler candidates.
Dynamic Path Optimization with Real-Time Information for Emergency Evacuation
Authors: Zhang Huajun , Zhao Qin , Cheng Zihui , Liu Linfan , Su Yixin
Published: August 2021

In order to find the optimal path for emergency evacuation, this paper proposes a dynamic path optimization algorithm based on real-time information to search the optimal path and it takes fire accident as an example to introduce the algorithm principle. Before the accidents, it uses the Dijkstra algorithm to get the prior evacuation network which includes evacuation paths from each node to the exit port. When the accidents occur, the evacuees are unable to pass through the passage where the accident point and the blocking point are located, then the proposed method uses the breadth-first search strategy to solve the path optimization problem based on the prior evacuation network, and it dynamically updates the evacuation path according to the real-time information. Because the prior evacuation network includes global optimal evacuation paths from each node to the exit port, the breadth-first search algorithm only searches local optimal paths to avoid the blockage node or dangerous area. Because the online optimization solves a local pathfinding problem and the entire topology optimization is an offline calculation, the proposed method can find the optimal path in a short time when the accident situation changes. The simulation tests the performances of the proposed algorithm with different situations based on the topology of a building, and the results show that the proposed algorithm is effective to get the optimal path in a short time when it faces changes caused by the factors such as evacuee size, people distribution, blockage location, and accident points.
Analytical Analysis for Parameter Design of Attached Nonlinear Energy Sink
Authors: Zhang Tianjiao , Li Luyu , Zheng Yilin
Published: August 2021

The dynamic responses of a linear primary structure coupled with a nonlinear energy sink (NES) are investigated under harmonic excitation in the 1 : 1 resonance regime. In civil engineering, initial conditions are usually zero or approximately zero. Therefore, in this study, only these conditions are considered. The strongly modulated response (SMR), whose occurrence is conditional, is the precondition for effective target energy transfer (TET) in this system. Therefore, this study aims to determine the parameter range in which the SMR can occur. The platform phenomenon and other related phenomena are observed while analyzing slow‐varying equations. An excitation amplitude interval during which the SMR can occur is obtained, and an approximate analytical solution of the optimal nonlinear stiffness is found. The numerical results show that the NES based on the optimal stiffness performs better in terms of control performance.
Path Loss Characterization Using Machine Learning Models for GS-to-UAV-Enabled Communication in Smart Farming Scenarios
Authors: Duangsuwan Sarun , Juengkittikul Phakamon , Myint Maw Myo
Published: August 2021

The purpose of this paper was to predict the path loss characterization of the ground-to-air (G2A) communication channel between the ground sensor (GS) and unmanned aerial vehicle (UAV) using machine learning (ML) models in smart farming (SF) scenarios. Two ML algorithms such as support vector regression (SVR) and artificial neural network (ANN) were studied to analyze the measured data in different scenarios with Napier and Ruzi grass farms as the measurement locations. The proposed empirical GS-to-UAV two-ray (GUT-R) model and the ML models were compared to characterize path loss prediction models. The performances of the path loss prediction models were evaluated using the statistical error indicators in different measurement locations and UAV trajectories. To obtain the statistical error indicators, the accuracy path loss results of UAV trajectory at 2 m altitudes showed the SVR model (MAE = 1.252 dB, RMSE = 3.067 dB, and R2 = 0.972) and the ANN model (MAE = 1.150 dB, RMSE = 2.502 dB, and R2 = 0.981) for the Napier scenario. In the Ruzi scenario, the SVR model (MAE = 1.202 dB, RMSE = 2.962 dB, and R2 = 0.965) and the ANN model (MAE = 1.146 dB, RMSE = 2.507 dB, and R2 = 0.983) were presented. For UAV trajectory at 5 m altitudes, the SVR model (MAE = 2.125 dB, RMSE = 4.782 dB, and R2 = 0.933) and the ANN model (MAE = 2.025 dB, RMSE = 4.439 dB, and R2 = 0.950) were resulted in the Napier scenario. In the Ruzi scenario, the SVR model (MAE = 2.112 dB, RMSE = 4.682 dB, and R2 = 0.935) and the ANN model (MAE = 2.016 dB, RMSE = 4.407 dB, and R2 = 0.954) were displayed. The proposed ML models using SVR and ANN can optimally predict the path loss characterization in SF scenarios, where the accuracy was 95% for the SVR and 97% for the ANN.
Distal Radius Salter-Harris III Transitional Fracture in an Adolescent Male
Authors: Kurland Adam , Batko Brian , Hreha Jeremy , Ignatiuk Ashley
Published: August 2021

In contrast to the well-described Tillaux fracture of the distal tibia, transitional fractures of the distal radius are exceedingly rare and have yet to be well described. Thus far, their presence in the literature has been limited to case reports and a singular series. None have involved a Salter-Harris III fracture pattern. We present the case of a 16-year-old male who sustained a Salter-Harris III transitional fracture of the distal radius with an associated ulnar styloid avulsion fracture secondary to a fall that was treated nonoperatively. Similar to the Tillaux fracture, examination of the distal radius transitional fracture should include computed tomography scan to better illustrate the pattern of injury and guide treatment.
Energy‐Efficient Clustering and Localization Technique Using Genetic Algorithm in Wireless Sensor Networks
Authors: Chen Junfeng , Sackey Samson Hansen , Anajemba Joseph Henry , Zhang Xuewu , He Yurun
Published: August 2021

Localization is recognized among the topmost vital features in numerous wireless sensor network (WSN) applications. This paper puts forward energy‐efficient clustering and localization centered on genetic algorithm (ECGAL), in which the residual energy, distance estimation, and coverage connection are developed to form the fitness function. This function is certainly fast to run. The proposed ECGAL exhausts a lesser amount of energy and extends wireless network existence. Finally, the simulations are carried out to assess the performance of the proposed algorithm. Experimental results show that the proposed algorithm approximates the unknown node location and provides minimum localization error.
Which Plants for What Ailments: A Quantitative Analysis of Medicinal Ethnobotany of Ile-Ife, Osun State, Southwestern Nigeria
Authors: Mukaila Yusuf Ola , Oladipo Olaniran Temitope , Ogunlowo Ifeoluwa , Ajao Abdulwakeel Ayokun-nun , Sabiu Saheed
Published: August 2021

Studies on medicinal ethnobotany in rural areas and communities are important for documentation and generation of indigenous knowledge on the medicinal use of plants, as well as identification of new botanicals of pharmacological significance. This paper presents, for the first time, the quantitative ethnobotanical uses of medicinal plants in Ile-Ife, Osun State, Nigeria. The ethnobotanical survey was carried out by conducting semistructured interviews with 70 informants/collaborators. Data were analyzed using various quantitative indices, namely, Ethnobotanical Knowledge Index (EKI), Species Popularity Index (SPI), Relative Frequency of Citation (RFC), Cultural Importance Index (CII), Informant Consensus Factor (FIC), Fidelity Level (FL), and Species Therapeutic Index (STI). A total of 87 plant species belonging to 43 families were documented along with their medicinal uses. Euphorbiaceae is the most implicated family (9%) of the plants documented, and herbs (36%) were the prevalent life form while leaf (46%) was the most used plant part. Fevers are the most common diseases treated with the medicinal plants with 1012 use-reports, followed by skin diseases with 314 use-reports while the most common mode of preparation is decoction (37%). Telfaria occidentalis has the highest SPI and RFC (0.99, 0.99) while Khaya grandifoliola has the highest CII of 1.91. The community has EKI of 0.57 indicating a good knowledge of medicinal plants around them. Species such as Citrus aurantifolia, Khaya grandifoliola, and Ocimum gratissimum have high quantitative indices suggesting that they are effective in the treatment of various diseases in the community and therefore should be considered for pharmacological studies to validate their folkloric usages.
Research on the Strength Characteristics and Crack Propagation Law of Noncoplanar Nonthrough Jointed Rock Mass by PFC2D
Authors: Chen Qingzhi , Liu Yuanming , Mei Shilong , Cao Kai , Du Bin , Wang Wei
Published: August 2021

In this study, five groups of numerical models with different conditions were established by using PFC2D (particle flow code) to simulate the direct shear tests of noncoplanar nonthrough jointed rock mass. It is proved that normal stress and shear rate, as well as the connectivity rate, relief angle, and inclination angle of joints, have significant influence on the strength characteristics, number of cracks, and the stress of the rock mass according to measurement taken at five different measurement circles in the rock mass. Moreover, it is determined that in the process of shearing, no matter which group of tests are conducted, the number of cracks in the rock mass caused by tension is far more than that caused by the shear action. In other words, the failure of rock mass with different planes and discontinuous joints is mainly caused by the tension in the process of the direct shear test.
The Influence of E-Marketing on Performance of Real Estate Enterprises: Based on Super-Efficiency DEA and Grey Entropy Methods
Authors: Wu Zhong-Huan , Chen Hong-jie
Published: August 2021

E-marketing is an important tool for real estate enterprises. We evaluate 3 online marketing channels of 44 Chinese real estate companies. Super-efficiency DEA and grey entropy methods are applied to analyse the influence of E-marketing on the performance of real estate enterprises. We find that E-marketing will affect the business performance of real estate companies. Real estate company managers should adopt more strategies to improve corporate performance.
Role of the Transient Receptor Potential Vanilloid Type 1 (TRPV1) in the Regulation of Nitric Oxide Release in Wistar Rat Aorta
Authors: Varela-López Elvira , del Valle-Mondragón Leonardo , Castrejón-Téllez Vicente , Pérez-Torres Israel , Arenas Araceli Páez , Rojas Felipe Massó , Guarner-Lans Verónica , Vargas-González Alvaro , Pastelín-Hernández Gustavo , Torres-Narváez Juan Carlos
Published: August 2021

The potential transient vanilloid receptor type 1 (TRPV1) plays important functional roles in the vascular system. In the present study, we explored the role of the TRPV1 in the production of nitric oxide (NO), biopterines (BH4 and BH2), cyclic guanosine monophosphate (cGMP), malondialdehyde (MDA), phosphodiesterase‐3 (PDE‐3), total antioxidant capacity (TAC), and calcitonin gene‐related peptide (CGRP) in the rat aorta. Wistar rats were divided into four groups: (1) control, (2) capsaicin (CS, 20 mg/kg), (3) capsazepine (CZ, 24 mg/kg), and (4) CZ + CS. Treatments were applied daily for 4 days before removing the thoracic aortas for testing of aortic tissue and endothelial cells. TRPV1 activation produced increases in BH4 14%, cGMP 25%, NO 29%, and TAC 59.2% in comparison to the controls. BH2 and MDA increased with CZ. CGRP shows a tendency to decrease with CZ. The analysis by immunocytochemistry confirmed that the TRPV1 is present in aortic endothelial cells. Aortic endothelial cells were obtained from healthy rats and cultured to directly explore the effects of CS and CZ. The activation of the TRPV1 (CS 30 μM) produced increases in BH4 17%, NO 36.6%, TAC 56.3%, and CGRP 65%, when compared to controls. BH2 decreased with CZ + CS. CS effects were diminished by CZ in cells and in the tissue. We conclude that the TRPV1 is a structure present in the membrane of aortic endothelial cells and that it participates in the production of NO. The importance of the TRPV1 should be considered in vascular reactivity studies.
Passivity Analysis of Coupled Stochastic Neural Networks with Multiweights
Authors: Cao Min , Yin Xun-Wu , Song Wen-He , Sun Xue-Mei , Yang Cheng-Dong , Ren Shun-Yan
Published: August 2021

In this paper, we devote to the investigation of passivity in two types of coupled stochastic neural networks (CSNNs) with multiweights and incompatible input and output dimensions. First, some new definitions of passivity are proposed for stochastic systems that may have incompatible input and output dimensions. By utilizing stochastic analysis techniques and Lyapunov functional method, several sufficient conditions are respectively developed for ensuring that CSNNs without and with multiple delay couplings can realize passivity. Besides, the synchronization criteria for CSNNs with multiweights are established by employing the results of output-strictly passivity. Finally, two simulation examples are given to illustrate the validity of the theoretical results.
Pancreatic Cancer and Primary Sjögren’s Syndrome: A Case Report
Authors: Oliveira Daniela , Chaves Vanessa , Martins José Carlos , Vaz Carlos , Bernardes Miguel , Almeida Jorge
Published: August 2021

Primary Sjögren syndrome (SS) is a chronic inflammatory systemic autoimmune disease with a high risk of malignancy development, namely, lymphoproliferative neoplasms. Few studies also reported a high risk of solid cancers; however, the coexistence of primary SS and pancreatic cancer has been rarely described. In this paper, we aim to describe a case of a 59-year-old woman who was an active smoker with sicca symptoms and symmetrical polyarthritis and was diagnosed with primary SS two years before the development of metastatic pancreatic adenocarcinoma. Despite institution of chemotherapy, the patient succumbed to the malignancy. Besides that, we explore the link between primary SS and solid cancers including the main predictors of malignancy and the role of primary SS as a paraneoplastic syndrome. Patients with primary SS should be closely monitored for malignancy, not only for hematological cancer, but also for solid tumors. Further research is necessary to understand which are the predictors of cancer proliferation in primary SS patients.
Performance Enhancement of the Micromixer by the Multiobjective Genetic Algorithm and Surrogate Model Based on a Navier–Stokes Analysis Using Trade-Off Objective Functions
Authors: Hossain Shakhawat , Islam Farzana , Tayeb Nass Toufik , Aslam Muhammad , Kim Jin-Hyuk
Published: August 2021

Optimal structure of the micromixer with a two-layer serpentine crossing device was accomplished by a multiobjective genetic algorithm and surrogate modeling based on a Navier–Stokes analysis using the trade-off objective functions behavior. The optimization analysis was conducted with three design parameters, i.e., channel width to the pitch span (

w
/
P

) ratio, major channel width to the pitch span (H/P) ratio, and channel depth to the pitch span (d/P) ratio. Two objective functions (i.e., mixing index and pressure drop) with trade-off characteristics have been used to solve the multiobjective optimization problem. The design domain was predetermined by a parametric investigation; afterward, the Latin hypercube sampling method was employed to select the appropriate design points surrounded by the design domain. The numerical data of the thirty-two design points were used to create the surrogate model; among the different surrogate models, in this study, the Kriging metamodel has been used. The concave pareto-optimal curve signifies the trade-off characteristics linking the objective functions.
Old Is (Not) Gold: Midazolam Monotherapy versus Midazolam Plus Fentanyl for Sedation during Cardiac Catheterization
Authors: Black William , Baljepally Raj , Shali Laylan , Alsharif Omar , Warden Scott , Heidel Eric , Zhao Xiaopeng
Published: August 2021

Objective. We aimed to study the differences in perception of pain during cardiac catheterization with midazolam monotherapy compared to the current standard of midazolam plus fentanyl. Background. Procedural sedation is important to ensure comfort and safety in patients undergoing left heart catheterization. Despite the widespread use of midazolam and fentanyl for procedural sedation, the effectiveness of this dual agent approach to sedation has never been studied in comparison to midazolam monotherapy. Methods. A total of 129 patients undergoing sedation for outpatient elective cardiac catheterization were randomly assigned to either midazolam monotherapy (n = 69) or combination of midazolam and fentanyl (n = 60). The primary outcome was assessment of pain perception prior to discharge by patient completion of a pain questionnaire. Participants were asked if they experienced any pain during their procedure (yes/no) and, if yes, asked to rate their overall pain level using a 10-point Likert scale that ranged from 1 (minimal pain) to 10 (worst pain imaginable). Results. Most patients (n = 94, 73%) reported no pain during their procedure. Patients sedated with midazolam monotherapy reported similar average pain scores compared to patients sedated with the combination of midazolam and fentanyl (1.1 vs. 1.1,

p
=
0.95

). Conclusions. Among patients undergoing elective cardiac catheterization, no significant differences in pain scores were noted between sedation with midazolam alone compared to midazolam and fentanyl. Due to fentanyl’s unfavorable interaction with P2Y12 agents, increased costs, and addiction potential, it is imperative that cardiologists revisit the role of effective procedural sedation with a single agent and avoid the use of fentanyl.
Influence of the Integrated Delivery System on the Medical Serviceability of Primary Hospitals
Authors: Feng Wenming , Feng Xin , Shen Ping , Wang Zhen , Wang Bing , Shen Jiantong , Shen Xuhui
Published: August 2021

Objective. To explore the change in the medical serviceability of primary hospitals since the establishment of the Huzhou No. 1 People’s Hospital medical care group incorporating the integrated delivery system. Methods. With reference to the “Grade Evaluation Standard of General Hospitals in Zhejiang Province” and the “Guidelines for Service Capacity Evaluation of Township Hospitals (2019 Edition),” we analyzed the influence of the integrated delivery system on the capacity of primary medical services and selected the targeted core indicators. From the four dimensions of diagnosis and treatment breadth, diagnosis and treatment efficiency, surgical ability, and patient satisfaction, an index evaluation system was established to explore the changes in the medical serviceability in primary hospitals. Results. The measurements were aimed at four specific issues, that is, the low medical technology level of grassroots personnel, the poor information communication among medical institutions, the difficulty in recruiting people, and the imperfect training mechanism in primary hospitals. After establishing a series of measurements related to the problems faced by the primary healthcare sector in China, the score of breadth of diagnosis and treatment, efficiency of diagnosis and treatment ability, surgical ability, and patient satisfaction of the primary hospitals in our medical group have greatly increased. Conclusion. The integrated delivery system improved the primary hospitals’ medical health ability obviously. Our study also provides various useful and operable suggestions for primary healthcare.
The Clinical Features of Inflammatory Bowel Disease in Patients with Obesity
Authors: Kim Seong Kyun , Lee Ho-Su , Kim Beom-Jun , Park Jin Hwa , Hwang Sung Wook , Yang Dong-Hoon , Ye Byong Duk , Byeon Jeong-Sik , Myung Seung-Jae , Yang Suk-Kyun , Park Sang Hyoung
Published: August 2021

Background and Aim. The prevalence of obesity is increasing globally as is the prevalence of inflammatory bowel disease (IBD). Herein, we sought to evaluate the characteristics and prognosis of IBD in patients with obesity. Methods. We retrospectively reviewed the medical records of IBD patients who visited Asan Medical center. We used a large, well-characterized referral center-based cohort. The clinical features of IBD patients with body mass index (BMI) over 30 and matched controls with BMI under 30 were compared. Results. Among the 6,803 IBD patients enrolled in the Asan IBD Registry between June 1989 and December 2016, we identified 16 patients with Crohn’s disease (CD) and 27 patients with ulcerative colitis (UC) whose BMI was over 30 at the time of diagnosis. Their clinical characteristics and course were compared with those of 64 and 108 matched patients with CD and UC, respectively. There were no significant differences in the risk of using steroids (hazards ratio (HR) = 0.633 and

P
=
0.254

), immunomodulators (HR = 0.831 and

P
=
0.517

), and anti-tumor necrosis factor (TNF) therapy (HR = 1.539 and

P
=
0.351

) and risk of bowel resections (HR = 1.858 and

P
=
0.231

) between CD patients with BMI over 30 and those with BMI under 30; similarly, UC patients did not show significant differences in the risk of using steroids (HR = 0.613 and

P
=
0.145

), immunomodulators (HR = 0.492 and

P
=
0.111

), anti-TNF therapy (HR = 0.385 and

P
=
0.095

), and risk of colectomy (HR = 0.262 and

P
=
0.104

). In the subgroup analysis, under-weight UC patients had a higher cumulative probability of needing steroids (HR = 0.2510 and

P
=
0.042

), needing immunomodulators (HR = 0.097 and

P
=
0.014

), and a higher risk of receiving colectomy (HR = 0.024 and

P
=
0.019

) than obese UC patients. Conclusions. Obese IBD patients with CD or UC did not show significantly different clinical features from nonobese IBD patients.