bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors contributing to clinical nurse compliance with infection prevention and control practices: A cross‐sectional study
Authors: Kim Hyunjung , Hwang Young Hui
Published: October 2019

Although healthcare‐associated infection is preventable, low compliance with infection prevention and control practices has been a significant issue for hospitals. This study aimed to evaluate the knowledge, attitudes, perceived safe environment, and compliance of clinical nurses and to identify the factors contributing to compliance with infection prevention and control practices. A cross‐sectional study was conducted with 197 nurses who worked in university hospitals in Korea. Data were collected using a self‐administrated questionnaire. Nurses correctly answered 67.4% of the questions regarding infection prevention and control knowledge, with the lowest correct scores (55%) related to multidrug‐resistant organisms. Nurses demonstrated favorable attitudes toward infection prevention and control (6.5 of 8) and favorable perceptions regarding safe environment (7.75 of 9). The overall compliance score was 87.41 of 100. Nurses' attitudes, perceived safe environment, and period of clinical experience had significant positive contributions to compliance. Among employment departments, the intensive care unit was associated with higher compliance. Our findings indicate that institutional support for safe environments should be combined with ongoing education for improving knowledge and attitudes of nurses, especially in general wards.
Exacerbation of gastroesophageal reflux symptoms after discontinuation of proton pump inhibitors is not associated with increased esophageal acid exposure
Authors: Hoshikawa Yoshimasa , Nikaki Kornilia , Sonmez Shirley , Nakagawa Kenichiro , Yazaki Etusro , Sifrim Daniel , Woodland Philip
Published: October 2019

Background

Discontinuation of long‐term proton pump inhibitors (PPIs) on patients with reflux symptoms can be challenging, as symptoms often exacerbate after stopping. The mechanism remains unknown. Our aim was to evaluate the impact of stopping long‐term PPIs on patients with heartburn, and its association with esophageal acid exposure.

Methods

Patients with heartburn on long‐term PPIs underwent symptom questionnaire, high‐resolution manometry, and 24h ambulatory impedance‐pH studies, following a 7‐day PPIs discontinuation. We investigated the association between exacerbation of symptoms and findings on ambulatory reflux studies.

Key Results

We studied 37 patients. After stopping PPIs, 27 patients (73%) had exacerbation of heartburn. Esophageal acid exposure time% (AET) in patients with exacerbation of heartburn was not significantly higher than in patients without (3.5% [1.3‐9.7] vs 2.5% [1.3‐8.7], NS). Fourteen of 27 patients with exacerbation had physiological AET (<4%) as compared with 6 of 10 patients with physiological AET (NS). All questioned symptoms (heartburn, regurgitation, epigastric discomfort/pain, bloating/belch) worsened after stopping PPIs (NS).

Conclusions & Inferences

Exacerbation of heartburn after discontinuation of PPIs does not appear to be due to increased esophageal acid exposure.
Kidney transplant practice patterns and outcome benchmarks over 30 years: The 2018 report of the NAPRTCS
Authors: Chua Annabelle , Cramer Carl , Moudgil Asha , Martz Karen , Smith Jodi , Blydt‐Hansen Tom , Neu Alicia , Dharnidharka Vikas R. ,   the NAPRTCS investigators
Published: October 2019

The NAPRTCS has collected clinical information on children undergoing renal transplantation since 1987 and now includes information on 12 920 renal transplants in 11 870 patients. Since the first data analysis in 1989, NAPRTCS reports have documented marked improvements in patient and allograft outcomes after pediatric renal transplantation in addition to identifying factors associated with both favorable and poor outcomes. The registry has served to document and influence practice patterns, clinical outcomes, and changing trends in renal transplantation and also provides historical perspective. This report highlights current practices in an era of major changes in DD kidney allocation and continuing steroid minimization. This report presents outcomes of the patients in the NAPRTCS transplant registry up to end of 2017. In particular, an increase in the cumulative incidence of late first AR has occurred in the most recent cohort, while all prior cohorts had a lower cumulative incidence of late first AR.
Use of intravenous immunoglobulin in a highly sensitized pediatric renal transplant recipient with severe BK DNAemia and rising DSA
Authors: Piburn Kim Huynh , Al‐Akash Samhar
Published: October 2019

BK DNAemia in renal transplant recipients is a significant cause of allograft dysfunction and can lead to graft loss due to BK polyomavirus–associated nephropathy or to graft rejection due to immunosuppression reduction. Currently, the first‐line treatment for BK DNAemia is immunosuppression reduction. Second‐line treatment for BK DNAemia has not been well‐established. In this report, we present a case of a highly sensitized second‐time pediatric renal transplant recipient with severe and persistent BK DNAemia and rising DSA, who was treated with IVIG and subsequently found to have clearance of BK viremia with concomitant reduction in DSA.
Nurses’ Kangaroo Mother Care practice implementation and future challenges: an integrative review
Authors: Maniago Jestoni D. , Almazan Joseph U. , Albougami Abdulrhman S.
Published: October 2019

Background

Nurses play a crucial role in Kangaroo Mother Care practice, but their application in specific policies and practices involves challenges. A comprehensive literature review is needed to improve understanding of specific barriers that are most relevant to nurses and the improvement of this practice. This review investigates nurses’ barriers in implementing Kangaroo Mother Care, in order to illustrate directions for future research.

Methods

This study was based on integrative review method and exploring nurses’ barriers in implementing Kangaroo Mother Care, strategies to reduce its barriers.CINAHL, Medline, Web of Science, ProQuest Nursing and Allied Health Database, PubMed and Science Direct Taylor & Francis databases were searched for the following: (i) studies with no year restrictions, (ii) peer‐reviewed journal articles, (iii) original research and (iv) articles written in English. Each article was appraised for methodological validity review using critical appraisal checklist.

Results

The search revealed 19 articles from diverse countries. Four main themes were generated from the synthesis of the findings: (i) barriers related to nurses’ perspective and emotion towardsKMC, (ii) healthcare institution barriers towardsKMC, (iii) barriers related to parental experience in providingKMCand (iv) strategy to improveKMCimplementation.

Conclusions

Nurses experience several barriers in successfully implementingKMCin healthcare settings. This review reported strategies to reduceKMCbarriers and to improve its utilisation in healthcare settings. Hospitals should establish adequate manpower, clear guidelines, sufficient supplies and equipment, capacity building among staff and proper Kangaroo Mother Care information dissemination for patients.
Nonpharmacological methods: frequency of use and follow‐up actions among healthcare staff in the care of older people
Authors: Lindberg Terese , Fagerström Cecilia
Published: October 2019

Older people are at risk of developing multi‐comorbidity and thus being exposed to multiple treatments and drugs to manage the emerging health complaints. More focus has been put on nonpharmacological alternatives. However, studies revealing the healthcare staff perspective on using nonpharmacological methods (NPMs) in the care of older people are still lacking. Thus, the aim of this study was to map the use of NPMs in daily practices and the follow‐up thereof. A population‐based survey with questionnaires was performed, included all healthcare professionals (n = 163; nurses and paramedical professionals) working in one district of elderly care in Sweden. The older person's anxiety and worry (76.1%), sleeping problems (53.1%) and pain (41.1%) were the health problems in daily life most likely to trigger use of NPMs. To manage the emerging health problems, interactions (87.1%), diet and nutrition supplements (63.2%) and physical activity were commonly used, particularly by nurses. One third (n = 54) stated that they did not evaluate the NPMs used, with no statistical differences between nurses and paramedical professionals. The present study indicated that NPMs were used in care of older people among nurses and paramedical professionals, but not in a systematic way and often without follow‐up.
Telenurses’ experiences of interaction with patients and family members: nurse–caller interaction via telephone
Authors: Yliluoma Paula , Palonen Mira
Published: October 2019

Background

Telephone nursing is expanding worldwide, but a little is known about nurses’ interactions with callers and the factors that affect these interactions.

Aim

The purpose of this paper is to describe how telenurses experience caller interactions.

Methods

A qualitative study designed through open telephone interviews with call centre nurses (n = 9) in 2017. The data were analysed using inductive content analysis. Ethical guidelines were followed at all stages of the study.

Results

Callers both enhanced and hindered interactions. Nurses’ professional skills, such as communication skills, nurse‐led control over the call and the nurses’ capabilities, enabled positive interactions. Disturbing background sounds, communication problems and service system failures made the telephone interactions challenging. Achieving connection with callers, callers who had supportive family members and a supportive organisational structure were features of successful interactions.

Study limitations

As all nine participants were recruited from one call centre, the findings are not directly transferable to another environment.

Conclusions

The results reveal that nurse–caller interactions are affected by several issues concerning the callers and the nurses’ skills. Communication problems were often present when telenurses were unable to provide the services callers expected due to lacking health and medical care resources. Family members could be considered important participants in telephone communication with nurses, though further research should examine the possible benefits of interacting with family members.

Practical implications

Based on the results of this study, telenurses could benefit from training that focuses on the communication skills that are needed for telephone nursing and the tools needed to meet individual callers’ needs. Work environments could also better support caller–nurse interactions. Organisations should provide more resources for telephone nursing in order to promote positive interactions.
Exact dimensionality selection for Bayesian PCA
Authors: Bouveyron Charles , Latouche Pierre , Mattei Pierre‐Alexandre
Published: October 2019

We present a Bayesian model selection approach to estimate the intrinsic dimensionality of a high‐dimensional dataset. To this end, we introduce a novel formulation of the probabilisitic principal component analysis model based on a normal‐gamma prior distribution. In this context, we exhibit a closed‐form expression of the marginal likelihood which allows to infer an optimal number of components. We also propose a heuristic based on the expected shape of the marginal likelihood curve in order to choose the hyperparameters. In nonasymptotic frameworks, we show on simulated data that this exact dimensionality selection approach is competitive with both Bayesian and frequentist state‐of‐the‐art methods.
Inferactive data analysis
Authors: Bi Nan , Markovic Jelena , Xia Lucy , Taylor Jonathan
Published: October 2019

We describeinferactive data analysis, so‐named to denote an interactive approach to data analysis with an emphasis on inference after data analysis. Our approach is a compromise between Tukey's exploratory and confirmatory data analysis allowing also for Bayesian data analysis. We see this as a useful step in concrete providing tools (with statistical guarantees) for current data scientists. The basis of inference we use is (a conditional approach to)selective inference, in particular its randomized form. The relevant reference distributions are constructed from what we call a DAG‐DAG—a Data Analysis Generative DAG, and a selective change of variables formula is crucial to any practical implementation of inferactive data analysis via sampling these distributions. We discuss a canonical example of an incomplete cross‐validation test statistic to discriminate between black box models, and a real HIV dataset example to illustrate inference after making multiple queries on data.
Activity limitation and match load in para‐footballers with cerebral palsy: An approach for evidence‐based classification
Authors: Reina Raúl , Iturricastillo Aitor , Castillo Daniel , Urbán Tomás , Yanci Javier
Published: October 2019

Classification is a hot topic in Paralympic sport, making the development of evidence‐based and sport‐specific classification systems mandatory. However, the development of measurements for exploring the relationships between the athletes' impairment and their activity limitation is a considerable scientific challenge in team Paralympic sport such as 7‐side football (ie, CP Football). The aims of this study were 1) to describe the activity limitation and external match load (ML) differences among impairment profiles (FT) in international level footballers with cerebral palsy (CPFP) and 2) to analyze the relationship among the activity limitation and external ML variables. Forty‐eight international male CPFP (23 ± 7 y; 174.7 ± 7.2 cm; 69.4 ± 9.2 kg; 22.7 ± 2.6 kg·m−2) participated in this study and were divided according to their impairment profile (FT5/6, FT7, and FT8). Significant differences (P < .05) have been observed among FT profiles in the activity limitation tests (ie, static balance, coordination, vertical jump, horizontal jump, acceleration capacity, and change of direction ability). Additionally, significant differences have been observed among FT profiles in certain ML values (ie, Velmax, High Acc and in Mod and High Dec), where generally, FT8 players reported the best performance values. On the other hand, especially in the FT5/6 and in the FT8 profiles, a large‐to‐very large significant relationship was observed between the CPFP activity limitation and the ML values. In general, the results of the present study show that players with a lower impairment have less activity limitation and better ML. This study concludes that the potential relationships between the impairments of hypertonia, ataxia, or athetosis and performance in this para‐sport might be impairment‐specific.
Revisiting Transnational European Consociationalism: The European Union a Decade After Lisbon
Authors: Piattoni Simona , Verzichelli Luca
Published: October 2019

This article discusses the notion of consociationalism as applied to the EU and assesses whether the institutional and procedural changes introduced by the Treaty of Lisbon (ToL) and by the management of the Euro and refugee crises still warrant considering the EU as a case of consociational democracy. Our contention is that the changes introduced by the ToL bore the promise to strengthen the consociational structural traits of the Union but that the further institutional and procedural changes engendered by the management of the Euro and refugee crises have made the behavioral dimension of consociationalism all the more necessary just as the accommodating orientation of the political elites had begun to evaporate. We support this argument by looking at empirical evidence which allows us to offer a set of propositions on the effects of the recent crises on the attitudes of the European elites towards the future of EU democracy.
A spatial‐temporal‐semantic approach for detecting local events using geo‐social media data
Authors: Xu Shishuo , Li Songnian , Huang Wei
Published: October 2019

Social media networks allow users to post what they are involved in with location information in a real‐time manner. It is therefore possible to collect large amounts of information related to local events from existing social networks. Mining this abundant information can feed users and organizations with situational awareness to make responsive plans for ongoing events. Despite the fact that a number of studies have been conducted to detect local events using social media data, the event content is not efficiently summarized and/or the correlation between abnormal neighboring regions is not investigated. This article presents a spatial‐temporal‐semantic approach to local event detection using geo‐social media data. Geographical regularities are first measured to extract spatio‐temporal outliers, of which the corresponding tweet content is automatically summarized using the topic modeling method. The correlation between outliers is subsequently examined by investigating their spatial adjacency and semantic similarity. A case study on the 2014 Toronto International Film Festival (TIFF) is conducted using Twitter data to evaluate our approach. This reveals that up to 87% of the events detected are correctly identified compared with the official TIFF schedule. This work is beneficial for authorities to keep track of urban dynamics and helps build smart cities by providing new ways of detecting what is happening in them.
Topologies of N6‐adenosine methylation (m6A) in land plant mitochondria and their putative effects on organellar gene expression
Authors: Murik Omer , Chandran Sam Aldrin , Nevo‐Dinur Keren , Sultan Laure D. , Best Corinne , Stein Yuval , Hazan Carina , Ostersetzer‐Biran Oren
Published: October 2019

Mitochondria serve as major sites of ATP production and play key roles in many other metabolic processes that are critical to the cell. As relicts of an ancient bacterial endosymbiont, mitochondria contain their own hereditary material (i.e. mtDNA, or mitogenome) and a machinery for protein biosynthesis. The expression of the mtDNA in plants is complex, particularly at the post‐transcriptional level. Following transcription, the polycistronic pre‐RNAs undergo extensive modifications, including trimming, splicing and editing, before being translated by organellar ribosomes. Our study focuses on N6‐methylation of adenosine ribonucleotides (m6A‐RNA) in plant mitochondria. m6A is a prevalent modification in nuclear‐encoded mRNAs. The biological significance of this dynamic modification is under investigation, but it is widely accepted that m6A mediates structural switches that affect RNA stability and/or activity. Using m6A‐pulldown/RNA‐seq (m6A‐RIP‐seq) assays of Arabidopsis and cauliflower mitochondria, we provide information on the m6A‐RNA landscapes in Arabidopsis thaliana and Brassica oleracea mitochondria. The results show that m6A targets different types of mitochondrial transcripts, including known genes, mtORFs, as well as non‐coding (transcribed intergenic) RNA species. While ncRNAs undergo multiple m6A modifications, N6‐methylation of adenosine residues with mRNAs seem preferably positioned near start codons and may modulate their translatability.
The effects of storage at 4°C and 20°C on the hemograms of C57BL/6 mice and Wistar rats using the IDEXX ProCyte Dx and blood smear evaluations
Authors: Layssol‐Lamour Catherine , Lavabre Typhaine , Braun Jean‐Pierre , Trumel Catherine , Bourgès‐Abella Nathalie
Published: October 2019

Background

Delayed blood analysis might be unavoidable in laboratory practice, but little is known about rodent blood stability, especially cell morphology and scattergram results.

Objectives

This study aimed to evaluate the stability of rodent blood cell counts and morphologies at different temperatures using the ProCyte Dx analyzer and performing manual observations.

Methods

Ten Wistar rats and 10 C57bl/6 mice were sampled on EDTA tubes and aliquoted for storage (4°C, 20°C). Hematologic analyses were performed immediately and at T6h, T24h, T48h (rats and mice), and T72h (rats only) after storage.

Results

In rats, at any temperature, red blood cell counts, hemoglobin concentrations (HGB), mean corpuscular hemoglobin (MCH) levels, and reticulocyte, white blood cell (WBC), eosinophil, and impedance platelet counts remained stable over time. The main changes were observed at 20°C for hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and WBC differential counts. Optical platelet counts (PLT‐O) and platelet variables underwent changes at both temperatures from T24h. In mice, red blood cell counts by impedance (RBC‐I), MCH, and WBC, lymphocyte, eosinophil, and platelet counts, and plateletcrit (PCT) were stable over time and at all temperatures. As in rats, the most significant changes were observed at 20°C and concerned the optical RBC (RBC‐O) counts, HCTs, MCVs, MCHCs, and reticulocyte, neutrophil, and monocyte counts. For both species, blood cell morphologies were altered from T24h at all temperatures, and platelet clumps were more numerous at 4°C.

Conclusions

When rodent blood analyses need to be delayed, storage at 4°C is preferred and should not exceed 24 hours. PLT counts should be interpreted cautiously in refrigerated specimens with mandatory blood smear evaluations when abnormal scattergrams are observed.
Managing the Gulf Coast Using Geology and Engineering
Authors: Davis Richard A. , Elko Nicole , Wang Ping
Published: October 2019

This book looks at coastal management as it applies to the physical barrier/inlet system of the Gulf of Mexico. This is an excellent region for considering this topic because it has a wide range of situations to be considered in its management—remote areas, huge urban populations, and tidal inlets, including some natural, some dredged, and others that have been structured for more than a century. Discussing options for managing and protecting the various elements of the barrier/inlet system, the authors consider each approach in terms of costs, logistics, and success or failure. They extensively cover anthropogenic impact as well as management problems generated by natural processes, especially hurricanes and other severe storms. The authors discuss the impact of management decisions and related projects, providing decision makers with the proper information to make decisions on zoning, development, construction of major structures, environmental concerns, etc.
The preparatory phase of the Mw 6.1 2009 L’Aquila (Italy) normal faulting earthquake traced by foreshock time-lapse tomography
Authors: Baccheschi Paola , De Gori Pasquale , Villani Fabio , Trippetta Fabio , Chiarabba Claudio
Published: October 2019

The Mw 6.1 (6 April 2009) L’Aquila (Italy) earthquake occurred in one of the most seismically active areas of central Italy and was preceded by a three-month-long foreshock period. Thanks to recordings by a regional permanent network, we derive for the first time P- and S-wave velocity tomographic models of a major fault prone to an imminent main shock. Close to the Mw 6.1 hypocenter, we observe high Vp (>6.8 km/s) and high Vp/Vs (>1.9) consistent with thick dolomitic volumes filled with fluids sealed by impermeable anhydritic layers. Significant changes in velocities defined by time-lapse imaging during the foreshock period suggest rapid fluid migration through the locked fault zone. The complex positive feedback between fluid pressure buildup and hydrofracturing of the dolomitic reservoir, testified by foreshock production, eventually provoked the catastrophic coseismic breaching of the fault seal. Our results show that foreshock time-lapse tomography provides clues on the preparatory phase of a large normal-faulting earthquake.
Land plant evolution decreased, rather than increased, weathering rates
Authors: D’Antonio Michael P. , Ibarra Daniel E. , Boyce C. Kevin
Published: October 2019

The repeated evolution of trees is widely thought to have enhanced the capacity of silicate weathering via the impact of deep rooting. However, land plants are also responsible for wetland assembly and organic carbon burial. The total burial output of carbon via both organic and inorganic deposition must balance input to the exogenic system from volcanic outgassing on million-year time scales. Increased partitioning of carbon burial toward organic carbon and away from inorganic carbon reduces the marine carbonate burial flux, necessitating a lowered total flux of alkalinity to the oceans to maintain mass balance in the Earth’s surface carbon cycle. This flux includes the nutrient delivery from the terrestrial vegetation implicated as a driver of marine evolution, extinction, and environmental change including anoxia and black shale formation. Here, the burial of terrestrial organic carbon, first substantially in the Devonian and continuing through to the present, is argued to require a reduction in silicate weathering rates when compared to earlier times, given the independence of volcanic outgassing from weathering on short time scales. Land plants still may cause reductions in steady-state atmospheric CO2 levels, but via increasing the silicate weathering feedback strength, not silicate weathering rates. The mass-balance constraints on the long-term carbon cycle provide a mechanism for linking how land plant evolution simultaneously increased nutrient recycling and weathering efficiency of the Earth’s surface.
Confinement of rectangular columns made with engineered cementitious composites (ECC)
Authors: Wong Wai Man , Cruz-Noguez Carlos A. , Tolou-Kian Mohammad J.
Published: October 2019

Engineered cementitious composites (ECC) is a type of high-performance fiber-reinforced cementitious composites (HPFRCC) designed to achieve high tensile strain capacity with strain hardening effect during the post-cracking response. Previous studies show that ECC has high damage-tolerance capacity in tension, increasing the durability, safety, and sustainability of structures susceptible to cracking and spalling under moderate to severe loading. Under compression, however, there is a lack of data regarding confinement effects on steel-reinforced ECC (RECC) members. Thus, designing ECC structures is usually done by assuming the ECC behaves in the same way as conventional concrete under compression. With scarce experimental data available, this assumption may be inaccurate, uneconomical, or even unsafe. An experimental test program on confined ECC columns was performed in this study. Sixteen 100 mm × 100 mm × 300 mm ECC square columns, consisting of one set of unconfined ECC and three sets of confined ECC with 1%, 1.5%, and 2% transverse steel content were fabricated and tested under monotonic compressive load until failure. The force–displacement and stress–strain relationships in the longitudinal direction were measured. The results show that confined ECC has a compressive stress–strain behavior similar to that of confined high-strength concrete, with a rapid compressive strength loss after peak strength, and a gradual loss of strength that is inversely proportional to the amount of steel reinforcement. An empirical stress–strain model for rectangularly confined high-strength ECC was developed based on an existing model for high-strength conventional concrete.
Adapting estimation methods of daily solar radiation for crop modelling applications in Canada
Authors: Qian Budong , Jing Qi , Zhang Xuebin , Shang Jiali , Liu Jiangui , Wan Hui , Dong Taifeng , De Jong Reinder
Published: October 2019

Estimating daily solar radiation from common meteorological variables plays an important role in agricultural applications, such as driving crop growth models. Relatively simple and accurate estimation methods, which use only daily air temperature together with precipitation, are often required. Based on all available solar radiation data across Canada, the most common and representative solar radiation models were evaluated. All estimation models provided more accurate estimates, in terms of all performance statistics used in this study, than those extracted directly from a high-resolution global dataset of meteorological forcings for land surface modelling. The DS model adapted from one originally developed for the Canadian Prairies performed better than other representative models for all stations. The DS model was then adapted for regional use in southern Canada, mostly the major agricultural regions. We compared simulated crop yields using the CSM–CERES–wheat and CSM–CROPGRO–canola models driven by observed and estimated daily solar radiation data, and we found a difference of approximately 5% for spring wheat (Triticum aestivum L.) and 12% for canola (Brassica napus L.). Based on the results for two locations under different climate regimes with relatively long records (45 and 40 yr, respectively) of solar radiation data, the models using daily temperature range and precipitation were found to be robust for daily solar radiation estimation for the entire time periods of the data records.
Methodology for the determination of <63 µm free mica fines in sand and within the cement matrix of hardened concrete blocks using scanning electron microscopy and energy dispersive spectroscopy
Authors: O'Connor Leona , Goodhue Robbie
Published: October 2019

We propose a method for quantification of the percentage of <63 µm muscovite fines (termed free mica) in mixed sand fines and the identification/semi-quantitative analysis of free mica in the cement matrix of hardened concrete blocks. In recent times homeowners in County Donegal, Ireland reported structural problems in their buildings and concern that it is due to high concentrations of free mica within the concrete blocks. Our method requires the generation of high-resolution backscattered electron (BSE) images using field emission scanning electron microscopy (FE-SEM), where the characteristic needle-like morphology of mica can easily be identified. Additional information on the size, shape and chemical composition of the free mica fines, is gathered using energy dispersive spectroscopy (EDS or EDX). The combination of high-magnification images, high-resolution elemental maps, and mineral liberation software allows accurate identification and quantification of free mica within the sand fines and cement matrix.

Supplementary material
: Information pertaining to the measurements by SEM-EDX are reported in Supplementary Tables 1 and 2, available at
https://doi.org/10.6084/m9.figshare.c.4709390
A Decentralized Energy Flow Control Framework for Regional Energy Internet
Authors: Wang Guofeng , Zhao Kangli , Yang Yu , Lu Junjie , Zhang Youbing
Published: October 2019

As a new form of smart grid, the energy transmission mode of the Energy Internet (EI) has changed from one direction to the interconnected form. Centralized scheduling of traditional power grids has the problems of low communication efficiency and low system resilience, which do not contribute to long‐term development in the future. Owing to the fact that it is difficult to achieve an optimal operation for centralized control, we propose a decentralized energy flow control framework for regional Energy Internet. Through optimal scheduling of regional EI, large‐scale utilization and sharing of distributed renewable energy can be realized, while taking into consideration the uncertainty of both demand side and supply side. Combing the multiagent system with noncooperative game theory, a novel electricity price mechanism is adopted to maximize the profit of the regional EI. We prove that Nash equilibrium of theoretical noncooperative game can realize consensus in the multiagent system. The numerical results of real‐world traces show that the regional EI can better absorb the renewable energy under the optimized control strategy, which proves the feasibility and economy of the proposed decentralized energy flow control framework.
Anomalous Circulation Patterns in Association with Summertime Regional Daily Precipitation Extremes over Northeast China
Authors: Chen Chuanlei , Guan Zhaoyong , Jiao Min , Hu Pengyu
Published: October 2019

Based on the NCEP/NCAR daily reanalysis product, NOAA monthly sea surface temperature (SST) dataset, and daily precipitation data collected at observational stations provided by Meteorological Information Center of China Meteorological Administration, the present study analyzes characteristic circulation anomalies conducive to regional extreme daily precipitation in the summer over Northeast China. Results indicate that 26 extreme precipitation events occurred during the 36-year period of 1979–2014. The precipitation threshold for the 99th percentile is 22.2 mm/d, and the maximum extreme daily precipitation occurred in Liaoning Province. When extreme precipitation occurs, Northeast China is located to the southeast of an anomalous cyclonic circulation and northwest of an anomalous anticyclonic circulation, where a strong convergence zone is formed in the lower troposphere. The low-level convergence and upper-level divergence as well as the baroclinic circulation structure are favorable for the development of extreme daily precipitation. Meanwhile, there exist two symmetrical meridional circulations to the north and south of Northeast China. The two meridional circulations share the same ascending branch, which is conducive to the occurrence of precipitation. Located in the strong convergence zone to the southeast of the abnormal cyclonic circulation and northwest of the abnormal anticyclonic circulation, huge amounts of water vapor from the Inner Mongolia, Russia, the Japan Sea, and the mid-high latitudes of the Northwest Pacific are transported to Northeast China, providing sufficient water vapor condition for the occurrence of extreme daily precipitation in this region. In addition, daily extreme precipitation in Northeast China is also closely related to the accumulation and convergence of disturbance energy in Northeast China. It may also be related to the abnormal SST distribution that is high in the north and low in the south. Corresponding to extreme daily precipitation, SST anomaly in the Pacific Ocean is roughly characterized by the feature of “positive-north and negative- south” with the equator as the boundary.
Levels of Selected Matrix Metalloproteinases, Their Inhibitors in Saliva, and Oral Status in Juvenile Idiopathic Arthritis Patients vs. Healthy Controls
Authors: Kobus Agnieszka , Bagińska Joanna , Łapińska-Antończuk Joanna , Ławicki Sławomir , Kierklo Anna
Published: October 2019

Aims. Matrix metalloproteinases (MMPs) are a group of calcium-dependent zinc-containing proteinases acting both physiologically and in pathological conditions. The aim of this study was to evaluate the concentration of MMP-2, MMP-8, and MMP-9 and their inhibitors TIMP-1 and TIMP-2 of unstimulated whole saliva (UWS) in correlation with the oral health in juvenile idiopathic arthritis (JIA) children. Methods. The study population comprised 34 JIA patients and 34 age- and sex-matched controls (C). They were divided into two groups: with mixed dentition (MD) and with permanent dentition (PD). Dental caries (DMFT/dmft), unstimulated salivary flow rate (SF), and gingival inflammation (Gingival Index (GI) and Papilla Bleeding Index (PBI)) and oral hygiene (Simplified Oral Hygiene Index (OHI-S)) indices were evaluated. Saliva samples were tested with the enzyme-linked immunosorbent assay (ELISA) for MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2. Data were statistically analysed with the Mann–Whitney U test and Spearman’s rank correlation (p<0.05). Results. There were no differences in dental hygiene or dental and periodontal status between the JIA and C groups. The MMP-9 concentration was higher in the whole JIA group compared with C (p=0.005) and JIA MD groups (p=0.038). A positive correlation of MMP-2 with the OHI-S index and a negative correlation of MMP-2 with SF were found in JIA. MMP-9 and its tissue inhibitor TIMP-1 had a positive mean correlation with the GI. A high correlation of MMP-8 with the number of decayed teeth (D) in JIA MD patients (p=0.037) was revealed. In the JIA-PD patients, there was a positive correlation of MMP-2, -8, and -9 levels with gingival inflammation indices and a negative correlation of MMP-2 and 8 with the SF. Conclusions. Despite a comparable clinical oral status of affected and unaffected children, in the JIA patients, a statistically significantly increased level of MMP-9 was found. In reference to the periodontal status, the role of MMPs increased in children with permanent dentition, whereas in reference to dental caries, the period of mixed dentition (MD) was critical.
Investigation of Var Compensation Schemes in Unbalanced Distribution Systems
Authors: Huang Yinuo , Wang Licheng , Wang Kai
Published: October 2019

Distributed rooftop photovoltaic (PV) generators prospered distributed generation (DG) in recent years. Certain randomness of rooftop PV connection may lead to significant PV power imbalance across three phases, especially in low‐voltage distribution systems. Due to interphase line coupling, traditional Var compensation methods which typically have competent voltage regulation performance may become less effective in such PV imbalance scenarios. In this paper, the limitation of traditional Var compensation methods in voltage regulation with unbalanced PV power integration is demonstrated and comprehensively analyzed. After describing the voltage regulation challenge, based on the voltage sensitivity analysis, it is revealed that PV power unbalanced level together with equivalent mutual impedance among phase conductors has a significant impact on the effectiveness of traditional Var compensation methods on voltage regulation. On this basis, to improve the performance of voltage regulation methods, some suggestions are proposed for both current system operation and future distribution system planning. Numerical studies demonstrate the effectiveness of the proposed suggestions. Future rooftop PV integration in LV systems can benefit from this research.
A Th2 Cytokine Profile in Appendicular Lavage Fluid Suggests Allergy as a Possible Etiology for Acute Appendicitis
Authors: Carvalho Nuno , Barros André , Coelho Hélder O. , Moita Catarina F. , Neves-Costa Ana , Pedroso Dora , Borges Filipe C. , Moita Luís F. , Costa Paulo M.
Published: October 2019

Acute appendicitis is the most frequent surgical abdominal emergency, but its etiology remains poorly understood. Histological examination of the appendix, following its removal due to acute appendicitis, consistently shows features in common with bronchial asthma, suggesting an allergic reaction as a candidate etiologic factor. Here, we propose the concept of appendicular lavage and use it to study the levels of the Th2 cytokines IL-4, IL-5, and IL-9 in patients with a clinical diagnosis of acute appendicitis. The study group included 20 patients with a histological diagnosis of phlegmonous appendicitis, 13 patients with gangrenous appendicitis, and a control group of 8 patients with a clinical diagnosis of appendicitis but with normal histology. Cytokine levels were higher in acute appendicitis. The difference was more pronounced when comparing phlegmonous appendicitis with nonpathological appendicitis (p=0.01) for IL-4 (48.3 vs. 21.3 pg/mL), IL-5 (29.2 vs. 8.0 pg/mL), and IL-9 (34.1 vs. 16.6 pg/mL). This Th2 cytokine profile is compatible with the hypothesis of allergy as an etiologic factor for acute appendicitis and may have important implications for the diagnosis, prevention, and treatment of this condition.
A Case of Hypertrophic Pachymeningitis Associated with Immunoglobulin-G4 and c-ANCA
Authors: Wyrostek Stephanie , Chakrabarti Satabdi , Baldwin Kelly , Avila J. David
Published: October 2019

Hypertrophic pachymeningitis (HP) is characterized by inflammation of the dura mater. It has been described in the setting of numerous systemic inflammatory diseases including immunoglobulin G4 (IgG4)-related disease as well as granulomatosis with polyangiitis (GPA). In this case report, we describe a 48-year-old man presenting with headache who was found to have HP and had systemic features of both GPA and IgG4-related disease as well as seropositivity for both cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) and IgG4. He was treated with prednisone and rituximab with improvement in his symptoms. Co-occurrence of IgG4 and ANCA against myeloperoxidase has been reported in other cases of HP. The overlap between IgG4 and ANCA has also been described in other systemic manifestations of the diseases. These reports suggest a clinical overlap between ANCA and IgG4-related disease, and the case presented herein suggests an overlap between GPA and IgG4-related disease.
Is Strength Training as Effective as Aerobic Training for Depression in Older Adults? A Randomized Controlled Trial
Authors: Moraes Helena S. , Silveira Heitor S. , Oliveira Natacha A. , Matta Mello Portugal Eduardo , Araújo Narahyana B. , Vasques Paulo E. , Bergland Astrid , Santos Tony M. , Engedal Knut , Coutinho Evandro S. , Schuch Felipe B. , Laks Jerson , Deslandes Andrea C.
Published: October 2019

Background: This study aimed to compare the effects of aerobic training (AT), strength training (ST) and low-intensity exercise in a control group (CG) as adjunct treatments to pharmacotherapy for major depressive disorder (MDD) in older persons. Methods: Older persons clinically diagnosed with MDD (n = 27) and treated with antidepressants were blindly randomized into three groups: AT, ST and a CG. All patients were evaluated prior to and 12 weeks after the intervention. Results: Compared with the CG, the AT and ST groups showed significant reductions in depressive symptoms (treatment ­response = 50% decrease in the pre- to postintervention assessment) through the Hamilton Depression Rating Scale (AT group: χ2, p = 0.044) and Beck Depression Inventory (ST group: χ2, p = 0.044). Conclusion: Adding AT or ST with moderate intensity to the usual treatment promoted a greater reduction of MDD symptoms.
Gender-Affirming Hormone Therapy, Vascular Health and Cardiovascular Disease in Transgender Adults
Authors: Connelly Paul J. , Marie Freel E. , Perry Colin , Ewan John , Touyz Rhian M. , Currie Gemma , Delles Christian
Published: October 2019

Gender-affirming or cross-sex hormone therapy is integral to the management of transgender individuals yet our appreciation of the effects of such hormones on cardiovascular health is limited. Insights into vascular pathophysiology and outcomes in transgender people receiving sex steroids could be fundamental in providing better care for this population through the management of cardiovascular risk and more broadly advance our understanding of the role of sex and gender in vascular health and disease. In addition, there is a need to understand how gender-affirming hormone therapy impacts cardiovascular disease risk and events as transgender individuals age. This review explores the available evidence on the associations between gender-affirming hormones and cardiovascular events such as coronary artery disease, stroke, hypertension, thrombosis, lipid abnormalities, and diabetes mellitus. Current research about vascular outcomes in adults receiving hormonal therapy is limited by the absence of large cohort studies, lack of appropriate control populations, and inadequate data acquisition from gender identity services. Existing epidemiological data suggest that the use of estrogens in transgender females confers an increased risk of myocardial infarction and ischemic stroke. Conversely, transgender males receiving testosterone lack any consistent or convincing evidence of increased risk of cardiovascular or cerebrovascular disease. Further studies are required to confirm whether such risk exists and the mechanisms by which they occur.
Necrosis Contributes to the Development of Hypertension in Male, but Not Female, Spontaneously Hypertensive Rats
Authors: Abdelbary Mahmoud , Rafikova Olga , Gillis Ellen E. , Musall Jacqueline B. , Baban Babak , O’Connor Paul M. , Brands Michael W. , Sullivan Jennifer C.
Published: October 2019

Necrosis is a pathological form of cell death that induces an inflammatory response, and immune cell activation contributes to the development and maintenance of hypertension. Necrosis was measured in kidney, spleen, and aorta of 12- to 13-week-old male and female SHRs (spontaneously hypertensive rats); male SHRs had greater renal necrotic cell death than female SHRs. Because male SHRs have a higher blood pressure (BP) and a more proinflammatory T-cell profile than female SHRs, the current studies tested the hypothesis that greater necrotic cell death in male SHRs exacerbates increases in BP and contributes to the proinflammatory T-cell profile. Male and female SHRs were randomized to receive vehicle or Necrox-5—a cell permeable inhibitor of necrosis—from 6 to 12 weeks of age or from 11 to 13 weeks of age. In both studies, Necrox-5 decreased renal necrosis and abolished the sex difference. Treatment with Necrox-5 beginning at 6 weeks of age attenuated maturation-induced increases in BP in male SHR; BP in female SHR was not altered by Necrox-5 treatment. Necrox-5 decreased proinflammatory renal T cells in both sexes, although sex differences were maintained. Administration of Necrox-5 for 2 weeks in SHR with established hypertension resulted in a small but significant decrease in BP in males with no effect in females. These results suggest that greater necrotic cell death in male SHR exacerbates maturation-induced increases in BP with age contributing to sex differences in BP. Moreover, although necrosis is proinflammatory, it is unlikely to explain sex differences in the renal T-cell profile.
Genetic Susceptibility, Dietary Protein Intake, and Changes of Blood Pressure
Authors: Sun Dianjianyi , Zhou Tao , Li Xiang , Heianza Yoriko , Liang Zhaoxia , Bray George A. , Sacks Frank M. , Qi Lu
Published: October 2019

High blood pressure (BP) is closely related to obesity, and weight loss lowers BP. Evidence has shown considerable interpersonal variation of changes in BP among people experiencing weight loss, and such variation might be partly determined by genetic factors. We assessed the changes in systolic and diastolic BP (SBP/DBP) among 692 participants randomly assigned to 1 of 4 diets varying in macronutrient content for 2 years. Two separate polygenic scores (SBP/DBP-PGS derived from 52/50 single nucleotide polymorphisms) were built for each participant based on 66 BP-associated single nucleotide polymorphisms. During a 2-year intervention, participants in the bottom versus upper tertile of SBP/DBP-PGS had a greater decrease in SBP (△SBP at 6, 12, and 24 months: −3.84 versus −1.61, −4.76 versus −2.75, −2.49 versus −1.63;
P
=0.001) or in DBP (△DBP at 6, 12, and 24 months: −3.09 versus −1.34, −2.69 versus −1.44, −1.82 versus −0.53;
P
<0.001). We also found gene-diet interaction on changes in SBP from baseline to 24 months (
P
interaction
=0.009). Among participants assigned to a high-protein diet, those with a lower SBP-polygenic scores had greater decreases in SBP at months 6 (
P
=0.018), months 12 (
P
=0.007), and months 24 (
P
=0.089); while no significant difference was observed across the SBP-polygenic scores tertile groups among those assigned to an average-protein diet (all
P
values >0.05). Our data indicate that genetic susceptibility may affect BP changes in response to weight-loss diet interventions, and protein intake may modify the genetic associations with changes in BP. This trial was registered at URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00072995.