bluuebunny/crossref_metadata_2025 huggingface dataset:
Using reintroduction to elucidate breeding system, breeding phenology, and infanticide for a solitary carnivore (fisher,Pekaniapennanti)
Authors: Smith K.P. , Facka A.N. , Powell R.A.
Published: March 2020

Breeding systems affect the timing of reproduction, spacing patterns and social organization, individual fitnesses, and population sizes. For many species, information on breeding systems and mating is limited or untested in wild populations, resulting in management actions that are incompletely informed. We used photographic data collected on a reintroduced fisher (Pekania pennanti (Erxleben, 1777)) population in northern California, USA, to test hypotheses about the breeding system, the timing of breeding, and the potential for male infanticide. We documented fishers of both sexes breeding with multiple partners in the same year, demonstrating polygynandry. We use logistic and linear regression to evaluate the timing and frequency of male visitation at 262 reproductive dens used by 50 individual females. Of 46 documented copulations and 577 male visits, 100% and 95%, respectively, occurred while females had kits in their natal dens. Seventy-five percent of documented male visits occurred before 31 March and 95% occurred before 17 April. Observed breeding occurred within 3.1 ± 1.6 days (mean ± SD) of locating females’ natal dens. We found no evidence for male-directed infanticide. Our results add precision to the timing of the reproductive cycle and provide the first descriptions of male–female interactions for wild fishers.
A Dimension Reduction Method Application to a Political Science Question: Using Exploratory Factor Analysis to Generate the Dimensionality of Political Ideology in the Arab World
Authors: Abduljaber Malek
Published: March 2020

This paper utilises data dimension reduction to settle a heavily debated question concerning the dimensionality of political ideology in the Arab World. It relies on recent data available through the World Values Survey to generate a stable solution for the number of important and exciting dimensions defining ordinary citizens’ political attitude structures. The findings of the analysis suggest that in four Arab states, political ideology is multi-dimensional on the mass level. This negates the widespread assumption made about Arab politics where Islam and secularism constitute the only dimension organising voters’ attitudes and behaviours. This is important because many analyses of Middle Eastern politics start with this assumption without questioning its validity. Further, models of political ideology are to be modified when transferred to studying Middle Eastern political attitudes. The single-dimension hypothesis applicable in some Western settings is not attainable in the Arab World.
A few remarks on invariable generation in infinite groups
Authors: Goffer Gil , Noskov Gennady A.
Published: March 2020

A subset [Formula: see text] of a group [Formula: see text] invariably generates [Formula: see text] if [Formula: see text] is generated by [Formula: see text] for any choice of [Formula: see text]. A topological group [Formula: see text] is said to be [Formula: see text] if it is invariably generated by some subset [Formula: see text], and [Formula: see text] if it is topologically invariably generated by some subset [Formula: see text]. In this paper, we study the problem of (topological) invariable generation for linear groups and for automorphism groups of trees. Our main results show that the Lie group [Formula: see text] and the automorphism group of a regular tree are [Formula: see text], and that the groups [Formula: see text] are not [Formula: see text] for countable fields of infinite transcendence degree over a prime field.
FIFTY YEARS OF LITERATURE ON EXPORT ASSISTANCE PROGRAMMES: A BIBLIOMETRIC ANALYSIS
Authors: RIBEIRO JOANA , FORTE ROSA
Published: March 2020

Literature on export assistance programmes (EAPs) was first published over half a century ago and has focused on many topics, such as the impact of EAPs on firms’ performance, their usefulness and use, among others. The numerous papers published in this area justify the present bibliometric analysis aimed at examining the trends in EAP literature from 1966 until 2017. An analysis of 367 studies published in this period allowed us to conclude that most of the works are empirical, adopt the perspective of the provider (the content of the specific programmes offered by public entities), and focus on macroeconomic evaluations (the impact of EAPs on countries’ exports). The bulk of studies have analysed advanced economies, such as the USA or UK. The publications are scattered among a large number of journals, and the influence of this literature is relatively small (few publications have a significant number of citations).
Enhancing the Reconfigurability Issues of Machine Tool for Reconfigurable Manufacturing System (RMS)
Authors: Singh Ashutosh , Asjad Mohammad , Gupta Piyush
Published: March 2020

This paper presents a novel concept to enhance the reconfigurability issues (i.e. convertibility, flexibility, etc.) of a small-scale reconfigurable machine tool (RMT) by combining multiple modules (both basic and auxiliary parts) and manufacturing operations on a single workstation. The proposed reconfigurable machine will reduce the overall space, transport time, ramp up time, reconfiguration time and interim storage space. Further, various characteristics of reconfigurability (such as scalability; convertibility, flexibility, etc.) and enablers of the machine tool have been discussed. The proposed design is illustrated with a figure, which is designed on a 3D design tool (solid-works software platform).This machine tool will perform six major cutting and finishing operations, namely, hacksaw cutting, milling, drilling, grinding, buffing and lathe operations on a single work platform.
Weak and Strong Compatibility in Data Fitting Problems Under Interval Uncertainty
Authors: Shary Sergey P.
Published: March 2020

For the data fitting problem under interval uncertainty, we introduce the concept of strong compatibility between data and parameters. It is shown that the new strengthened formulation of the problem reduces to computing and estimating the so-called tolerable solution set for interval systems of equations constructed from the data being processed. We propose a computational technology for constructing a “best-fit” linear function from interval data, taking into account the strong compatibility requirement. The properties of the new data fitting approach are much better than those of its predecessors: strong compatibility estimates have polynomial computational complexity, the variance of the strong compatibility estimates is almost always finite, and these estimates are rubust. An example considered in the concluding part of the paper illustrates some of these features.
Toward a Uniform Theory of Effectful State Machines
Authors: Goncharov Sergey , Milius Stefan , Silva Alexandra
Published: March 2020

Using recent developments in coalgebraic and monad-based semantics, we present a uniform study of various notions of machines, e.g., finite state machines, multi-stack machines, Turing machines, valence automata, and weighted automata. They are instances of Jacobs’s notion of a
T
-
automaton
, where
T
is a monad. We show that the generic language semantics for
T
-automata correctly instantiates the usual language semantics for a number of known classes of machines/languages, including regular, context-free, recursively-enumerable, and various subclasses of context free languages (e.g., deterministic and real-time ones). Moreover, our approach provides new generic techniques for studying the expressivity power of various machine-based models.
Can Early Diagnosis of Varices, Regular Praziquantel, and Reduction of Hepatitis Coinfection Reduce Mortality among Patients Attended for Periportal Fibrosis in Northwestern Tanzania? A Case-Control Study
Authors: Gunda Daniel W. , Mtui Elizabeth F. , Kilonzo Semvua B. , Manyiri Paulina M. , Majinge David C. , Mazigo Humphrey D.
Published: March 2020

Background.Schistosoma mansoniis highly endemic in the Lake Zone part of Tanzania and most people are chronically infected. Periportal fibrosis (PPF) is the commonest complication of chronicS. mansoniinfection documented in up to 42% of studied participants in the community-based studies. These patients are at high risk of mortality since most of them are diagnosed late with bleeding varices. At Bugando, Schistosoma-related varices contributed to 70% of patients admitted due to vomiting blood with a two months’ mortality of over 10%. Earlier studies had reported higher mortality of up to 29% among patients with PPF even with the best in-hospital care. Understanding factors that increased the risk of mortality is important clinically in devising ways that can improve the outcome of this subgroup of patients.Methods. A retrospective analysis of patients with PPF from 2015 through 2018 was done. Their sociodemographic, clinical, laboratory, ultrasonographic, endoscopic, and survival status data were collected for analysis. STATA 13 was used for analysis, the prevalence of varices, active schistosomiasis, and hepatitis B coinfection was determined. Cumulative mortality as a major outcome was also determined, and factors associated with increased risk of mortality were assessed by a logistic regression model.Results. In total, 250 participants were included in this analysis. Majority, 222 (88.8%; 95% CI: 84.2-92.4) had activeS. mansoniinfection, and 40 (16.0%; 95% CI: 11.6-21.1) hadS. mansoni-HBV coinfection. Cumulatively, 39 (15.6%; 95% CI: 11.3-20.7) patients died, with most deaths, 31 (79.5%; 95% CI: 63.5-90.7) occurring within two years following the diagnosis of PPF (chi2=6.3;p=0.012). The odds of mortality were independently associated with fishing (OR: 10.8; 95% CI: 2.2-52;p=0.003), upper gastro intestinal bleeding (OR: 2.4; 95% CI: 1.1-5.4;p=0.037), HBV coinfection (OR: 3.3; 95% CI: 1.2-91;p=0.019), and ascites (OR: 3.3; 95% CI: 1.3-8.2;p=0.010).Conclusions. In this,S. mansoniendemic area, varices, actives schistosomiasis, hepatitis B coinfection, and mortality are highly common. Screening for varices and initiation of prophylaxis, administration of praziquantel, and screening for hepatitis B should be part and parcel of care of these patients. The first two years of diagnosis, patients are at high risk of mortality; risk factors in this study should assist planning a closer follow-up of patients at risk of mortality to improve their long-term outcome.
The Modulation of Reward and Habit Systems by Acupuncture in Adolescents with Internet Addiction
Authors: Wang Yang , Qin Yun , Li Hui , Yao Dezhong , Sun Bo , Li Zhiliang , Li Xin , Dai Yu , Wen Chao , Zhang Lingrui , Zhang Chenchen , Zhu Tianmin , Luo Cheng
Published: March 2020

Purpose. Acupuncture is an effective therapy for Internet addiction (IA). However, the underlying mechanisms of acupuncture in relieving compulsive Internet use remain unknown. Neuroimaging studies have demonstrated the role of the ventral striatum (VS) in the progress of IA; hence, the aim of this study was to explore the effects of acupuncture on the resting-state functional connectivity (rsFC) and relevant network of VS in IA. Methods. Twenty-seven IA individuals and 30 demographically matched healthy control subjects (HCs) were recruited in this study. We acquired the functional magnetic resonance imaging (fMRI) data in IA subjects before and after 40 days of acupuncture treatment. Seed-to-voxel and ROI-to-ROI analyses were applied to detect the rsFC alterations of the VS and related network in IA subjects and to investigate the modulation effect of acupuncture on the rsFC. Results. Compared with HCs, IA subjects exhibited enhanced rsFC of the right ventral rostral putamen (VRP) with the left orbitofrontal cortex (OFC), premotor cortex (PMC), cerebellum, and right ventromedial prefrontal cortex (vmPFC). In the network including these five ROIs, IA also showed increased ROI-to-ROI rsFC. Using a paired t-test in IA subjects before and after 40 days of acupuncture, the increased ROI-to-ROI rsFC was decreased (normalized to HC) with acupuncture, including the rsFC of the right VRP with the left OFC, PMC, and cerebellum, and the rsFC of the left cerebellum with the left OFC, PMC, and right vmPFC. Furthermore, the change in rsFC strength between the right VRP and left cerebellum in IA individuals was found positively correlated with the Internet craving alleviation after acupuncture. Conclusions. These findings verified the modulation effect of acupuncture on functional connectivity of reward and habit systems related to the VS in IA individuals, which might partly represent the underlying mechanisms of acupuncture on IA.
Experimental Study on the Dynamic Behavior of Running Crack Affected by Defect Shape and Filling Material
Authors: Lei Zhen , Zhao Mingsheng
Published: March 2020

Using the caustics method and the experimental system of digital laser dynamic caustics, the model experiment of drop hammer impact loading was carried out, and the effect of the defect shape (circular and rectangular) and the filling material (air, epoxy, and silicone rubber) on the propagation behavior of the running crack was investigated. The experimental results show that, under the impact loading, the running crack initiates at the end of precrack and propagates toward the defect. After the running crack connects to the defect, it accumulates energy within a certain period before initiating again at the upper edge of the defect. Subsequently, only one running crack is formed at the upper edge of the circular defect, but two running cracks are formed at the upper edge of the rectangular defect. The defect shape and the filling material have a significant effect not only on the energy accumulation time of the running crack at the defect but also on the stress intensity factor when initiating at the defect. The effect degree of the defect shape on the running crack propagation behavior is in the following order: circular defect > rectangular defect, whereas the effect degree of the filling material on the running crack propagation behavior follows this order: air > silicone rubber > epoxy.
Long-term Trends in Prostate Cancer Incidence by Stage at Diagnosis in Japan Using the Multiple Imputation Approach, 1993–2014
Authors: Saito Eiko , Hori Megumi , Matsuda Tomohiro , Yoneoka Daisuke , Ito Yuri , Katanoda Kota
Published: March 2020

Background:

This study aimed to assess long-term trends in the incidence of prostate cancer by stage at diagnosis before and after the introduction of population-based PSA screening.

Methods:

We used data from three population-based cancer registries in Japan. A total of 29,458 malignant prostate cancer cases diagnosed between 1993 and 2014 were used for the analysis. Multiple imputation with chained equations was used to impute a specific stage at diagnosis for cases with “unknown” and missing status. We estimated the age-standardized incidence rates by stage at diagnosis from 1993 to 2014, and used joinpoint linear regression models to assess changes in trend.

Results:

Joinpoint analyses after imputation showed that localized cancer was stable from 1993 to 2000, followed by a pronounced but insignificant increase through 2003 (from 12.1 per 100,000 in 2001 to 34.1 per 100,000 in 2003), and a significant increase thereafter [annual percentage change (APC), 4.1%]. For regional cancer, the imputed data showed that the increasing trend lasted from 1993 to 2006 (APC, 12.5%), then leveled off through 2014. For distant prostate cancer, the imputed data showed the increasing trend continued from 1993 to 2004 (APC, 2.4%), and started to marginally decline thereafter (APC, −2.2%).

Conclusions:

Our study confirmed a significantly rapid increase in localized prostate cancer after the spread of PSA screening in Japan, with a marginal decrease in distant prostate cancer after 2004.

Impact:

Evaluation of the effectiveness of PSA screening would require a comprehensive analysis of changes in mortality, survival, and treatment practices over time.
Dietary Intake of Acrylamide and Risk of Breast, Endometrial, and Ovarian Cancers: A Systematic Review and Dose–Response Meta-analysis
Authors: Adani Giorgia , Filippini Tommaso , Wise Lauren A. , Halldorsson Thorhallur I. , Blaha Ludek , Vinceti Marco
Published: March 2020

Acrylamide is a probable human carcinogen. Aside from occupational exposures and smoking, diet is the main source of exposure in humans. We performed a systematic review of the association between estimated dietary intake of acrylamide and risk of female breast, endometrial, and ovarian cancers in nonexperimental studies published through February 25, 2020, and conducted a dose–response meta-analysis. We identified 18 papers covering 10 different study populations: 16 cohort and two case–control studies. Acrylamide intake was associated with a slightly increased risk of ovarian cancer, particularly among never smokers. For endometrial cancer, risk was highest at intermediate levels of exposure, whereas the association was more linear and positive among never smokers. For breast cancer, we found evidence of a null or inverse relation between exposure and risk, particularly among never smokers and postmenopausal women. In a subgroup analysis limited to premenopausal women, breast cancer risk increased linearly with acrylamide intake starting at 20 μg/day of intake. High acrylamide intake was associated with increased risks of ovarian and endometrial cancers in a relatively linear manner, especially among never smokers. Conversely, little association was observed between acrylamide intake and breast cancer risk, with the exception of premenopausal women.
Stromal-MDM2 Promotes Lung Cancer Cell Invasion through Tumor–Host Feedback Signaling
Authors: Kamer Iris , Daniel-Meshulam Inbal , Zadok Oranit , Bab-Dinitz Elizabeta , Perry Gili , Feniger-Barish Rotem , Perelman Marina , Barshack Iris , Ben-Nun Alon , Onn Amir , Bar Jair
Published: March 2020

Tumor–host interactions play a major role in malignancies' initiation and progression. We have reported in the past that tumor cells attenuate genotoxic stress–induced p53 activation in neighboring stromal cells. Herein, we aim to further elucidate cancer cells' impact on signaling within lung cancer stroma. Primary cancer-associated fibroblasts were grown from resected human lung tumors. Lung cancer lines as well as fresh cultures of resected human lung cancers were used to produce conditioned medium (CM) or cocultured with stromal cells. Invasiveness of cancer cells was evaluated by transwell assays, and in vivo tumor growth was tested in Athymic nude mice. We found CM of a large variety of cancer cell lines as well as ex vivo–cultured lung cancers to rapidly induce protein levels of stromal-MDM2. CM of nontransformed cells had no such effect. Mdm2 induction occurred through enhanced translation, was mTORC1-dependent, and correlated with activation of AKT and p70 S6 Kinase. AKT or MDM2 knockdown in fibroblasts reduced the invasion of neighboring cancer cells, independently of stromal-p53. MDM2 overexpression in fibroblasts enhanced cancer cells' invasion and growth of inoculated tumors in mice. Our results indicate that stromal-MDM2 participates in a p53-independent cancer–host feedback mechanism. Soluble cancer-originated signals induce enhanced translation of stromal-MDM2 through AKT/mTORC1 signaling, which in turn enhances the neighboring cancer cells' invasion ability. The role of these tumor–host interactions needs to be further explored.

Implications:

We uncovered a novel tumor–stroma signaling loop, which is a potentially new therapeutic target in lung cancer and possibly in additional types of cancer.
Problematic Alcohol and Drug Use Is Associated with Low Self-Directedness and Cooperativeness
Authors: Steingrimsson Steinn , Carlsen Hanne Krage , Lundström Emil , Lundström Sebastian , Nilsson Thomas
Published: March 2020

Background: Personality traits, such as self-directedness (SD) and cooperativeness (CO), may be indicative of problematic alcohol and/or drug use. Objectives: The aim of this study was to quantify the association of substance use with SD and CO in a large cohort of adolescents. Method: A total of 6,917 individuals (58% women) at the age of 18 who had filled in the Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT), and the SD and CO scales from the Temperament and Character ­Inventory, as part of the Child and Adolescent Twin study in Sweden were included in the analyses. Results: High AUDIT scores (>15) were found in 2.4% of the population and high DUDIT scores (>7) in 1.2% of the population. Total score on the AUDIT was negatively correlated (p < 0.001) with SD (r = –0.18) and CO (r = –0.15), as well as total DUDIT with SD (r = –0.11) and CO (r = –0.08). The risk of high AUDIT (>15) and DUDIT (>7) was highest for those with a low (1 standard deviation below mean) SD score (ORs 4.1 and 4.5, p < 0.001) and a low CO score (ORs 3.5 and 4.5, p < 0.001). However, at 1 standard deviation above mean, no association between alcohol or drug use and SD or CO was seen. Using SD and CO scores to predict AUDIT >15 or DUDIT >7 yielded a sensitivity between 62.4 and 71.3% and a specificity between 64.9 and 70.4%. Conclusions: Personality traits of low SD and CO are associated with increased alcohol and drug use. These findings support the notion that personality traits can be used to identify individuals at high risk of substance abuse.
Association of Copeptin, a Surrogate Marker of Arginine Vasopressin, with Decreased Kidney Function in Sugarcane Workers in Guatemala
Authors: Butler-Dawson Jaime , Dally Miranda , Johnson Richard J. , Johnson Evan C. , Krisher Lyndsay , Sánchez-Lozada Laura-Gabriela , Griffin Benjamin R. , Brindley Stephen , Newman Lee S.
Published: March 2020

Background: Vasopressin is elevated in response to heat and dehydration and has been postulated to have a role in the chronic kidney disease of unknown origin being observed in Central America. The aims of this study were to examine whether the vasopressin pathway, as measured by copeptin, is associated with the presence of kidney dysfunction, and to examine whether higher fluid intake is associated with lower circulating copeptin and thereby preserves kidney health among sugarcane workers exposed to hot conditions. Methods: Utilizing a longitudinal study of 105 workers in Guatemala, we examined relationships between hydration indices, plasma copeptin concentrations, and kidney function markers at 3 times during the 6-month harvest. We also examined whether baseline copeptin concentrations increased the odds of developing an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Results: Copeptin concentrations were positively associated with serum creatinine (β 1.41, 95% CI 0.88–2.03) and negatively associated with eGFR (β –1.07, 95% CI –1.43 to –0.70). In addition, as workers improved their hydration (measured by increases in fluid balance), copeptin concentrations were reduced, and this reduction was associated with an improvement in kidney function. Conclusions: Results suggest that copeptin should be studied as a potential prognostic biomarker.
Exosomal miRNAs Profile in Children’s Nonalcoholic Fatty Liver Disease and the Correlation with Transaminase and Uric Acid
Authors: Zhou Xuelian , Huang Ke , Jia Junjun , Ni Yan , Yuan Jinna , Liang Xinyi , Lin Hu , Peng Wei , Wu Wei , Dong Guanping , Fu Junfen
Published: March 2020

Objective: The incidence of non-alcoholic fatty liver disease (NAFLD) in children increased rapidly. However, the pathogenesis of NAFLD, especially how non-alcoholic fatty liver progress to non-alcoholic steatohepatitis, is still unclear. This study aims to explore the exosomal miRNAs profiles and the underline pathogenesis of child NAFLD. Methods: Twenty NAFLD and 20 health control were enrolled in this study. Circulating exosomes were isolated, and RNA sequencing was performed in test set (3 NAFLD/3 Controls). The differentially expressed miRNAs (DEM) were further validated in validation set (17 NAFLD/17 Controls). Spearman correlation ­analysis was used to investigate the association between DEM and clinical parameters. Results: Eighty-two miRNAs were differentially expressed (absolute fold change >2 and p < 0.05) in the 2 groups, they were involved in fat acid metabolism, starch and sucrose metabolism, bile acid metabolism and inflammation. miRNA122-5p, miRNA34a-5p, ­miRNA155-5p and miRNA146b-3p were up-regulated in NAFLD group (p < 0.05) and positively correlated with body mass index (r, 0.41–0.59), alanine aminotransferase (r, 0.36–0.52), aspartate transaminase (r, 0.31–0.48) and uric acid (UA, r, 0.51–0.69; p < 0.05). Conclusions: Circulating exosomal miRNAs may be involved in the pathogenesis of NAFLD and correlated with transaminase and UA.
MRI Evaluation of Global Developmental Delay: A Retrospective Study
Authors: Habibullah Hafiz , Albaradie Raidah , Bashir Shahid
Published: March 2020

Introduction: Global developmental delay (GDD) is defined as a significant delay in one or more developmental domains. Aims and Objectives: To study the prevalence of normal and abnormal magnetic resonance imaging (MRI) in pediatric patients presenting with GDD, and how abnormal MRI helps in the diagnosis of children with GDD. Materials and Methods: This was a retrospective observational study conducted at the King Fahad Specialist Hospital Dammam. MRI of the brain was conducted on 170 patients who were referred by the Pediatric Neurology Department between February 2016 and April 2018. Results: Normal MRI findings were seen in 45.3% and 54.7% had abnormal findings. The ventricles and white matter, mainly the corpus callosum, were the most commonly affected anatomical structures. In 15 (16%) patients, MRI enabled a direct diagnosis, and in 22 (23.6%) MRI suggested a diagnosis which was confirmed by further investigation. Conclusion: The clinical diagnosis of GDD should not be the end point, but rather a springboard for an effective search for causal factors. MRI is the best investigation with a high yield in such patients.
The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study
Authors: Papadakou Panagiota , Chatziralli Irini , Papathanassiou Miltiadis , Lambadiari Vaia , Siganos Charalambos S. , Theodossiadis Panagiotis , Kozobolis Vassilios
Published: March 2020

Purpose: The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. Methods: Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. Results: Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm2, respectively; p < 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (p < 0.001), longer DM duration (p = 0.003), and more severe diabetic retinopathy status (p = 0.008). Conclusion: DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.
Early Escalation of Mechanical Circulatory Support Stabilizes and Potentially Rescues Patients in Refractory Cardiogenic Shock
Authors: Tongers Jörn , Sieweke Jan-Thorben , Kühn Christian , Napp L. Christian , Flierl Ulrike , Röntgen Philipp , Schmitto Jan D. , Sedding Daniel G. , Haverich Axel , Bauersachs Johann , Schäfer Andreas
Published: March 2020

Background:

Limited progress has been made in the management of cardiogenic shock (CS). Morbidity and mortality of refractory CS remain high. The effects of mechanical circulatory support (MCS) are promising, although many aspects are elusive. We evaluated efficacy and safety of early combined MCS (Impella microaxial pump + venoarterial extracorporeal membrane oxygenation [VA-ECMO]) in refractory CS and aimed to determine factors for decision-making in combined MCS.

Methods and Results:

We analyzed 69 consecutive patients with refractory CS from our registry requiring combined MCS. In 12 cases, therapy was actively withdrawn according to patient’s will. Patients were severely sick (Survival After Venoarterial ECMO score mean±SD, –8.9±4.4) predicting 30% in-hospital survival; ventilation 94%, dialysis 56%. Impella pumps and VA-ECMO were combined early (duration of combined MCS: median 94 hours; interquartile range, 49–150 hours). Early MCS escalation stabilized patients rapidly, reducing number and doses of catecholamines (
P
<0.05 versus baseline) while hemodynamics improved. Reflecting an improved microcirculation, lactate levels normalized within 24 hours (
P
<0.05 versus baseline). Despite refractory CS and disease severity, survival was favorable (on MCS 61%, 30 days 49%, 6 months 40%). In multivariate Cox-regression, duration of shock-to-first device (hours, hazard ratio, 1.05 [95% CI, 1.01–1.08];
P
=0.007) and lactate levels after 12 hours of MCS (hazard ratio, 1.28 [95% CI, 1.09–1.51];
P
=0.002) independently predicted survival. Additional right ventricular failure predisposed to futility (hazard ratio, 8.48 [95% CI, 1.85–38.91];
P
=0.006).

Conclusions:

The early and consequent combination of MCS by Impella microaxial pumps and VA-ECMO enables stabilization and may rescue high-risk patients with refractory CS at low overall risk. Independent predictors of survival may guide prognostication, decision-making, and allocation of medical resources.
Dual-Tracer Positron-Emission Tomography for Identification of Culprit Carotid Plaques and Pathophysiology In Vivo
Authors: Evans Nicholas R. , Tarkin Jason M. , Chowdhury Mohammed M. , Le Elizabeth P.V. , Coughlin Patrick A. , Rudd James H.F. , Warburton Elizabeth A.
Published: March 2020

Background:

Inflammation and microcalcification are interrelated processes contributing to atherosclerotic plaque vulnerability. Positron-emission tomography can quantify these processes in vivo. This study investigates (1)
18
F-fluorodeoxyglucose (FDG) and
18
F-sodium fluoride (NaF) uptake in culprit versus nonculprit carotid atheroma, (2) spatial distributions of uptake, and (3) how macrocalcification affects this relationship.

Methods:

Individuals with acute ischemic stroke with ipsilateral carotid stenosis of ≥50% underwent FDG-positron-emission tomography and NaF-positron-emission tomography. Tracer uptake was quantified using maximum tissue-to-background ratios (TBR
max
) and macrocalcification quantified using Agatston scoring.

Results:

In 26 individuals, median most diseased segment TBR
max
(interquartile range) was higher in culprit than in nonculprit atheroma for both FDG (2.08 [0.52] versus 1.89 [0.40];
P
<0.001) and NaF (2.68 [0.63] versus 2.39 [1.02];
P
<0.001). However, whole vessel TBR
max
was higher in culprit arteries for FDG (1.92 [0.41] versus 1.71 [0.31];
P
<0.001) but not NaF (1.85 [0.28] versus 1.79 [0.60];
P
=0.10). NaF uptake was concentrated at carotid bifurcations, while FDG was distributed evenly throughout arteries. Correlations between FDG and NaF TBR
max
differed between bifurcations with low macrocalcification (
r
s
=0.38;
P
<0.001) versus high macrocalcification (
r
s
=0.59;
P
<0.001).

Conclusions:

This is the first study to demonstrate increased uptake of both FDG and NaF in culprit carotid plaques, with discrete distributions of pathophysiology influencing vulnerability in vivo. These findings have implications for our understanding of the natural history of the disease and for the clinical assessment and management of carotid atherosclerosis.
Analysis of Brightness and Color Temperature of Liquid Crystal Display on Visual Comfort Based on Eye Health Monitoring of Humans
Authors: Wang Kun , Ho Chun-Heng , Zong Yan
Published: March 2020

Changing the brightness and color temperature of the bright screen display can improve visual comfort for health monitoring of human operators using computers. Such techniques have been applied on some mobile tablets, but there is little eye research on the impact of industrial machine
operation on the visual comfort for humans, which can influence their eye health. In this health informatics study, 20 operators were evaluated using operational exercises under different ambient light conditions, brightness and color temperature, through the tobiipro/x3-120 eye tracker to
obtain the blink frequency in the sampling. Combined with the experimental task of testing the operating efficiency, and combined with the operators’ subjective perception scores of the operation display, we can then comprehensively evaluate the influence of display brightness and color
temperature on visual fatigue. The result shows that: (1) Ambient light, display brightness and display color temperature together affect the workers’ visual fatigue; (2) Increasing the brightness of the display under low ambient light conditions can improve operational efficiency, but
it can also cause visual fatigue. In conclusion, the health analysis used in our research has a vital role in improving optical health of humans and can be used as a guide for future health informatics study related to this field.
Effect of Aerobic Capacity on Health-Related Quality of Life in Adults with Cerebral Palsy
Authors: You Jungwan , Lee Soeun , Kim Heejae , Shim Yoojin , Kim Aram , Choi Chulsoon , Han Taeyong
Published: March 2020

This study aimed to investigate the relationship between aerobic capacity and health-related quality of life (HRQOL) in men with cerebral palsy (CP) by measuring aerobic capacity and using the Health-Related Quality of Life questionnaire. The subjects were ambulant men with CP (N =
34), with a mean age, height, weight, and body mass index of 36.6 ± 9.2 years, 163.9 ± 8.9 cm, 58.6 ± 9.1 kg, and 21.6 ± 2.9 kg·m-2, respectively. Aerobic capacity was measured during a graded exercise test and shuttle run test. Quality of life was evaluated
using the Health-Related Quality of Life (Medical Outcomes Study Short Form-36 [SF-36]). The analysis performed using the physical scale of HRQOL as the dependent variable revealed that the contribution rate of physical functioning was 46.3%, role physical was 21.8%, bodily pain was 7.5%,
general health was 27.3%, and physical component summary was 36.1%; the aerobic capacity differed significantly in terms of physical functioning, role physical, general health, and physical component summary (p < .05). Peak oxygen uptake was a particularly significant explanatory variable
for role physical, and role physical (p < .05). However, the analysis performed using the mental scale of HRQOL as the dependent variable revealed that the contribution rate of vitality was 13.0%, social functioning was 17.3%, role emotional was 14.9%, mental health was 8.1%, and mental
component summary was 15.3%; the aerobic capacity showed no significant difference. The aerobic capacity representing the athletic performance level of men with CP positively affected physical health satisfaction but not mental health satisfaction.
A Novel Surface Registration for Image-Guided Neurosurgery: Effects of Intervals of Points in Patient Space on Registration Accuracy
Authors: Yoo Hakje , Choi Ahnryul , Kim Hyunggun , Mun Joung Hwan
Published: March 2020

Surface registration is an important factor in surgical navigation in determining the success rate and stability of surgery by providing the operator with the exact location of a lesion. The problem of surface registration is that point cloud in the patient space is acquired at irregular
intervals due to the operator’s tracking speed and method. The purpose of this study is to analyze the effect of irregular intervals of point cloud caused by tracking speed and method on the registration accuracy. For this study, we created the head phantom to obtain a point cloud in
the patient space with a similar object to that of a patient and acquired a point cloud in a total of ten times. In order to analyze the accuracy of registration according to the interval, cubic spline interpolation was applied to the existing point cloud. Additionally, irregular intervals
of the point cloud were regenerated into regular intervals. As a result of applying the regenerated point cloud to the surface registration, the surface registration error was not statistically different from the existing point cloud. However, the target registration error significantly lower
(p < 0.01). These results indicate that the intervals of point cloud affect the accuracy of registration, and that point cloud with regular intervals can improve the surface registration accuracy.
Modeling and Parameter Estimation of Hurricane Wind Fields with Asymmetry
Authors: Chang Derek , Amin Saurabh , Emanuel Kerry
Published: March 2020

This article presents an azimuthally asymmetric gradient hurricane wind field model that can be coupled with hurricane-track models for engineering wind risk assessments. The model incorporates low-wavenumber asymmetries into the maximum wind intensity parameter of the Holland et al. wind field model. The amplitudes and phases of the asymmetries are parametric functions of the storm-translation speed and wind shear. Model parameters are estimated by solving a constrained, nonlinear least squares (CNLS) problem that minimizes the sum of squared residuals between wind field intensities of historical storms and model-estimated winds. There are statistically significant wavenumber-1 asymmetries in the wind field resulting from both storm translation and wind shear. Adding the translation vector to the wind field model with wavenumber-1 asymmetries further improves the model’s estimation performance. In addition, inclusion of the wavenumber-1 asymmetry resulting from translation results in a greater decrease in modeling error than does inclusion of the wavenumber-1 shear-induced asymmetry. Overall, the CNLS estimation method can handle the inherently nonlinear wind field model in a flexible manner; thus, it is well suited to capture the radial variability in the hurricane wind field’s asymmetry. The article concludes with brief remarks on how the CNLS-estimated model can be applied for simulating wind fields in a statistically generated ensemble.
Detailed Dual-Doppler Structure of Kelvin–Helmholtz Waves from an Airborne Profiling Radar over Complex Terrain. Part I: Dynamic Structure
Authors: Grasmick Coltin , Geerts Bart
Published: March 2020

Kelvin–Helmholtz (KH) waves are remarkably common in deep stratiform precipitation systems associated with frontal disturbances, at least in the vicinity of complex terrain, as is evident from transects of vertical velocity and 2D circulation, obtained from a 3-mm airborne Doppler radar, the Wyoming Cloud Radar. The high range resolution of this radar (~40 m) allows detection and depiction of KH waves in fine detail. These waves are observed in a variety of wavelengths, depths, amplitudes, and turbulence intensities. Proximity rawinsonde data confirm that they are triggered in layers where the Richardson number is very small. Complex terrain may locally enhance wind shear, leading to KH instability. In some KH waves, the flow remains mostly laminar, while in other cases it breaks down into turbulence. KH waves are frequently locked to the terrain, and occur at various heights, including within the free troposphere, at the boundary layer top, and close to the surface. They are observed not only upwind of terrain barriers, as has been documented before, but also in the wake of steep terrain, where the waves can be highly turbulent. Vertical-plane dual-Doppler analyses of KH waves reveal the mixing of layers of differential momentum across the high-shear zone. Doppler radar data are used to explore the dynamics of KH waves, including the response of thermodynamic and kinematic variables above, below, and within the instability layer.
Extracting the Buoyancy-Driven Atlantic Meridional Overturning Circulation
Authors: Larson Sarah M. , Buckley Martha W. , Clement Amy C.
Published: March 2020

Variations in the Atlantic meridional overturning circulation (AMOC) driven by buoyancy forcing are typically characterized as having a low-frequency time scale, interhemispheric structure, cross-equatorial heat transport, and linkages to the strength of Northern Hemisphere gyre circulations and the Gulf Stream. This study first tests whether these attributes ascribed to the AMOC are reproduced in a coupled model that is mechanically decoupled and, hence, is only buoyancy coupled. Overall, the mechanically decoupled model reproduces these attributes, with the exception that in the subpolar gyre, buoyancy drives AMOC variations on interannual to multidecadal time scales, yet only the multidecadal variations penetrate into the subtropics. A stronger AMOC is associated with a strengthening of the Northern Hemisphere gyre circulations, Gulf Stream, and northward oceanic heat transport throughout the basin. We then determine whether the characteristics in the mechanically decoupled model can be recovered by low-pass filtering the AMOC in a fully coupled version of the same model, a common approach used to isolate the buoyancy-driven AMOC. A major conclusion is that low-pass filtering the AMOC in the fully coupled model reproduces the buoyancy-driven AMOC pattern and most of the associated attributes, but not the statistics of the temporal variability. The strength of the AMOC–Gulf Stream connection is also not reproduced. The analyses reveal caveats that must be considered when choosing indexes and filtering techniques to estimate the buoyancy-driven AMOC. Results also provide insight on the latitudinal dependence of time scales and drivers of ocean circulation variability in coupled models, with potential implications for measurement and detection of the buoyancy-driven AMOC in the real world.
Assessment of the Teleconnection Patterns Affecting July Precipitation in China and Their Forcing Mechanisms in the Met Office Unified Model
Authors: Carvalho Maria João , Milton Sean F. , Rodríguez José M.
Published: March 2020

In this study, we evaluate the ability of the MetUM to reproduce the Silk Road (SR) and Europe–China (EC) teleconnection patterns and their relationship with precipitation over China. The SR and EC patterns are the main modes of interannual variability of July upper-tropospheric meridional wind. The three main factors to the formation of these patterns are analyzed: 1) the tropical precipitation anomalies, which act as a forcing mechanism; 2) the emission of Rossby waves in the Mediterranean–Caspian Sea region; and 3) the basic state of the tropospheric jet over Eurasia. It was found that the model has some difficulty reproducing the main modes of variability in atmosphere-only mode (SR and EC pattern correlation of 0.31 and 0.54, respectively) with some improvement in coupled mode (pattern correlations of 0.56 and 0.44, respectively). Relaxation experiments were used to assess the impact that improving circulation in key regions has on the teleconnections. It was found that nudging wind and temperatures in the forcing regions within the tropics improved the Silk Road pattern whereas nudging in the region where the jet transitions between the North Atlantic Ocean and Eurasian continent—correcting the basic state—had the most impact on the EC teleconnection pattern. This suggests that while the Silk Road pattern is more sensitive to changes in the forcing, the Europe–China pattern is more sensitive to the basic state.
Impact of Combined Assimilation of Radar and Rainfall Data on Short-Term Heavy Rainfall Prediction: A Case Study
Authors: Sun Juanzhen , Zhang Ying , Ban Junmei , Hong Jing-Shan , Lin Chung-Yi
Published: March 2020

Radar and surface rainfall observations are two sources of operational data crucial for heavy rainfall prediction. Their individual values on improving convective forecasting through data assimilation have been examined in the past using convection-permitting numerical models. However, the benefit of their simultaneous assimilations has not yet been evaluated. The objective of this study is to demonstrate that, using a 4D-Var data assimilation system with a microphysical scheme, these two data sources can be assimilated simultaneously and the combined assimilation of radar data and estimated rainfall data from radar reflectivity and surface network can lead to improved short-term heavy rainfall prediction. In our study, a combined data assimilation experiment is compared with a rainfall-only and a radar-only (with or without reflectivity) experiments for a heavy rainfall event occurring in Taiwan during the passage of a mei-yu system. These experiments are conducted by applying the Weather Research and Forecasting (WRF) 4D-Var data assimilation system with a 20-min time window aiming to improve 6-h convective heavy rainfall prediction. Our results indicate that the rainfall data assimilation contributes significantly to the analyses of humidity and temperature whereas the radar data assimilation plays a crucial role in wind analysis, and further, combining the two data sources results in reasonable analyses of all three fields by eliminating large, unphysical analysis increments from the experiments of assimilating individual data only. The results also show that the combined assimilation improves forecasts of heavy rainfall location and intensity of 6-h accumulated rainfall for the case studied.
Prognostic Value of Abnormal Ankle–Brachial Index in Patients With Coronary Artery Disease: A Meta-Analysis
Authors: Liu Longguang , Sun Hongxiao , Nie Fengze , Hu Xinhua
Published: March 2020

The prognostic value of the ankle–brachial index (ABI) in patients with coronary artery disease (CAD) remains undefined. This meta-analysis sought to investigate the association of abnormal ABI and adverse outcomes in patients with CAD. PubMed, Embase, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched for studies published from inception to September 10, 2019. All observational studies investigating the association of abnormal baseline ABI and risk of major adverse cardiovascular events (MACE) or all-cause mortality were selected. Normal ABI is usually defined as between 0.9 and 1.4. The prognostic values were summarized by pooling risk ratio (RR) with 95% confidence intervals (CIs) for abnormal versus normal ABI category. Nine (9384 patients with CAD) studies were included. Abnormal ABI was independently associated with MACE (RR: 2.46; 95% CI: 2.02-2.99) and all-cause mortality (RR: 1.74; 95% CI: 1.32-2.30). Subgroup analysis showed that the pooled RR for MACE was 2.34 (95% CI: 1.73-3.16) for an abnormal low ABI. Abnormal ABI predicts MACE and all-cause mortality in patients with CAD, even after adjusting conventional confounding factors. However, the prognostic value of abnormal ABI is mainly dominated by a low ABI rather than a high ABI.