bluuebunny/crossref_metadata_2025 huggingface dataset:
Shaking Table Test of GFRP Reinforced Concrete Frame Structure
Authors: Gai Liangwei , Xu Xinsheng
Published: May 2020

It is necessary to analyze the seismic performance of the structure based on the response of the structure to the seismic wave excitation of the FRP tendon concrete structure model through the shaking table. Based on the study of the mechanical properties of GFRP (Glass Fiber Reinforced Polymer) tendons, this paper uses GFRP tendons as the main beam-column tendons to design and manufacture a three-layer, two-span, and 1/4 scale frame model. Four seismic waves are selected, and the model is subjected to unidirectional, bidirectional, and tridirectional seismic wave excitations under a total of 27 conditions of 4 different acceleration peaks, and the acceleration response of each floor of the model under different conditions is obtained. Through the data processing, the displacement response of each floor of the model and the displacement angle between the floors are further obtained. The seismic behavior of the GFRP reinforced concrete frame structure is studied in combination with the experimental phenomena. The analysis results of this experiment show that the prototype structure can also meet the requirements of small earthquakes and moderate earthquakes Repairable, large earthquake-resistant seismic requirements for waterproofing.
Strain rate effect on dynamic response of bridge piers in high-speed railway under the earthquake loading
Authors: Shao Guangqiang , Zuo Yong-Jian , Huang Lin-Sheng
Published: May 2020

Both concrete and steel are sensitive to strain rate, and the high strain rate caused by earthquakes will improve the material property including the strength and elasticity modulus. While analysing the dynamic response of bridges under the earthquake loading, there are some certain errors based on static constitutive model. By the method of dynamic increasing factors (DIF) of concrete and steel, the dynamic responses of bridges in high-speed railway were analysed in fibre beam-column element models to study the strain rate effect, and the reasonable uniaxial constitutive model of concrete and steel were used in the numerical simulation. The results show that the maximum moment at the bottom of pier calculated by quasi-static constitutive models is less than that calculated by constitutive models considering strain rate. Compared with the dynamic constitutive models considering strain rate, the larger curvature at the bottom of the pier and displacement at the top of pier were obtained in the analysis on the basis of quasi-static constitutive models. The strain rate has less effect on the dynamic response before the piers yield, and the effect can be ignored. While the earthquake loading can cause piers to fail or collapse, the strain rate effect needs to be precisely considered.
Experimental study on bearing characteristics of pile foundation in loess area of Longdong
Authors: Du Ting , Luo Wenbin
Published: May 2020

In order to study the bearing characteristics of pile foundation in the deep loess layer of Longdong area, field tests were carried out on the basis of a project in Huachi County, Qingyang City. Three test cast-in-place piles of the basement were selected for static load tests. The Q-S curve of the three test piles was gentle, without obvious steep drop. The S-lgt curve was arranged in a gentle and regular way, with high bearing capacity, uniform and small settlement. So it can be used as the foundation of buildings bearing large loads. In the test, the load is mainly borne by the reaction force provided by the side friction of the pile; the axial force distribution of the pile body with depth is not only related to the load on the top of the pile, but also to the nature of the soil around the pile.
A Study on the Architecture Culture of The Wind and Rain Bridge -- A Case Study of Huilong Bridge in Tongdao County
Authors: Lu Xiaoying , Wei Yanhai , Hu Xueka , Fang Jiajue
Published: May 2020

At present, minority tourism is booming. People hope to understand minority culture through minority tourism. Dong nationality is an ancient minority of China. The architecture of Dong nationality forms a unique architectural art in the long-term development. As one of the three treasures of Dong architecture, the wind and rain bridge is the classic of Dong architecture, which is closely related to the daily life of Dong residents with rich cultural connotation. To show visitors the brilliant culture of Dong nationality, this paper takes the Huilong bridge as the research target, to discuss the causes and functions of wind and rain bridge, the whole architecture and the art of decoration, so as to more people have a deeper understanding of the connotation of wind and rain bridge, and comprehensive the bridge systematically.
Frequency conversion sampling technology based on vehicle triggered bridge deflection response
Authors: Li Haiguang , Runjian Wang , Jianming Hu , Wenlong Hua
Published: May 2020

According to the multi-time characteristics of deflection and deformation of operating bridge structures, trigger control strategies were applied to bridge deflection sampling control, which breaks the periodic constraints of existing deflection sampling technologies. On that basis, we present an on-demand sampling method to achieve deflection deformation low-frequency sampling when the response amplitude is small, and high-frequency sampling when the response amplitude is large. This method fully collects the dynamic deflection peaks, reduces the number of sampling points significantly, and relieves the system pressure, reduces hardware resource consumption, and extends the system’s service life. This study will provide a reference for real-time frequency conversion sampling.
Research on Durability Evaluation Method of Bridge Slings Based on Set Pair Analysis
Authors: He Weinan , Sun Xiaohong , Li Chaozheng
Published: May 2020

The service durability of bridge slings is directly related to the safety of the entire bridge and has become one of the important indicators for measuring the performance of bridge structures. How to make a more accurate assessment of bridge slings is a problem that bridge management and maintenance departments must consider. Based on the investigation of the durability damage of the bridge sling structure in China, this paper establishes a comprehensive evaluation system for the durability of the bridge sling structure, divides the evaluation criteria, and proposes the durability of the sling based on set pair analysis Sex evaluation methods. On the basis of calculating the weight of the durability evaluation index by the analytic hierarchy process, the durability level of the bridge sling structure is accurately quantified through the set pair analysis operation. The example application shows that the method proposed in this paper has a good engineering application prospect.
Finite Element Analysis of Unsymmetrical Pressure Treatment of Shallow-Buried Tunnel with Half-road and Half-tunnel
Authors: Zhang Qian , Su Jianping , Liu Bin
Published: May 2020

Taking the Sajin tunnel project of T26 contract section of Du (Yun) An (Shun) Highway as an example, this paper analyzes the difficult problem of unsymmetrical pressure construction of the tunnel. This paper puts forward a systematic treatment scheme of setting anti slide pile as the main part, and compares and verifies the calculation model established by Midas SoilWorks software. The calculation results show that this method can effectively reduce the bending moment and deformation at the left arch waist of the tunnel. The minimum safety factor of the initial support structure of the tunnel is 1.36, which greatly reduces the construction risk. At the same time, the quality control of the treatment process of the project is analyzed, and the corresponding treatment suggestions are put forward, which can provide reference for similar highway tunnel engineering design and construction.
A construction method of water conservancy model library based on Microservice
Authors: Feng Kuaile , Zhou Jianzhong , Liu Yi , He Feifei , he Zhongzheng , Jia Benjun
Published: May 2020

With the development of network information technology, the water conservancy industry is faced with the new situation of big data and informatization, and the water resources informatization is getting more and more attention. The water conservancy model library is the core part of water conservancy informatization, which provides many functions, including runoff forecast, reservoir operation, accuracy assessment and so on. This paper makes full use of mainstream software science and technology to construct the architecture of water conservancy model library based on microservice, uses Json as the interactive data format of the model, and encapsulates the water resources model as a service. The model library has the advantages of scalability and high availability.
Design and Implementation of River Data Acquisition and Storage System Based on Cloud Platform
Authors: Long Rui , Deng Chunyan , Wang Min
Published: May 2020

In view of the huge geospatial information data in the Yangtze River Basin, messy data storage and difficulty in searching, a cloud platform for river scientific research was established based on Browser/Server Architecture. The system design comprehensively considers and balances the advancement and maturity, enabling the system to mass-store and manage data from various units or departments, multiple types and multiple channels, and to provide advanced data management methods to ensure data security and data unified management, thus providing researchers with fast and reliable data information. The system realizes a set of standards, a map, a library and a platform for the whole basin, which is of great significance to the standardized management and application of data in the Yangtze River Basin.
Study on Comprehensive Evaluation of Protection and Utilization of Artificial canal in Yichang City
Authors: Zhou Mingyuan , Xu Jijun , Hong Xiaofeng , Liu Junlong
Published: May 2020

In order to effectively evaluate the protection and utilization of artificial canals. This article takes the Dongshan Canal as an example, combining the characteristics of Dongshan Canal, and constructing artificial canal protection and utilization evaluation index system based on the conceptual model of “driving force-pressure-state-impact-response-management”. At the same time, the comprehensive evaluation method of the protection and utilization of the artificial canal is established by combining the analytic hierarchy process. The results show that: The comprehensive evaluation result of Dongshan canal protection and utilization is 0.80 ( I grade), and the river has a high degree of protection and utilization. The evaluation results are consistent with the actual situation of Dongshan canal, which verifies the feasibility of the index system constructed in this paper.
Influence of parameters valuing on calculation results in reservoir sediment mathematical model
Authors: Deng Chunyan , Xia Junqiang , Long Rui , yuan Yuan
Published: May 2020

Sediment deposition in the reservoir not only has a serious impact on the service life of the reservoir and the existence value of the hydropower station, but also profoundly affects the erosion and siltation of the downstream riverbed and the safety of the dam. Being an important method to the research of sedimentation problem, calculation accuracy of mathematical model is a subject worthy of continuous discussion. In this paper, influence of some key parameters of the model are analysed. The calculation results show that the changes of dry density, water flow sedimentation parameters and saturation recovery coefficient have significant influence on the calculation results, and the change of dry density has the greatest influence, while the effect of flocculation is the weakest. It is worth noting that when considering these influencing factors, this paper adopts a simplified processing method, and the mechanism of each parameter is complex, and further research is needed.
The Seismic Ductility Capability Influence Factors Analysis of Integral Station-Bridge Frame Structure
Authors: Wang Shenxia
Published: May 2020

When performance-based structure design is adopted, the structure has a clear structural performance objective under the specified setting criteria, and the performance target is specifically reflected in the damage degree of the structure. The components of the “bridge-building” structure are mainly concentrated on the pier column of the station hall. Therefore, the degree of damage of the pier column of the station hall layer reflects the degree of damage of the structure to a certain extent. This paper describes the earthquake-resistant ductility of the combined bridge structure. The performance indexes were quantitatively analyzed. Then, through the elasto-plastic analysis of the structure, the influence of various factors on the seismic ductility of the structure was obtained. The ductility of the piers under the earthquake was discussed, which provided a reference for structural design.
Research on static load test of foundation piles by self-blance method
Authors: Chao Yuan , Yong Zhao Xiao , Wen Zheng Song
Published: May 2020

The pile foundation static load test is a technique for detecting pile foundation bearing capacity in engineering. In determining the ultimate bearing capacity of a single pile, it is a relatively accurate and reliable test method, which can accurately reflect the stress condition and deformation characteristics of a single pile, and determine the vertical compressive bearing capacity of a single pile. Based on the static test of pile foundation, the process of self-balancing loading method is expounded.
Analysis of Scouring and Silting Changes in the Middle and Lower Reaches of the Yangtze River after the Three Gorges Project Operation
Authors: Zhang Xiao , Wu Guangdong
Published: May 2020

The annual runoff of the middle and lower reaches of the Yangtze River has little change before and after the Three Gorges Project is put into operation, but the annual distribution of runoff has changed, and the sediment discharge of the reach has fallen in a cliff-like manner. The application of the Three Gorges Project has changed the scouring and silting situation of the main stream and the two lakes, making them change from silting to scouring direction, causing the water level of the rivers and lakes to drop. The changes of scouring and silting conditions, flow velocity, water depth and water level have a certain impact on the survival and reproduction of the four major domestic fish, porpoise and waterfowl. In order to protect the fragile aquatic ecosystem from the adverse effects of the operation of the Three Gorges Project, this paper puts forward three suggestions, namely, the delimitation of protected areas of top priority, the spatial management and control of river and lake shorelines, and the ecological scheduling, which is of great significance to the scientific decision-making of the water administrative department in the process of protection of the Yangtze River.
Tempo-spatial Evolution Law of Valley Width Deformation of High Arch Dams and Analysis of the Causes
Authors: Heng Cheng , Guoxin Zhang , Jianxin Liao , Yi Liu , Qiujing Zhou , Chenfang Jiang
Published: May 2020

In China, some high arch dams have undergone valley width contraction after water storage, which affects the behavior and long-term safety of the dams. This paper reviews typical cases of high arch dam valley width deformation in the world and analyzes its characteristics and causes. From this it continues to address the deformation of the Xiluodu arch dam valley and studies its width deformation monitoring data, revealing the temporal evolution and spatial distribution characteristics of the deformation. The mechanism of the deformation is then studied in the context of the engineering geology and hydrogeological conditions of the dam site. The results suggest that with the seepage force acting on P2βn after water storage, the effective stress in this rock layer fell and the rock mass might undergo displacement and creep deformation along P2βn, causing the valley to narrow. Therefore, the contraction of the Xiluodu arch dam valley was caused by the reduction of the effective stress in the rock mass during the evolution of the seepage field following water storage under the specific hydrogeological and geostress field distribution conditions.
Feasibility Study of Applying BIM Technology in Shantytowns Renocation Project
Authors: Ma Shaochun , Wang Hao , Bao Peng , Dong Hao , Wang Sen
Published: May 2020

The transformation of shantytowns is a very important livelihood project in our country. After more than 10 years’ efforts and vigorous efforts of the Chinese government, shantytowns have been improved and optimized to some extent. Based on BIM technology, this paper applies it to the actual shantytown reconstruction project. By using the powerful functions of Building Information Modeling (Hereinafter referred to as BIM) technology, the shantytowns renovation project is discussed from aspects of schedule control, construction simulation, collision inspection, rapid measurement and valuation, and process monitoring. Compared with the traditional methods, BIM technology has shown a good result, which has played a better positive role in the fine management level of shantytowns renovation projects, and promoted the healthy and orderly development of the construction industry.
Flow Patterns and Rectification Measures in the Forebay of Pumping Station
Authors: Li Yuan , Gu Jinde , Guo Chao , Zhou Chenlu
Published: May 2020

Due to land limitation, the forebay in the pumping station is generally not long enough, some disadvantageous flow patterns are easy to appear in the forebay, which is not beneficial to the safety and economic operation of the pump. In this paper, the flow pattern in the forebay of pumping station is taken as the research object, and we focus on the physical model test method, the analysis method of the flow pattern and the rectification measures such as beam, breast wall and column. At the same time, the research results show that the abovementioned rectification measures are helpful to improve the pumping station inlet conditions and operation reliability.
Research on influencing factors of non-stress gauge measurement on mesoscopic scale
Authors: Qiu Yongrong , Zhang Guoxin
Published: May 2020

Concrete stress is an important item of dam safety monitoring. The stress of dam body can be mastered and the safety degree of dam can be estimated through systematic monitoring and analysis of the stress and strain of concrete. Non-stress gauge, as well as a strain gauge group, is used to monitor the stress and strain of concrete dams. The stress-free strain of concrete can be obtained by utilizing a non-stress gauge, which is the basis for stress analysis. Results of stress-free monitoring are influenced by surrounding environments, instrument structure, and installation method. Finite element numerical simulation and meso-mechanical methods are used to study factors, such as non-uniform temperature field around the gauge, stiffness of a bucket, and aggregate state of concrete. Results show that the stiffness of bucket and non-uniform temperature field slightly influence the results of non-stress strain measurements. In addition, when the aggregate content is the same, the influence of the aggregate distribution is less. However, extra-large aggregate removal method significantly influences the monitoring results. The influence of the removal method on the stress analysis to monitor the data of the strain gauge group is evaluated using an example. Recommendations to deal with extra-large aggregate in the installation of non-stress gauges are presented.
COVID-19 preparedness: Clinical pharmacy services remote staffing in a quaternary, level I trauma and comprehensive stroke center
Authors: Kjerengtroen Sara , Wilde Samuel M , Fontaine Gabriel V , Forbush Kevin M , Van Gorder Charles M , Wohlt Paul
Published: May 2020

Purpose

The rapid spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has strained the resources of healthcare systems around the world. In accordance with recommendations from the World Health Organization, Centers for Disease Control and Prevention, and US Department of Defense, Intermountain Medical Center (IMED) in Murray, UT, has developed a plan to provide remote clinical pharmacy services to protect the health of pharmacy caregivers while maintaining appropriate clinical pharmacy coverage to optimally care for patients.

The utilization of telemedicine technology permits clinical pharmacists to readily communicate with nurses, physicians, other caregivers, and patients. We have identified strategies to allow clinical pharmacists to continue to participate in daily rounds, provide consultations under collaborative practice agreements, verify medication orders, collect medication histories, provide antimicrobial stewardship, and deliver medication education to patients from off-site locations. The pharmacy department at IMED proactively tested telemedicine technologies, defined the roles of clinical pharmacists, and identified communication strategies prior to a rapid rise in COVID-19 cases in the state of Utah.

Conclusion

The proactive measures described can help ensure that pharmacy caregivers have appropriate remote access and are capable of confidently using the resources. These steps allow for optimal care of hospitalized patients and promote social distancing, which may have the added benefit of decreasing the spread of SARS-CoV-2 among patients and caregivers.
IX—Equal Opportunity: A Unifying Framework for Moral, Aesthetic, and Epistemic Responsibility
Authors: Nelkin Dana Kay
Published: May 2020

On the one hand, there seem to be compelling parallels to moral responsibility, blameworthiness, and praiseworthiness in domains other than the moral. For example, we often praise people for their aesthetic and epistemic achievements and blame them for their failures. On the other hand, it has been argued that there is something special about the moral domain, so that at least one robust kind of responsibility can only be found there. In this paper, I argue that we can adopt a unifying framework for locating responsible agency across domains, thereby capturing and explaining more of our actual practices. The key, I argue, is to identify the right conditions for being morally accountable, which I take to be a matter of having an opportunity of a good enough quality to act well. With this account in hand, I argue that we can adopt a unifying framework that allows us to recognize parallels across domains, even as it points the way to important differences among them.
Optimal subsampling for quantile regression in big data
Authors: Wang Haiying , Ma Yanyuan
Published: May 2020

We investigate optimal subsampling for quantile regression. We derive the asymptotic distribution of a general subsampling estimator and then derive two versions of optimal subsampling probabilities. One version minimizes the trace of the asymptotic variance-covariance matrix for a linearly transformed parameter estimator and the other minimizes that of the original parameter estimator. The former does not depend on the densities of the responses given covariates and is easy to implement. Algorithms based on optimal subsampling probabilities are proposed and asymptotic distributions, and the asymptotic optimality of the resulting estimators are established. Furthermore, we propose an iterative subsampling procedure based on the optimal subsampling probabilities in the linearly transformed parameter estimation which has great scalability to utilize available computational resources. In addition, this procedure yields standard errors for parameter estimators without estimating the densities of the responses given the covariates. We provide numerical examples based on both simulated and real data to illustrate the proposed method.
Secondary Traumatization Among Social Work Students—The Contribution of Personal, Professional, and Environmental Factors
Authors: Ben-Porat Anat , Shemesh Shahar , Reuven Even Zahav Ronit , Gottlieb Shelly , Refaeli Tehila
Published: May 2020

This study examined the rate of secondary traumatic stress (STS) among social work students and the contribution of background variables, personal resources (mastery and self-differentiation) and environmental resources (supervision satisfaction and peer support) to STS. The sample consisted of 259 social work students at three social work schools in Israel. The findings indicated that the mean level of STS was mild. Of the students, 36 per cent suffered STS to a mild extent, 19 per cent to a moderate extent and 18 per cent reported a ‘high to extreme extent’. A significant contribution was made by the student’s year of study, students in their second year of social work school suffered more severely from STS than did students in their first or third years. A positive contribution was made by the student’s level of exposure and a unique contribution was made by mastery and supervision satisfaction to the explained variance of STS. The findings highlight the importance of raising awareness of STS and its implications for social work students, as well as the necessity of helping students cope with this phenomenon. In addition, the study emphasises the significant role of supervisors in the training agencies and the importance of increasing students’ sense of mastery.
Public Perceptions of Social Work in Nigeria: Does the Profession Has What It Takes to Address Nigeria’s Social Problems?
Authors: Amadasun Solomon
Published: May 2020

The value of all hitherto existing professions stems from how the public in which they serve perceive the import of their services. This study examines the perceptions of a cross-section of Nigerians regarding their knowledge of the social work profession. Through a structured survey instrument, data were collected from a nationally representative sample of 350 Nigerians from the age of twenty years and above. Although the majority of the respondents were not familiar with the professional designation ‘social work’, they, however, demonstrated substantial knowledge about social workers’ roles, areas of practice and other measures. Since practitioners are actively involved in community organising and development practice across the country, more than two-thirds of the respondents believed that the profession has the potential to address social development problems not only in Nigeria but across the African continent.
“Ending the Epidemic” Will Not Happen Without Addressing Racial/Ethnic Disparities in the United States Human Immunodeficiency Virus Epidemic
Authors: Nosyk Bohdan , Krebs Emanuel , Zang Xiao , Piske Micah , Enns Benjamin , Min Jeong E , Behrends Czarina N , Del Rio Carlos , Feaster Daniel J , Golden Matthew , Marshall Brandon D L , Mehta Shruti H , Meisel Zachary F , Metsch Lisa R , Pandya Ankur , Schackman Bruce R , Shoptaw Steven , Strathdee Steffanie A
Published: May 2020

We estimated human immunodeficiency virus incidence and incidence rate ratios (IRRs) for black and Hispanic vs white populations in 6 cities in the United States (2020–2030). Large reductions in incidence are possible, but without elimination of disparities in healthcare access, we found that wide disparities persisted for black compared with white populations in particular (lowest IRR, 1.69 [95% credible interval, 1.19–2.30]).
Resistance-Guided Treatment of Gonorrhea: A Prospective Clinical Study
Authors: Klausner Jeffrey D , Bristow Claire C , Soge Olusegun O , Shahkolahi Akbar , Waymer Toni , Bolan Robert K , Philip Susan S , Asbel Lenore E , Taylor Stephanie N , Mena Leandro A , Goldstein Deborah A , Powell Jonathan A , Wierzbicki Michael R , Morris Sheldon R
Published: May 2020

Background

Novel treatment strategies to slow the continued emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae are urgently needed. A molecular assay that predicts in vitro ciprofloxacin susceptibility is now available but has not been systematically studied in human infections.

Methods

Using a genotypic polymerase chain reaction assay to determine the status of the N. gonorrhoeae gyrase subunit A serine 91 codon, we conducted a multisite prospective clinical study of the efficacy of a single oral dose of ciprofloxacin 500 mg in patients with culture-positive gonorrhea. Follow-up specimens for culture were collected to determine microbiological cure 5–10 days post-treatment.

Results

Of the 106 subjects possessing culture-positive infections with wild-type gyrA serine N. gonorrhoeae genotype, the efficacy of single-dose oral ciprofloxacin treatment in the per-protocol population was 100% (95% 1-sided confidence interval, 97.5–100%).

Conclusions

Resistance-guided treatment of N. gonorrhoeae infections with single-dose oral ciprofloxacin was highly efficacious. The widespread introduction and scale-up of gyrA serine 91 genotyping in N. gonorrhoeae infections could have substantial medical and public health benefits in settings where the majority of gonococcal infections are ciprofloxacin susceptible.

Clinical Trials Registration

NCT02961751.
Failure to vasodilate in response to salt loading blunts renal blood flow and causes salt-sensitive hypertension
Authors: Wu Jing , Agbor Larry N , Fang Shi , Mukohda Masashi , Nair Anand R , Nakagawa Pablo , Sharma Avika , Morgan Donald A , Grobe Justin L , Rahmouni Kamal , Weiss Robert M , McCormick James A , Sigmund Curt D
Published: May 2020

Aims

Salt-sensitive (SS) hypertension is accompanied by impaired vasodilation in the systemic and renal circulation. However, the causal relationship between vascular dysfunction and salt-induced hypertension remains controversial. We sought to determine whether primary vascular dysfunction, characterized by a failure to vasodilate during salt loading, plays a causal role in the pathogenesis of SS hypertension.

Methods and results

Mice selectively expressing a peroxisome proliferator-activated receptor γ dominant-negative mutation in vascular smooth muscle (S-P467L) exhibited progressive SS hypertension during a 4 week high salt diet (HSD). This was associated with severely impaired vasodilation in systemic and renal vessels. Salt-induced impairment of vasodilation occurred as early as 3 days after HSD, which preceded the onset of SS hypertension. Notably, the overt salt-induced hypertension in S-P467L mice was not driven by higher cardiac output, implying elevations in peripheral vascular resistance. In keeping with this, HSD-fed S-P467L mice exhibited decreased smooth muscle responsiveness to nitric oxide (NO) in systemic vessels. HSD-fed S-P467L mice also exhibited elevated albuminuria and a blunted increase in urinary NO metabolites which was associated with blunted renal blood flow and increased sodium retention mediated by a lack of HSD-induced suppression of NKCC2. Blocking NKCC2 function prevented the salt-induced increase in blood pressure in S-P467L mice.

Conclusion

We conclude that failure to vasodilate in response to salt loading causes SS hypertension by restricting renal perfusion and reducing renal NO through a mechanism involving NKCC2 in a mouse model of vascular peroxisome proliferator-activated receptor γ impairment.
Hybrid repair of extensive thoracic aortic aneurysms
Authors: Piffaretti Gabriele , Trimarchi Santi , Gelpi Guido , Romagnoni Claudia , Ferrarese Sandro , Tozzi Matteo , Bush Ruth L , Lomazzi Chiara
Published: May 2020

OBJECTIVES

Our goal was to report the midterm results of hybrid treatment of extensive thoracic aortic aneurysm (ETAA) with the completion of thoracic endovascular aortic repair after proximal ascending-arch graft replacement.

METHODS

This was a multicentre, observational study. Data were collected prospectively between January 2002 and March 2019 and analysed retrospectively. Inclusion criteria for the final analysis were the treatment of elective or urgent ETAA performed in a single-stage or a planned two-stage approach. Early and late survival rates were the primary outcomes.

RESULTS

Indications for repair were degenerative ETAA in 27 (64.3%) patients and dissection-related ETAA in 15 (35.7%). The mean aortic diameter was 68 ± 16 mm (interquartile range 60–75). Five (11.9%) patients had a single-stage repair; and 37 underwent a two-stage approach. Three (7.1%) patients died in-hospital. The median follow-up was 49 months (range 0–204). During the follow-up period, 4 (9.5%) patients underwent aortic reintervention after a median of 32 months; however, no aortic rupture of the treated segment occurred. Overall, the estimated survival rate was 85% ± 6% [95% confidence interval (CI) 70.8–93] at 12 and 36 months and 69.5% ± 9% (95% CI 49.7–84) at 60 months.

CONCLUSIONS

Hybrid repair of ETAA had satisfactory early results in this cohort of patients. At the midterm follow-up, the aneurysm-related mortality rate was acceptable with the reconstruction proving to be durable and safe with few distal aortic events.
Preliminary results of spot-stent grafting in Stanford type B aortic dissection and intramural haematoma
Authors: Meisenbacher Katrin , Böckler Dittmar , Geisbüsch Philipp , Hank Thomas , Bischoff Moritz Sebastian
Published: May 2020

OBJECTIVES

Optimal treatment for patients with diseased proximal landing zones in acute/subacute Stanford type B dissection and intramural haematoma remains unclear. This study describes the preliminary outcomes of a localized endovascular treatment [spot-stent grafting (SSG)] of main entries/intramural blood pooling located downstream (aortic zones 4 and 5) using one single short device comprising diseased landing zones, looking particularly at the technical and morphological outcomes.

METHODS

Patients undergoing thoracic endovascular aortic repair (TEVAR) for acute/subacute aortic dissection Stanford type B/intramural haematoma Stanford type B between 1997 and 2018 were identified from a prospectively maintained institutional database. In a total of 183 cases, 22 patients (7 women; median age 62 years; range 35–79 years) received SSG. The primary study end point was technical success. The primary morphological end point was false lumen thrombosis/aortic remodelling. Secondary end points were TEVAR-related mortality/morbidity and reinterventions. The median follow-up was 28.5 months (5 days–15.6 years).

RESULTS

The primary technical success rate was 100% (22/22). During follow-up, false lumen thrombosis was seen in 21 patients (95.5%) at a median of 6 days (0 days to 2.7 years) after the index procedure (limited/extended false lumen thrombosis: n = 9 vs 12). Aortic remodelling was achieved in 15 of 22 patients (68.2%) at a median of 360 days (3 days to 7.2 years). Limited/extended remodelling was observed in 8/15 and 7/15, respectively. Retrograde dissection or stent graft-induced new entry was not observed. No stroke or spinal cord injury occurred. Reinterventions were performed in 4/22 cases. The in-hospital mortality and 30-day mortality were 0%. Overall mortality during the follow-up period was 22.7% (5/22).

CONCLUSIONS

This study shows favourable technical and morphological results for SSG in selected patients with acute/subacute aortic dissection Stanford type B/intramural haematoma Stanford type B. Patient allocation to SSG remains individual. Prospective large-scale long-term data may allow refinement of the application.
Patterns of multimorbidity and pharmacotherapy: a total population cross-sectional study
Authors: Forslund Tomas , Carlsson Axel C , Ljunggren Gunnar , Ärnlöv Johan , Wachtler Caroline
Published: May 2020

Background

Treatment of multimorbid patients can be improved. Development of patient-centred care of high-quality requires context-bound understanding of the multimorbid population’s patterns of demographics, co-morbidities and medication use.

Objective

The aim of this study was to identify patterns of multimorbidity in the total population of Region Stockholm, Sweden, by exploring demographics, claimed prescription drugs, risk of mortality and non-random association of conditions.

Methods

In this cross-sectional descriptive population-based cohort study, we extracted data from the Swedish VAL database (N = 2 323 667) including all consultations in primary and specialized outpatient care, all inpatient care and all prescriptions claimed during 2017. We report number of chronic conditions and claimed prescription drugs, physical and mental co-morbidity, and 1-year mortality. We stratified the analyses by sex. We examined non-random associations between diseases using cluster analysis.

Results

In total, 21.6% had multimorbidity (two or more chronic conditions) and 24.1% had polypharmacy (more than five claimed prescription drugs). Number of claimed drugs, co-occurrence of mental and physical conditions, and 1-year mortality increased as multimorbidity increased. We identified seven multimorbidity clusters with clinically distinct characteristics. The smallest cluster (7% of individuals) had prominent cardiovascular disease, the highest 1-year mortality rate, high levels of multimorbidity and polypharmacy, and was much older. The largest cluster (27% of individuals) was younger and heterogenous, with primarily mental health problems.

Conclusions

Individuals with chronic conditions often show clinical complexity with both concordant and discordant conditions and polypharmacy. This study indicates that clinical guidelines addressing clustering of conditions may be one strategy for managing complexity.
A synthetic 2-D-elastic full-waveform inversion study for the Ecuadorian margin—resolution capability of a dense onshore/offshore network
Authors: Gassner L , Thiel N , Rietbrock A
Published: May 2020

Subduction zones are the places on the Earth where the greatest earthquakes occur. It is now widely accepted that seismic asperities at the interface of subducting plates play a major role in whether a region of a subduction zone behaves seismically, creating strong earthquakes or exhibits aseismic slip. In the last decades, huge advances have been made to decipher the underlying processes; however, the physical parameters along the subduction zone interfaces are still not very well known due to a sparsity of high-resolution experiments and significant costs associated with amphibious seismic experiments.

Therefore, synthetic tests are needed to investigate the potential of currently possible high density seismic deployments and to aid future experiment design. As standard local earthquake traveltime tomography in a subduction zone setting cannot resolve structures on a kilometre scale at depth, we explore the suitability of full-waveform inversion (FWI) to increase resolution by using amplitude and phase information in the recorded earthquake seismograms.

We apply 2-D-elastic FWI to synthetic earthquake data, using vertical and horizontal receivers, and utilize a realistic model of the seismic velocities at the Ecuadorian margin. We add perturbations within the subducting plates of 4×4 km and 2×2 km in P- and S-wave velocities, respectively, such that potential crosstalk between the two models can be identified. Our results show that the location and amplitude of the perturbations can be reconstructed in high quality down to approximately 70 km depth. We find that the inversion of the S-wave velocity prior to the inversion of the P-wave velocity is necessary to guarantee a good reconstruction of both models; however, the spatial resolution of the S-wave model is superior to the P-wave model. We also show that frequencies up to 1 Hz are sufficient to achieve high resolution. Further tests demonstrate how results depend on the accuracy of the estimated source orientation. Resulting models do not suffer in quality as artefacts near the source positions compensate for the inaccuracy of source orientation. If sources are located within the subducted plate instead of beneath, resulting models are comparable and the convergence of the inversion scheme is sped up. The accuracy of the source position within the model compared to the true earthquake location is critical and implies that earthquake relocation during the inversion process is necessary, in a similar way as in local earthquake traveltime tomography.
Emerging functions of Fanconi anemia genes in replication fork protection pathways
Authors: Kolinjivadi Arun Mouli , Crismani Wayne , Ngeow Joanne
Published: May 2020

Germline mutations in Fanconi anemia (FA) genes predispose to chromosome instability syndromes, such as FA and cancers. FA gene products have traditionally been studied for their role in interstrand cross link (ICL) repair. A fraction of FA gene products are classical homologous recombination (HR) factors that are involved in repairing DNA double-strand breaks (DSBs) in an error-free manner. Emerging evidence suggests that, independent of ICL and HR repair, FA genes protect DNA replication forks in the presence of replication stress. Therefore, understanding the precise function of FA genes and their role in promoting genome stability in response to DNA replication stress is crucial for diagnosing FA and FA-associated cancers. Moreover, molecular understanding of the FA pathway will greatly help to establish proper functional assays for variants of unknown significance (VUS), often encountered in clinics. In this short review, we discuss the recently uncovered molecular details of FA genes in replication fork protection pathways. Finally, we examine how novel FA variants predispose to FA and cancer, due to defective replication fork protection activity.
International Refugee Law between Scholarship and Practice
Authors: Byrne Rosemary , Gammeltoft-Hansen Thomas
Published: May 2020

Current challenges to the traditionally privileged position of law in both refugee policy and refugee studies invite scholars to consider carefully the approach we take to our craft. This article argues that refugee law scholarship is surrounded by thin walls, as researchers broker the ‘dual imperative’ to simultaneously advance knowledge and protection in a field heavily influenced by policy interests and networks of practitioners that actively take part in, and promote, scholarly production. These close links between the field and the policy world continue to shape research agendas, methodologies, and scholarly positions. This article draws from Bourdieusian field theory and legal sociology to offer a prism through which to look at the forces that influence refugee law research and to consider their implications for scholarship. It is argued that greater sensitivity to the underlying dynamics of our profession is essential, not only to ensure more inclusivity in the community of scholars and expand the current canon of refugee law, but ultimately to sustain claims to policy relevance.
Thue Inequalities With Few Coefficients
Authors: Bengoechea Paloma
Published: May 2020

Let $F(x, y)$ be a binary form with integer coefficients, degree $n\geq 3$, and irreducible over the rationals. Suppose that only $s + 1$ of the $n + 1$ coefficients of $F$ are nonzero. We show that the Thue inequality $|F(x,y)|\leq m$ has $\ll s m^{2/n}$ solutions provided that the absolute value of the discriminant $D(F)$ of $F$ is large enough. We also give a new upper bound for the number of solutions of $|F(x,y)|\leq m$, with no restriction on the discriminant of $F$ that depends mainly on $s$ and $m$, and slightly on $n$. Our bound becomes independent of $m$ when $m<|D(F)|^{2/(5(n-1))}$, and also independent of $n$ if $|D(F)|$ is large enough.
Protective Activity of Programmed Cell Death Protein 1 Blockade and Synergy With Caspofungin in a Murine Invasive Pulmonary Aspergillosis Model
Authors: Wurster Sebastian , Robinson Prema , Albert Nathaniel D , Tarrand Jeffrey J , Goff Marisa , Swamydas Muthulekha , Lim Jean K , Lionakis Michail S , Kontoyiannis Dimitrios P
Published: May 2020

Pharmacological immune checkpoint blockade has revolutionized oncological therapies, and its remarkable success has sparked interest in expanding checkpoint inhibitor therapy in infectious diseases. Herein, we evaluated the efficacy of programmed cell death protein 1 (PD-1) blockade in a murine invasive pulmonary aspergillosis model. We found that, compared with isotype-treated infected control mice, anti–PD-1–treated mice had improved survival, reduced fungal burden, increased lung concentrations of proinflammatory cytokines and neutrophil-attracting chemokines, and enhanced pulmonary leukocyte accumulation. Furthermore, combined treatment with anti–PD-1 and caspofungin resulted in a significant survival benefit compared with caspofungin or anti–PD-1 therapy alone, indicating a synergistic effect between PD-1 inhibitors and immunomodulatory antifungal agents.
Synergistic Effect of Biejia-Ruangan on Fibrosis Regression in Patients With Chronic Hepatitis B Treated With Entecavir: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Rong Guanghua , Chen Yongping , Yu Zujiang , Li Qin , Bi Jingfeng , Tan Lin , Xiang Dedong , Shang Qinghua , Lei Chunliang , Chen Liang , Hu Xiaoyu , Wang Jing , Liu Huabao , Lu Wei , Chen Yan , Dong Zheng , Bai Wenlin , Yoshida Eric M , Mendez-Sanchez Nahum , Hu Ke-Qin , Qi Xingshun , Yang Yongping
Published: May 2020

Background

Long-term nucleos(t)ide analogue (NA) treatment can reverse liver fibrosis in chronic hepatitis B (CHB), but its effect on fibrosis regression remains limited. Biejia-Ruangan (BR) has been approved in China as an antifibrotic traditional Chinese medicine drug in patients with chronic liver diseases. A multicenter randomized controlled trial aims to evaluate the effect of BR on fibrosis regression in CHB patients treated with NAs.

Methods

CHB patients with histologically confirmed advanced fibrosis or cirrhosis were randomly assigned to receive entecavir (ETV) (0.5 mg per day) plus BR (2 g 3 times a day) or placebo for 72 weeks. Liver fibrosis regression was defined as a reduction of ≥ 1 point by the Ishak fibrosis stage (IFS).

Results

Overall, 500 patients were enrolled in each group as the intention-to-treat population. The rate of fibrosis regression after 72 weeks of treatment was significantly higher in the ETV + BR group (40% vs 31.8%; P = .0069). Among 388 patients with cirrhosis (ie, IFS ≥ 5) at baseline, the rate of cirrhosis reversal (ie, IFS ≤ 4) was significantly higher in the ETV + BR group (41.5% vs 30.7%; P = .0103).

Conclusions

Addition of BR to the current standard treatment with NAs in CHB patients with advanced fibrosis or cirrhosis can improve liver fibrosis regression.

Clinical Trials Registration

NCT01965418.