bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescribing of proton pump inhibitors for gastrointestinal bleeding prophylaxis in the Lebanese outpatient setting: patterns, compliance with guidelines and risks
Authors: Soubra Lama , Issa Mohamed
Published: April 2019

Objectives

To determine patterns of proton pump inhibitor (PPIs) prescribing for gastrointestinal bleeding prophylaxis (GIBP) in the Lebanese outpatient setting, to assess their compliance with guidelines for approved GIBP indications and to delineate independent factors that are associated with non-compliance.

Methods

A community-based multicentre cross-sectional study was conducted. Eligible patients were those who presented to the community pharmacy setting with a PPI prescription for GIBP. Prescriptions were reviewed by a clinical pharmacist to ascertain their compliance with guidelines approved for GIBP indications. Several variables were tested to determine independent factors that were associated with guidelines non-compliance.

Key findings

Of the 720 reviewed PPI prescriptions, 297 (41.25%) were found to be compliant with guidelines approved for GIBP indications. The presence of two or more comorbid conditions, prescribing initiated by a primary care physician, patients taking three or more medications, and prescribing of NSAIDs including low-dose aspirin were found to be independent factors that were significantly associated with PPI prescribing non-compliance (P ≤ 0.05). PPIs were also inappropriately coprescribed with corticosteroids (102 (24.1%)), selective serotonin reuptake inhibitors (SSRIs) (48 (11.4%)), amoxicillin-clavulanic acid (20 (4.7%)) and bisphosphonates (13 (3.1%)) for GIBP.

Conclusion

This study demonstrated that PPIs were appropriately prescribed for GIBP in less than the half of the study patients. The need for improvement of clinical practice in this regard is therefore indispensable since inappropriate prescribing is costly and put the patient at risk for adverse health outcomes. Strategies to alter inappropriate prescribing may include education, guidelines awareness and decision support systems.
Optimization of processing variables for the development of virgin coconut oil cake based extruded snacks
Authors: Shameena Beegum Puthiya P. , Manikantan Musuvadi R. , Sharma Monika , Pandiselvam Ravi , Gupta Ram K. , Hebbar Kukkehalli B.
Published: April 2019

Virgin coconut oil (VCO) is a value added export‐oriented coconut product. One of the major by‐products of VCO called as VCO cake is a rich source of protein (15%) which is presently underutilized. The effect of important variables including percent of VCO cake (20–30%), screw speed (300–350 rpm) and feed moisture (14–18%) on physical, pasting, functional, textural, and sensory attributes of VCO cake based extruded snacks were estimated using Box and Behnken Design. The responses studied were expansion ratio, bulk density, peak viscosity, hardness, water solubility index, water absorption index and overall acceptability of sensory attributes. The optimized conditions obtained for the extrudates were 28.7% VCO cake, 14% feed moisture, and 300 rpm screw speed with the maximum desirability of 0.88. The percentage of protein, carbohydrate, crude fiber, and ash in the optimized sample were 11.14, 74.19, 1.58, and 2.3%, respectively. The promising results suggest that addition of VCO cake has improved the protein content of the extrudates with high consumer acceptability.

Practical application

Virgin coconut oil (VCO) is a leading value‐added product of coconut. Among the different production methods of VCO, hot processed VCO has more functional compounds such as polyphenols, antioxidants, and phytosterols. Hence, it is mainly used to consume orally. Indian Council of Agricultural Research (ICAR)‐Central Plantation Crops Research Institute, Kasaragod, India, has been transferred the VCO production technology to about 30 entrepreneurs from the last 5 years. The mean recovery of VCO cake during hot process VCO production is estimated at 6.3–8.8% of fresh kernel weight (i.e., 1 kg kernel give 63–88 g VCO cake) of the WCT coconut variety. VCO cake is a rich source of protein. By selling this by‐product in the form of extrudates would definitely give more income to the entrepreneurs apart from residue management. The results indicated that 28.7% VCO cake in the extruded formulation gave a nutritious product with a calorific value of 388 imparted with the natural sweetness of VCO cake.
The efficacy of the Dietary Approaches to Stop Hypertension diet with respect to improving pregnancy outcomes in women with hypertensive disorders
Authors: Jiang F. , Li Y. , Xu P. , Li J. , Chen X. , Yu H. , Gao B. , Xu B. , Li X. , Chen W.
Published: April 2019

Background

The DASH (Dietary Approaches to Stop Hypertension) diet serves as a dietary pattern for the prevention and control of hypertension. The present study aimed to investigate whether the DASH diet can improve the outcomes of pregnancy with gestational hypertension (GH) and chronic hypertension.

Methods

The current randomised controlled clinical trial was performed in 85 pregnant women diagnosed with GH and chronic hypertension between July 2015 and December 2017. The women were categorised into a control group (41 cases) and a DASH group (44 cases). Participants were followed until delivery. The clinical outcomes of mothers included gestational weeks of birth, delivery mode, postpartum haemorrhage and GH, as well as the incidence of pre‐eclampsia during the second and third trimesters. Newborn measurements were collected by evaluating prematurity, birth weight, body length and neonatal Apgar score.

Results

The incidence of pre‐eclampsia, prematurity and low birth weight in the DASH group was lower than that in the control group (P < 0.05). Significant differences were also observed in gestational age at delivery and the newborn body length between the two groups (P < 0.05). We failed to find a significant difference in changes of delivery mode, postpartum haemorrhage, postpartum GH, mean birth weight and Apgar score (P > 0.05) between the two diets.

Conclusions

A DASH diet might comprise a potential strategy for improving the clinical outcomes in pregnant women with GH and chronic hypertension. Future robust clinical trials are warranted to corroborate these findings.
Characteristics of the social networks of families living with parental cancer and support provided
Authors: Hauken May Aasebø , Dyregrov Kari , Senneseth Mette
Published: April 2019

Objective

To examine the characteristics of the social networks of families living with parental cancer and the kind of social support they provide compared with what the families report having received.

Background

Parental cancers are highly distressing for both parents and children. Among other concerns, families report a severe lack of social support. However, we know little about these families’ private social networks, nor support provided and received as reported by network members and the family.

Methods

Using a descriptive cross‐sectional design, 16 families living with parental cancer and 130 of their network members participated. Healthy parents and network members filled out The Assistance Questionnaire‐Receivers of support (AQR)/The Assistance Questionnaire‐Providers of Support (AQP).

Results

Network members were mainly resourceful friends (44%) and family members (42%). Only 1/3 became supporters at diagnosis, and nearly 50% had to be asked. Supporters provided a variety of types of help, especially emotional support. A match between the perception of the healthy parent and that of the network members was found for provided (p = 0.211) and received (p = 0.741) support. Supporters were satisfied with their provided support, experiencing it as rewarding and associated with few negative aspects. The STROBE checklist for observational studies was followed in reporting the results.

Conclusions

The social networks, being mainly family and friends, were able to provide different types of help, especially emotional support. A useful suggestion may be to involve supporters at an earlier stage, providing more practical support.

Relevance for clinical practice

Nurses are in a unique position to promote social support for families living with parental cancer by embracing a network focus, by emphasising the importance and potential of social support, by helping families to map their network and by teaching them how to be explicit in their requests for support.
Custom Nasal Septum Prosthesis Fabricated from a 3D‐Printed Working Model: A Clinical Report
Authors: Somohano Marquez Tanya
Published: April 2019

This clinical report describes the treatment of a 47‐year‐old female patient with a nasal septum perforation. The treatment used a 2‐piece magnetic custom prosthesis fabricated from a 3D‐printed model. By using an existing medical CT scan to generate the printed working model, the number of clinical appointments was reduced. The workflow expanded the purpose of the radiologic images from simply diagnostic to include the prosthetic aspect of treatment.
Goblet cells and mucus layer in the gut of young pigs: Response to dietary contents of threonine and non‐essential amino acids
Authors: Święch Ewa , Tuśnio Anna , Barszcz Marcin , Taciak Marcin , Siwiak Ewelina
Published: April 2019

Mucins secreted by goblet cells (GC) are the major components of mucus layer coating and protecting gut epithelium. The study aimed at determining the effect of non‐essential amino acids (NEAA) and threonine (Thr) levels on GC number and mucus layer thickness measured in different parts of the gut. A two‐factorial experiment was conducted on 72 pigs (initial BW 12.5 kg) using as factors: Thr level (5.1, 5.7, 6.3 and 6.9 g standardized ileal digestible [SID] Thr/kg) and wheat gluten (WG) level used as a source of NEAA (20.4, 40.4 and 60.4 g WG protein in WG20, WG40 and WG60 diets respectively). All diets covered the requirement for essential AA, except for Thr, and they were fed to six pigs for 20 days. Thr level affected only the count of GC containing acidic mucins in the proximal colon, which was higher in pigs fed a diet with 5.1 g SID Thr/kg in comparison with diet containing 6.3 g SID Thr/kg. In the villi, WG40 and/or WG60 increased the GC number containing acidic mucins and lowered that with neutral mucins in the middle jejunum. In the crypts, higher WG levels decreased the GC number with acidic mucins in the duodenum, ileum and proximal colon and increased that with neutral and mixed mucins in the duodenum and ileum. The mucus layer was thicker in the proximal and middle jejunum in WG20 pigs, whereas in the proximal colon it was thicker in WG60 pigs. The lowest GC count was found in the middle jejunum and the highest in the duodenum and proximal colon. The mucus layer was the thinnest in the proximal and middle jejunum and the thickest in the ileum. The results did not show the negative effect of a moderate Thr deficiency and the positive effect of non‐essential AA supplementation on GC functions.
Art and the Desire for God: A Thomistic Perspective in Aesthetics
Authors: Pouivet Roger
Published: April 2019

“Aesthetics” is mainly devoted to the description of an assumed aesthetic experience. My intention is to try to show that this modern account, defining a large part of Aesthetics as a discipline, does not allow a correct description of our aesthetic life. Criticism of this modern and contemporary conception will be followed by the defence of a completely different thesis according to which we are made to apprehend in natural things and works of art those properties by which they signify, and in particular their aesthetic properties. Apprehension and appreciation of works of art presuppose the ability to respond to the aesthetic properties of things and works of art. We need to exercise virtues, intellectual and moral ones, to answer appropriately to aesthetic properties of works of art and natural things. Good in general, and good in our aesthetic life and in art, can be understood according to what Aquinas calls “the gradation to be found in things”. I will try to show that it is a reason to think that a successful aesthetic life is a form of desire for God as the source of all perfection.
Antonio's sadness in the Stoic theatrum mundi of the Early Modern city
Authors: Vangshardt Rasmus
Published: April 2019

Antonio's opening claim in The Merchant of Venice, that he is ‘so sad’ because he has been given a sad role on the world stage, has often been neglected in the history of the play's reception. The present analysis begins with an examination of central passages to clarify the role of sadness in relation to the trope of the theatrum mundi. It shows that the sadness is persistent and earnest, and that this is caused by an understanding of the meaning of the theatrum mundi, which has hitherto been overlooked. The article then considers the historical light in which the theatrum mundi should be seen in the context of the play with respect to the prior textual analysis. The suggestion is that in relation to both the intellectual history of ideas and to Elizabethan audience‐response, the play negotiates a Christian‐Stoic version of the theatrum mundi without breaking away from the genre of comedy and paradoxically not abandoning Antonio's sadness.
The Rise of Public–Private Partnerships in China: An Effective Financing Approach for Infrastructure Investment?
Authors: Tan Jie , Zhao Jerry Zhirong
Published: April 2019

The rise of public‐private partnerships (PPPs) in China has spurred heated debates about their purpose and effectiveness. This article traces the fluctuation of China's PPPs over several decades and finds that PPPs have played a supplementary role in China's infrastructure investment, as a response to the pressures of fiscal shortfalls and government debts. The resurgence of PPPs in recent years aims to bridge the infrastructure gap and alleviate ballooning local debts. These expectations, however, are hard to realize. China's PPPs mainly involve state‐owned enterprises and place increasing financial burdens on the government. The central government has taken measures to attract private sector investment to mitigate the financial risk, but the prospects for PPPs remain unclear.
The dynamics of endothelial changes in vivo following standardized skin injury
Authors: Hanssen Sabina Catharina Andrea , Keijsers Romy Rosa Maria Catharina , Hendriks Anke Gertruda Martina , Seyger Marieke Martha Benedicta , van der Vleuten Catharina Joanna Maria , van de Kerkhof Peter Cornelis Maria
Published: April 2019

Background

Vascular changes, that is, functional and cellular endothelial changes, are of essential importance in healing. Alongside these vascular changes, inflammatory factors and hypoxia may play an important role in recovery.

Objectives

To investigate the dynamics of functional and cellular endothelial changes and hypoxia in vivo following standardized skin damage caused by tape stripping.

Methods

Vascular changes (endothelial cell proliferation, vascular network size, vessel diameter) and hypoxia‐inducible factor‐1α were examined immunohistochemically using a CD31/Ki67 double staining and HIF‐1α single staining. Cutaneous perfusion was evaluated using the Twente Optical Perfusion Camera (TOPCam).

Results

The initial phase is seen to be dominated by endothelial cell proliferation, HIF‐1α expression, and vasodilatation. Cutaneous perfusion intensity is particularly increased in the first 16 hours.

The late phase of recovery (after 72 hours) is characterized by a peak of expansion of the vascular network and a second peak of endothelial cell proliferation and HIF‐1α expression.

Conclusion

Endothelial cell proliferation and HIF‐1α expression appear to be (strongly) related, having maximum levels at 16 hours and 72 hours. Angiogenesis and HIF‐1α expression are not continuous processes, but rather occur intermittently.
Identification of the novel KIR3DL3*02602 allele from a southern Chinese Han individual
Authors: Cai Siqi , Zhang Guobin , Deng Zhi‐hui
Published: April 2019

The novel KIR3DL3*02602 allele differs from the closest allele KIR3DL3*02601 by a single silent mutation.
Determination of trypan blue efficacy in the mitigation of ex vivo canine PCO formation
Authors: Brash Breanna M. , Gemensky‐Metzler Anne J. , Wilkie David A. , Miller Eric J. , Chandler Heather L.
Published: April 2019

Purpose

To determine whether trypan blue (TB) reduces canine lens epithelial cell (LEC) or corneal endothelial cell (CEC) viability in vitro; if cell death is noted, to subsequently evaluate the molecular mechanism.

Methods

Cellular viability was determined using a lactate dehydrogenase (LDH) assay. In TB‐treated LECs, caspase 3/7 activity was assessed to evaluate apoptosis; autophagy was evaluated using immunoblotting against LC3 and p62. To evaluate the effects of TB on ex vivo posterior capsule opacification (PCO), following mock cataract surgery, lens capsules were treated with TB and subsequently maintained in culture to determine LEC migration and proliferation.

Results

Following acute exposure, TB did not significantly reduce LEC or CEC viability at any of the concentrations tested. Increased caspase 3/7 activity was found in LEC cultures treated with TB for an extended period of time; no change in LC3 or p62 expression was noted. Ex vivo PCO formation was not significantly altered by TB treatment.

Conclusions

Acute exposure to TB did not reduce LEC or CEC viability, and only longer exposure to TB was able to initiate apoptosis. Treatment with intraocular TB at the time of cataract surgery is likely safe to the CECs but will not prevent PCO formation.
An Improved Phased Array Ultrasonic Testing Technique for Thick-Wall Polyethylene Pipe Used in Nuclear Power Plant
Authors: Qin Yinkang , Shi Jianfeng , Zheng Jinyang , Hou Dongsheng , Guo Weican
Published: April 2019

With the application of high-density polyethylene (HDPE) pipe with thick wall in nuclear power plant (NPP), great attention has been paid to the safety of the pipeline joints, which can be assessed by phased array ultrasonic testing (PAUT). PAUT creates constructive interference of acoustic waves to generate focused beams according to delay law based on time-of-flight. However, due to the existence of acoustic attenuation and dispersion, waveform distortion occurs when ultrasonic pulse propagates in HDPE, which will accumulate with the increase of propagation distance, and then results in imaging errors. In this paper, the relationship between acoustic attenuation and dispersion in HDPE was obtained by numerical simulation in Field II®, which can be verified by the experiment of our previous work. Then, the investigation of the waveform distortion revealed the linear relation between peak offset and propagation distance. Considering the relation, an improved delay law was proposed to increase the intensity of ultrasonic field. This improved delay law was compared with the conventional one by numerical simulation of ultrasonic field and PAUT experiments, which showed that the improved delay law could increase the image sensitivity.
Decontamination Effect of the Spindle and 222-Nanometer Krypton-Chlorine Excimer Lamp Combination against Pathogens on Apples (
Malus domestica
Borkh.) and Bell Peppers (
Capsicum annuum
L.)
Authors: Kang Jun-Won , Kang Dong-Hyun
Published: April 2019

Although most fresh-produce processing currently controls pathogens by means of washing with sanitizers, there are still problems such as the generation of harmful substances and changes in product quality. A combination system composed of the Spindle and a 222-nm KrCl excilamp (Sp-Ex) developed in this study reduced pathogens on apple and bell pepper surfaces using sanitizer-free water without altering produce color and texture. This study demonstrates the potential of the Sp-Ex to replace conventional washing with sanitizers, and it can be used as baseline data for practical application by industry. In addition, implementation of the Sp-Ex developed in this study is expected not only to meet consumer preference for fresh, minimally processed produce but also to reduce human exposure to harmful chemicals while being beneficial to the environment.
Study of
Legionella
Effector Domains Revealed Novel and Prevalent Phosphatidylinositol 3-Phosphate Binding Domains
Authors: Nachmias Nimrod , Zusman Tal , Segal Gil
Published: April 2019

Legionella pneumophila
and other
Legionella
species replicate intracellularly using the Icm/Dot type IV secretion system. In
L. pneumophila
this system translocates >300 effectors into host cells and in the
Legionella
genus thousands of effectors were identified, the function of most of which is unknown.
Phylogenetic Analysis of Mycobacterium tuberculosis Strains in Wales by Use of Core Genome Multilocus Sequence Typing To Analyze Whole-Genome Sequencing Data
Authors: Jones R. C. , Harris L. G. , Morgan S. , Ruddy M. C. , Perry M. , Williams R. , Humphrey T. , Temple M. , Davies A. P.
Published: April 2019

An inability to standardize the bioinformatic data produced by whole-genome sequencing (WGS) has been a barrier to its widespread use in tuberculosis phylogenetics. The aim of this study was to carry out a phylogenetic analysis of tuberculosis in Wales, United Kingdom, using Ridom SeqSphere software for core genome multilocus sequence typing (cgMLST) analysis of whole-genome sequencing data.
Genome Sequences of Three Ross River Virus Isolates Obtained from the Australian Defence Force
Authors: Liu Wenjun , Kizu Joanne , Le Grand Luke , Mitchell Ian , Gauci Penelope J. , Gubala Aneta J.
Published: April 2019

The complete genome sequences of three Ross River virus (RRV) isolates from infected Australian Defence Force (ADF) personnel and from mosquitoes collected in ADF training areas were determined. Phylogenetic analysis in comparison with all available complete RRV nucleotide sequences from GenBank split these three RRV isolates into two distinct sublineages.
Draft Genome Sequence of
Bradyrhizobium
sp. Strain LVM 105, a Nitrogen-Fixing Symbiont of
Chamaecrista fasciculata
(Michx.) Greene
Authors: Krishnan Hari B. , Kim Won-Seok , Givan Scott A.
Published: April 2019

Here, we present the draft genome sequence of
Bradyrhizobium
sp. strain LVM 105, a soil bacterium that forms nitrogen-fixing nodules on the roots of partridge pea.
Draft Genome Sequence of Phocine Herpesvirus 1 Isolated from the Brain of a Harbor Seal
Authors: Rosales Stephanie M. , Vega Thurber Rebecca
Published: April 2019

Phocine herpesvirus 1 (PhHV-1) is a viral pathogen with high prevalence, morbidity, and mortality in harbor seals. In this study, we used a metagenomic approach to assemble the PhHV-1 genome from the brain tissue of a harbor seal.
Genome Sequence of Rhodococcus erythropolis Type Strain JCM 3201
Authors: Yoshida Keitaro , Kitagawa Wataru , Ishiya Koji , Mitani Yasuo , Nakashima Nobutaka , Aburatani Sachiyo , Tamura Tomohiro
Published: April 2019

Rhodococcus erythropolis
JCM 3201 can express several recombinant proteins that are difficult to express in
Escherichia coli
. It is used as one of the hosts for protein expression and bioconversion.
‘Off pump’ self-expanding injectable tissue valves (IPVR) versus ‘on pump’ conventional tissue valves (PVR) for replacement of the pulmonary valve: trial protocol for a randomised controlled trial (InVITe trial)
Authors: Heys Rachael , Angelini Gianni , Caputo Massimo , Culliford Lucy , Pufulete Maria , Reeves Barnaby C , Rogers Chris A , Stoica Serban , Parry Andrew
Published: April 2019

Introduction

Patients with congenital heart disease often need repeated operations throughout life to replace the pulmonary valve. Valve replacement with ‘injectable’ self-expanding valves (which is performed ‘off pump’ without the use of cardiopulmonary bypass, CPB) may result in quicker recovery and lower risk of major complications than valve replacement with conventional valves (which is performed ‘on pump’ with the use of CPB).

Methods and analysis

We are conducting a multicentre, single-blind randomised controlled trial in patients with congenital heart disease and aged between 12 and 80 years. We will randomise participants in a 1:1 ratio to receive either ‘off pump’ injectable pulmonary valve replacement or ‘on pump’ conventional pulmonary valve replacement. The primary outcome will be the difference between the groups with respect to post-surgery blood loss (as measured by chest drain volume) in the first 24 hours. Secondary outcomes will include in-hospital outcomes (intensive care unit stay, inotropic/vasodilator support, chest drain volume in the first 12 hours post-surgery, time of readiness for extubation, blood products used in the first 24 hours post-surgery, time of fitness for discharge, valve and heart function 6 months post-surgery (assessed using cardiovascular magnetic resonance and ECHOCARDIOGRAPHY) and health-related quality of life 6 weeks and 6 months post-surgery.

Ethics and dissemination

This trial has been approved by the South West Exeter Research Ethics Committee. Findings will be shared with participating hospitals and disseminated to the academic community through peer reviewed publications and presentation at national and international meetings. Patients will be informed of the results through patient organisations and newsletters to participants.

Trial registration number

ISRCTN23538073
Abdominal aortic calcification, bone mineral density and fractures: a systematic review and meta-analysis protocol
Authors: Rodríguez Alexander J , Leow Kevin , Szulc Pawel , Scott David , Ebeling Peter , Sim Marc , Wong Germaine , Lim Wai H , Schousboe John T , Kiel Douglas P , Prince Richard L , R Lewis Joshua
Published: April 2019

Introduction

Abdominal aortic calcification (AAC) is associated with low bone mass and increased fracture risk. Two previous meta-analyses have investigated the association between AAC and fracture. However, these meta-analyses only identified articles until December 2016, undertook limited searches and did not explore potential sources of between-study heterogeneity. We aim to undertake a sensitive and comprehensive assessment of the relationship between AAC, bone mineral density (BMD) as well as prevalent and incident fractures.

Methods

We will search MEDLINE, EMBASE, Web of Science core collection and Google Scholar (top 200 articles sorted by relevance) from their inception to 1 June 2018. Reference lists of included studies and previous systematic reviews will be hand searched for additional eligible studies. Retrospective and prospective cohort studies (cross-sectional, case–control and longitudinal) reporting the association between AAC, BMD and fracture at any site will be included. At least two investigators will independently: (A) evaluate study eligibility and extract data, with a third investigator to adjudicate when discrepancies occur, (B) assess study quality by the Newcastle-Ottawa Scale for each cohort/study. The meta-analysis will be reported in adherence to the Meta-analysis of Observational Studies in Epidemiology criteria. AAC will be grouped as either: (1) AAC present or absent, (2) AAC categorised as ‘low’ (referent—lowest reported group) versus ‘high’ (all other groups) or (3) dose–response when AAC was assessed in ≥3 groups. Where primary event data were reported in individual studies, pooled risk differences and risk ratios with 95% CI will be calculated, from which, a summary estimate will be determined using DerSimonian-Laird random effects models. For the AAC and BMD pooled analyses, estimates will be expressed as standardised mean difference with 95% CI. We will examine the likelihood of publication bias and where possible, investigate potential reasons for between-study heterogeneity using subgroup analyses and meta-regression.

Ethics and dissemination

The study will be submitted to a peer- reviewed journal and disseminated via research presentations.

PROSPERO registration number

CRD42018088019.
How to decide adequately? Qualitative study of GPs’ view on decision-making in self-referred and physician-referred emergency department consultations in Berlin, Germany
Authors: Oslislo Sarah , Heintze Christoph , Schmiedhofer Martina , Möckel Martin , Schenk Liane , Holzinger Felix
Published: April 2019

Objectives

Patients with acute symptoms present not only to general practitioners (GPs), but also frequently to emergency departments (EDs). Patients’ decision processes leading up to an ED self-referral are complex and supposed to result from a multitude of determinants. While they are key providers in primary care, little is known about GPs’ perception of such patients. This qualitative study explores the GPs’ view regarding motives and competences of patients self-referring to EDs, and also GPs’ rationale for or against physician-initiated ED referrals.

Design

Qualitative study with semi-structured, face-to-face interviews; qualitative content analysis.

Setting

GP practices in Berlin, Germany.

Participants

15 GPs (female/male: 9/6; mean age 53.6 years).

Results

The interviewed GPs related a wide spectrum of factors potentially influencing their patients’ decision to visit an ED, and also their own decision-making in potential referrals. Considerations go beyond medical urgency. Statements concerning patients’ surmised rationale corresponded to GPs’ reasoning in a variety of important areas. For one thing, the timely availability of an extended spectrum of diagnostic and therapeutic options may make ED services attractive to both. Access difficulties in the ambulatory setting were mentioned as additional triggers for an ED visit initiated by a patient or a GP. Key patient factors like severity of symptoms and anxiety also play a major role; a desire for reassurance may lead to both self-referred and physician-initiated ED visits. Patients’ health competence was prevailingly depicted as limited, with the internet as an important influencing factor. Counselling efforts by GP were described as crucial for improving health literacy.

Conclusions

Health education could hold promise when aiming to reduce non-urgent ED consultations. Primary care providers are in a key position here. Amelioration of organisational shortages in ambulatory care, for example, limited consultation hours, might also make an important impact, as these trigger both self-referrals and GP-initiated ED referrals.

Trial registration number

DRKS00011930.
ZnS nanoparticles-based tunable dielectric metamaterials
Authors: Wu Hongya , Zhou Ruoshan , Xu Liang , Qin Guoqiang , Qin Shengjian , Yu Gang , Yang Zhigang , Zhang Guanglei , Zhou Ji
Published: April 2019

In recent years, increasing attention has been paid to Mie resonance-based dielectric metamaterials. Here, we report a ZnS nanoparticles-based dielectric metamaterials. The permittivity of ground state and excited state of ZnS were calculated by Materials Studio, and the obtained permittivity was used to simulate the light transmission characteristics of ZnS nanoparticles-based Mie metamaterials. ZnS nanoparticles were prepared by solid reaction process, which were dispersed into alcohol solution to get Mie resonance-based metamaterials. The transmission characteristics were measured by UV–Vis spectrophotometer. There is resonance peak both in simulation and experiment and the different electromagnetic response in ground state and excited state indicates that tunable Mie resonance-based metamaterials were fabricated. This work demonstrates the feasibility of fabrication of tunable dielectric metamaterials at optics frequencies which can be used as sensors with chemical methods.
Interval Methods in Knowledge Representation
Authors: Kreinovich Vladik
Published: April 2019

Please send your abstracts (or copies of papers that you want to see reviewed here) to vladik@utep.edu, or by regular mail to Vladik Kreinovich, Department of Computer Science, University of Texas at El Paso, El Paso, TX 79968, USA.
ANALYSIS OF LIQUID MEDIATED CONTACT OF GLASS COLLOIDAL PARTICLE WITH POLYSTYRENE COATED SURFACE
Authors: AHMAD KHURSHID , AHMAD ABDUS SABOOR , HASSAN MUHAMMAD , AHMAD ZUBAIR , ZHAO XUEZENG , PAN YUNLU
Published: April 2019

Spin coating has been widely used for obtaining uniform thin polymeric coating over glass surfaces. Previous studies have shown that the thin-coated film can deform and bulge out upon immersion in liquid. Such deformations can affect various properties of the films. In this study, we have analyzed the interaction of glass colloidal particle and the polystyrene (PS) spin-coated surface immersed in deionized (DI) water. It was found that the glass colloidal particle interacts with the surface in dissimilar way at various locations on the surface. A sudden reduction in the forces was also observed at different locations on the same surface. The separation distances at which the sudden change in the force occurred was closer to the height of the spherical domains. Therefore, the change could be attributed to the presence of blisters on the surface formed due to permeation of water into the thin film-substrate interface.
Structure of Tantalum and Tantalum Oxide Coatings on Steel and Glass Surfaces
Authors: Melnikova G. B. , Petrovskaya A. S. , Kuznetsova T. A. , Chizhik S. A. , Zykova A. , Safonov V. , Yakovin S.
Published: April 2019

The research of structure, roughness and friction coefficients of tantalum and tantalum oxide coatings on steel and glass substrates by the AFM method is presented. The samples are characterized by low friction coefficients. These materials are proposed for fabrication of stents in medical applications.
Evolutionary Heuristic A* Search: Pathfinding Algorithm with Self-Designed and Optimized Heuristic Function
Authors: Yiu Ying Fung , Du Jing , Mahapatra Rabi
Published: April 2019

The performance and efficiency of A* search algorithm heavily depends on the quality of the heuristic function. Therefore, designing an optimal heuristic function becomes the primary goal of developing a search algorithm for specific domains in artificial intelligence. However, it is difficult to design a well-constructed heuristic function without careful consideration and trial-and-error, especially for complex pathfinding problems. The complexity of a heuristic function increases and becomes unmanageable to design when an increasing number of parameters are involved. Existing approaches often avoid complex heuristic function design: they either trade-off the accuracy for faster computation or taking advantage of the parallelism for better performance. The objective of this paper is to reduce the difficulty of complex heuristic function design for A* search algorithm. We aim to design an algorithm that can be automatically optimized to achieve rapid search with high accuracy and low computational cost. In this paper, we present a novel design and optimization method for a Multi-Weighted-Heuristics function (MWH) named Evolutionary Heuristic A* search (EHA*) to: (1) minimize the effort on heuristic function design via Genetic Algorithm (GA), (2) optimize the performance of A* search and its variants including but not limited to WA* and MHA*, and (3) guarantee the completeness and optimality. EHA* algorithm enables high performance searches and significantly simplifies the processing of heuristic design. We apply EHA* to multiple grid-based pathfinding benchmarks to evaluate the performance. Our experiment result shows that EHA* (1) is capable of choosing an accurate heuristic function that provides an optimal solution, (2) can identify and eliminate inefficient heuristics, (3) is able to automatically design multi-heuristics function, and (4) minimizes both the time and space complexity.
Identification of Discriminative Subnetwork from fMRI-Based Complete Functional Connectivity Networks
Authors: Hamdi Shah Muhammad , Wu Yubao , Angryk Rafal , Krishnamurthy Lisa Crystal , Morris Robin
Published: April 2019

The comprehensive set of neuronal connections of the human brain, which is known as the human connectomes, has provided valuable insight into neurological and neurodevelopmental disorders. Functional Magnetic Resonance Imaging (fMRI) has facilitated this research by capturing regionally specific brain activity. Resting state fMRI is used to extract the functional connectivity networks, which are edge-weighted complete graphs. In these complete functional connectivity networks, each node represents one brain region or Region of Interest (ROI), and each edge weight represents the strength of functional connectivity of the adjacent ROIs. In order to leverage existing graph mining methodologies, these complete graphs are often made sparse by applying thresholds on weights. This approach can result in loss of discriminative information while addressing the issue of biomarkers detection, i.e. finding discriminative ROIs and connections, given the data of healthy and disabled population. In this work, we demonstrate a novel framework for representing the complete functional connectivity networks in a threshold-free manner and identifying biomarkers by using feature selection algorithms. Additionally, to compute meaningful representations of the discriminative ROIs and connections, we apply tensor decomposition techniques. Experiments on a fMRI dataset of neurodevelopmental reading disabilities show the highly interpretable nature of our approach in finding the biomarkers of the diseases.
Discontinuous phenomena in bioreactor and membrane reactor systems
Authors: Hosham Hany A.
Published: April 2019

In this work, we analyze the existence of discontinuous bifurcation and stability issues in discontinuous flow of bioreactor and membrane reactor models with or without recycle. The reaction is assumed to be governed by certain types of discontinuities in Monod growth kinetics curve leading to discontinuous dynamical system. The criteria for the existence and stability of steady-states of these models are established. More generally, our analysis highlights the presence of several types of bifurcation depending upon the effect of the dilution factor (residence time), biomass concentration and solid-liquid-gas separator efficiency. As well, we present bifurcation conditions defining the dynamics near steady-state branches on the border, providing a possible framework for existing of saddle-node, nonsmooth fold, persistence and grazing-sliding scenarios. It is shown that the critical values of residence time dependence upon recycle ratio, decay rate and existence of discontinuity surface. Further, the performance of the reactor at largest residence times will be discussed. In addition, numerical simulations to illustrate and confirm the results will be carried out.
The Physics of Railway Signalling
Authors: Tan B. T. G.
Published: April 2019

Railway signalling technology can provide real-world illustrations of a number of key physics concepts, making them more interesting to physics students.
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Ar thermochronology in the Ios basement terrane resolves the tectonic significance of the South Cyclades Shear Zone
Authors: Forster Marnie , Koudashev Oleg , Nie Ruoran , Yeung Sonia , Lister Gordon
Published: April 2019

We conducted
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Ar diffusion experiments using potassium feldspar from the South Cyclades Shear Zone on Ios, in the Cyclades, Aegean Sea, Greece. Irradiated samples were step-heated in an ultra-high-vacuum resistance furnace attached to a mass spectrometer, thus also allowing
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Ar geochronology. Conjoint inversion of these datasets allowed estimation of the relevant diffusion parameters, which were then used to forward model the effect of arbitrary temperature–time histories. Simulations used Monte Carlo methods to improve approximations to the observed age spectra. Two periods of rapid cooling could be inferred. The South Cyclades Shear Zone commenced operation during or shortly after the Eocene–Oligocene transition. Episodes of south-directed movement continued into Early Miocene time, however, with the footwall still hot enough to cause biotite ± garnet metamorphic mineral growth at the base of the overlying, already substantially exhumed, eclogite–blueschist unit. Since its footwall continued to cool, the South Cyclades Shear Zone was an extensional shear zone during both episodes of its operation.
Hybrid Live Cell–Supported Membrane Interfaces for Signaling Studies
Authors: Biswas Kabir H. , Groves Jay T.
Published: April 2019

A wide range of cell–microenvironmental interactions are mediated by membrane-localized receptors that bind ligands present on another cell or the extracellular matrix. This situation introduces a number of physical effects including spatial organization of receptor–ligand complexes and development of mechanical forces in cells. Unlike traditional experimental approaches, hybrid live cell–supported lipid bilayer (SLB) systems, wherein a live cell interacts with a synthetic substrate supported membrane, allow interrogation of these aspects of receptor signaling. The SLB system directly offers facile control over the identity, density, and mobility of ligands used for engaging cellular receptors. Further, application of various nano- and micropatterning techniques allows for spatial patterning of ligands. In this review, we describe the hybrid live cell–SLB system and its application in uncovering a range of spatial and mechanical aspects of receptor signaling. We highlight the T cell immunological synapse, junctions formed between EphA2- and ephrinA1-expressing cells, and adhesions formed by cadherin and integrin receptors.
Analysis of excitatory and inhibitory neuron types in the inferior colliculus based on Ih properties
Authors: Naumov Victor , Heyd Julia , de Arnal Fauve , Koch Ursula
Published: April 2019

The inferior colliculus (IC) is a large midbrain nucleus that integrates inputs from many auditory brainstem and cortical structures. Despite its prominent role in auditory processing, the various cell types and their connections within the IC are not well characterized. To further separate GABAergic and non-GABAergic neuron types according to their physiological properties, we used a mouse model that expresses channelrhodopsin and enhanced yellow fluorescent protein in all GABAergic neurons and allows identification of GABAergic cells by light stimulation. Neuron types were classified upon electrophysiological measurements of the hyperpolarizing-activated current ( Ih) in acute brain slices of young adult mice. All GABAergic neurons from our sample displayed slow-activating Ih with moderate amplitudes, whereas a subset of excitatory neurons showed fast-activating Ih with large amplitudes. This is in agreement with our finding that immunoreactivity against the fast-gating hyperpolarization-activated and cyclic-nucleotide-gated 1 (HCN1) channel was present around excitatory neurons, whereas the slow-gating HCN4 channel was found perisomatically around most inhibitory neurons. Ih properties and neurotransmitter types were correlated with firing patterns to depolarizing current pulses. All GABAergic neurons displayed adapting firing patterns very similar to the majority of glutamatergic neurons. About 15% of the glutamatergic neurons showed an onset spiking pattern, always in combination with large and fast Ih. We conclude that HCN channel subtypes are differentially distributed in IC neuron types and correlate with neurotransmitter type and firing pattern. In contrast to many other brain regions, membrane properties and firing patterns were similar in GABAergic neurons and about one-third of the excitatory neurons.

NEW & NOTEWORTHY Neuron types in the central nucleus of the auditory midbrain are not well characterized regarding their transmitter type, ion channel composition, and firing pattern. The present study shows that GABAergic neurons have slowly activating hyperpolarizing-activated current ( Ih) and an adaptive firing pattern whereas at least four types of glutamatergic neurons exist regarding their Ih properties and firing patterns. Many of the glutamatergic neurons were almost indistinguishable from the GABAergic neurons regarding Ih properties and firing pattern.
An Implementation of Hardware-Accelerated Serial Interface of IoT Gateway for Enabling Machine-Type Communication: A Case Study of Networking IR Controllable Home Appliances
Authors: Tsai Wen-Chung , Zhu Shi-Xiang , Huang Nien-Ting , Chiang Mao-Lun
Published: April 2019

In this paper, we propose an implementation of machine-type communications by combining a novel hardware-accelerated serial interface and a conventional Internet of things (IoT) gateway. Even all home appliances with an infrared (IR) remote controller can be operated through the Internet. In the future, application paradigms will transfer from human-type communications to machine-type communications to provide services such as health care and smart-home control systems. Therefore, commercial IoT gateways are required for intranet-Internet bridging of various wireless access services. Home appliances that are currently used or will foreseeably be used in the future lack network capabilities but can be controlled by an IR remote controller. Accordingly, to leverage existing IR control capabilities, we implemented a smart-home control system, which enables an IR signal to be remotely controlled to emit through the Internet. The implemented system provides a hardware-accelerated serial interface to sample IR signals—including extremely high-frequency signals—and includes a hardware-based data compression mechanism able to reduce the size of oversampled data and save flash memory space. A more intelligent control style can thus be realized by leveraging existing home appliances for the smart-homes of the future.
Miniature All-Silica Microbubble-Based Fiber Optic Fabry-Perot Pressure Sensor with Pressure Leading-In Tube
Authors: Zhang Huixin , Liu Jia , Li Jiashun , Jia Pinggang , Feng Fei , Hong Yingping , Shen Sanmin , Liang Ting , Xiong Jijun
Published: April 2019

A novel all-silica fiber optic Fabry-Perot (FP) pressure sensor with pressure leading-in tube based on microbubble structure is developed and experimentally demonstrated. The FP cavity is formed by fixing the end face of the single-mode fiber (SMF) parallel to the outer surface of the microbubble, in which the microbubble with a diameter of about 318 μm is constructed at the end of silica hollow tube. When external pressure is transmitted on the inner surface of the microbubble by the pressure leading-in tube, the FP cavity length changes with the diameter of microbubble. Experimental results show that such a sensor has a linear sensitivity of approximately 4.84 nm/MPa at room temperature over the pressure range of 1.1 MPa; the sensor has a very low temperature coefficient of approximately 2 pm/°C from room temperature to 600°C. The sensor has advantages of extremely low temperature coefficient, compact structure, and small size, which has potential applications for measuring pressure in high-temperature environment.
The Intersection between Tumor Angiogenesis and Immune Suppression
Authors: Rahma Osama E. , Hodi F. Stephen
Published: April 2019

Both immune checkpoint inhibitors (ICI) and antiangiogenesis agents have changed the landscape of cancer treatment in the modern era. While antiangiogenesis agents have demonstrated activities in tumors with high vascularization, including renal cell carcinoma and colorectal cancer, the effect of ICIs has been seen mainly in immunologically recognized tumors, with highly immune-infiltrative lymphocytes. The main challenge in the drug development of ICIs is moving their activities to noninflamed tumors and overcoming resistance that is driven, in part, by the immune-suppressive microenvironment. Angiogenesis factors drive immune suppression by directly suppressing the antigen-presenting cells as well as immune effector cells or through augmenting the effect of regulatory T cells (Treg), myeloid-derived suppressor cells (MDSC), and tumor-associated macrophages (TAM). Those suppressive immune cells can also drive angiogenesis, creating a vicious cycle of impaired immune activation. The combination of bevacizumab and ipilimumab was the first to show the promising effect of antiangiogenesis and ICIs. A plethora of similar combinations has entered the clinic since then, confirming the promising effects of such approach.