bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary evaluation of the use of high‐flow nasal cannula oxygen therapy during recovery from general anesthesia in dogs with obstructive upper airway breathing
Authors: Jagodich Tiffany A. , Bersenas Alexa M. E. , Bateman Shane W. , Kerr Carolyn L.
Published: June 2020

Background

Brachycephalic airway syndrome can pose a risk of complicated recovery from anesthesia as a result of irritation to the excess pharyngeal andlaryngeal tissue present in affected dogs. High‐flow nasal cannula (HFNC) oxygen therapy is a respiratory support modality that offers provision of continuous positive airway pressure via high gas flow rates. The HFNC system actively warms and humidifies inspired gases, which improves comfort and facilitates tolerance of the high flow rates in people and dogs. HFNC oxygen therapy was applied to brachycephalic dogs that developed increased work of breathing or hypoxemia in the recovery phase of anesthesia to determine if this device would be tolerable and effective for relief of upper respiratory difficulty.

Key Findings

The HFNC nasal prong interface is well suited to the brachycephalic facial structure. The application of HFNC was found to reduce dyspnea scores in patients with signs of upper airway obstruction after general anesthesia. Aerophagia and changes in PCO2 were noted.

Significance

Application of HFNC in the recovery period may result in improved airflow during times of somnolent obstructive breathing, not unlike the use of continuous positive airway pressure therapy in sleep‐disordered breathing in people.
Performance Degradation and Flow Instability of Axial-Flow Fan Due to Upstream Obstacle
Authors: Kang Donghyuk , Shinohara Takeru , Nakamura Shinsaku , Nishibe Koichi , Sato Kotaro , Yokota Kazuhiko , Ohue Hiroshi
Published: June 2020

This paper elucidates the performance degradation and flow instability of an axial fan caused by the presence of disk-shaped obstacles upstream of the fan, such as wall surfaces. The increase in pressure loss and the decrease in shaft power coefficient due to inlet swirl flow, and the increase in pressure loss due to the outlet swirl flow, cause performance degradation. When the obstacle is closer to the fan, the strong swirl flow causes a negative pressure region between the fan and the obstacle, reversing the flow direction. This phenomenon is caused by the diffuser effect of the outward flow and the increase in pressure by acting as a multiblade centrifugal fan. At a low flow rate, a clockwise vortex is generated at the center of the obstacle and induces two counterclockwise rotating vortices. The vortices circumferentially separate the inward and outward flows along the fan's axis in a uniform manner, and their cores are circularly rotated by the clockwise vortex. These findings can contribute to the layout of fans under spatial restriction and suppression of flow instability due to obstacles.
Lumbar medial branch cryoneurolysis under ultrasound guidance: initial report of five cases
Authors: Kastler Adrian , Kogl Nikolaus , Gruber Hannes , Skalla Elisabeth , Loizides ALexander
Published: June 2020

Aims: To assess the feasibility and preliminary results of ultrasound guided medial branch cryoneurolysis in the management of facet joint syndrome.Material and methods: Between March 2017 and August 2017, a total of 20 patients underwent medial branch blocks, 12 of which were positive. Five patients chose to participate in the study and 8 medial branch cryoneurolysis were performed. The primary endpoint of the study was the feasibility of the procedure. The secondary endpoint was the efficacy on pain assessed over the following year after the procedure.Results: Technical feasibility of cryoneurolysis under ultrasound guidance was 100%. Accurate needle positioning at the accurate target in the angle between the posterior aspect of the transverse process and the lateral aspect of the facet joint was achieved in all cases. Needle progression could be depicted with US guidance in all cases. Mean pre-procedural Visual Analogue Scale and Oswestry disability Index scores were 6.8 (range 5-8) and 20.6 (range 12- 31), respectively. Follow up showed a decrease of Visual Analogue Scale score at one month (1.75, range 0-7), and at three months (1.75 range 0-3), Mean self-reported improvement at 6 months was 76% (60- 100%) and 77% at 12 months (50-100%). We report one case of failure at one month. No complications were noted during or after the procedure.Conclusion: Our findings suggest that ultrasound is a valid imaging modality to perform lumbar medial branch cryoneurolysis. Initial results show that cryoneurolysis under ultrasound guidance appears as a safe and effective procedure in patients suffering for facet joint pain
On the manipulation of flow and acoustic fields of a blunt trailing edge aerofoil by serrated leading edges
Authors: Hasheminejad Seyed Mohammad , Chong Tze Pei , Lacagnina Giovanni , Joseph Phillip , Kim Jung-Hoon , Choi Kwing-So , Omidyeganeh Mohammad , Pinelli Alfredo , Stalnov Oksana
Published: June 2020

This paper employs serrated leading edges to inject streamwise vorticity to the downstream boundary layer and wake to manipulate the flow field and noise sources near the blunt trailing edge of an asymmetric aerofoil. The use of a large serration amplitude is found to be effective to suppress the first noise source—bluntness-induced vortex shedding tonal noise—through the destruction of the coherent eigenmodes in the wake. The second noise source is the instability noise, which is produced by the interaction between the boundary layer instability and separation bubble near the blunt edge. The main criterion needed to suppress this noise source is related to a small serration wavelength because, through the generation of more streamwise vortices, it would facilitate a greater level of destructive interaction with the separation bubble. If the leading edge has both a large serration amplitude and wavelength, the interaction between the counter-rotating vortices themselves would trigger a turbulent shear layer through an inviscid mechanism. The turbulent shear layer will produce strong hydrodynamic pressure fluctuations to the trailing edge, which then scatter into broadband noise and transform into a trailing edge noise mechanism. This would become the third noise source that can be identified in several serrated leading edge configurations. Overall, a leading edge with a large serration amplitude and small serration wavelength appears to be the optimum choice to suppress the first and second noise sources and, at the same time, avoid the generation of the third noise source.
Estimating the effects of pile driving sounds on seals: Pitfalls and possibilities
Authors: Whyte Katherine F. , Russell Debbie J. F. , Sparling Carol E. , Binnerts Bas , Hastie Gordon D.
Published: June 2020

Understanding the potential effects of pile driving sounds on marine wildlife is essential for regulating offshore wind developments. Here, tracking data from 24 harbour seals were used to quantify effects and investigate sensitivity to the methods used to predict these. The Aquarius pile driving model was used to model source characteristics and acoustic propagation loss (16 Hz–20 kHz). Predicted cumulative sound exposure levels (SELcums) experienced by each seal were compared to different auditory weighting functions and damage thresholds to estimate temporary (TTS) and permanent (PTS) threshold shift occurrence. Each approach produced markedly different results; however, the most recent criteria established by Southall et al. [(2019) Aquat. Mamm. 45, 125–232] suggests that TTS occurrence was low (17% of seals). Predictions of seal density during pile driving made by Russell et al. [(2016) J. Appl. Ecol. 53, 1642–1652] were compared to distance from the wind farm and predicted single-strike sound exposure levels (SELss) by multiple approaches. Predicted seal density significantly decreased within 25 km or above SELss (averaged across depths and pile installations) of 145 dB re 1 μPa2⋅s. However, there was substantial variation in SELss with depth and installation, and thus in the predicted relationship with seal density. These results highlight uncertainty in estimated effects, which should be considered in future assessments.
Is Physical Activity Associated With Physical Performance in Adults With Intellectual Disability?
Authors: Xu Jian , Choi Poram , Motl Robert W. , Agiovlasitis Stamatis
Published: June 2020

Physical activity (PA) and sedentary behavior may contribute to physical function in adults with intellectual disability (ID). This study examined whether objectively measured PA and sedentary behavior levels are associated with physical performance in adults with ID. Fifty-eight adults with ID (29 women and 29 men, age 44 ± 14 years) underwent a measurement of physical performance with the Short Physical Performance Battery (SPPB) and PA and sedentary time using a hip-worn accelerometer (wGT3X-BT; ActiGraph, Pensacola, FL). Moderate PA and age were significantly associated with the SPPB score (r = .39 and .34, respectively; p < .01). A hierarchical-regression model with moderate PA and age as independent variables indicated that moderate PA was a significant predictor of SPPB (p < .001; R2 = .153), but age was not (p = .123; R2 change = .036). Overall, moderate PA was significantly associated with the SPPB score, even after accounting for age, in adults with ID.
Oral Microbiota Display Profound Differential Metabolic Kinetics and Community Shifts upon Incubation with Sucrose, Trehalose, Kojibiose, and Xylitol
Authors: Onyango Stanley O. , De Clercq Nele , Beerens Koen , Van Camp John , Desmet Tom , Van de Wiele Tom
Published: June 2020

This study provides a detailed scientific insight on the metabolism of a rare disaccharide, kojibiose, whose mass production has recently been made possible. While the resistance of kojibiose was established with monocultures, delayed utilization of kojibiose was observed with communities containing lactobacilli and
A. viscosus
as well as with complex communities of bacteria from human saliva. Kojibiose is, therefore, less metabolizable than sucrose and trehalose. Moreover, although conventional sugars cause distinct shifts in salivary microbial communities, our study has revealed that kojibiose is able to closely maintain the salivary microbiome composition, suggesting its low cariogenic properties. This study furthermore underscores the importance and relevance of microbial culture and
ex vivo
mixed cultures to study cariogenicity and substrate utilization; this is in sharp contrast with tests that solely rely on monocultures such as
Streptococcus mutans
, which clearly fail to capture complex interactions between oral microbiota.
An Avirulence Gene Cluster in the Wheat Stripe Rust Pathogen (Puccinia striiformis f. sp.
tritici
) Identified through Genetic Mapping and Whole-Genome Sequencing of a Sexual Population
Authors: Xia Chongjing , Lei Yu , Wang Meinan , Chen Wanquan , Chen Xianming
Published: June 2020

Stripe rust is a destructive disease of wheat worldwide. Growing resistant cultivars is the most effective, easy-to-use, economical, and environmentally friendly strategy for the control of the disease. However,
P. striiformis
f. sp.
tritici
can produce new virulent races that may circumvent race-specific resistance. Therefore, understanding the genetic basis of the interactions between wheat genes for resistance and
P. striiformis
f. sp.
tritici
genes for avirulence is useful for improving cultivar resistance for more effective control of the disease. This study developed a high-quality map that facilitates genomic and genetic studies of important traits related to pathogen pathogenicity and adaptation to different environments and crop cultivars carrying different resistance genes. The information on avirulence/virulence genes identified in this study can be used for guiding breeding programs to select combinations of genes for developing new cultivars with effective resistance to mitigate this devastating disease.
The Functional Characterization of TcMyoF Implicates a Family of Cytostome-Cytopharynx Targeted Myosins as Integral to the Endocytic Machinery of Trypanosoma cruzi
Authors: Chasen Nathan Michael , Etheridge Menna Grace , Etheridge Ronald Drew
Published: June 2020

The parasiteTrypanosoma cruziis the etiological agent of Chagas disease and chronically infects upwards of 7 million people in the Americas. Current diagnostics and treatments remain grossly inadequate due, in part, to our general lack of understanding of this parasite’s basic biology. One aspect that has resisted detailed scrutiny is the mechanism employed by this parasite to extract nutrient resources from the radically different environments that it encounters as it transitions between its invertebrate and mammalian hosts. These parasites engulf food via a tubular invagination of its membrane, a strategy used by many protozoan species, but how this structure is formed or functions mechanistically remains a complete mystery. The significance of our research is in the identification of the mechanistic underpinnings of this feeding organelle that may bring to light new potential therapeutic targets to impede parasite feeding and thus halt the spread of this deadly human pathogen.
Advances in the diagnosis and management of IgG4 related disease
Authors: Lanzillotta Marco , Mancuso Gaia , Della-Torre Emanuel
Published: June 2020

IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and salivary glands are the most frequently observed disease phenotypes, differing in epidemiological features, serological findings, and prognostic outcomes. In view of this multifaceted presentation, IgG4 related disease represents a great mimicker of many neoplastic, inflammatory, and infectious conditions. Histopathology remains key to diagnosis because reliable biomarkers are lacking. Recently released classification criteria will be invaluable in improving early recognition of the disease. IgG4 related disease is highly treatable and responds promptly to glucocorticoids, but it can lead to end stage organ failure and even death if unrecognized. Prolonged courses of corticosteroids are often needed to maintain remission because the disease relapses in most patients. Rapid advancement in our understanding of the pathophysiology of IgG4 related disease is leading to the identification of novel therapeutic targets and possible personalized approaches to treatment.
Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen
Authors: Heller Simon R , Peyrot Mark , Oates Shannon K , Taylor April D
Published: June 2020

There are many misconceptions about the prevalence and effects of hypoglycemia in people with type 2 diabetes (T2D), including hypoglycemia does not occur or does not have adverse consequences in T2D. This narrative review aims to help dispel these myths. Around 25% of people with T2D taking insulin for >5 years were found to have severe hypoglycemic events, which is comparable to the severe hypoglycemia rate in adults with type 1 diabetes (T1D) diagnosed within 5 years. The total number of hypoglycemic events among insulin-treated T2D, including severe hypoglycemia, is as high or higher than among those with T1D. Recent evidence suggests serious consequences of hypoglycemia may, in some respects, be greater in individuals with T2D, particularly regarding effects on the cardiovascular system. Hypoglycemia is generally patient-reported. Issues with hypoglycemia unawareness, limited glucose testing, limited recall, lack of event logging and fear of failure or shaming limits the number of hypoglycemic episodes reported by people with diabetes. Barriers to healthcare provider inquiry and reporting include lack of knowledge regarding the problem’s magnitude, competing priorities during patient visits, lack of incentives to report and limitations to documentation systems for adequate reporting. All people with diabetes should be encouraged to discuss their experiences with hypoglycemia without judgment or shame. Glucose targets, testing schedules (blood glucose or continuous glucose monitoring) and treatment plans should be reviewed often and individualized to the minimize risk of hypoglycemia. Finally, people with T2D on insulin should always be encouraged to have oral glucose and rescue medication immediately available.
The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability
Authors: Schaaf Marta , Warthin Caitlin , Freedman Lynn , Topp Stephanie M
Published: June 2020

This paper is a critical interpretive synthesis of community health workers (CHWs) and accountability in low-income and middle-income countries. The guiding questions were: What factors promote or undermine CHWs as accountability agents? (and) Can these factors be intentionally fostered or suppressed to impel health system accountability? We conducted an iterative search that included articles addressing the core issue of CHWs and accountability, and articles addressing ancillary issues that emerged in the initial search, such as ‘CHWs and equity.’

CHWs are intended to comprise a ‘bridge’ between community members and the formal health system. This bridge function is described in three key ways: service extender, cultural broker, social change agent. We identified several factors that shape the bridging function CHWs play, and thus, their role in fomenting health system accountability to communities, including the local political context, extent and nature of CHW interactions with other community-based structures, health system treatment of CHWs, community perceptions of CHWs, and extent and type of CHW unionisation and collectivisation.

Synthesising these findings, we elaborated several analytic propositions relating to the self-reinforcing nature of the factors shaping CHWs’ bridging function; the roles of local and national governance; and the human resource and material capacity of the health system. Importantly, community embeddedness, as defined by acceptability, social connections and expertise, is a crucial attribute of CHW ability to foment local government accountability to communities.
Association between faecal haemoglobin concentration and the risk of cardiovascular diseases among Taiwanese adults in a community-based screening cohort
Authors: Chien Kuo-Liong , Lin Ting-Yu , Hsu Chen-Yang , Chan Chang-Chuan , Chen Tony Hsiu-Hsi , Chen Li-Sheng
Published: June 2020

Objectives

The role of faecal haemoglobin as a colorectal cancer screening tool has been demonstrated. However, the association between the faecal haemoglobin concentration and the risk of cardiovascular disease events and deaths is still unclear.

Design

Cohort study design.

Setting

Population-based organised integrated service screening in Keelung City, Taiwan

Participants

A total of 33 355 healthy individuals aged over 40 years who were free of cardiovascular disease at study entry were followed up.

Main outcomes and measures

Newly diagnosed cardiovascular disease events and deaths.

Results

After a median follow-up of 2.39 years, a total of 2768 participants developed cardiovascular events, and after a median follow-up of 8.43 years, 317 cases of cardiovascular deaths occurred. The risk of cardiovascular disease increased with baseline faecal haemoglobin in a dose–response manner, yielding a significant elevated risk of cardiovascular disease in parallel with the incremental concentration of faecal haemoglobin (adjusted HRs=1.04, 1.10, 1.40 and 1.23 for faecal haemoglobin concentrations of 1–19, 20–49, 50–99 and ≥100 ng/mL, trend test, p<0.0001, as compared with the reference group with undetectable faecal haemoglobin concentrations). A similar pattern was observed for the risk of cardiovascular disease deaths. In addition, the faecal haemoglobin improved the prediction performance of the model for the risk of cardiovascular diseases; the integrated discrimination improvement was 0.3% (p<0.001) for cardiovascular events and 0.1% (p=0.020) for cardiovascular deaths.

Conclusions

Our data support that faecal haemoglobin concentrations may be associated with the risk of cardiovascular diseases. The biological mechanisms underlying the role of faecal haemoglobin as health outcomes should be investigated.
Cost–utility analysis of antibiotic treatment in patients with chronic low back pain and Modic changes: results from a randomised, placebo-controlled trial in Norway (the AIM study)
Authors: Grotle Margreth , Bråten Lars Christian , Brox Jens Ivar , Espeland Ansgar , Zolic-Karlsson Zinajda , Munk Killingmo Rikke , Tingulstad Alexander , Grøvle Lars , Froholdt Anne , Kristoffersen Per Martin , Wigemyr Monica , van Tulder Maurits W , Storheim Kjersti , Zwart John-Anker
Published: June 2020

Objective

To evaluate the cost–utility of 100 days of antibiotics in patients with chronic low back pain (LBP) and type I or II Modic changes included in the Antibiotic treatment In patients with chronic low back pain and Modic changes (AIM) study.

Design

A cost–utility analysis from a societal and healthcare perspective alongside a double-blinded, parallel group, placebo, multicentre trial.

Setting

Hospital outpatient clinics at six hospitals in Norway. The main results from the AIM study showed a small effect in back-related disability in favour of the antibiotics group, and slightly larger in those with type I Modic changes, but this effect was below the pre-defined threshold for clinically relevant effect.

Participants

180 patients with chronic LBP, previous disc herniation and Modic changes type I (n=118) or type II (n=62) were randomised to antibiotic treatment (n=89) or placebo-control (n=91).

Interventions

Oral treatment with either 750 mg amoxicillin or placebo three times daily for 100 days.

Main outcome measures

Quality-adjusted life years (QALYs) by EuroQoL-5D over 12 months and costs for healthcare and productivity loss measured in Euro (€1=NOK 10), in the intention-to-treat population. Cost–utility was expressed in incremental cost-effectiveness ratio (ICER).

Results

Mean (SD) total cost was €21 046 (20 105) in the amoxicillin group and €19 076 (19 356) in the placebo group, mean difference €1970 (95% CI; −3835 to 7774). Cost per QALY gained was €24 625. In those with type I Modic changes, the amoxicillin group had higher healthcare consumption than the placebo group, resulting in €39 425 per QALY gained. Given these ICERs and a willingness-to-pay threshold of €27 500 (NOK 275 000), the probability of amoxicillin being cost-effective was 51%. Even when the willingness-to-pay threshold increased to €55 000, the probability of amoxicillin being cost-effective was never higher than 53%.

Conclusions

Amoxicillin treatment showed no evidence of being cost-effective for people with chronic LBP and Modic changes during 1-year follow-up.

Trial registration number

ClinicalTrials.govNCT02323412.
Role of the intelligent exercise rehabilitation management system on adherence of cardiac rehabilitation in patients with coronary heart disease: a randomised controlled crossover study protocol
Authors: Xu Linqi , Xiong Wenji , Li Jinwei , Shi Hongyu , Shen Meidi , Zhang Xin , Pang Yue , Ni Yuanyuan , Zhang Wei , Li Yuewei , Guo Lirong , Zhang Shuang , Zhao Lijing , Li Feng
Published: June 2020

Introduction

The benefits of cardiac rehabilitation (CR) on the reduction of cardiac and all-cause mortality are well documented. However, adherence remains suboptimal in China. It is clear that traditional CR does not meet the needs of many eligible patients and innovation is required to improve its application. Home-based CR (HBCR) is a cost-effective method that may be a valuable alternative for many individuals in China. In HBCR, it is often difficult to maintain an exercise intensity that is both effective and within safe limits, factors that are essential for patient safety. Mobile health interventions have the potential to overcome these obstacles and may be efficacious in improving adherence. The purpose of this study is to evaluate whether an Intelligent Exercise Rehabilitation Management System (IERMS)-based HBCR could improve adherence to CR and to assess the effects on exercise capacity, mental health, self-efficacy, quality of life and lifestyle-related risk factors.

Methods and analysis

We propose a single-blinded, two-arm, randomised controlled crossover study of 70 patients with coronary heart disease (CHD). Participants will be randomly assigned in a 1:1 ratio to one of the two groups. Patients in group 1 will receive the IERMS intervention together with usual care for the first 6 weeks and usual care for the last 6 weeks, while patients assigned to group 2 will receive usual care for the first 6 weeks and will use IERMS in the last 6 weeks. The primary outcome is adherence to the programme and secondary outcomes include exercise capacity, psychological well-being, quality of life, self-efficacy and lifestyle-related risk factors. All secondary outcomes will be measured at baseline, 6 weeks and 12 weeks.

Ethics and dissemination

This study has been approved by the Human Research Ethics Committee of the School of Nursing, Jilin University (HREC 2019120901). The results will be published in peer-reviewed journals and at conferences.

Trial registration number

ChiCTR1900028182; Pre-results.
Study protocol for a nationwide Knowledge, Attitudes and Practices (KAP) survey on diabetes in Singapore’s general population
Authors: AshaRani PV , Abdin Edimansyah , Kumarasan Roystonn , Siva Kumar Fiona Devi , Shafie Saleha , Jeyagurunathan Anitha , Chua Boon Yiang , Vaingankar Janhavi Ajit , Fang Sum Chee , Lee Eng Sing , Van Dam Rob , Chong Siow Ann , Subramaniam Mythily
Published: June 2020

Introduction

This study aims to establish the Knowledge, Attitudes and Practices (KAP) of the general population (people with and without diabetes) towards diabetes. The study will examine (a) recognition and understanding of causes, prevention and treatment strategies of diabetes; (b) identify the knowledge gaps and behavioural patterns that may hamper diabetes prevention and control; (c) stigma towards and stigma perceived by people with diabetes and (d) awareness of anti-diabetes campaigns.

Methods and analysis

The study is a nationwide, cross-sectional study of Singapore’s general population aged 18 years and above (n=3000), comprising Chinese, Malay, Indian and other ethnic groups, who can understand English, Chinese, Malay or Tamil language. The sample was derived using a disproportionate stratified sampling using age and ethnicity. The proportion of respondents in each ethnic group (Chinese, Malay and Indian) was set to approximately 30%, while the proportion of respondents in each age group was set around 20% in order to ensure a sufficient sample size. The respondents will be administered questionnaires on diabetes KAP, stigma towards diabetes, lifestyle, diet and awareness of local anti-diabetes campaigns. The analysis will include descriptive statistics and multiple logistic and linear regression analyses to determine the socio-demographic correlates of correct recognition of diabetes, help-seeking preferences, as well as overall knowledge and attitudes among those with and without diabetes. We will consider a p value ≤0.05 as significant.

Ethics and dissemination

This study protocol has been reviewed by the Institutional Research Review Committee and the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref 2018/00430). The results of the study will be shared with policymakers and other stakeholders. There will be a local mass media briefing to disseminate the findings online, in print and on television and radio. The results will be published in peer-reviewed journals and presented in scientific meetings.
Pharmacokinetics during therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy: a literature review
Authors: Lutz Isabelle Claire , Allegaert Karel , de Hoon Jan N , Marynissen Heleen
Published: June 2020

Background

Neonatal hypoxic ischaemic encephalopathy due to perinatal asphyxia, can result in severe neurodevelopmental disability or mortality. Hypothermia is at present the only proven neuroprotective intervention. During hypothermia, the neonate may need a variety of drugs with their specific pharmacokinetic profile. The aim of this paper is to determine the effect that hypothermia for neonates suffering from hypoxic ischaemic encephalopathy has on the pharmacokinetics and to what extent dosing regimens need adjustments.

Method

A systematic search was performed on PubMed, Embase and Cochrane Library of literature (2000–2020) using a combination of the following search terms: therapeutic hypothermia, neonate, hypoxic ischemic encephalopathy and pharmacokinetics. Titles and abstracts were screened, and inclusion/exclusion criteria were applied. Finally, relevant full texts were read, and secondary inclusion was applied on the identified articles.

Results

A total of 380 articles were retrieved, and 34 articles included after application of inclusion/exclusion criteria and duplicate removal, two additional papers were included as suggested by the reviewers. Twelve out of 36 studies on 15 compounds demonstrated a significant decrease in clearance, be it that the extent differs between routes of elimination and compounds, most pronounced for renal elimination (phenobarbital no difference, midazolam metabolite −21%, lidocaine −24%; morphine −21% to −47%, gentamicin −25% to −35%, amikacin −40%) during hypothermia. The data as retrieved in literature were subsequent compared with the dosing regimen as stated in the Dutch paediatric formulary.

Conclusion

Depending on the drug-specific disposition characteristics, therapeutic hypothermia in neonates with hypoxic ischaemic encephalopathy affects pharmacokinetics.
Comparison of pulse oximetry and earlobe blood gas with CO-oximetry in children with sickle cell disease: a retrospective review
Authors: Arigliani Michele , Zheng Sean , Ruiz Gary , Chakravorty Subarna , Bossley Cara J , Rees David , Gupta Atul
Published: June 2020

Objectives

To investigate the agreement between pulse oximetry (SpO2) and oxygen saturation (SaO2) measured by CO-oximetry on arterialised earlobe blood gas (EBG) in children and adolescents with sickle cell disease (SCD).

Design and setting

We retrospectively reviewed 39 simultaneous and paired SaO2 EBG and SpO2 measurements from 33 ambulatory patients with SCD (32 subjects with Haemoglobin SS and one with Haemoglobin Sß+, 52% male, mean±SD age 11.0±3.6, age range 5–18). Measurements were performed between 2012 and 2015 when participants were asymptomatic. Hypoxaemia was defined as SaO2 ≤93%. A Bland-Altman analysis was performed to assess the accuracy of SpO2 as compared with EBG SaO2.

Results

The mean±SD SpO2 and SaO2 values in the same patients were, respectively, 93.6%±3.7% and 94.3%±2.9%. The bias SpO2–SaO2 was −0.7% (95% limits of agreement from −5.4% to 4.1%) and precision was 2.5%. In 9/39 (23%) cases, the difference in SpO2–SaO2 was greater than the expected error range ±2%, with SaO2 more often underestimated by SpO2 (6/9), especially at SpO2values ≤93%. Thirteen participants (33%) were hypoxaemic. The sensitivity of SpO2 for hypoxaemia was 100%, specificity 85% and positive predictive value 76%.

Conclusions

Pulse oximetry was inaccurate in almost a quarter of measurements in ambulatory paediatric patients with SCD, especially at SpO2values ≤93%. In these cases, oxygen saturation can be confirmed through EBG CO-oximetry, which is easier to perform and less painful than traditional arterial blood sampling.
Breaking the myths of competition: a cross-sectional analysis of injuries among CrossFit trained participants
Authors: Feito Yuri , Burrows Evanette , Tabb Loni , Ciesielka Kerri-Anne
Published: June 2020

Objectives

The purpose of this study was to examine the injury rates of individuals engaged in CrossFit training and examine the risk of injury associated with competition.

Study design

Cross-sectional analysis.

Methods

Descriptive statistics, including injury incidence and rates, were examined for individuals reporting participation in a CrossFit sanctioned competition between 2013 and 2017. To examine the odds of being injured, we considered logistic regression models, where the primary independent measure was participation length—individual measures of interest included age, sex, body mass index, CrossFit affiliation and competition status.

Results

3049 individuals completed the survey (60% completion rate). All competitors, regardless of competition level, had similar incidence of injury (χ2=1.1, p=0.571). For those who reported competing, our calculated injury rate was 0.21–0.54 injuries per 1000 training hours, while for those not competing, the injury rate was calculated as 0.39–1.30 injuries per 1000 training hours. Logistic regression demonstrated short length of participation in CrossFit training as the main factor associated with the odds of being injured (OR=1.82; 95% CI: 1.15 to 2.92). Additionally, training at an official CrossFit affiliate appeared to have a protective effect from injury (OR=0.85; 95% CI: 0.65, 1.10).

Conclusion

Our findings provide evidence of the low risk of injury related to these events. Moreover, these findings support the notion that musculoskeletal injuries may be the result of poor progression plans, which may be minimised by participating in an official CrossFit affiliate.
Collaborative framework for working with older simulated participants
(SP)
Authors: Smith Cathy M , Sokoloff Lisa Guttman , Alsaba Nemat
Published: June 2020

Introduction

As the global population ages, healthcare providers must prepare for the
complexities associated with caring for older adults, defined according to the
WHO, as being over the age of 60. Simulation-based education in healthcare
allows caregivers to practice and master skills and competencies associated
with care of older adults. Simulated
patients/participants (SP), well
people trained to portray other individuals, are an effective choice when
training behavioural skills (eg, communication). When working with older SPs,
it is important to recognise unique considerations and requirements related to
physiological changes, in physical, cognitive and sensory systems associated
with normal ageing.

Method

SP educators from two different countries, with diverse backgrounds and
contexts, collaborated through an iterative, consensus-based process to create
a framework for working with older SPs.

Results

A practical three-phase framework with specific strategies was developed
that synthesised elements of best practices related to simulation methodology
with relevant clinical evidence.

Discussion

Effective collaboration with older SPs is achievable through investing
resources in preparing, training and ensuring their well-being. Through faculty
development of healthcare simulation educators, we can ensure that older SPs
and simulation communities have the right tools and support to safely and
effectively contribute to simulation-based education.
Evaluating the extent of lumbar erector spinae plane block: an anatomical study
Authors: Harbell Monica W , Seamans David P , Koyyalamudi Veerandra , Kraus Molly B , Craner Ryan C , Langley Natalie R
Published: June 2020

Background and objectives

The erector spinae plane (ESP) block is a relatively new interfascial block technique. Previous cadaveric studies have shown extensive cephalocaudal spread with a single ESP injection at the thoracic level. However, little data exist for lumbar ESP block. The objective of this study was to examine the anatomical spread of dye following an ultrasound-guided lumbar ESP block in a human cadaveric model.

Methods

An ultrasound-guided ESP block was performed in unembalmed human cadavers using an in-plane approach with a curvilinear transducer oriented longitudinally. 20 mL of 0.166% methylene blue was injected into the plane between the distal end of the L4 transverse process and erector spinae muscle bilaterally in four specimens and unilaterally in one specimen (nine ESP blocks in total). The superficial and deep back muscles were dissected, and the extent of dye spread was documented in both cephalocaudal and medial–lateral directions.

Results

There was cephalocaudal spread from L3 to L5 in all specimens with extension to L2 in four specimens. Medial–lateral spread was documented from the multifidus muscle to the lateral edge of the thoracolumbar fascia. There was extensive dye in and around the erector spinae musculature and spread to the dorsal rami in all specimens. There was no dye spread anteriorly into the dorsal root ganglion, ventral rami, or paravertebral space.

Conclusions

A lumbar ESP injection has limited craniocaudal spread compared with injection in the thoracic region. It has consistent spread to dorsal rami, but no anterior spread to ventral rami or paravertebral space.
Cardiac rehabilitation is associated with greater improvements in psychological health following coronary artery bypass graft surgery when compared with percutaneous coronary intervention
Authors: Montesano Matthew , Reed Jennifer L. , Tulloch Heather E. , Pipe Andrew L. , Terada Tasuku
Published: June 2020

Following coronary revascularization, patients treated with coronary artery bypass graft surgery (CABG) have lower risk of major adverse cardiovascular events when compared with those treated with percutaneous coronary intervention (PCI). We compared changes in cardiovascular risk factors, such as psychological and cardiometabolic health indicators, among patients who completed cardiac rehabilitation (CR) following CABG and PCI. Longitudinal records of 278 patients who completed an outpatient CR program following CABG or PCI were analyzed. We compared changes in anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS); health-related quality of life (HR-QoL) measured by the Medical Outcomes Study Short Form-36 (SF-36); and indicators of cardiometabolic health (i.e., body mass, blood pressure, glucose, and lipid profiles) between CABG and PCI groups using analysis of covariance (ANCOVA). At baseline, patients treated with PCI (n = 191) had superior physical function (i.e., physical functioning: 62.5 ± 22.1 vs. 54.3 ± 23.0 points, p = 0.006; and role limitations due to physical health: 31.2 ± 36.8 vs. 20.6 ± 31.8 points, p = 0.024) when compared with those treated with CABG (n = 87). Following CR, patients treated with PCI showed significantly smaller improvements in depression (–0.4 ± 3.1 vs. –1.3 ± 2.7 points, p = 0.036) and mental HR-QoL (mental component summary: 2.4 ± 10.8 vs. 5.7 ± 10.7 points, p = 0.020) when compared with those treated with CABG.

Novelty Patients with coronary artery disease treated with PCI have smaller functional limitations but similar psychological health when compared with those treated with CABG at CR enrollment. Patients participating in CR following PCI appear to achieve smaller psychological health benefits from CR when compared with those recovering from CABG.
Binding of lactoferrin to the surface of low-density lipoproteins modified by myeloperoxidase prevents intracellular cholesterol accumulation by human blood monocytes
Authors: Vasilyev V.B. , Sokolov A.V. , Kostevich V.A. , Elizarova A.Yu. , Gorbunov N.P. , Panasenko O.M.
Published: June 2020

Myeloperoxidase (MPO) is a unique heme-containing peroxidase that can catalyze the formation of hypochlorous acid (HOCl). The strong interaction of MPO with low-density lipoproteins (LDL) promotes proatherogenic modification of LDL by HOCl. The MPO-modified LDL (Mox-LDL) accumulate in macrophages, resulting in the formation of foam cells, which is the pathognomonic symptom of atherosclerosis. A promising approach to prophylaxis and atherosclerosis therapy is searching for remedies that prevent the modification or accumulation of LDL in macrophages. Lactoferrin (LF) has several application points in obesity pathogenesis. We aimed to study LF binding to Mox-LDL and their accumulation in monocytes transformed into macrophages. Using surface plasmon resonance and ELISA techniques, we observed no LF interaction with intact LDL, whereas Mox-LDL strongly interacted with LF. The affinity of Mox-LDL to LF increased with the degree of oxidative modification of LDL. Moreover, an excess of MPO did not prevent interaction of Mox-LDL with LF. LF inhibits accumulation of cholesterol in macrophages exposed to Mox-LDL. The results obtained reinforce the notion of LF potency as a remedy against atherosclerosis.
Impact of in-stream restoration structures on salmonid abundance and biomass: an updated meta-analysis
Authors: Foote Kyleisha J. , Biron Pascale M. , Grant James W.A.
Published: June 2020

Owing to declines in salmonid populations, in-stream restoration structures have been used for over 80 years to increase abundance of fish. However, the relative effectiveness of these structures remains unclear for some species or regions, partly due to contrasting conclusions from two previous meta-analyses. To update and reconcile these previous analyses, we conducted a meta-analysis using data available from 1969 to 2019 to estimate the effect of in-stream structures on salmonid abundance (number and density) and biomass. Data from 100 stream restoration projects showed a significant increase in salmonid abundance (effect size 0.636) and biomass (0.621), consistent with previous reviews and studies, and a stronger effect was found in adults than in juvenile fish. Despite a shift towards using more natural structures (wood and boulders) since the 1990s, structures have not become more effective. However, most projects monitor for less than 5 years, which may be insufficient time in some systems for channel morphology to adjust and population changes to be apparent. Process-based techniques, which give more space for the river, allow more long-term, self-sustaining restoration.
Holographic complexity of subregions in the hyperscaling violating theories
Authors: Borvayeh Z. , Tanhayi M. Reza , Rafibakhsh S.
Published: June 2020

In this paper, we use the complexity equals action proposal and investigate holographic complexity for hyperscaling violating theories on different subregions of space-time enclosed by the null boundaries. We are interested in computing the onshell action for certain subregions of the intersection between the Wheeler DeWitt patch and the past, as well as, the future interior of a two-sided black brane. More precisely, we extend the results of Ref. 1 in parts, to hyperscaling violating geometries and to find the finite onshell action, we define the proper counter terms. We show that in computing the rate of complexification the dynamical exponent plays a crucial rule, but, at the late time, rate of the complexity growth is independent of the hyperscaling parameters.
2024 ALUMINUM OXIDE FILMS PREPARED BY THE INNOVATIVE AND ENVIRONMENT-FRIENDLY OXIDATION TECHNOLOGY
Authors: YU YUNDAN , GE HONGLIANG , WEI GUOYING , JIANG LI , ZHANG DONG
Published: June 2020

A kind of environment-friendly anodic oxidation technology was used to oxidize 2024 aluminum alloys from mixed acid solutions to effectively improve the anticorrosion and mechanical performances. The influences of anode oxidation method on surface morphology, microstructure, composition, electrochemistry parameter, anticorrosion property were studied. Aluminum alloy oxidation is actually a dynamic equilibrium process of the formation and dissolution of oxide film which is composed of porous and non-porous layer. With the treatment of anodic oxidation, [Formula: see text]-Al2O3 and [Formula: see text]-Al2O3 structures were obtained on the surface of aluminum alloys, which contributed directly to the increase of anticorrosion performance. The potassium dichromate solution was used to seal the surface of oxide films to further improve the anticorrosion property. The oxide films sealed with potassium dichromate were covered with leaf-like structures resulting in larger corrosion resistance that attributed directly to the decrease of corrosion current.
VALUATION, HEDGING, AND BOUNDS OF SWAPS UNDER MULTI-FACTOR BNS-TYPE STOCHASTIC VOLATILITY MODELS
Authors: ISSAKA AZIZ
Published: June 2020

In this paper, we consider price weighted-volatility swap and price weighted-variance swap. The underlying asset considered in this paper is assumed to follow a general stochastic differential equation and exhibits stochastic volatility. We obtain analytical pricing formulas for the weighted-variance swap and approximate expression for the weighted-volatility swap. Nice bounds for the arbitrage-free variance swap price are also found. The proposed pricing formulas are easy to implement in real time and can be applied efficiently for practical applications. We consider the problem of hedging volatility swap with variance swap and obtain analytical formula for the hedge ratio. We also consider a problem of hedging an asset with variance swap and option. We determined the optimal amount of the underlying asset that has to be held for minimizing the hedging error by taking positions in options and weighted-variance swap. A numerical example is also provided.
The Book Review Column
Authors: Green Frederic
Published: June 2020

In this column, we review these three books:
Review of Applied Number Theory
Authors: Yan Song Y.
Published: June 2020

Number theory (or the theory of numbers [1]) starts from elementary (not necessarily simple and easy, and in fact, it is often very hard) number theory and grows up with analytic number theory (including additive and multiplicative number theory), algebraic number theory, geometric number theory (including arithmetic algebraic geometry), combinatorial number theory, computational number theory (including algorithmic number theory), to name just a few. Applied number theory, on the other hand, is involved in the application of various branches of number theory to a wide range of areas including, e.g., physics, chemistry, biology, graphics, arts, music, and particularly computing and digital communications [2]. Number theory was once viewed as the purest of the pure mathematics, with little application to other areas. However, with the advent of modern computers and digital communications, number theory becomes increasingly important and applicable to many areas ranging from natural sciences, engineering to social sciences.
Technical Report Column
Authors: Kelley Dean
Published: June 2020

Welcome to the Technical Reports Column. If your institution publishes technical reports that you'd like to have included here, please contact me at the email address above.
Open Problems Column
Authors: Gasarch William
Published: June 2020

In this column we state a class of open problems that are well known in Ramsey Theory but probably not to my non-Ramsey readers. Nothing I present is original.
Distributed Computing Column 78
Authors: Alistarh Dan
Published: June 2020

Overview. In this edition of the column, we have a fascinating contribution by Sergio Rajsbaum and Michel Raynal, who provide an in-depth survey of how our understanding of concurrency has evolved over the past sixty years.