bluuebunny/crossref_metadata_2025 huggingface dataset:
Leg lean mass correlates with exercise systemic output in young Fontan patients
Authors: Avitabile Catherine M , Goldberg David J , Leonard Mary B , Wei Zhenglun Alan , Tang Elaine , Paridon Stephen M , Yoganathan Ajit P , Fogel Mark A , Whitehead Kevin K
Published: October 2017

Objective

We previously described lower leg lean mass Z-scores (LLMZ) in Fontan patients associated with worse peak oxygen consumption on metabolic exercise testing. We hypothesised that LLMZ correlates with indexed systemic flow (Qsi) and cardiac index (CI) on exercise cardiac magnetic resonance (eCMR).

Methods

Thirteen patients had LLM measured by dual-energy X-ray absorptiometry within mean 40 (range 0–258) days of eCMR. LLM was converted to sex and race-specific Z-scores based on healthy reference data. Ventricular volumes and flow measurements of the ascending and descending (DAO) aorta and superior vena cava (SVC) were obtained by CMR at rest and just after supine ergometer exercise to a heart rate associated with anaerobic threshold on prior exercise test. Baseline and peak exercise measures of Qsi (SVC+DAO/BSA) and CI, as well as change in Qsi and CI with exercise, were compared with LLMZ by linear regression.

Results

LLMZ was not correlated with resting flows, stroke volume or CI. There was a strong linear correlation between LLMZ and change in both CI (r=0.77, p=0.002) and Qsi (r=0.73, p=0.005) from rest to exercise. There was also a significant correlation between LLMZ and Qsi at exercise (r=0.70, p=0.008). The correlation between LLMZ and CI at exercise did not reach significance (r=0.3, p=0.07).

Conclusions

In our cohort, there was a strong linear correlation between LLMZ and change in both CI and Qsi from rest to exercise, suggesting that Fontan patients with higher LLMZ may be better able to augment systemic output during exercise, improving performance.
Spatial distribution of pedestrian-motor vehicle collisions before and after pedestrian countdown signal installation in Toronto, Canada
Authors: Rothman Linda , Cloutier Marie-Soleil , Macpherson Alison K , Richmond Sarah A , Howard Andrew William
Published: October 2017

Background

Pedestrian countdown signals (PCS) have been installed in many cities over the last 15 years. Few studies have evaluated the effectiveness of PCS on pedestrian motor vehicle collisions (PMVC). This exploratory study compared the spatial patterns of collisions pre and post PCS installation at PCS intersections and intersections or roadways without PCS in Toronto, and examined differences by age.

Methods

PCS were installed at the majority of Toronto intersections from 2007 to 2009. Spatial patterns were compared between 4 years of police-reported PMVC prior to PCS installation to 4 years post installation at 1864 intersections. The spatial distribution of PMVC was estimated using kernel density estimates and simple point patterns examined changes in spatial patterns overall and stratified by age. Areas of higher or lower point density pre to post installation were identified.

Results

There were 14 911 PMVC included in the analysis. There was an overall reduction in PMVC post PCS installation at both PCS locations and non-PCS locations, with a greater reduction at non-PCS locations (22% vs 1%). There was an increase in PMVC involving adults (5%) and older adults (9%) at PCS locations after installation, with increased adult PMVC concentrated downtown, and older adult increases occurring throughout the city following no spatial pattern. There was a reduction in children’s PMVC at both PCS and non-PCS locations, with greater reductions at non-PCS locations (35% vs 48%).

Conclusions

Results suggest that the effects of PCS on PMVC may vary by age and location, illustrating the usefulness of exploratory spatial data analysis approaches in road safety. The age and location effects need to be understood in order to consistently improve pedestrian mobility and safety using PCS.
Neighbourhood social trust and youth perceptions of safety during daily activities
Authors: Flynn Kalen , Richmond Therese S , Branas Charles C , Wiebe Douglas J
Published: October 2017

Exposure to adverse neighbourhood conditions can negatively impact adolescent well-being and perceived safety. However, the impact of neighbourhood social trust on perceived safety is largely unknown. We studied 139 adolescent men to investigate how their perceptions of safety varied as a function of social trust levels in the neighbourhoods they traversed; neighbourhoods that were not necessarily their own. Adolescents mapped their minute-by-minute activities over a recent day and rated their perceived safety on a 10-point scale during in-person interviews. Neighbourhood social trust was measured via a citywide random sample survey. Mixed effects regression showed that, compared with their safety perceptions when in areas of low social trust, older adolescents were 73% more likely to feel unsafe when in areas of medium social trust, and 89% more likely to feel unsafe when in areas of high social trust. Inverse relationships between neighbourhood social trust and adolescents’ perceived safety highlight the complex interplay between youth, environmental contexts and safety.
The outcome of patients in traumatic cardiac arrest presenting to deployed military medical treatment facilities: data from the UK Joint Theatre Trauma Registry
Authors: Barnard Ed B G , Hunt P A F , Lewis P E H , Smith J E
Published: October 2017

Background

The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns.

Methods

A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken. Patients who were transported to a UK deployed hospital between 2003 and 2014 and suffered TCA were included. Those patients injured by asphyxiation, electrocution, burns without other significant trauma and drowning were excluded. Data included mechanism of injury, Injury Severity Score (ISS), Abbreviated Injury Scale (AIS) for each body region and survival to deployed (Role 3) field hospital discharge.

Results

424 TCA patients were identified during the study period; median age was 23 years, with a median ISS of 45. The most common mechanism of injury was explosive (55.7%), followed by gunshot wound (38.9%), road traffic collision (3.5%), crush (1.7%) and fall (0.2%). 45 patients (10.6% (95% CI 8.0% to 13.9%)) survived to deployed (Role 3) hospital discharge. The most prevalent body region with a severe to maximum AIS injury was the head, followed by the lower limbs, thorax and abdomen. Haemorrhage secondary to abdominal and lower limb injury was associated with survival; traumatic brain injury was associated with death.

Conclusions

This study has shown that short-term survival from TCA in a military population is 10.6%. With appropriate and aggressive early management, although unlikely, survival is still potentially possible in military patients who suffer traumatic cardiac arrest.
Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records
Authors: Johnston James Blain , Reimer Joss N , Wylie John L , Bullard Jared
Published: October 2017

Objectives

HIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.

Methods

A retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.

Results

3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.

Conclusions

POCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.

MeSH terms

HIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.
Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study
Authors: Aicken Catherine R H , Sutcliffe Lorna J , Gibbs Jo , Tickle Laura J , Hone Kate , Harding-Esch Emma M , Mercer Catherine H , Sonnenberg Pam , Sadiq S Tariq , Estcourt Claudia S , Shahmanesh Maryam
Published: October 2017

Objective

We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone helpline, staffed by Sexual Health Advisers, is available to support patients and direct them to conventional services if appropriate. We sought to understand how patients used this ehealth intervention.

Methods

Within exploratory studies of the eSHC (2014–2015), we conducted in-depth interviews with a purposive sample of 36 patients diagnosed with chlamydia, who had chosen to use the eSHC (age 18–35, 20 female, 16 male). Thematic analysis was conducted.

Results

Participants described choosing to use this ehealth intervention to obtain treatment rapidly, conveniently and privately, within busy lifestyles that hindered clinic access. They described completing the online consultation promptly, discreetly and with ease. The information provided online was considered comprehensive, reassuring and helpful, but some overlooked it in their haste to obtain treatment. Participants generally described being able to collect treatment from pharmacies discreetly and promptly, but for some, poor awareness of the eSHC by pharmacy staff undermined their ability to do this. Those unsuitable for remote management, who were directed to clinic, described frustration and concern about health implications and clinic attendance. However, the helpline was a highly valued source of information, assistance and support.

Conclusion

The eSHC is a promising adjunct to traditional care. Its users have high expectations for convenience, speed and privacy, which may be compromised when transitioning from online to face-to-face elements of the eSHC. Managing expectations and improving implementation of the pharmacy process, could improve their experiences. Positive views on the helpline provide further support for embedding this ehealth intervention within a specialist clinical service.
Pathways between depression, substance use and multiple sex partners among Northern and Indigenous young women in the Northwest Territories, Canada: results from a cross-sectional survey
Authors: Logie Carmen H , Lys Candice , Okumu Moses , Leone Cristina
Published: October 2017

Objectives

Sexual and mental health disparities exist in the Northwest Territories (NWT) compared with other Canadian regions. STI rates are 10-fold higher, and youth suicide rates double the Canadian average. Scant research has examined associations between mental and sexual health among youth in the NWT. The study objective was to explore pathways from depression to multiple sex partners (MSP) among young women in the NWT, Canada.

Methods

We implemented a cross-sectional survey in 2015–2016 with a venue-based recruitment sample of young women aged 13–17 attending secondary schools in 17 NWT communities. We conducted path analysis to test a conceptual model examining associations between depression and a history of MSP, examining substance use and peer support as mediators.

Results

Participants (n=199; mean age: 13.8, SD: 1.27) mostly identified were Indigenous (n=154; 77.4%) and one-fifth (n=39; 20.5%) were sexually diverse/non-heterosexual. Almost two-thirds (n=119; 63.3%) reported depression symptoms. One-quarter (n=53; 26.6%) were currently dating, and 16.1% (n=32) reported a lifetime history of >1 sex partner (classified as having MSP). There was no direct effect between depression and MSP (β=0.189, p=0.087, 95% CI 0.046 to 0.260). Depression had a direct effect on substance use (β=0.023, p<0.050, 95% CI 0.118 to 0.500), and an indirect effect on MSP through substance use (β=0.498, SE=0.10, p<0.001, 95% CI 0.141 to 0.280). Depression was associated with lower peer support (β=−0.168, p<0.010, 95% CI −0.126 to 0.280); peer support was not associated with MSP (β=−0.158, p=0.130, 95% CI −0.126 to 0.001).

Conclusion

This research is among the first to identify mental health factors associated with STI vulnerability among young women in the NWT. Findings demonstrate the importance of addressing depression and substance use in sexual health interventions in Northern contexts.
Population-level impact of infant 10-valent pneumococcal conjugate vaccination on adult pneumonia hospitalisations in Finland
Authors: Okasha Omar , Rinta-Kokko Hanna , Palmu Arto A , Ruokokoski Esa , Jokinen Jukka , Nuorti J Pekka
Published: October 2017

Introduction

Limited data are available on population-level herd effects of infant 10-valent pneumococcal conjugate vaccine (PCV10) programmes on pneumonia. We assessed national trends in pneumococcal and all-cause pneumonia hospitalisations in adults aged ≥18 years, before and after infant PCV10 introduction in 2010.

Methods

Monthly hospitalisation rates of International Statistical Classification of Diseases, 10th revision (ICD-10)-coded primary discharge diagnoses compatible with pneumonia from 2004–2005 to 2014–2015 were calculated with population denominators from the population register. Trends in pneumonia before and after PCV10 introduction were assessed with interrupted time-series analysis. Rates during the PCV10 period were estimated from adjusted negative binomial regression model and compared with those projected as continuation of the pre-PCV10 trend. All-cause hospitalisations were assessed for control purposes.

Results

Before PCV10, the all-cause pneumonia rate in adults aged ≥18 years increased annually by 2.4%, followed by a 4.7% annual decline during the PCV10 period. In 2014–2015, the overall all-cause pneumonia hospitalisation rate was 109.3/100 000 (95% CI 96.5 to 121.9) or 15.4% lower than the expected rate. A significant 6.7% decline was seen in persons aged ≥65 years (131.5/100 000), which translates to 1456 fewer pneumonia hospitalisations annually. In comparison, hospitalisations other than pneumonia decreased by 3.5% annually throughout the entire study period.

Conclusion

These national data suggest that herd protection from infant PCV10 programme has reversed the increasing trend and substantially decreased all-cause pneumonia hospitalisations in adults, particularly the elderly.
Size-dependent electronic and optical properties in zinc-blende InGaN/GaN multilayer spherical quantum dot
Authors: Ortakaya S. , Kirak M. , Guldeste A.
Published: October 2017

A theoretical investigation of the binding energy, the radial probability distribution and optical properties (absorption coefficient (AC) and refractive index change (RIC)) of InGaN/GaN multilayer quantum dot (QD) is presented. The calculations are performed within the effective-mass approximation. A shooting method is presented to obtain numerical values for the eigenvalues and eigenfunctions of the structure. The energy eigenvalue, density of probability and optical absorption are compared for cases without and with impurity. It is also found that the ACs and RICs exhibit blue or redshift with different structure of potential profile. The results indicate that the optical properties can be sensitively adjusted by geometry of structure and the presence of impurity.
Parachute-Like Mitral Valve Tuberculoma: A Rare Presentation
Authors: Masood Arslan , Khan Gul Zaman , Bashir Irfan , Akram Zubair
Published: October 2017

There have been anecdotal reports of tuberculous cardiac involvement, mainly in cases of military tuberculosis or immune deficient individuals. The spectrum of clinical presentations of tuberculous cardiac involvements includes incidental detection of single and multiple well-circumscribed tuberculomas, symptomatic obstructive lesions, AV conduction abnormalities, and even sudden death. We present a case of cardiac tuberculoma in an immune-competent person who presented with worsening dyspnea. The unique morphology of this mass posed an imaging challenge that required 4-dimensional (4D) echocardiography and cardiac magnetic resonance (CMR) detail to differentiate the mass from an anterior mitral leaflet (AML) aneurysm. Histological examination after surgical resection confirmed its tuberculous etiology.
Layout-Independent Wireless Facility Constructing and Scheduling for Data Center Networks
Authors: Wei Xianglin , Sun Qin
Published: October 2017

The control packets in the data center networks (DCNs) have to contest with the data packets although they are usually much shorter in size and much more important in network management. Moreover, the uneven distribution of the packets may create potential traffic hotspots in the DCN which could degrade network performance drastically. To bridge these gaps, a layout-independent constructing algorithm and a scheduling method are put forward towards layout-independent wireless facility in data centers. First of all, a conflict aware spanning tree algorithm is developed to construct the wireless facility network (WFN). Secondly, a scheduling method which contains three steps, route calculation, traffic estimation, and flow scheduling, is presented. In the route calculation step, a route set between each node pair is calculated in advance for later usage. The scheduler estimates the traffic loads on the links on a regular basis in the traffic estimation step. Then, arrived data and control flows are scheduled according to multiple policies based on given route sets and scheduling objectives in the flow scheduling step. Finally, a series of experiments have been conducted on NS3 based on two typical data center layouts. Experimental results in both scenarios have validated our proposal’ effectiveness.
Smart Microgrid Energy Management Using a Novel Artificial Shark Optimization
Authors: Singh Pawan , Khan Baseem
Published: October 2017

At present, renewable energy sources (RESs) integration using microgrid (MG) technology is of great importance for demand side management. Optimization of MG provides enhanced generation from RES at minimum operation cost. The microgrid optimization problem involves a large number of variables and constraints; therefore, it is complex in nature and various existing algorithms are unable to handle them efficiently. This paper proposed an artificial shark optimization (ASO) method to remove the limitation of existing algorithms for solving the economical operation problem of MG. The ASO algorithm is motivated by the sound sensing capability of sharks, which they use for hunting. Further, the intermittent nature of renewable energy sources is managed by utilizing battery energy storage (BES). BES has several benefits. However, all these benefits are limited to a certain fixed area due to the stationary nature of the BES system. The latest technologies, such as electric vehicle technologies (EVTs), provide all benefits of BES along with mobility to support the variable system demands. Therefore, in this work, EVTs incorporated grid connected smart microgrid (SMG) system is introduced. Additionally, a comparative study is provided, which shows that the ASO performs relatively better than the existing techniques.
Rhabdomyolysis Induced by Coadministration of Fusidic Acid and Atorvastatin: A Case Report and Comprehensive Review of the Literature
Authors: Patoulias Dimitrios , Michailidis Theodoros , Papatolios Thomas , Papadopoulos Rafael , Keryttopoulos Petros
Published: October 2017

Statins are among the most widely prescribed medications worldwide. Acute rhabdomyolysis constitutes a potentially life-threatening side effect regardless of whether statins are administered alone or in combination. The potentially fatal combination of a statin and fusidic acid has been well described in the literature. Acute renal failure can be a direct consequence of this drug-drug interaction. We present a case of a 79-year-old woman who presented to our Emergency Department with a one-week history of limb weakness, myalgia, and inability to stand and walk. The patient had been given fusidic acid to treat Methicillin-Sensitive Staphylococcus Aureus (MSSA) positive dermatitis in the 3 weeks prior to admission, while she continued to take her complete therapeutic regimen, which included atorvastatin. Thus, she developed rhabdomyolysis due to the interaction between fusidic acid and atorvastatin. Herein, we report a life-threatening complication of coadministration of fusidic acid and a statin, which is preventable and predictable. The exact mechanism of the interaction is not fully understood, but coadministration of these two medications must be avoided in clinical practice.
A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair
Authors: Lilungulu Athanase , Mwibea Willy , Nassoro Mzee , Gumodoka Balthazar
Published: October 2017

Background. Haematometra is a rare postobstetrics fistula surgical repair outcome complication; however the condition can be misinterpreted especially in limited resource areas that lack routine ultrasound guidance and with a slowly progressed increase in size of abdomen accompanied with a history of amenorrhoea together with a history of having unprotective sexual intercourse which may increase the possibility of being controversial to full-term gravid uterus. The causes of haematometra might be either due to congenital abnormality of the vaginal canal or acquired iatrogenically. However, any other cause that involved vaginal canal can be a predisposing factor of haematometra. We present a case of a 32-year-old female patient, who had obstetric fistula which was successfully repaired over the past two years. She presented with one-year-and-two-month history of an amenorrhoea that was progressive accompanied with distended abdomen to the extent of looking typically as the gravid uterus. Explorative laparotomy was performed successfully and surgical incision managed by hysterotomy and salpingotomy, whereby approximately ten liters of serosanguinous blood fluid mixed with blood clots was completely suctioned. Despite being a rare condition after vesicle vaginal fistula repair complication outcome, haematometra remains to be relatively common gynaecological condition among female adolescence during postpubertal period.
Cytomegalovirus Associated Duodenal Ulcer and Duodenitis in a Malnourished Pediatric Patient
Authors: Bernard Rachel , Aljomah Ghanim , Klepper Emily , McDonough Elizabeth
Published: October 2017

Cytomegalovirus (CMV) duodenitis is a rare occurrence, especially in pediatric patients. A thirteen-month-old female presented to the Emergency Department for a febrile seizure. She was incidentally admitted for severe malnutrition with an initial workup remarkable for only a slight elevation in her ALT at 48. The patient was found to have an oral aversion requiring nasogastric tube feeds for adequate caloric intake. She continued to fail to gain weight and underwent an EGD that demonstrated a duodenal ulcer. She was consequently started on sucralfate and omeprazole. Post-EGD lab work demonstrated a pronounced increase in AST and ALT. Pathology from the EGD biopsies later demonstrated viral inclusion bodies consistent with CMV duodenitis. Apart from malnutrition, other causes of immune deficiency were eliminated from the differential diagnosis due to negative HIV PCR and normal immunoglobulins. While on antiviral treatment, her viral load of 1080 IU/mL trended to resolution and her liver enzymes normalized. The patient was ultimately discharged home demonstrating adequate weight gain via gastrostomy tube feeds. This case advocates for pediatricians to include immunodeficiency and infectious etiologies in their differential for malnourished patients in order to lead to earlier diagnosis and management of this treatable condition.
Recent Advances in Nanoparticles Enhanced Oil Recovery: Rheology, Interfacial Tension, Oil Recovery, and Wettability Alteration
Authors: Kamal Muhammad Shahzad , Adewunmi Ahmad A. , Sultan Abdullah S. , Al-Hamad Mohammed F. , Mehmood Umer
Published: October 2017

Chemically enhanced oil recovery methods are utilized to increase the oil recovery by improving the mobility ratio, altering the wettability, and/or lowering the interfacial tension between water and oil. Surfactants and polymers have been used for this purpose for the last few decades. Recently, nanoparticles have attracted the attention due to their unique properties. A large number of nanoparticles have been investigated for enhanced oil recovery applications either alone or in combination with surfactants and/or polymers. This review discusses the various types of nanoparticles that have been utilized in enhanced oil recovery. The review highlights the impact of nanoparticles on wettability alteration, interfacial tension, and rheology. The review also covers the factors affecting the oil recovery using nanoparticles and current challenges in field implementation.
Evaluation of Catalytic Effects of Chymotrypsin and Cu2+ for Development of UV-Spectroscopic Method for Gelatin-Source Differentiation
Authors: Hamizah Anis , Hammed Ademola Monsur , Asiyanbi-H Tawakalit Tope , Mirghani Mohamed Elwathig Saeed , Jaswir Irwandi , Ahamad Fadzillah Nurrulhidayah binti
Published: October 2017

The consumers interest in gelatin authentication is high due to allergic reactions and adoption of Halal and Kosher eating cultures. This research investigated browning development due to enzymatic hydrolysis and presence of Cu2+ during Maillard reaction of fish, porcine, and bovine gelatin. The rate of browning index samples showed two phases—rapid and slow—for all the gelatin samples and changes in browning index (ΔBindex) were increased (>100%) in presence of Cu2+. ΔBindex of enzymatic hydrolysates were different among the gelatin species. Fish gelatin hydrolyzate displayed > 400% increase in browning in the first six hours compared to gelatin hydrolyzates from porcine (200%) and bovine (140%). The variation in ΔBindex of chymotrypsin digested gelatin in presence of Cu2+ could be valuable for the development of an efficient UV-spectroscopic method for gelatin differentiation.
Obese Children with Metabolic Syndrome Have 3 Times Higher Risk to Have Nonalcoholic Fatty Liver Disease Compared with Those without Metabolic Syndrome
Authors: Papandreou Dimitrios , Karavetian Mirey , Karabouta Zacharoula , Andreou Eleni
Published: October 2017

Background. The aim of this study was to investigate the relationship between metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in obese children. One hundred and twenty-five subjects aged 11-12 years old participated in the study.Methods. Anthropometric and biochemical indices were measured, including lipid and liver profile, blood glucose, serum insulin, and liver ultrasound.Results. Forty-four children (58.6%) were found to have MS. Insulin resistance was present in 78 (62.4%) children. Patients with MS were more likely to have NAFLD (P<0.001). Children with NAFLD had significantly higher body mass index, waist circumference, triglycerides, fasting insulin, and lower high-density lipoprotein compared to patients with normal livers (P<0.001). Insulin resistance was significantly higher in children with NAFLD (P<0.001). Obese children presenting with MS were 3.01 (2.87–3.57,P<0.002) times more likely to develop NAFLD compared to those without metabolic syndrome after adjustment of cofounders.Conclusions. Obese children with MS have a higher risk of developing NAFLD. Weight management and early prevention should be the first line of treatment to prevent any possible health issues later on.
A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers
Authors: Xu Furong , Marchand Stephanie , Corcoran Celeste , DiBiasio Heather , Clough Rachel , Dyer Christopher S. , Nobles Jennifer , White Jade , Greaney Mary L. , Greene Geoffrey W.
Published: October 2017

There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns. Families were referred to the program by their physician and participated in the program at no cost. The 16-week intervention includes weekly group nutrition and physical activity sessions. Analyses determined that 65 out of the 97 children who completed SCFFF provided 2-year follow-up data and had reduced BMIz-scores over 2 years following the intervention. These participants decreased their energy, fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention. SCFFF was effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese.
Discordant HIV Test Results: Implications on Perinatal and Haemotransfusion Screening for HIV Infection, Cape Coast, Ghana
Authors: Tetteh Ato Kwamena , Agyarko Edward
Published: October 2017

Screening results of 488 pregnant women aged 15–44 years whose blood samples had been tested on-site, using First Response® HIV 1/2, and confirmed with INNO-LIA™ HIV I/II Score were used. Of this total, 178 were reactive (HIV I, 154; HIV II, 2; and HIV I and HIV II, 22). Of the 154 HIV I-reactive samples, 104 were confirmed to be HIV I-positive and 2 were confirmed to be HIV II-positive, while 48 were confirmed to be negative [false positive rate = 17.44% (13.56–21.32)]. The two HIV II samples submitted were confirmed to be negative with the confirmatory test. For the 22 HIV I and HIV II samples, 7 were confirmed to be HIV I-positive and 1 was confirmed to be HIV I- and HIV II-positive, while 14 were confirmed to be negative. Of the 310 nonreactive samples, 6 were confirmed to be HIV I-positive and 1 was confirmed to be HIV II-positive [false negative rate = 5.79% (1.63–8.38)], while 303 were negative. False negative outcomes will remain unconfirmed, with no management options for the client. False negative rate of 5.79% requires attention, as its resultant implications on control of HIV/AIDS could be dire.
Bee‐Inspired Algorithms Applied to Vehicle Routing Problems: A Survey and a Proposal
Authors: Masutti Thiago A. S. , de Castro Leandro N.
Published: October 2017

Vehicle routing problems constitute a class of combinatorial optimization tasks that search for optimal routes (e.g., minimal cost routes) for one or more vehicles to attend a set of nodes (e.g., cities or customers). Finding the optimal solution to vehicle routing tasks is an NP‐hard problem, meaning that the size of problems that can be solved by exhaustive search is limited. From a practical perspective, this class of problems has a wide and important set of applications, from the distribution of goods to the integrated chip design. Rooted on the use of collective intelligence, swarm‐inspired algorithms, more specifically bee‐inspired approaches, have been used with good performance to solve such problems. In this context, the present paper provides a broad review on the use of bee‐inspired methods for solving vehicle routing problems, introduces a new approach to solve one of the main tasks in this area (the travelling salesman problem), and describes open problems in the field.
Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis
Authors: Mei Binbin , Wang Wenting , Cui Feifei , Wen Zunjia , Shen Meifen
Published: October 2017

Background. This meta-analysis was performed to assess the efficacy and safety of chewing gum in intestinal function recovery after colorectal cancer surgery. Methods. A systematic search was conducted in PubMed, Embase, Science Direct, and Cochrane library for relevant randomized controlled trials (RCTs) published until April 2017. Summary risk ratios or weighted mean differences with 95% confidence intervals were used for continuous and dichotomous outcomes, respectively. Results. 17 RCTs with a total number of 1845 patients were included. Gum chewing following colorectal cancer surgery significantly reduced the time to first passage of flatus (WMD −0.55; 95% CI −0.94 to −0.16; P=0.006), first bowel movement (WMD −0.60; 95% CI −0.87 to −0.33; P<0.0001), start feeding (WMD −1.32; 95% CI −2.18 to −0.46; P=0.003), and the length of postoperative hospital stay (WMD −0.88; 95% CI −1.59 to −0.17; P=0.01), but no obvious differences were found in postoperative nausea, vomiting, abdominal distention, pneumonia, and mortality, which were consistent with the findings of intention to treat analysis. Conclusions. Chewing gum could accelerate the recovery of intestinal function after colorectal cancer surgery. However, it confers no advantage in postoperative clinical complications. Further large-scale and high-quality RCTs should be conducted to confirm these results.
Output Feedback Finite‐Time Stabilization of Systems Subject to Hölder Disturbances via Continuous Fractional Sliding Modes
Authors: Muñoz-Vázquez Aldo-Jonathan , Parra-Vega Vicente , Sánchez-Orta Anand , Romero-Galván Gerardo
Published: October 2017

The problem of designing a continuous control to guarantee finite‐time tracking based on output feedback for a system subject to a Hölder disturbance has remained elusive. The main difficulty stems from the fact that such disturbance stands for a function that is continuous but not necessarily differentiable in any integer‐order sense, yet it is fractional‐order differentiable. This problem imposes a formidable challenge of practical interest in engineering because (i) it is common that only partial access to the state is available and, then, output feedback is needed; (ii) such disturbances are present in more realistic applications, suggesting a fractional‐order controller; and (iii) continuous robust control is a must in several control applications. Consequently, these stringent requirements demand a sound mathematical framework for designing a solution to this control problem. To estimate the full state in finite‐time, a high‐order sliding mode‐based differentiator is considered. Then, a continuous fractional differintegral sliding mode is proposed to reject Hölder disturbances, as well as for uncertainties and unmodeled dynamics. Finally, a homogeneous closed‐loop system is enforced by means of a continuous nominal control, assuring finite‐time convergence. Numerical simulations are presented to show the reliability of the proposed method.
Adaptive Antenna Null Broadening Beamforming against Array Calibration Error Based on Adaptive Variable Diagonal Loading
Authors: Li Wenxing , Zhao Yu , Ye Qiubo , Yang Bin
Published: October 2017

An approach for null broadening beamforming is proposed based on adaptive variable diagonal loading (VDL) and combined with the covariance matrix taper (CMT) approach, aiming at improving the robustness of adaptive antenna null broadening beamforming when array calibration error exists. Hence, it is named VDL-CMT. In this novel approach, the signal-to-noise ratio in the tapered sample covariance matrix is estimated and the VDL factor can be obtained adaptively. Then, the covariance matrix of the CMT approach is loaded with the obtained VDL factor. According to simulation results, in the case of array calibration error, robustness of the VDL-CMT is significantly improved and its performance is better than that of the existing adaptive antenna null broadening beamforming approaches.
A Rare Variant in PGAP2 Causes Autosomal Recessive Hyperphosphatasia with Mental Retardation Syndrome, with a Mild Phenotype in Heterozygous Carriers
Authors: Perez Yonatan , Wormser Ohad , Sadaka Yair , Birk Ruth , Narkis Ginat , Birk Ohad S.
Published: October 2017

Mutations in genes involved in the biosynthesis of the glycosylphosphatidylinositol (GPI) anchor cause autosomal recessive glycosylation defects, with a wide phenotypic spectrum of intellectual disability, seizures, minor facial dysmorphism, hypotonia, and elevated serum alkaline phosphatase. We now describe consanguineous Bedouin kindred presenting with an autosomal recessive syndrome of intellectual disability and elevated serum alkaline phosphatase. Genome-wide linkage analysis identified 6 possible disease-associated loci. Whole-exome sequencing followed by Sanger sequencing validation identified a single variant in PGAP2 as the disease-causing mutation (C.554G>A; p.185(R>Q)), segregating as expected within the kindred and not found in 150 Bedouin controls. The mutation replaces a highly conserved arginine residue with glutamine within the Frag1 (FGF receptor activating) domain of PGAP2. Interestingly, this mutation is a known dbSNP variant (rs745521288, build 147) with a very low allele frequency (0.00000824 in dbSNP, no homozygotes reported), highlighting the fact that dbSNP variants should not be automatically ruled out as disease-causing mutations. We further showed that PGAP2 is ubiquitously expressed, but in line with the disease phenotype, it is highly transcribed in human brain, skeletal muscle, and liver. Interestingly, a mild phenotype of slightly elevated serum levels of alkaline phosphatase and significant learning disabilities was observed in heterozygous carriers.
Molecular Dynamics of POPC Phospholipid Bilayers through the Gel to Fluid Phase Transition: An Incoherent Quasi-Elastic Neutron Scattering Study
Authors: Wanderlingh U. , Branca C. , Crupi C. , Conti Nibali V. , La Rosa G. , Rifici S. , Ollivier J. , D’Angelo G.
Published: October 2017

The microscopic dynamics for the gel and liquid-crystalline phase of highly aligned D2O-hydrated bilayers of 1-palmitoyl-oleoyl-sn-glycero-phosphocholine (POPC) were investigated in the temperature range from 248 to 273 K by using incoherent quasi-elastic neutrons scattering (QENS). We develop a model for describing the molecular motions of the liquid phase occurring in the 0.3 to 350 ps time range. Accordingly, the complex dynamics of hydrogen are described in terms of simple dynamical processes involving different parts of the phospholipid chain. The analysis of the data evidences the existence of three different motions: the fast motion of hydrogen vibrating around the carbon atoms, the intermediate motion of carbon atoms in the acyl chains, and the slower translational motion of the entire phospholipid molecule. The influence of the temperature on these dynamical processes is investigated. In particular, by going from gel to liquid-crystalline phase, we reveal an increase of the segmental motion mainly affecting the terminal part of the acyl chains and a change of the diffusional dynamics from a localized rattling-like motion to a confined diffusion.
Separation of Electrolytic Reduction Product from Stainless Steel Wire Mesh Cathode Basket via Salt Draining and Reuse of the Cathode Basket
Authors: Choi Eun-Young , Lee Jeong , Heo Dong Hyun , Hur Jin-Mok
Published: October 2017

We demonstrated that the metallic product obtained after electrolytic reduction (also called oxide reduction (OR)) can be simply separated from a stainless steel wire mesh cathode basket only by using a salt drain. First, the OR run of a simulated oxide fuel (0.6 kg/batch) was conducted in a molten Li2O–LiCl salt electrolyte at 650°C. The simulated oxide fuel of the porous cylindrical pellets was used as a cathode by loading a stainless steel wire mesh cathode basket. Platinum was employed as an anode. After the electrolysis, the residual salt of the cathode basket containing the reduction product was drained by placing it at gas phase above the molten salt using a holder. Then, at a room temperature, the complete separation of the reduction product from the cathode basket was achieved by inverting it without damaging or deforming the basket. Finally, the emptied cathode basket obtained after the separation was reused for the second OR run by loading a fresh simulated oxide fuel. We also succeeded in the separation of the metallic product from the reused cathode basket for the second OR run.
Antioxidant and Anti-Inflammatory Activities in Extracts from Minke Whale (Balaenoptera acutorostrata) Blubber
Authors: Walquist Mari Johannessen , Stormo Svein Kristian , Jensen Ida-Johanne , Østerud Bjarne , Eilertsen Karl-Erik
Published: October 2017

Intake of long-chain omega-3 polyunsaturated fatty acids (LC-n3-PUFA) is commonly recognized to reduce cardiovascular disease (CVD). In previous studies, cold-pressed whale oil (CWO) and cod liver oil (CLO) were given as a dietary supplement to healthy volunteers. Even though CWO contains less than half the amount of LC-n3-PUFA of CLO, CWO supplement resulted in beneficial effects on anti-inflammatory and CVD risk markers compared to CLO. In the present study, we prepared virtually lipid-free extracts from CWO and CLO and evaluated the antioxidative capacity (AOC) and anti-inflammatory effects. Oxygen radical absorbance capacity (ORAC) and ferric reducing antioxidant power (FRAP) assays were used to test the AOC, and the results indicated high levels of antioxidants present in all extracts. The anti-inflammatory effects of the extracts were tested with lipopolysaccharide- (LPS-) treated THP-1 cells, measuring its ability to reduce cytokine and chemokine secretion. Several CWO extracts displayed anti-inflammatory activity, and a butyl alcohol extract of CWO most effectively reduced TNF-α(50%,p<0.05) and MCP-1 (85%,p<0.001) secretion. This extract maintained a stable effect of reducing MCP-1 secretion (60%,p<0.05) even after long-term storage. In conclusion, CWO has antioxidant and anti-inflammatory activities that may act in addition to its well-known LC-n3-PUFA effects.
Random Error Reduction Scheme for Combinational Stochastic Circuit
Authors: Cheng Ye , Hu Jianhao
Published: October 2017

In conventional stochastic computation, all the input streams are Bernoulli sequences (BSs), which may result in large random error. To reduce random error and improve computational accuracy, some other sequences have been reported as alternatives to BSs. However, these sequences only apply to the specific stochastic circuits, have difficulties in hardware generation, or have length constraints. To this end, new sequences without these disadvantages should be considered. This paper proposes the random error analysis method for stochastic computation based on autocorrelation sequence (AS), which is more general than the conventional one based on BS. The analysis results show that we can use the proper ASs as input streams of stochastic circuits to reduce random error. On the basis of that conclusion, we propose the random error reduction scheme based on maximal concentrated autocorrelation sequence (MCAS) and BS, both of which are ASs. MCAS and BS are applicable to any combinational stochastic circuit, are easily generated by hardware, and have no length constraints, which avoid the disadvantages of sequences in the previous work. Moreover, we apply the proposed random error reduction scheme into several typical stochastic circuits as case studies. The simulation results confirm the effectiveness of the proposed scheme.
D-Shaped Left Ventricle, Anatomic, and Physiologic Implications
Authors: Cativo Calderon Eder Hans , Mene-Afejuku Tuoyo O. , Valvani Rachna , Cativo Diana P. , Tripathi Devendra , Reyes Hans A. , Mushiyev Savi
Published: October 2017

Right ventricular loading/pressure influences left ventricular function because the two ventricles pump in series and because they are anatomically arranged in parallel, sharing the common ventricular septum. Flattening of the interventricular septum detected during echocardiographic examination is called D-shaped left ventricle. We present a case of an elderly male of African descent, who presented with increased shortness of breath. Transthoracic echocardiogram showed flattening and left sided deviation of interventricular septum causing a decreased size in left ventricle, secondary to volume/pressure overload in the right ventricle. While patient received hemodialysis therapy and intravascular volume was removed, patient blood pressure was noted to increase, paradox. Repeated transthoracic echocardiogram demonstrated less left deviation of interventricular septum compared with previous echocardiogram. We consider that it is important for all physicians to be aware of the anatomic and physiologic implication of D-shaped left ventricle and how right ventricle pressure/volume overload affects its function and anatomy.
Climatic Characteristics and Determination Method for Freezing Rain in China
Authors: Zhou Yue , Yue Yanyu , Gao Zhengxu , Zhou Yuehua
Published: October 2017

The climatic characteristics and temperature profiles of freezing rain in China are analyzed based on the observational data at 650 stations in China from 2000 to 2015. The freezing rain of China is generally in stripe-shape spatial distribution. The stations with freezing rain over 100 station-hours are mainly concentrated at the southeast areas of Southwest China and high-elevation mountainous areas of Eastern China. There are mainly two types of freezing rain temperature profiles, including single-warm-layer profile and double-warm-layer profile. The freezing rain profiles of mountainous area and urban area in Southwest China are similar to each other, and the freezing rain in Central and East China shares the similar single-warm-layer profile. The profiles in South China show the characteristics of freezing rain’s profile in both Southwest China and Central/East China as the position of stations. PA of freezing rain’s profiles is negatively correlated with NA, with correlation coefficients ranging from −0.36 to −0.70. The configuration of weak cold/warm layer (both smaller than 150°C·hPa) is one of major reasons causing frequent freezing rain at mountainous areas of Southwest China. The more obvious the change of NA with the variations of PA is, the more the freezing rain is likely to occur.