bluuebunny/crossref_metadata_2025 huggingface dataset:
The marine record of the onset of farming around the Arabian Sea at the dawn of the Bronze Age
Authors: Gourlan Alexandra T , Albarede Francis , Achyuthan Hema , Campillo Sylvain
Published: February 2020

The rise and fall of human cultures are strongly modulated by the strong environmental changes taking place during the Holocene. Here, we use the sedimentological and geochemical records of a core taken in the Arabian Sea, west of Kerala, to identify potential factors that may reflect on-land history of local civilizations, in particular the Harappan culture which appeared and collapsed in the Indus Valley during the early and middle Bronze Age. The 14C record highlights a fourfold increase in sedimentation rate at ~5380 cal. yr BP. The short duration of this event (~220 years) suggests a steep regional increase in erosion at the beginning of the Bronze Age. Factor analysis of downcore changes in geochemistry identified two distinct detrital components dominated by silt and clay, respectively, and a component characteristic of chemical erosion. This interpretation is consistent with sediment mineralogy. Comparison with the known climatic record indicates that increased erosion rate at 5380 cal. yr BP around the Arabian Sea is because of the advent of farming. The development of tillage associated with both wheat and barley crops and animal husbandry was favored by trade between Mesopotamia and India. Human activities, therefore, were the trigger of major changes in the sedimentological and geochemical records at sea at the onset of the Bronze Age.
Foreign Direct Investment in Sub-Saharan Africa: Is Tax Obligation Still an Issue?
Authors: Andoh Francis K. , Cantah William G.
Published: February 2020

This study examines the extent to which three aspects of tax obligations affect foreign direct investment (FDI) stock in sub-Saharan Africa (SSA). Using a panel of 36 countries in SSA from 2005 to 2016 and employing the dynamic system generalized method of moments (GMM) regression approach, the findings show a significant negative impact of all measures of tax obligations. However, the effect of the number of taxes and the time it takes to honour tax obligations are found to have greater negative effect. The findings show that although foreign investors are attracted by natural resources, they still care about the complicated and bureaucratic tax system. This challenges the conventional notion that FDI will always be attracted to and be maintained in Africa as long as there are natural resources. The practical implication is that reducing the number of taxes as well as the time it takes to honour tax obligations should be among the key measures for SSA economies to maintain high stock of FDI. As a contribution, this study provides an important information for the debate on fiscal environment and FDI in Africa.
Factors Related to Depressive Symptoms Among Multicultural Adolescents in Korea
Authors: Joung Kyoung Hwa , Chung Sung Suk
Published: February 2020

This study aimed to compare related factors of depressive symptoms among multicultural adolescents in South Korea. Cross-sectional data were collected from 1,325 students studying in ninth grade (mean age: 14.97 ± 0.36 years) who had one Korean parent and one foreign-born parent. The score of depressive symptoms among girls (1.777 ± 0.550) was higher than boys (1.647 ± 0.512). The regression model—including demographic, psychological, and social factors—explained 38.3% of depressive symptoms among boys and 27.9% among girls. Body image satisfaction was the most powerful factor related to depressive symptoms in both boys and girls. Gender-differentiated factors identified in this study such as demographic, psychological, and social factors need to be studied while planning gender-tailored intervention programs to help relieve depressive symptoms among multicultural adolescents.
Rayleigh-type surface wave on a rotating orthotropic elastic half-space with impedance boundary conditions
Authors: Singh Baljeet , Kaur Baljinder
Published: February 2020

The propagation of Rayleigh type surface waves in a rotating elastic half-space of orthotropic type is studied under impedance boundary conditions. The secular equation is obtained explicitly using traditional methodology. A program in MATLAB software is developed to obtain the numerical values of the nondimensional speed of Rayleigh wave. The speed of Rayleigh wave is illustrated graphically against rotation rate, nondimensional material constants, and impedance boundary parameters.
Behavior of multidirectional friction dampers
Authors: Suk Recep , Altintaș Gökhan
Published: February 2020

Earthquakes are catastrophic events causing loss of lives, injuries, and extensive losses in properties. Majority of the life and property losses of earthquakes are dependent on the incapabilities of the building stock to resist earthquakes. Although unsuitable design, analyses, and production techniques play a major role as the main reasons for the poor performance of buildings against earthquakes, buildings constructed in accordance with building codes also suffer from the devastating impact of earthquakes. In this context, the lack of proper management and adequate damping of the energy caused by earthquakes is a major cause of structural damage in earthquakes. The efficiency of conventional basic elements in structures with energy damping is very limited and may not be sufficient for the damping of a large amount of earthquake-induced energy. Thanks to the rapid advances in technology and associated engineering techniques, numerous new products, and production and calculation techniques are underway to mitigate the devastating effects of earthquakes on buildings. In this study, it was aimed to theoretically and experimentally investigate the performance of a versatile friction-type seismic damper that eliminates earthquake energy. The damper is designed using a spherical surface friction joint to respond to all loads regardless of the loading direction. The damper can be easily adjusted to the desired capacity by means of bolt tensioning elements. Experiments have been carried out for various shear loads and damping parameters. Furthermore, numerical analysis of the model was carried out by use of the finite element method. The results of this study revealed that the shear load capacity of the device did not change at different frequencies. Analyzing the effect of the equipment on a structure, it was understood that it reduces roof displacement and periods of the structure. The analysis revealed that the damper significantly improved the earthquake performance of the structure.
Adaptive compensation control of an electromagnetic active suspension system based on nonlinear characteristics of the linear motor
Authors: Li Yinong , Zheng Ling , Liang Yixiao , Yu Yinghong
Published: February 2020

With the electrification and intellectualization of vehicle systems, electromagnetic active suspension has been paid more and more attention. Linear motor is one of the effective actuators of the electromagnetic active suspension system. The nonlinear factors of linear motor, such as nonlinear friction force and ripple force, as well as power limit and magnetic saturation, will reduce the performance of electromagnetic active suspension. However, the current research rarely considers the effect of these nonlinear factors on active suspension control. In this article, the effect of nonlinearities of linear motors on electromagnetic active suspension performance and the ways to improve their performance are studied. An adaptive filtering compensation method is proposed to reduce the influence of nonlinear factors on the electromagnetic active suspension control. According to the simulated calculations, performance degradation of the active suspension is observed in both the primary control objective and high-frequency range due to inherent disturbance from the nonlinear factors. Also, the electromagnetic nonlinearities will reduce the active suspension effective force output. By proposing an adaptive compensator based on the filtered-x recursive least squares algorithm, the first-order resonance of the suspension system could be controlled and the electromagnetic active suspension effective force could be magnified. Also, convergence of the adaptive compensator is found to be rapid and reasonable.
Elevated D-dimer as an immediate response to alemtuzumab treatment
Authors: Libertinova Jana , Meluzinova Eva , Nema Eva , Rockova Petra , Elisak Martin , Petrzalka Marko , Mojzisova Hana , Hammer Jiri , Tomek Ales , Marusic Petr
Published: February 2020

Alemtuzumab as a treatment of highly active multiple sclerosis causes a rapid decrease in inflammatory activity due the lysis of immune cells. Subsequent cytokine release determines the infusion-associated reaction that is a frequent adverse event of alemtuzumab treatment. Recently, serious cardiovascular and thrombotic adverse reactions following alemtuzumab infusion have been described. In our study, the dynamics of coagulation parameters were analyzed in 13 multiple sclerosis patients treated with alemtuzumab. An immediate, significant increase in the level of D-dimer was observed after the first administration of alemtuzumab. This observation provides evidence of coagulation activation and the potential risk of thrombotic complications with this therapy. Prophylactic low molecular weight heparin pretreatment maybe considered in patients receiving alemtuzumab.
Research on the characteristics of wind pressures on L-shaped tall buildings
Authors: Li Yi , Duan Ru-Biao , Li Qiu-Sheng , Li Yong-Gui , Li Chao
Published: February 2020

Eight L-shaped rigid models with different geometric dimensions were tested at four typical terrain categories in a boundary wind tunnel to investigate the characteristics of wind pressures on L-shaped tall buildings. The effects including wind direction, turbulence intensity, and geometric dimension on the characteristics of wind pressures on L-shaped tall buildings were studied. Shape factors of each face under the unfavorable wind direction were summarized. Moreover, the power spectral densities, correlation coefficients, and coherence functions were analyzed in frequency domain. Based on the testing results, it is shown that the proposed exponential functions fit the measurements well. The objective of this study is to provide useful information for the wind-resistant design ofL-shaped tall buildings.
Being (co-)present: Reflecting the personal and public spheres of asylum seeking in relation to connectivity
Authors: Lintner Claudia
Published: February 2020

This article links the personal use/meaning of information and communications technology for refugees and asylum seekers with their visibility/invisibility in public spaces. More precisely, it gives insights into how the personal and public spheres of asylum seeking interrelate when discussing connectivity. In doing so, I discuss the following research questions: How is connectivity embedded in refugees and asylum seekers’ everyday practices? And in addition, in which ways does this personal dimension interact with the public (structural level), given their increased presence in public spaces? In order to respond to the research questions, a qualitative-ethnographic approach was chosen for this study by adopting different research methods: Participatory observations, semi-structured interviews, expert interviews, and document analysis. Such an approach is fundamental to avoid a media-centric analysis without accounting for offline contextual lives, power relations, and experiences. As the results show the meaning of connectivity within the asylum experience raises a public as well as a personal dimension. As such the meaning of the Internet is based on the agency of asylum seekers given restricted access to public spaces and social support offline. Thus, the results reveal that both Internet access and experiences of transnationalism/displacement constitute and configure connectivity. Following this line of argument, connectivity widely compensates for the spaces of action, spaces of learning, spaces of interaction, and spaces for information that are missing offline, in the process of emplacing themselves in a new environment.
Self-oscillatory flow in the Hartmann resonator – Numerical simulation
Authors: Lebedev MG , Bocharova OV
Published: February 2020

Self-oscillatory flow in the Hartmann resonator is numerically calculated within the framework of ideal (inviscid and non-heat-conducting) gasdynamics. The calculations are performed for the case of a sonic jet impinging on a tube varying from that with a sealed inlet (rod) to a fairly deep cavity. The spacing between the tube and the nozzle and the nozzle pressure ratio are also varied in the calculations. On the basis of the calculated results the oscillation process is described in detail and its mechanism is revealed for both shallow and deep tubes. For shallow tubes and a rod it is due to an imbalance in the flow rate and momentum between two regions in the jet that impinges on the obstacle. For deep tubes the oscillations are due to the tube filling and evacuation somewhat reminiscent of the process occurring in a one-quarter-wave resonator. In any case no signature of a feedback loop in the external acoustic field of the jet was detected. The results of the calculations are in good agreement with experimental data. The effects of mounting a lip on the tube (transition from a low- to high-frequency operation mode) and heating in the Hartmann tube are also discussed.
Learning together: Participatory rural appraisal for coproduction of climate change knowledge
Authors: Omondi Lilian A
Published: February 2020

Literature indicates a general consensus that knowledge on climate change is critical for enhancing community-based adaptation. Local knowledge tends to be localized to specific contexts and needs to be enhanced to ensure sustainability of adaptation measures. Traditional epistemological methods of research, however, tend to be extractive in nature with little focus on community capacity building, while dissemination of findings is mainly done with academic communities in mind. The focus of this article is to highlight the potential presented by participatory rural appraisal techniques in the process of data collection, with an aim of enhancing collaborative learning and improving community knowledge for climate change adaptation.
Illuminance meter calibration with an LED spectrally tunable light source
Authors: Godo K , Tamura Y , Watari O
Published: February 2020

Calibration of an illuminance meter is indispensable for accurate measurement of the illuminance of indoor lighting and daylight. In recent years, because of the phasing-out of incandescent lamps and their replacement with LED lamps, it has become difficult to obtain an incandescent type standard lamp to calibrate an illuminance meter. To replace the standard lamp method, we constructed an illuminance meter calibration system based on an LED-based spectrally tunable light source. The approximate CIE Illuminant A spectrum realized by the LED-based spectrally tunable light source was controlled at various illuminance values (800–10,000 lx). A test illuminance meter was calibrated by comparison against a reference photometer with the realized approximate Illuminant A spectrum. The illuminance values measured using the reference photometer and using the test illuminance meter in the calibration system agreed within 2.5% without reference plane correction of the test illuminance meter, and within 1% with reference plane correction. Reference plane correction depends strongly on the measurement distance and the illuminance meter structure. This study demonstrated that it can be improved. Therefore, we infer that an illuminance meter calibration method using an LED-based spectrally tunable light source is a promising means of overcoming difficulties posed by the phasing-out of incandescent standard lamps.
Staged Fenestrated/Branched Repair of Postdissecting Thoracoabdominal Aneurysm With Candy-Plug False Lumen Occlusion for Spinal Cord Preconditioning
Authors: Carta Niccolò , Salvati Simone , Melissano Germano , Chiesa Roberto , Bertoglio Luca
Published: February 2020

Purpose: To describe a possible application of thoracic false lumen occlusion techniques with a Candy-Plug occluder to induce false lumen thrombosis for preconditioning the spinal cord during staged fenestrated repair of postdissecting thoracoabdominal aneurysms. Technique: A Candy-Plug occluder is deployed within the thoracic false lumen after proximal entry tear coverage with a standard thoracic stent-graft during staged repair of postdissecting thoracoabdominal aneurysms. The blockade of thoracic false lumen retrograde reperfusion from distal entry tears induces a controlled thrombosis of both the thoracic false lumen and intercostal arteries. Then, when the fenestrated device is delivered 4 to 6 weeks later, the procedure is completed with standard techniques according to the staging protocols of individual centers. Conclusion: A new possible application of a Candy-Plug false lumen occlusion technique might be an intermediate procedure aimed at preconditioning the spinal cord by occluding the thoracic false lumen during complex staged fenestrated thoracoabdominal repairs.
Outcomes of Peripheral Vascular Interventions via Retrograde Pedal Access for Chronic Limb-Threatening Ischemia in a Multicenter Registry
Authors: Perry Mark , Callas Peter W. , Alef Matthew J. , Bertges Daniel J.
Published: February 2020

Purpose: To describe the use and 1-year outcomes of retrograde pedal access during peripheral vascular interventions (PVI) for chronic limb-threatening ischemia (CLTI). Materials and Methods: From October 2016 to September 2017, 159 patients (mean age 71±10 years; 112 men) undergoing PVI via retrograde pedal access were enrolled in the multicenter Vascular Quality Initiative (VQI) registry. The pedal access approach included retrograde femoral (40%), antegrade femoral (26%), retrograde to antegrade femoral (22%), and pedal only (11%). A comparator group of 1972 patients (mean age 69±12 years; 1129 men) having a contralateral retrograde femoral access was established for propensity matching, which resulted in 156 patients per group. Procedure characteristics, technical success, and access site complications were compared. Major adverse limb events (MALE) and amputation-free survival (AFS) at 1 year were analyzed using the Kaplan-Meier method and Cox proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results: Technical failure was similar for retrograde femoral and pedal access (7% vs 13%, p=0.07). Complications were rare and included access site hematoma (2 vs 5, p=0.32) and target artery thrombosis (0 vs 2) for the femoral vs pedal access groups, respectively. The rates of MALE at 1 year were significantly lower after retrograde femoral access (24%) compared with pedal access (38%; log-rank p=0.01; HR 1.95, 95% CI 1.15 to 3.30). AFS estimates at 1 year were similar: 86% for retrograde femoral and 83% for pedal access (log-rank p=0.37; HR 1.32, 95% CI 0.73 to 2.39), as were major amputation estimates: 10% for retrograde femoral access and 13% for pedal access group (log-rank p=0.21; HR 1.58, 95% CI 0.77 to 3.26). Conclusion: In this analysis of multicenter registry data, retrograde pedal access in patients with CLTI had similar technical success and early complications in comparison with traditional contralateral retrograde femoral access. The rates of MALE were higher after pedal access but AFS was similar, indicating a tradeoff between limb salvage and repeat interventions.
Building information modeling–based cyber-physical platform for building performance monitoring
Authors: Zhang Yun-Yi , Kang Kai , Lin Jia-Rui , Zhang Jian-Ping , Zhang Yi
Published: February 2020

Building performance management requires massive data input; however, the relevant data are separated and heterogeneous; thus, it prevents a comprehensive building performance management. Building information modeling brings a new way to capture rich information of a building, and has great potential in data interoperability for building performance management. This article presents a scalable building information modeling–based cyber-physical platform for building performance monitoring to integrate heterogeneous data from different buildings. A smart sensor network based on Arduino and standard protocol is installed for data sensing and collection. A building information modeling–based sensing information model integrating heterogeneous data in a unified structure is proposed, and a scalable NoSQL database is established to store data in a cloud environment. A series of RESTful web services is developed to share data for building performance management applications. The proposed platform is developed taking the advantage of horizontal scalability of NoSQL database, and the data schema and services are generated automatically based on the unified data model. The platform has collected data from 77 buildings in China, and the results of a case study show the platform brings a new paradigm in collecting, storing, integrating, and sharing of sensor data and building information for building performance monitoring and analytics.
Prospective, Double-blind Evaluation of Perioperative Intravenous Acetaminophen and Ketorolac for Postoperative Pain and Opioid Consumption After Endoscopic Carpal Tunnel Release
Authors: Truelove Elizabeth C. , Urrechaga Eva , Fernandez Carmella , Fowler John R.
Published: February 2020

Background: The current opioid epidemic highlights the need for pain management strategies to decrease or eliminate postoperative use of opioid medications. The purpose of this study was to determine if perioperative administration of intravenous (IV) acetaminophen and/or IV ketorolac decreases postoperative pain and opioid consumption after endoscopic carpal tunnel release. Methods: In all, 44 subjects were enrolled in this randomized, double-blind, placebo-controlled study from October 2015 to April 2017 and divided into 4 treatment arms: placebo, IV acetaminophen, IV ketorolac, or both IV acetaminophen and IV ketorolac. Patients recorded pain at 8-hour intervals on an 11-point scale and daily opioid use for 7 days after surgery. Analysis of variance and Kruskal-Wallis tests were used to compare mean pain scores and opioid consumption. Results: Mean pain scores over the 7-day study period were lower in the placebo and IV acetaminophen groups. Patients in the placebo and acetaminophen groups reported less pain than those in the ketorolac and combination groups on postoperative days 6 and 7. Patients administered IV acetaminophen had lower daily mean opioid usage. In all, 50% of the patients did not take any opioids after surgery. Conclusions: There are small, statistically significant differences in postoperative pain and opioid consumption supporting the use of IV acetaminophen for pain control after endoscopic carpal tunnel release, though these results are likely not clinically relevant. We recommend continued investigation into multimodal pain management in upper extremity surgery as well as limiting the number and quantity of opioid prescriptions provided to patients postoperatively.
Capturing Lived Experience: Methodological Considerations for Interpretive Phenomenological Inquiry
Authors: Frechette Julie , Bitzas Vasiliki , Aubry Monique , Kilpatrick Kelley , Lavoie-Tremblay Mélanie
Published: February 2020

Interpretive phenomenology presents a unique methodology for inquiring into lived experience, yet few scholarly articles provide methodological guidelines for researchers, and many studies lack coherence with the methodology’s philosophical foundations. This article contributes to filling these gaps in qualitative research by examining the following question: What are the key methodological and philosophical considerations of leading an interpretive phenomenological study? An exploration of interpretive phenomenology’s foundations, including Heideggerian philosophy and Benner’s applications in health care, will show how the philosophical tradition can guide research methodology. The interpretive phenomenological concepts of Dasein, lived experience, existentialia, authenticity are at the core of the discussion while relevant methodological concerns include research paradigm, researcher’s stance, objective and research question, sampling and recruitment, data collection, and data analysis. A study of pediatric intensive care unit nurses’ lived experience of a major hospital transformation project will illustrate these research considerations. This methodological article is innovative in that it explicitly describes the ties between the operational elements of an interpretive phenomenological study and the philosophical tradition. This endeavor is particularly warranted, as the essence of phenomenology is to bring to light what is taken for granted, and yet phenomenological research paradoxically makes frequent assumptions concerning the philosophical underpinnings.
Motion characteristics of a novel elastic rotating micro-electromechanical power system
Authors: Liu Chunzhi , Ren Haigen , Shao Yiming , Yuan Chenheng
Published: February 2020

This article reports a conceptual study of a new micro-electromechanical power system using elastic leaf piston rotating engine rather than conventional engines as the main component. The proposed innovative elastic rotating micro-electromechanical power system adopts two leaf pistons to substitute the traditional rigid piston for establishing elastic combustors and operates with a novel Humphrey thermodynamic cycle, which brings about high power density and energy conversion efficiency. The motion model of leaf piston is carried out by using the Euler–Bernoulli theory, and a novel calculation method of trial and error is presented to iteratively simulate the motion of elastic piston. The effects of the piston length and installation position on the combustor variation are also investigated. Results indicate that the contact point of piston and cylinder is not the piston end and keeps moving, and the combustor is periodically compressed and expanded by the rotor and piston motion to perform the intake, compression, expansion, and exhaust. Besides, the minimum combustor volume lasts an amount of time, which provides a possible realization of full isovolumetric combustion. A larger installation phase angle of pistons means a longer compression and expansion, larger combustor volume and shorter constant-volume duration.
Design and control of a variable structure robot
Authors: Guo Lei , Zhao Liang , Song Yuan , Hu Jikun
Published: February 2020

Because wheeled mobile robots have so many applications in warehouse logistics, improving their ability to adapt to the environment has been the subject of extensive research. To enhance the traffic and obstacle avoidance capabilities of wheeled robots, a wheeled mobile robot with a transformable chassis is proposed in this article for use in an automated warehouse. The robot can not only move in all directions but also change its chassis structure according to the specific warehouse environment. First, the robot structure is designed, and the motion modes of the robot are analyzed. After kinematics analysis is performed, a kinematics model is presented. In addition, with the goal of trajectory tracking and indoor positioning, a sliding mode controller and an extended Kalman filter controller are designed. Then, the effectiveness of the kinematics model and the controller design is verified by computer simulation. Finally, a physical prototype of the robot is built and the effectiveness of the robot is demonstrated through experiments.
Whose voices? How media policy shapes minority language radio in Taiwan
Authors: Chen Ya-Chi
Published: February 2020

This article explores the interaction between media policy and the development of minority language media, in this case, Hakka language radio stations. It examines how media policy has been caught between neo-liberal economic development and election politics and delineates the extent to which media policy has impacted the establishment, programming and performance of minority language media, especially in the context of political democratization. This article argues that the mission to promote cultural diversity and to ‘make more voices heard’ should not fall on minority language media alone, and that the government and mainstream media ought to take the lead if this goal is to be achieved.
Speech perception in a second language: Hearing is believing—seeing is not
Authors: Ma Fengyang , Ai Haiyang , Xiao Ting , Guo Taomei , Pae Hye K.
Published: February 2020

This study examined the effects of the speaker’s face and accent on second language (L2) speech perception. Forty-two Chinese speakers of English immersed in the L2 environment were instructed to perform a cross-modal semantic judgement task. They saw an Asian or Caucasian face on the screen and heard word pairs in L2 in a native English accent or a Chinese accent, and were asked to judge whether the word pairs were related to each other in meaning or not. Results showed that for words presented in the native accent, there was a semantic effect in both reaction time and accuracy, irrespective of the face shown. For words presented in the non-native accent, the RT data showed a semantic effect, whereas the accuracy revealed a reversed semantic effect. The speed-accuracy trade-off suggests a relatively weak semantic effect. These patterns were not modulated by the faces accompanying the word pairs. These results suggest that the cue of accent plays an important role during bilinguals’ speech perception in L2, such that non-native accent hampers speech perception, even when it matches bilinguals’ first language. In contrast, bilinguals do not seem to depend on the social indexical cue of the face when it is not reliable. The present findings hold implications for the Bilingual Model of Lexical Access (BIMOLA) of bilingual speech perception and the monolingual models of social speech perception.
Total small vessel disease score and cerebro-cardiovascular events in healthy adults: The Kashima scan study
Authors: Suzuyama Kohei , Yakushiji Yusuke , Ogata Atsushi , Nishihara Masashi , Eriguchi Makoto , Kawaguchi Atsushi , Noguchi Tomoyuki , Nakajima Junko , Hara Hideo
Published: February 2020

Background and aims

We explored the association between the total small vessel disease score obtained from baseline magnetic resonance imaging and subsequent cerebro-cardiovascular events in neurologically healthy Japanese adults.

Methods

The presence of small vessel disease features, including lacunae, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on magnetic resonance imaging, was summed to obtain a “total small vessel disease score” (range, 0–4). After excluding participants with previous stroke or ischemic heart disease, intracranial artery stenosis (≥50%), or cerebral aneurysm (≥4 mm), a total of 1349 participants (mean age, 57.7 years; range, 22.8–85.0 years; 46.9% male) were classified into three groups by total small vessel disease score: 0 ( n = 984), 1 ( n = 269), and ≥2 ( n = 96). Cerebro-cardiovascular events (i.e., any stroke, transient ischemic attack, ischemic heart disease, acute heart failure, and aortic dissection) were defined as the primary end point. The hazard ratio (HR) of events during follow-up was calculated using Cox proportional hazards modeling with adjustments for age, sex, hypertension, diabetes mellitus, and smoking. Cumulative event-free rates were estimated using the Kaplan–Meier method.

Results

During follow-up (mean, 6.7 years), 35 cerebro-cardiovascular (16 cerebrovascular) events were identified. Higher small vessel disease score was associated with increased risk of cerebro-cardiovascular events (HR per unit increase, 2.17; 95% confidence interval, 1.36–3.46; P = 0.001). Events were more frequent among participants with higher score ( P < 0.001, log-rank test).

Conclusions

This study offered additional evidence for the clinical relevance of total small vessel disease score, suggesting the score as a promising tool to predict the risk of subsequent vascular events even in healthy populations.
Primary intraventricular hemorrhage outcomes in the CLEAR III trial
Authors: Nelson Sarah E , Mould W Andrew , Gandhi Dheeraj , Thompson Richard E , Salter Sarah , Dlugash Rachel , Awad Issam A , Hanley Daniel F , Ziai Wendy
Published: February 2020

Background

Intraventricular hemorrhage occurs due to intracerebral hemorrhage with intraventricular extension or without apparent parenchymal involvement, known as primary intraventricular hemorrhage.

Aims

We evaluated the prognosis of primary intraventricular hemorrhage patients in the CLEAR III trial (Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage).

Methods

In patients with primary intraventricular hemorrhage versus those with secondary intraventricular hemorrhage, we compared intraventricular alteplase response and outcomes including modified Rankin Scale, Barthel Index, National Institutes of Health Stroke Scale (NIHSS), and extended Glasgow Outcome Scale (eGOS) at 30, 180, and 365 days. Outcomes were also compared in primary intraventricular hemorrhage patients who received intraventricular alteplase versus placebo (normal saline) and in matched primary and secondary intraventricular hemorrhage patients using inverse-probability-weighted regression adjustment.

Results

Of 500 patients enrolled in CLEAR III, 46 (9.2%) had primary intraventricular hemorrhage. Combining both treatment groups, primary intraventricular hemorrhage patients had larger intraventricular hemorrhage volumes (median: 34.2 mL vs. 20.8 mL, p < 0.01) but similar intraventricular hemorrhage removal (51.0% vs. 59.0%, p = 0.24) compared to secondary intraventricular hemorrhage patients, respectively. Confirming previous studies, primary intraventricular hemorrhage patients achieved better NIHSS, modified Rankin Scale, Barthel Index, and eGOS scores at days 30, 180, and 365, respectively (all p < 0.01), although mortality was similar to secondary intraventricular hemorrhage patients; matching analysis yielded similar results. Primary intraventricular hemorrhage patients who received intraventricular alteplase ( n = 19) and saline ( n = 27) achieved similar outcomes.

Conclusions

In CLEAR III, primary intraventricular hemorrhage patients who survived achieved better long-term outcomes than surviving secondary intraventricular hemorrhage patients with similar mortality. Outcomes and safety were similar between primary intraventricular hemorrhage patients receiving alteplase and those receiving saline.
Epigenetic aberrations in natural killer/T-cell lymphoma: diagnostic, prognostic and therapeutic implications
Authors: Küçük Can , Wang Junli , Xiang Ying , You Hua
Published: February 2020

Natural killer/T-cell lymphoma (NKTCL) is an aggressive malignancy that usually presents in the upper aerodigestive tract. This malignancy shows substantial geographic variability in incidence, and is characterized by Epstein-Barr virus (EBV) infections. Epigenetic aberrations may dysregulate the expression of genes involved in different hallmarks of cancer. A growing body of evidence underscores the importance of epigenetic aberrations in the pathogenesis of NKTCL. Promoter hypermethylation is a common epigenetic mechanism for the inactivation of tumour suppressor genes. Several epigenetically silenced tumour suppressor candidates (e.g. PRDM1, BIM) were identified in this aggressive cancer using locus-specific and genome-wide promoter methylation analyses. Importantly, genes involved in epigenetic modifications were identified to be mutated (e.g. KMT2D) or methylated (e.g. TET2) in NKTCL patients, which may contribute to pathogenesis through global alterations in chromatin states. Cancer-associated microRNAs, some of which are expressed by EBV, and long noncoding RNAs have been observed to be dysregulated in NKTCL. This review focuses on studies investigating epigenetic aberrations in NKTCL to bolster our overall understanding of the role of these abnormalities in disease pathobiology. We also discuss the potential of these epigenetic aberrations to improve diagnosis and prognosis as well as reveal novel targets of therapy for NKTCL.
Chinese consensus on the diagnosis and treatment of gastric cancer with liver metastases
Authors: Zhang Kecheng , Chen Lin
Published: February 2020

Background:

The incidence of gastric cancer with liver metastases (GCLM) is 9.9–18.7%, with a median survival time of 11 months and a 5-year survival rate <20%. Multidisciplinary treatment (MDT) is gradually gaining recognition as the most important method. However, specific treatment plans remain unclear. The aim of study was to provide a consensus to improve the diagnosis and treatment of GCLM.

Methods:

We brought together experts from relevant medical fields across China, including the Chinese Research Hospital Association Digestive Tumor Committee, Chinese Association of Upper Gastrointestinal Surgeons, Chinese Gastric Cancer Association, and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association, to discuss and formulate this consensus.

Results:

A consensus was reached on the diagnosis and treatment of GCLM. Moreover, we have developed a new clinical classification system, the Chinese Type for Gastric Cancer Liver Metastases, based on the likelihood of a surgical treatment being successful.

Conclusions:

The MDT mode should be implemented throughout all treatment of GCLM. A Chinese version of this expert consensus has been published in the Chinese Journal of Practical Surgery (Volume 39, Issue 10, p. 405-411). Written permission was obtained from the Chinese Journal of Practical Surgery to disseminate the expert consensus in English.
Green and Efficient Extraction of Polysaccharides From Poria cocos F.A. Wolf by Deep Eutectic Solvent
Authors: Zhang Weida , Cheng Shaobo , Zhai Xiaona , Sun Junshe , Hu Xuefang , Pei Haisheng , Chen Guogang
Published: February 2020

Deep eutectic solvents (DESs) were proposed for the extraction of polysaccharides from Poria cocos (PCPs). Six types of DESs were prepared, and the DES composed of choline chloride and oxalic acid was proved to be suitable. Based on the results of single-factor test, the Box-Behnken experimental design with response surface methodology was carried out, giving the optimal extraction conditions including mole ratio of 1:2 (choline chloride:oxalic acid) and extraction 15 minutes at 100°C. Under the optimal extraction conditions, the extraction yield (46.24% ± 0.13%) was 8.6 times higher than that of hot water. The reusability of DES was demonstrated by a 6-run test, and an extraction yield of PCP was 38.40% ± 0.23% after reusing for 6 times without adding any additional chemicals. Moreover, molecular weight distributions of the resulting PCP were analyzed, and then mainly distributed in the range of 753 to 3578 g/mol. Therefore, DESs were proved to be an excellent extraction solvent alternative to the extraction of PCP.
Knowledge and preventive practices against Lassa fever among heads of households in Abakaliki metropolis, Southeast Nigeria: A cross-sectional study
Authors: Ossai Edmund Ndudi , Onwe Ogah Emeka , Okeagu Nnaemeka Philips , Ugwuoru Amarachi Laura , Eze Thankgod Kelechi , Nwede Augustine Sunday
Published: February 2020

Background:

Lassa fever is associated with high morbidity and mortality.

Objectives:

This study aimed to determine the knowledge and preventive measures against Lassa fever among heads of households in Abakaliki metropolis, Southeast Nigeria.

Methods:

This was a descriptive cross-sectional study. A four-stage sampling design was used to select 420 respondents from Abakaliki metropolis. A good knowledge of Lassa fever was determined by the proportion of respondents scoring ⩾50% in 15 variables. Good preventive practices against Lassa fever were determined by the proportion of respondents obtaining a score of ⩾50% in 12 variables.

Results:

The mean age of respondents was 34.1±9.4 years, and the majority (56.5%) were males. Major sources of information included television (66.4%) and radio (64.3%). A minority (11.0%) consume rats at present, while 86.7% knew that rats could transmit Lassa fever to humans. The majority (60.0%) had a good knowledge of Lassa fever, while 66.4% demonstrated good preventive practices. A predictor of good knowledge included being a consumer of rats, (adjusted odds ratio (AOR)=2.3; 95% confidence interval (CI) 1.1–4.9). Predictors of good preventive practices included being in a low socio-economic class (AOR=2.1; 95% CI 1.3–3.6) and having a good knowledge of Lassa fever (AOR=10.2; 95% CI: 6.2–10.6).

Conclusions:

The majority of respondents had a good knowledge of Lassa fever and demonstrated good preventive practices against it. A good knowledge of Lassa fever was associated with good preventive practices. There is need for a good understanding of Lassa fever among the population, as this will improve preventive practices. Health workers have an important role to play in disseminating information concerning Lassa fever.
Bisoprolol transdermal patch treatment for patients with atrial fibrillation after noncardiac surgery: A single-center retrospective study of 61 patients
Authors: Yasui Taku , Oka Toru , Shioyama Wataru , Oboshi Makiko , Fujita Masashi
Published: February 2020

Objectives:

Atrial fibrillation after surgery is associated with increased rates of heart failure and ischemic stroke, and extension of hospitalization. Bisoprolol is a β-blocker used to reduce heart rate and manage arrhythmias during atrial fibrillation. However, the safety and efficacy of bisoprolol transdermal patch treatment in patients with postoperative atrial fibrillation remain unclear.

Methods:

We retrospectively assessed the electronic health records of our hospital between September 2013 and July 2018 and identified patients with postoperative atrial fibrillation who had been treated with a bisoprolol transdermal patch. We excluded patients with sinus rhythm using bisoprolol transdermal patch to prevent atrial fibrillation recurrence and those with sustained atrial fibrillation before surgery. Data on heart rhythm, heart rate, and blood pressure at the baseline and after 24 h of treatment were obtained from the electronic health records.

Results:

Of the 603 patients treated with the bisoprolol transdermal patch, 61 patients with postoperative atrial fibrillation after noncardiac surgery were included. The bisoprolol transdermal patch was discontinued due to bradycardia in two patients (3.3%). In both cases, the heart rate increased after the removal of the bisoprolol transdermal patch and no additional treatment was necessary. Among the 61 patients, sinus rhythm was restored within 24 h of bisoprolol treatment in 47 patients (77.0%). The heart rate significantly decreased from 124.8 ± 26.3 bpm at the baseline to 78.9 ± 16.6 bpm at 24 h after treatment ( p < 0.001). There were no significant differences in the systolic and diastolic blood pressures between patients before and at 24 h after treatment.

Conclusion:

The results of this study indicate that the bisoprolol transdermal patch is well tolerated and effective in patients with atrial fibrillation after noncardiac surgery.
Mobile health applications for improving the sexual health outcomes among adults with chronic diseases: A systematic review
Authors: Karim Hesam , Choobineh Hamid , Kheradbin Niloofar , Ravandi Mohammad Hosseini , Naserpor Ahmad , Safdari Reza
Published: February 2020

Aims

Chronic diseases may affect sexual health as an important factor for well-being. Mobile health (m-health) interventions have the potential to improve sexual health in patients with chronic conditions. The aim of this systematic review was to summarise the published evidence on mobile interventions for sexual health in adults with chronic diseases.

Methods

Five electronic databases were searched for English language peer-reviewed literature from 1 January 2009 to 31 December 2019. Appropriate keywords were identified based on the study’s aim. Study selection was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The full texts of potential studies were reviewed, and final studies were selected. The m-health evidence reporting and assessment (mERA) checklist was used to assess the quality of the selected studies. After data extraction from the studies, data analysis was conducted.

Results

Nine studies met the inclusion criteria. All interventions were delivered through websites, and a positive effect on sexual problems was reported. Prostate and breast cancer were considered in most studies. Interventions were delivered for therapy, self-help and consultation purposes. Quality assessment of studies revealed an acceptable quality of reporting and methodological criteria in the selected studies. Replicability, security, cost assessment and conceptual adaptability were the criteria that had not been considered in any of the reviewed studies.

Conclusions

Reviewed studies showed a positive effect of mobile interventions on sexual health outcomes in chronic patients. For more effective interventions, researchers should design web-based interventions based on users’ needs and consider the m-health essential criteria provided by mERA. Additionally, mobile interventions can be more effective in combination with smartphone apps.
Physician attitudes towards—and adoption of—mobile health
Authors: Kong Tracie , Scott Mary Morgan , Li Yang , Wichelman Cynthia
Published: February 2020

Objective

Smartphone apps and mobile devices are an emerging method of healthcare data collection. This study sought to understand how physicians currently view mobile health (mHealth) technologies and use them in patient care.

Methods

A total of 186 physicians affiliated with Washington University School of Medicine in St. Louis, Missouri, USA completed a survey in 2016 regarding their current implementation of mHealth technologies for patient care and support for further development.

Results

More than half of respondents were willing to discuss health apps and mobile devices with patients. However, most were not currently recommending them to patients. Apps/devices that encouraged a healthy diet and weight or tracked heart rate received the highest satisfaction ratings. Apps/devices that accessed the EMR (electronic medical record) remotely, provided medication reminders, or enrolled research subjects garnered the most interest despite respondents lacking prior experience. A majority agreed that collected biometrics are useful for promoting a healthy lifestyle (68%), tracking medical treatment (64%), or conducting research (56%); and agreed that proof of accuracy and precision (81%) and the efficient integration of collected data (68%) are necessary improvements. Uploading data automatically and updating physicians in real-time was the most preferred method of data integration into the EMR.

Conclusions

Physicians show interest in using mHealth technologies for patient care but have limited experience, usually with those specific to their specialties. Proof of quality and a method to integrate data into the EMR are necessary for a mainstream role in healthcare.