bluuebunny/crossref_metadata_2025 huggingface dataset:
Why patients prefer high-level healthcare facilities: a qualitative study using focus groups in rural and urban China
Authors: Liu Yun , Zhong Liwei , Yuan Shasha , van de Klundert Joris
Published: September 2018

Introduction

Despite policy measure to strengthen and promote primary care, Chinese patients increasingly choose to access higher level hospitals. The resulting overcrowding at higher level hospitals and underutilisation of primary care are viewed to diminish the effects of the continuing health system investments on population health. We explore the factors that influence the choice of healthcare facility level in rural and urban China and aim to reveal the underlying choice processes.

Methods

We conducted eight semistructured focus group discussions among the general population and the chronically ill in a rural area in Chongqing and an urban area in Shanghai. Respondents’ discussions of (evidence-based) factors and how they influenced their facility choices were analysed using qualitative analysis techniques, from which we elicited choice process maps to capture the partial order in which the factors were considered in the choice process.

Results

The factors considered, after initial illness perception, varied over four stages of health service utilisation: initial visit, diagnosis, treatment and treatment continuation. The factors considered per stage differed considerably between the rural and urban respondents, but less so between the general population and the chronically ill. Moreover, the rural respondents considered the township health centres as default and prefer to continue in primary care, yet access higher levels when necessary. Urban respondents chose higher levels by default and seldom moved down to primary care.

Conclusions

Disease severity, medical staff, transportation convenience, equipment and drug availability played important roles when choosing healthcare facilities in China. Strengthening primary care correspondingly may well be effective to increase primary care utilisation by the rural population but insufficient for the urban population. The developed four-stage process maps are general enough to serve as the basis for (partially) ordering factors influencing facility level choices in other contexts.
Defining the prevalence and symptom burden of those with self-reported severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a two-phase community pilot study in the North East of England
Authors: Strassheim Victoria Jane , Sunnquist Madison , Jason Leonard A , Newton Julia L
Published: September 2018

Objectives

To define the prevalence of severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and its clinical characteristics in a geographically defined area of Northern England. To understand the feasibility of a community-based research study in the severely affected CFS/ME group.

Design

A two-phase clinical cohort study to pilot a series of investigations in participants own homes.

Setting

Participants were community living from the area defined by the Northern clinical network of the UK.

Participants

Adults with either a medical or a self-reported diagnosis of CFS/ME. Phase 1 involved the creation of a database. Phase 2: five participants were selected from database, dependent on their proximity to Newcastle.

Interventions

The De Paul fatigue questionnaire itemised symptoms of CFS/ME, the Barthel Functional Outcome Measure and demographic questions were collected via postal return. For phase 2, five participants were subsequently invited to participate in the pilot study.

Results

483 questionnaire packs were requested, 63 were returned in various stages of completion. 56 De Paul fatigue questionnaires were returned: all but 12 met one of the CFS/ME criteria, but 12 or 22% of individuals did not fulfil the Fukuda nor the Clinical Canadian Criteria CFS/ME diagnostic criteria but 6 of them indicated that their fatigue was related to other causes and they barely had any symptoms. The five pilot participants completed 60% of the planned visits.

Conclusions

Severely affected CFS/ME individuals are keen to participate in research, however, their symptom burden is great and quality of life is poor. These factors must be considered when planning research and methods of engaging with such a cohort.
Sarcopenic obesity associated with high-sensitivity C-reactive protein in age and sex comparison: a two-center study in South Korea
Authors: Park Chul-Hyun , Do Jong Geol , Lee Yong-Taek , Yoon Kyung Jae
Published: September 2018

Objectives

To evaluate the association between high-sensitivity C-reactive protein (hs-CRP) and sarcopenic obesity, and to determine age or sex differences underlying the relationship between hs-CRP and sarcopenic obesity.

Design

Observational study.

Participants

The study included 237 838 participants whose body composition and hs-CRP were analysed at the two health promotion centres in South Korea. Participants were divided into four groups based on body composition: normal, obesity only, sarcopenia only and sarcopenic obesity.

Primary measures

The levels of hs-CRP and proportion of participants with high (≥1.0 mg/L) hs-CRP. Sarcopenic obesity was defined as subjects fulfilling the criteria for sarcopenia (below 2 SD of mean of Skeletal Muscle Mass Index for young adults) and obesity (waist circumference ≥90 cm for men and ≥85 cm for women).

Results

The level of hs-CRP was highest in the sarcopenic obesity group. Following adjustment for various confounders including age, sex, comorbidities, metabolic, health-related behaviour and demographic factors, the adjusted ORs (95% CI) for subjects with high hs-CRP associated with obesity, sarcopenia and sarcopenic obesity compared with normal group (reference) were 1.17 (1.05 to 1.31), 2.23 (1.21 to 4.07) and 3.23 (2.71 to 3.83), respectively. In age subgroup analyses, multivariate logistic regression analysis revealed that the association of high hs-CRP with sarcopenic obesity was stronger in younger (<60 years) participants than in older (≥60 years) participants (p for interaction <0.001). In subgroup analyses for sex, the association of high hs-CRP with sarcopenic obesity was higher in female participants than in males (p for interaction <0.001).

Conclusions

This study demonstrated that high level of hs-CRP was independently associated with sarcopenic obesity in Korean population. We found for the first time that there was a strong association between increased hs-CRP and sarcopenic obesity in female and younger (<60 years) subjects.
Telehealth for patients with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis protocol
Authors: Gaveikaite Violeta , Fischer Claudia , Schonenberg Helen , Pauws Steffen , Kitsiou Spyros , Chouvarda Ioanna , Maglaveras Nicos , Roca Josep
Published: September 2018

Introduction

Chronic obstructive pulmonary disease (COPD) is a highly prevalent chronic disease characterised by persistent respiratory symptoms. A focus of COPD interventional studies is directed towards prevention of exacerbations leading to hospital readmissions. Telehealth as a method of remote patient monitoring and care delivery may be implemented to reduce hospital readmissions and improve self-management of disease. Prior reviews have not systematically assessed the efficacies of various telehealth functionalities in patients with COPD at different stages of disease severity. We aim to evaluate which COPD telehealth interventions, classified by their functionalities, are most effective in improving patient with COPD management measured by both clinical and resource utilisation outcomes.

Methods and analysis

We will conduct a systematic review which will include randomised controlled trials comparing the efficacy of telehealth interventions versus standard care in patients with COPD with confirmed disease severity based on forced expiratory volume(%) levels. An electronic search strategy will be used to identify trials published since 2000 in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINHAL. Telehealth is described as remote monitoring and delivery of care where patient data/clinical information is routinely or continuously collected and/or processed, presented to the patient and transferred to a clinical care institution for feedback, triage and intervention by a clinical specialist. Two authors will independently screen articles for inclusion, assess risk of bias and extract data. We will merge studies into a meta-analysis if the interventions, technologies, participants and underlying clinical questions are homogeneous enough. We will use a random-effects model, as we expect some heterogeneity between interventions. In cases where a meta-analysis is not possible, we will synthesise findings narratively. We will assess the quality of the evidence for the main outcomes using GRADE.

Ethics and Dissemination

Research ethics approval is not required. The findings will be disseminated through publication in a peer-reviewed journal.

PROSPERO registration number

CRD42018083671.
Cross-sectional analysis of sleep-promoting and wake-promoting drug use on health, fatigue-related error, and near-crashes in police officers
Authors: Ogeil Rowan P , Barger Laura K , Lockley Steven W , O’Brien Conor S , Sullivan Jason P , Qadri Salim , Lubman Dan I , Czeisler Charles A , Rajaratnam Shantha M W
Published: September 2018

Objectives

To examine sleep-promoting and wake-promoting drug use in police officers and associations between their use and health (excessive sleepiness, stress and burnout), performance (fatigue-related errors) and safety (near-crashes) outcomes, both alone and in combination with night-shift work.

Design

Cross-sectional survey.

Setting

Police officers from North America completed the survey either online or via paper/pencil at a police station.

Participants

4957 police participated, 3693 online (91.9%, participation rate) and 1264 onsite (cooperation rate 63.1%).

Main outcome measures

Sleep-promoting and wake-promoting drug use, excessive sleepiness, near-crash motor vehicle crashes, dozing while driving, fatigue errors, stress and burnout.

Results

Over the past month, 20% of police officers reported using sleep-promoting drugs and drugs causing sleepiness, while wake-promoting agents were used by 28% of police (5% used wake-promoting drugs, 23% used high levels of caffeine and 4% smoked to stay awake). Use of sleep-promoting drugs was associated with increased near-crashes (OR=1.61; 95% CI 1.21 to 2.13), fatigue-related errors (OR=1.75; 95% CI 1.32 to 2.79), higher stress (OR=1.41; 95% CI 1.10 to 1.82), and higher burnout (OR=1.83; 95% CI 1.40 to 2.38). Wake-promoting drug use, high caffeine and smoking to stay awake were associated with increased odds of a fatigue-related error, stress and burnout (ORs ranging from 1.68 to 2.56). Caffeine consumption was common, and while smoking was not, of those participants who did smoke, one-in-three did so to remain awake. Night-shift work was associated with independent increases in excessive sleepiness, near-crashes and fatigue-related errors. Interactions between night-shift work and wake-promoting drug use were also found for excessive sleepiness.

Conclusions

Police who use sleep-promoting and wake-promoting drugs, especially when working night shifts, are most vulnerable to adverse health, performance and safety outcomes. Future research should examine temporal relationships between shift work, drug use and adverse outcomes, in order to develop optimal alertness management strategies.
Comparison of high flow nasal cannula oxygen and conventional oxygen therapy on ventilatory support duration during acute-on-chronic respiratory failure: study protocol of a multicentre, randomised, controlled trial. The ‘HIGH-FLOW ACRF’ study
Authors: Ricard Jean-Damien , Dib Fadia , Esposito-Farese Marina , Messika Jonathan , Girault Christophe
Published: September 2018

Introduction

This study protocol describes a trial designed to investigate whether high-flow heated and humidified nasal oxygen (HFHO) therapy in patients with hypercapnic acute respiratory failure (ARF) reduces the need of non-invasive ventilation (NIV).

Methods and analysis

This is an open-label, superiority, international, parallel-group, multicentre randomised controlled two-arm trial, with an internal feasibility pilot phase. 242 patients with hypercapnic ARF requiring NIV admitted to an intensive care unit, an intermediate care or a respiratory care unit will be randomised in a 1:1 ratio to receive HFHO or standard oxygen in between NIV sessions. Randomisation will be centralised and stratified by centre and pH at admission (pH ≤7.25 or >7.25). The primary outcome will be the number of ventilator-free days (VFDs) and alive at day 28 postrandomisation. The secondary outcomes will encompass parameters related to the VFDs, comfort and tolerance variables, hospital length of stay and mortality. VFDs at 28 days postrandomisation will be compared between the two groups by Wilcoxon-Mann-Whitney two-sample rank-sum test in the intention-to-treat population. A sensitivity analysis will be conducted in the population of patients for whom the criteria of switching from NIV to spontaneous breathing, or conversely, are not strictly verified.

Ethics and dissemination

The protocol has been approved by theComité de Protection des Personnes(CPP)Sud-Ouest & Outre-Mer IV(ref CPP17-049a/2017-A01830-53) and will be carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. A trial steering committee will oversee the progress of the study. Findings will be disseminated through national and international scientific conferences, and publication in peer-reviewed journals.

Trial registration number

NCT03406572.
Patient safety and the ageing physician: a qualitative study of key stakeholder attitudes and experiences
Authors: White Andrew A , Sage William M , Osinska Paulina H , Salgaonkar Monica J , Gallagher Thomas H
Published: September 2018

Background

Unprecedented numbers of physicians are practicing past age 65. Unlike other safety-conscious industries, such as aviation, medicine lacks robust systems to ensure late-career physician (LCP) competence while promoting career longevity.

Objective

To describe the attitudes of key stakeholders about the oversight of LCPs and principles that might shape policy development.

Design

Thematic content analysis of interviews and focus groups.

Participants

40 representatives of stakeholder groups including state medical board leaders, institutional chief medical officers, senior physicians (>65 years old), patient advocates (patients or family members in advocacy roles), nurses and junior physicians. Participants represented a balanced sample from all US regions, surgical and non-surgical specialties, and both academic and non-academic institutions.

Results

Stakeholders describe lax professional self-regulation of LCPs and believe this represents an important unsolved challenge. Patient safety and attention to physician well-being emerged as key organising principles for policy development. Stakeholders believe that healthcare institutions rather than state or certifying boards should lead implementation of policies related to LCPs, yet expressed concerns about resistance by physicians and the ability of institutions to address politically complex medical staff challenges. Respondents recommended a coaching and professional development framework, with environmental changes, to maximise safety and career longevity of physicians as they age.

Conclusions

Key stakeholders express a desire for wider adoption of LCP standards, but foresee significant culture change and practical challenges ahead. Participants recommended that institutions lead this work, with support from regulatory stakeholders that endorse standards and create frameworks for policy adoption.
Dark angular momentum of the galaxy
Authors: Tartaglia Angelo
Published: September 2018

This paper proposes a strategy for detecting the presence of a gravito-magnetic field due to the rotation of the galactic dark halo. Visible matter in galaxies rotates and dark matter, supposed to form a halo incorporating baryonic matter, rotates also, since it interacts gravitationally with the rest. Pursuing the same line of reasoning, dark matter should produce all gravitational effects predicted by general relativity, including a gravito-magnetic field. I discuss a possible strategy for measuring that field. The idea recovers the old Sagnac effect and proposes to use a triangle having three Lagrange points of the Sun–Earth pair at its vertices. The asymmetry in the times of flight along the loop in opposite directions is proportional to the gravito-magnetic galactic field.
Media Cloud Service Scheduling Optimization for Resource-Intensive Mobile Application
Authors: Li Chunlin , Zhang Jing , Chen Yi
Published: September 2018

How to reduce energy consumption, improve resource utilization and put forward efficient resource management model so as to improve the media cloud performance and mobile users’ quality of service (QoS) is the problem needed to be addressed. Our proposed media cloud distributed scheduling model aims to maximize the utility of media cloud. The media cloud distributed scheduling policy for resource-intensive mobile application includes media service provisioning and cloud resource scheduling among media cloud datacenter. The media cloud service scheduling optimization algorithms include two sub-algorithms. The practical example of video streaming service for mobile users is also given. The experiments study the performance of media cloud distributed scheduling algorithm and related algorithms. The experiment results show that proposed algorithm has better performance than related algorithms.
Adjusted likelihood-ratio test for variants with unknown genotypes
Authors: Nowling Ronald J. , Emrich Scott J.
Published: September 2018

Association tests performed with the Likelihood-Ratio Test (LR Test) can be an alternative to [Formula: see text], which is often used in population genetics to find variants of interest. Because the LR Test has several properties that could make it preferable to [Formula: see text], we propose a novel approach for modeling unknown genotypes in highly-similar species. To show the effectiveness of this LR Test approach, we apply it to single-nucleotide polymorphisms (SNPs) associated with the recent speciation of the malaria vectors Anopheles gambiae and Anopheles coluzzii and compare to [Formula: see text].
Protein function prediction from protein–protein interaction network using gene ontology based neighborhood analysis and physico-chemical features
Authors: Saha Sovan , Prasad Abhimanyu , Chatterjee Piyali , Basu Subhadip , Nasipuri Mita
Published: September 2018

Protein Function Prediction from Protein–Protein Interaction Network (PPIN) and physico-chemical features using the Gene Ontology (GO) classification are indeed very useful for assigning biological or biochemical functions to a protein. They also lead to the identification of those significant proteins which are responsible for the generation of various diseases whose drugs are still yet to be discovered. So, the prediction of GO functional terms from PPIN and sequence is an important field of study. In this work, we have proposed a methodology, Multi Label Protein Function Prediction (ML_PFP) which is based on Neighborhood analysis empowered with physico-chemical features of constituent amino acids to predict the functional group of unannotated protein. A protein does not perform functions in isolation rather it performs functions in a group by interacting with others. So a protein is involved in many functions or, in other words, may be associated with multiple functional groups or labels or GO terms. Though functional group of other known interacting partner protein and its physico-chemical features provide useful information, assignment of multiple labels to unannotated protein is a very challenging task. Here, we have taken Homo sapiens or Human PPIN as well as Saccharomyces cerevisiae or yeast PPIN along with their GO terms to predict functional groups or GO terms of unannotated proteins. This work has become very challenging as both Human and Yeast protein dataset are voluminous and complex in nature and multi-label functional groups assignment has also added a new dimension to this challenge. Our algorithm has been observed to achieve a better performance in Cellular Function, Molecular Function and Biological Process of both yeast and human network when compared with the other existing state-of-the-art methodologies which will be discussed in detail in the results section.
Microwave absorption properties of magnetite multi-granule nanocluster–multiwall carbon nanotube composites
Authors: An Boo Hyun , Park Bum Chul , Kanagaraj Amarsingh Bhabu , Chaturvedi Prerna , Yassi Hamad Al , Park Jung-Rae , Kim Young Keun , Ryu Jong Eun , Sanduleanu Mihai , Choi Daniel Sunghoi
Published: September 2018

Fe3O4 multi-granule nanocluster–multiwall carbon nanotube composites for microwave absorbing applications are fabricated by the surface-engineered tape-casting method. The multi-granule nanoclusters are synthesized by a modified polyol hydrothermal method and characterized by transmission electron microscopy, X-ray diffraction and vibrating sample magnetometer. The complex permittivity and permeability of the composites with different granule size of nanoclusters are characterized in X-band range with the reflection method. The absorption peak of the composites are shifted from 11.1[Formula: see text]GHz to 11.51[Formula: see text]GHz as granule size increased from 18[Formula: see text]nm to 35[Formula: see text]nm.
Seneca sandstone: a heritage stone from the USA
Authors: Grissom Carol A. , Aloiz Emily M. , Vicenzi Edward P. , Livingston Richard A.
Published: September 2018

Seneca sandstone is a fine-grained arkosic sandstone of dark-red coloration used primarily during the nineteenth century in Washington, DC. Several inactive Seneca sandstone quarries are located along the Potomac River 34 km NW of Washington near Poolesville, Maryland. Seneca sandstone is from part of the Poolesville Member of the Upper Triassic Manassas Formation, which is in turn a Member of the Newark Supergroup that crops out in eastern North America. Its first major public use is associated with George Washington, the first president of the Potomac Company founded in 1785 to improve the navigability of the Potomac River, with the goal of opening transportation to the west for shipping. The subsequent Chesapeake and Ohio Canal built parallel to the river made major use of Seneca sandstone in its construction and then facilitated the stone's transport to the capital for the construction industry. The most significant building for which the stone was used is the Smithsonian Institution Building or ‘Castle’ (1847–55), the first building of the Smithsonian Institution and still its administrative centre. Many churches, school buildings and homes in the city were built wholly or partially with the stone during the ‘brown decades’ of the latter half of the nineteenth century.
Adaptive Metabolism in Staphylococci: Survival and Persistence in Environmental and Clinical Settings
Authors: Onyango Laura A. , Alreshidi Mousa M.
Published: September 2018

Staphylococci are highly successful at colonizing a variety of dynamic environments, both nonpathogenic and those of clinical importance, and comprise the list of pathogens of global public health significance. Their remarkable survival and persistence can be attributed to a host of strategies, one of which is metabolic versatility—their ability to rapidly alter their metabolism in the presence of transient or long-term bacteriostatic and bactericidal conditions and facilitate cellular homeostasis. These attributes contribute to their widespread dissemination and challenging eradication particularly from clinical settings. The study of microbial behaviour at the metabolite level provides insight into mechanisms of survival and persistence under defined environmental and clinical conditions. This paper reviews the range of metabolic modulations that facilitate staphylococcal acclimatization and persistence in varying terrestrial and host conditions, and their public health ramifications in these settings.
With or against Each Other? The Influence of a Virtual Agent’s (Non)cooperative Behavior on User’s Cooperation Behavior in the Prisoners’ Dilemma
Authors: Straßmann Carolin , Rosenthal-von der Pütten Astrid M. , Krämer Nicole C.
Published: September 2018

Most applications for virtual agents require the user to cooperate. Thus, it is helpful to investigate different strategies for virtual agents to evoke the user’s cooperation. In the present work (N = 80), we experimentally tested the influence of an agent’s (non)cooperative nonverbal behavior and actual decision-making behavior on user’s cooperation in the Prisoners’ Dilemma considering different age groups (students and seniors). Therefore, we used a 2 (nonverbal behavior) x 2 (age group) between-subjects design in Wizard-of-Oz study. Results show age differences with seniors cooperating more often than students do. The nonverbal behavior had no effect on the users’ willingness to cooperate nor on the evaluation of the agent’s cooperativeness. However, the agent’s decision-making behavior in the game influenced the users’ willingness to cooperate. In summary, the nonverbal behavior seemed to be too subtle, while the actions of the agent were important in terms of cooperation.
Prediction of Thin-Walled Areas of Unruptured Cerebral Aneurysms through Comparison of Normalized Hemodynamic Parameters and Intraoperative Images
Authors: Cho Kwang-Chun , Choi Ji Hun , Oh Je Hoon , Kim Yong Bae
Published: September 2018

Object. Rupture of a cerebral aneurysm occurs mainly in a thin-walled area (TWA). Prediction of TWAs would help to assess the risk of rupture and select appropriate treatment strategy. There are several limitations of current prediction techniques for TWAs. To predict TWAs more accurately, HP should be normalized to minimize the influence of analysis conditions, and the effectiveness of normalized, combined hemodynamic parameters (CHPs) should be investigated with help of the quantitative color analysis of intraoperative images. Methods. A total of 21 unruptured cerebral aneurysms in 19 patients were analyzed. A normalized CHP was newly suggested as a weighted average of normalized wall shear stress (WSS) and normalized oscillatory shear index (OSI). Delta E from International Commission on Illumination was used to more objectively quantify color differences in intraoperative images. Results. CFD analysis results indicated that WSS and OSI were more predictive of TWAs than pressure (P<.001, P=.187, P=.970, respectively); these two parameters were selected to define the normalized CHP. The normalized CHP became more statistically significant (P<.001) as the weighting factor of normalized WSS increased and that of normalized OSI decreased. Locations with high CHP values corresponded well to those with high Delta E values (P<.001). Predicted TWAs based on the normalized CHP showed a relatively good agreement with intraoperative images (17 in 21 cases, 81.0%). Conclusion. 100% weighting on the normalized WSS produced the most statistically significant result. The normalization scheme for WSS and OSI suggested in this work was validated using quantitative color analyses, rather than subjective judgments, of intraoperative images, and it might be clinically useful for predicting TWAs of unruptured cerebral aneurysms. The normalization scheme would also be integrated into further fluid-structure interaction analysis for more reliable estimation of the risk of aneurysm rupture.
Side-Chain Polyimides as Binder Polymers for Photolithographic Patterning of a Black Pixel Define Layer for Organic Light Emitting Diode
Authors: Shi Genggongwo , Park Sung Hoon , Kim Jeseob , Kim Minji , Park Lee Soon
Published: September 2018

A pixel define layer (PDL) in an organic light emitting diode (OLED) is patterned using a photolithographic process before the deposition of organic layers on top of ITO anode. If the patterning of PDL on OLED panels can be achieved using a black photoresist, the patterning of black matrix (BM) on top of PDL patterns can be omitted by reducing the reflection of ambient light from OLED panels. In this study, we synthesized a series of side-chain-type polyimides as binder polymers of black photoresists and investigated the potential of using the black photoresist for the fine patterning of black PDL on OLED panels.
Factors Associated with Management Outcome of Incomplete Abortion in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia
Authors: Gebretsadik Achamyelesh
Published: September 2018

Background. Each year, several millions of women who underwent abortion also bear several consequences, including infection, massive blood loss, chronic pelvic pain, infertility, and death. Poor treatment outcomes also cause disability and death. The aim of this study was to determine factors associated with management outcomes of incomplete abortion in Yirgalem General Hospital.Methods. Health facility-based cross-sectional study design was used. Medical record review of 186 women who received abortion service from July 1st2015 to June 30 2017 was done. Then the data were entered into the computer using epi info version 7.2 and exported into SPSS version 20, Descriptive analysis was done to determine social, demographic characteristics, and bivariate and multivariate logistic regression analysis were done to identify factors associated with management outcome of incomplete abortion, 95% CI and odds ratio used to present the result.Results. A total of 180 (96.7%) of cases managed for incomplete abortion was included in the study. Of this, 53.3% of patients with incomplete abortion belonged to age group of 18–25 years old. More than half incomplete abortion cases were managed surgically 122 (67.8%). Of the total, 36 (19.4%) of the patients developed unfavorable management outcome. Gestational age at which abortion occurs AOR = 3.39, 95% (1.29, 8.89) and delayed seeking of medical help AOR = 2.96, 95% (1.04, 8.4) were found to be significantly associated with unfavorable management outcome.Conclusion. High numbers of cases managed for abortion resulted unfavorable management outcome. However, no death occurred and major surgery done as the result of abortion management. Delayed seeking of medical care and seeking care past 1st trimester are significantly associated with unfavorable management outcomes. Therefore, awareness creation for adolescent and youth about prompt health-care seeking after the start of the first sign and symptom of spontaneous abortion should be strengthened.
Takotsubo Cardiomyopathy Associated with Polycythemia Vera
Authors: Basnet Sijan , Rajagopalan Priya , Dhital Rashmi , Tharu Biswaraj
Published: September 2018

Takotsubo cardiomyopathy is characterized by transient apical ballooning with preserved basal ventricular function triggered by physical or emotional stressors. We present a case of a 75-year-old man referred to our facility for the management of acute myocardial infarction later diagnosed as takotsubo cardiomyopathy. We believe platelet-mediated adrenaline release from massive thrombocytosis might have been the precipitating factor for the pathogenesis of takotsubo cardiomyopathy.
Assessing Cancer Risk Associated with Aquatic Polycyclic Aromatic Hydrocarbon Pollution Reveals Dietary Routes of Exposure and Vulnerable Populations
Authors: Gearhart-Serna Larisa M. , Jayasundara Nishad , Tacam Moises , Di Giulio Richard , Devi Gayathri R.
Published: September 2018

Polycyclic aromatic hydrocarbon (PAH) exposure is widespread, and many PAHs are considered carcinogenic. The PAH-contaminated AWI Superfund site in Virginia provides a model for studying a complex PAH mixture and its extrapolation to cancer risk and PAH exposure in the general population. We examined cancer risk at the Superfund site due to sediment-derived PAHs and then evaluated PAH sources in the general population and potentially vulnerable subpopulations upon PAH mixture exposure. The PAH mixture was assessed for potential carcinogenicity using the US EPA’s OncoLogic™ ranking tool and the US EPA list of priority PAHs. Cancer risk due to PAH exposure was calculated for Superfund site users and compared to the US EPA assessment. Human intake and health endpoints of PAHs within the mixture were extracted from USEtox® chemical fate database, while mean intake exposure was calculated for U.S. adults for select PAHs using NHANES database urinary biomarkers. Eleven PAH compounds within the mixture were of carcinogenic concern, and seven PAHs conveyed significant excess cancer risk at the Superfund site and in the general population, wherein PAH-contaminated seafood ingestion was a main contributor. Other dietary sources of PAHs derived from PAH-contaminated soil or water could also play a role in total exposure. Vulnerable populations to PAH exposure and coinciding increased cancer risk may include, in addition to smokers, children and non-Hispanic blacks, which is a public health concern.
Unsteady Aerodynamic Modeling Based on POD-ARX
Authors: Wang Xiaopeng , Zhang Chen’an , Liu Wen , Wang Famin , Ye Zhengyin
Published: September 2018

The lack of stability is a problem encountered when applying the classical POD-Galerkin method to problems of unsteady compressible flows around a moving structure. To solve this problem, a hybrid reduced-order model named POD-ARX is constructed in this paper. The construction of this model involves two steps, including first extracting the fluid modes with the POD technique and then identifying the modal coefficients with the ARX model. The POD modes with the block of all modified primitive variables are extracted from the system response to the training signal. Once the POD modes are obtained, the snapshots are projected on these modes to determine the time history of modal coefficients and the resulting modal coefficients are used to identify the parameters of ARX model. Then, the ARX model is used to predict the modal coefficients of the system response to the validation signal. Sample two-dimensional aerodynamic force calculations are conducted to demonstrate this method. Results show that this method can produce a stable and accurate prediction to the aerodynamic response with significant improvement of computational efficiency for linear and even some nonlinear aerodynamic problems. In addition, this method also shows good wide-band characteristics by using the “3211” multistep signal as the training signal.
Multilayered Equivalent Finite Element Method for Embedded Honeycomb Plates
Authors: Xu Yang , Wang Haohui , Sheng Xiaowei
Published: September 2018

To investigate the mechanical properties of embedded honeycomb plates with high efficiency and accuracy, a new multilayered equivalent finite element method (FEM) model is proposed. A series of FEM numerical studies (modal analysis, static analysis, and shock spectrum analysis) are performed. The goal is to compare the errors produced by the multilayered equivalent method and by existing equivalent approaches. The obtained results indicate that the proposed model shows good agreement with the original plate. Moreover, based on the new model, a parametric study correlating the microstructure parameters (embedded depth/cell size) to modal frequency is proposed, and a multiparameter equation for frequency and embedded depth/cell size is established to serve as a basis for structural optimization design.
Analysis of Large‐Strain Consolidation Behavior of Soil with High Water Content in Consideration of Self‐Weight
Authors: Cao Yupeng , Yang Jian , Xu Guizhong , Xu Jianwen
Published: September 2018

Based on the axisymmetric large‐strain consolidation (ALSC) model with the void ratio as the variable under equal strain condition, difference schemes of model’s equation, initial condition, and boundary condition were given. Taking phosphatic clay in Florida as a research object, the consolidation behaviors of soil with high water content by axisymmetric large‐strain theory and one‐dimensional large‐strain theory were analyzed. The effect of different kinds of consolidation theories and self‐weight stress on an average degree of consolidation was evaluated. The development of the void ratio and excess pore water pressure along the soil layer was clarified. The results show that the theoretical value of Terzaghi’s consolidation degree is always less than that of ALSC (Us, the average degree of consolidation defined by strain)‐vertical drainage in the consolidation process. Terzaghi’s solution overestimates the dissipation rate of excess pore water pressure during the earlier consolidation period but underestimates it during the later consolidation period. The degree of consolidation calculated by Hansbo develops faster than ALSC (Up, the average degree of consolidation defined by stress)‐radial drainage, but slower than ALSC (Us)‐radial drainage. In the ALSC model, Us is always been faster than Up. The effect of self‐weight on the consolidation degree of axisymmetric large‐strain consolidation theory is relatively small (maximum error is less than 16%), while it can accelerate the consolidation rate of soil in one‐dimensional large‐strain consolidation theory largely. When only the vertical drainage occurs, the consolidation rate in the middle of the soil is obviously lagging the upper and lower parts, while the radial drainage can reduce the void ratio and the excess pore water pressure along the soil layer uniformly and more rapidly.
Study on the Biological Effects of Oligochitosan Fractions, Prepared by Synergistic Degradation Method, on Capsicum
Authors: Dung Pham Dinh , Hung Le Thanh , Le Truc Ha Tran , Luan Le Quang , Van Le Bui , Thang Nguyen Tien
Published: September 2018

Chitosan with an initial molecular weight (Mw) of approximately 193 kDa was degraded into about 11.4 and 14.8 kDa by γ-ray irradiation of the solution containing 5% chitosan in 0.2 M acetic acid at 75 kGy and the solution of 5% chitosan in 0.2 M acetic acid supplemented with 1% H2O2 at 10 kGy, respectively. The synergistic degraded chitosan sample with Mw ~14.8 kDa was separated into 5 fractions by using ultrafiltration membranes. The analysis results from UV, FTIR, and NMR spectra indicated that the combined treatment of low irradiation dose and low H2O2 concentration did not cause any change in the molecular structure of degraded chitosan fractions. Separated chitosan fractions with Mw > 1 kDa inhibited the growth of Colletotrichum capsici in vitro. While all separated chitosan fractions remarkably enhanced fresh biomass (11–56%) and chlorophyll content (20–92%) of capsicum seedlings. In the field test, the treatment with oligochitosan fractions with Mw in a range of 1–3 kDa (F2) to 3–10 kDa (F3) gained 9.0–11.4% of the fruit yield and reduced 64.8–67.2% of the rate of anthracnose disease outbreak fruits caused by C. capsici. Thus, the F2 and F3 fractions in degraded chitosan product are the key fractions for the enhancement of both the growth promotion effect and defense respond activity against the infection of pathogenic Colletotrichum fungi causing anthracnose disease in capsicum.
Infinitely Many Trees with Maximum Number of Holes Zero, One, and Two
Authors: Kola Srinivasa Rao , Gudla Balakrishna , Niranjan P. K.
Published: September 2018

An L(2,1)-coloring of a simple connected graph G is an assignment f of nonnegative integers to the vertices of G such that fu-fv⩾2 if d(u,v)=1 and fu-fv⩾1 if d(u,v)=2 for all u,v∈V(G), where d(u,v) denotes the distance between u and v in G. The span of f is the maximum color assigned by f. The span of a graph G, denoted by λ(G), is the minimum of span over all L(2,1)-colorings on G. An L(2,1)-coloring of G with span λ(G) is called a span coloring of G. An L(2,1)-coloring f is said to be irreducible if there exists no L(2,1)-coloring g such that g(u)⩽f(u) for all u∈V(G) and g(v)<f(v) for some v∈V(G). If f is an L(2,1)-coloring with span k, then h∈0,1,2,…,k is a hole if there is no v∈V(G) such that f(v)=h. The maximum number of holes over all irreducible span colorings of G is denoted by Hλ(G). A tree T with maximum degree Δ having span Δ+1 is referred to as Type-I tree; otherwise it is Type-II. In this paper, we give a method to construct infinitely many trees with at least one hole from a one-hole tree and infinitely many two-hole trees from a two-hole tree. Also, using the method, we construct infinitely many Type-II trees with maximum number of holes one and two. Further, we give a sufficient condition for a Type-II tree with maximum number of holes zero.
Endosonographic Findings and the Natural Course of Chronic Gastric Anisakiasis: A Single-Center Experience
Authors: Park Eun Young , Baek Dong Hoon , Kim Gwang Ha , Lee Bong Eun , Lee So-Jeong , Park Do Youn
Published: September 2018

Background. Chronic gastric anisakiasis is a rare, usually asymptomatic, and difficult to diagnose infection incidentally discovered during endoscopy, resembling a subepithelial tumor (SET). Because its endoscopic ultrasonography (EUS) findings are not established, it is occasionally misdiagnosed as gastrointestinal mesenchymal tumors and removed by endoscopic or surgical resection. We aimed to assess the characteristic EUS findings of chronic gastric anisakiasis and the clinical course during follow-up. Methods. The database of all patients who underwent EUS at Pusan National University Hospital (Busan, Korea) between January 2011 and December 2016 was retrospectively analyzed. A total of 28 SET cases with EUS features suggesting chronic gastric anisakiasis were included in the study. The EUS, histopathologic, and follow-up endoscopic features were analyzed. Results. On EUS, the lesions were mainly located in the submucosal and/or propria muscle layers. Twenty-seven lesions (27/28, 96%) showed hypoechoic echogenicity, and 22 lesions (22/28, 79%) were heterogeneous. Hyperechoic tubular structures suggesting denaturalized Anisakidae larvae were seen in 22 lesions (22/28, 79%). Endoscopic biopsies revealed significant eosinophil infiltration (≥30 per high-power field) in 12 lesions (12/21, 57%). During the median follow-up period of 9 months (range, 1–55 months), SETs decreased or subsided in 26 lesions (26/28, 93%) with no change in the size of the two lesions (2/28, 7%). Conclusions. Chronic gastric anisakiasis, although rare, should be included in the differential diagnoses for gastric SETs, especially in regions where raw fish is widely consumed. EUS findings suggesting chronic gastric anisakiasis are heterogeneously hypoechoic lesions with hyperechoic tubular structures, mainly in the submucosal and/or muscularis propria layers. Because chronic gastric anisakiasis decreases or subsides in most cases, follow-up endoscopy 6–12 months later is recommended.
Effect of Wing-Wing Interaction on the Propulsive Performance of Two Flapping Wings at Biplane Configuration
Authors: Zhu Jianyang , Lei Bin
Published: September 2018

The biplane counter-flapping wing is a special type of wing flapping which is inspired from the fish and insect in nature. The propulsive performance is one of the most important considerations for this kind of flapping wing. This paper is aimed at providing a systematic synthesis on the propulsive characteristics of two flapping wings at biplane configuration based on the numerical analysis approach. Firstly, parameters of this special flapping wing are presented. Secondly, the numerical method for simultaneously solving the incompressible flow and counter-flapping motion of the wing is illustrated, and the method is then validated. Thirdly, the effects of phase angle and mean wing spacing on the propulsive characteristics of the biplane counter-flapping wing are analyzed. Finally, the quantification effects of the phase angle and mean wing spacing on the propulsive characteristics of the biplane counter-flapping wing can be obtained. The analysis results in this study will provide useful guidelines to design an effectively propulsive system applying for the flapping micro air or underwater vehicle.
Fault-Tolerant Optical Flow Sensor/SINS Integrated Navigation Scheme for MAV in a GPS-Denied Environment
Authors: Chen Zhongyuan , Chen Wanchun , Liu Xiaoming , Song Chuang
Published: September 2018

An integrated navigation scheme based on multiple optical flow sensors and a strapdown inertial navigation system (SINS) are presented, instead of the global position system (GPS) aided. Multiple optical flow sensors are mounted on a micro air vehicle (MAV) at different positions with different viewing directions for detecting optical flow around the MAV. A fault-tolerant decentralized extended Kalman filter (EKF) is performed for estimating navigation errors by fusing the inertial and optical flow measurements, which can prevent the estimation divergence caused by the failure of the optical flow sensor. Then, the estimation of navigation error is inputted into the SINS settlement process for correcting the SINS measurements. The results verify that the navigation errors of SINS can be effectively reduced (even more than 9/10). Moreover, although the sensor is in a state of failure for 400 seconds, the fault-tolerant integrated navigation system can still work properly without divergence.
Alexithymia, Ego-Dystonicity, and Obsessive-Compulsive Symptoms: A Path Modeling Analysis
Authors: Wu Chao , Shi Chuan , Dong Wentian , Li Bing , Wu Rengang
Published: September 2018

Aims: This cross-sectional study aimed to test the path relations between alexithymia, ego-dystonicity, anxiety, depression and obsessive-compulsive (OC) symptoms in obsessive-compulsive disorder (OCD) and healthy individuals. Methods: Fifty-eight patients with OCD (mean age 35.5 years) and 54 healthy participants (mean age 33.5 years) completed an assessment via a structured clinical interview. All of them completed the Toronto Alexithymia Scale (TAS-20), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Self-Consistency and Congruence Scale (SCCS), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The data were analyzed using partial least squares structural equation modeling (PLS-SEM). Results: In the OCD patients, alexithymia (a linear combination of difficulty identifying and describing emotions in the self) was associated with the OC symptoms either with or without the presence of ego-dystonicity (a profile of self-inconsistency and self-stereotype). In the heathy participants, alexithymia was associated with the OC symptoms only through ego-dystonic experiences. Conclusion: This study provides evidence that ego-dystonicity partially affects the association between alexithymia and obsessive-compulsions. Alexithymia and ego-dystonicity have a synergistic effect on the symptoms of OCD. Alexithymia in healthy participants associates to the OC symptoms only through ego-dystonicity. Targeting ego-dystonicity dimensions in psychotherapy would help improve the symptoms of OCD.