bluuebunny/crossref_metadata_2025 huggingface dataset:
Unnecessary antibiotic prescribing in children hospitalised for asthma exacerbation: a retrospective national cohort study
Authors: Jewell Marcella J , Leyenaar JoAnna , Shieh Meng-Shiou , Pekow Penelope S , Stefan Mihaela , Lindenauer Peter K
Published: May 2020

Background

Antibiotic resistance represents a worldwide public health threat. Characterising prescribing patterns for conditions for which antibiotics have no role can inform antimicrobial stewardship efforts. Asthma is among the most common non-infectious diseases in children and results in 100 000 hospitalisations annually in the USA. We sought to identify the rate of antibiotic prescribing in children hospitalised for asthma exacerbations, and to characterise patient and hospital factors associated with receipt of antibiotics.

Methods

Children and adolescents aged 2–17 years admitted to hospital between 1 October 2015 and 30 June 2018 with an asthma exacerbation were identified from the Premier Alliance Database. After excluding hospitalisations for which antibiotics appeared to have been justified, we assessed receipt and duration of antibiotic treatments during the hospital stay. We developed a hierarchical logistic regression model to identify patient and hospital factors associated with antibiotic treatment. For each hospital with at least 10 asthma cases we computed the percentage of cases receiving antibiotic treatment.

Results

23 129 hospital stays met inclusion criteria; in 3329 (14%) of these, antibiotics were prescribed without clear indication. Hospital prescribing rates varied widely (range 0%–95%), with 25% of hospitals prescribing antibiotics at a rate of 27.5% or more. Patient factors most strongly associated with receipt of antibiotics included the presence of a complex chronic condition (OR: 2.4, 95% CI 2.1 to 2.9; p<0.0001) and admission to the intensive care unit compared with a general medical-surgical bed (OR: 1.6, 95% CI 1.5 to 1.9; p<0.0001). Hospitalisation at general hospitals with minimum paediatric specialty support conferred a nearly threefold higher odds of antibiotic treatment (OR: 2.9, 95% CI 1.5 to 5.6; p<0.0001).

Conclusions

These findings illustrate an opportunity to reduce unnecessary exposure to antibiotics in children hospitalised with asthma, particularly in general hospitals where three-quarters of children in the USA receive their hospital-based care.
Evaluation of two simulation methods for teaching a disaster skill
Authors: Smith Sherrill , Farra Sharon L , Hodgson Eric
Published: May 2020

Introduction

With increasing use of virtual reality simulation (VRS) in nursing
education, there is a paucity of research exploring learning outcomes following
training with VRS as compared with traditional mannequin-based simulation.
Given the resource intensive nature of mannequin-based simulation, especially
for disaster education, understanding outcomes from newer technologies like VRS
are needed.

Methods

A quasi-experimental design was used to examine the differences in
learning outcomes for the disaster skill of decontamination, based on type of
simulation. The study was framed by the National Leage for Nursing (NLN)
Jeffries Simulation Theory, with participant outcomes identified by the
framework (satisfaction, self-confidence and performance). Outcomes were
measured using the NLN Student Satisfaction and Self­ Confidence in Learning
scale and a Decontamination Checklist. Senior nursing students in the final
semester of a baccalaureate nursing programme were recruited to participate
during one of their scheduled laboratory days. Following a didactic
presentation, students were randomly assigned to one of two treatment groups
(VRS or mannequin-based simulation training) to learn the skill of
decontamination.

Results

A total of 121 participants took part in the study. No statistically
significant results were noted for any of the study outcomes: performance
(accuracy and time), satisfaction and self-efficacy. Results of the study
demonstrate that VRS is as effective as mannequin-based simulation in training
participants for the skill of decontamination.

Conclusions

Simulation-based education experiences must be matched to learning
outcomes and evaluated for effectiveness. As evidence emerges regarding use of
newer technologies, like VRS, educators will have more options for providing
students with opportunities that best match available resources.
What is the meaning of health literacy? A systematic review and qualitative synthesis
Authors: Liu Chenxi , Wang Dan , Liu Chaojie , Jiang Junnan , Wang Xuemei , Chen Haihong , Ju Xin , Zhang Xinping
Published: May 2020

The objective of this review was to clarify what health literacy represents. A systematic review with qualitative syntheses was performed (CRD42017065149). Studies concerning health literacy in all settings were included. Studies before 15 March 2017 were identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the Cochrane Library. The included literature either had defined the concept of health literacy or made a detailed explanation of health literacy. A total of 34 original studies met the inclusion criteria, including 13 involved in previous systematic reviews and 21 new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of skills or a hierarchy of functions (functional-interactive-critical). The construct of health literacy covers three broad elements: (1) knowledge of health, healthcare and health systems; (2) processing and using information in various formats in relation to health and healthcare; and (3) ability to maintain health through self-management and working in partnerships with health providers. Health literacy is defined as the ability of an individual to obtain and translate knowledge and information in order to maintain and improve health in a way that is appropriate to the individual and system contexts. This definition highlights the diversity of needs from different individuals and the importance of interactions between individual consumers, healthcare providers and healthcare systems.
Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting
Authors: Koo Chieh Yang , Aung Aye-Thandar , Chen Zhengfeng , Kristanto William , Sim Hui-Wen , Tam Wilson W , Gochuico Carlo F , Tan Kent Anthony , Kang Giap-Swee , Sorokin Vitaly , Ong Paul Jau Lueng , Kojodjojo Pipin , Richards Arthur Mark , Tan Huay-Cheem , Kofidis Theodoros , Lee Chi-Hang
Published: May 2020

Objective

Patients with advanced coronary artery disease are referred for coronary artery bypass grafting (CABG) and it remains unknown if sleep apnoea is a risk marker. We evaluated the association between sleep apnoea and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing non-emergent CABG.

Methods

This was a prospective cohort study conducted between November 2013 and December 2018. Patients from four public hospitals referred to a tertiary cardiac centre for non-emergent CABG were recruited for an overnight sleep study using a wrist-worn Watch-PAT 200 device prior to CABG.

Results

Among the 1007 patients who completed the study, sleep apnoea (defined as apnoea-hypopnoea index ≥15 events per hour) was diagnosed in 513 patients (50.9%). Over a mean follow-up period of 2.1 years, 124 patients experienced the four-component MACCE (2-year cumulative incidence estimate, 11.3%). There was a total of 33 cardiac deaths (2.5%), 42 non-fatal myocardial infarctions (3.7%), 50 non-fatal strokes (4.9%) and 36 unplanned revascularisations (3.2%). The crude incidence of MACCE was higher in the sleep apnoea group than the non-sleep apnoea group (2-year estimate, 14.7% vs 7.8%; p=0.002). Sleep apnoea predicted the incidence of MACCE in unadjusted Cox regression analysis (HR 1.69; 95% CI 1.18 to 2.43), and remained statistically significant (adjusted HR 1.57; 95% CI 1.09 to 2.25), after adjustment for age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, hypertension, chronic kidney disease and excessive daytime sleepiness.

Conclusion

Sleep apnoea is independently associated with increased MACCE in patients undergoing CABG.

Trial registration number

NCT02701504
The Society for Immunotherapy of Cancer statement on best practices for multiplex immunohistochemistry (IHC) and immunofluorescence (IF) staining and validation
Authors: Taube Janis M , Akturk Guray , Angelo Michael , Engle Elizabeth L , Gnjatic Sacha , Greenbaum Shirley , Greenwald Noah F , Hedvat Cyrus V , Hollmann Travis J , Juco Jonathan , Parra Edwin R , Rebelatto Marlon C , Rimm David L , Rodriguez-Canales Jaime , Schalper Kurt A , Stack Edward C , Ferreira Cláudia S , Korski Konstanty , Lako Ana , Rodig Scott J , Schenck Emanuel , Steele Keith E , Surace Michael J , Tetzlaff Michael T , von Loga Katharina , Wistuba Ignacio I , Bifulco Carlo B
Published: May 2020

Objectives

The interaction between the immune system and tumor cells is an important feature for the prognosis and treatment of cancer. Multiplex immunohistochemistry (mIHC) and multiplex immunofluorescence (mIF) analyses are emerging technologies that can be used to help quantify immune cell subsets, their functional state, and their spatial arrangement within the tumor microenvironment.

Methods

The Society for Immunotherapy of Cancer (SITC) convened a task force of pathologists and laboratory leaders from academic centers as well as experts from pharmaceutical and diagnostic companies to develop best practice guidelines for the optimization and validation of mIHC/mIF assays across platforms.

Results

Representative outputs and the advantages and disadvantages of mIHC/mIF approaches, such as multiplexed chromogenic IHC, multiplexed immunohistochemical consecutive staining on single slide, mIF (including multispectral approaches), tissue-based mass spectrometry, and digital spatial profiling are discussed.

Conclusions

mIHC/mIF technologies are becoming standard tools for biomarker studies and are likely to enter routine clinical practice in the near future. Careful assay optimization and validation will help ensure outputs are robust and comparable across laboratories as well as potentially across mIHC/mIF platforms. Quantitative image analysis of mIHC/mIF output and data management considerations will be addressed in a complementary manuscript from this task force.
The COVID-19 pandemic: resilient organisational response to a low-chance, high-impact event
Authors: Lloyd-Smith McKenzie
Published: May 2020

The global healthcare sector is currently in the midst of the COVID-19 pandemic, a ‘low-chance, high-impact’ event which will require healthcare systems, and the organisations within them, to maintain organisational resilience in order to respond effectively. However, contrary to the instinctive reaction to tighten control, the quality of response depends on healthcare systems’ capacity to loosen control and, subsequently, enhance improvisation. Three factors critical to enhancing an organisation’s capacity for improvisation are highlighted; increasing autonomy, maintaining structure and creating a shared understanding. By drawing on the case of Christchurch Hospital’s response to a major earthquake, this paper demonstrates the vital role that improvisation can play within a clinical setting, when responding to a low-chance, high-impact event.
Dual antiplatelet therapy after carotid artery stenting: trends and outcomes in a large national database
Authors: Sussman Eric S , Jin Michael , Pendharkar Arjun V , Pulli Benjamin , Feng Austin , Heit Jeremy J , Telischak Nicholas A
Published: May 2020

Background

While dual antiplatelet therapy (dAPT) is standard of care following carotid artery stenting (CAS), the optimal dAPT regimen and duration has not been established.

Methods

We canvassed a large national database (IBM MarketScan) to identify patients receiving carotid endarterectomy (CEA) or CAS for treatment of ischemic stroke or carotid artery stenosis from 2007 to 2016. We performed univariable and multivariable regression methods to evaluate the impact of covariates on post-CAS stroke-free survival, including post-discharge antiplatelet therapy.

Results

A total of 79 084 patients diagnosed with ischemic stroke or carotid stenosis received CEA (71 178; 90.0%) or CAS (7906; 10.0%). After adjusting for covariates, <180 days prescribed post-CAS P2Y12-inhibition was associated with increased risk for stroke (<90 prescribed days HR=1.421, 95% CI 1.038 to 1.946; 90–179 prescribed days HR=1.484, 95% CI 1.045 to 2.106). The incidence of hemorrhagic complications was higher during the period of prescribed P2Y12-inhibition (1.16% per person-month vs 0.49% per person-month after discontinuation, P<0.001). The rate of extracranial hemorrhage was nearly six-fold higher while on dAPT (6.50% per patient-month vs 1.16% per patient-month, P<0.001), and there was a trend towards higher rate of intracranial hemorrhage that did not reach statistical significance (5.09% per patient-month vs 3.69% per patient-month, P=0.0556). Later hemorrhagic events beyond 30 days post-CAS were significantly more likely to be extracranial (P=0.028).

Conclusions

Increased duration of post-CAS dAPT is associated with lower rates of readmissions for stroke, and with increased risk of hemorrhagic complications, particularly extracranial hemorrhage. The potential benefit of prolonging dAPT with regard to ischemic complications must be balanced with the corresponding increased risk of predominantly extracranial hemorrhagic complications.
Is Madagascar at the edge of a generalised HIV epidemic? Situational analysis
Authors: Raberahona Mihaja , Monge François , Andrianiaina Rijasoa Harivelo , Randria Mamy Jean de Dieu , Ratefiharimanana Andosoa , Rakatoarivelo Rivo Andry , Randrianary Lanto , Randriamilahatra Emma , Rakotobe Liva , Mattern Chiarella , Andriananja Volatiana , Rajaonarison Hobimahanina , Randrianarisoa Mirella , Rakotomanana Elliott , Pourette Dolorès , Andriamahenina Hery Zo , Dezé Charlotte , Boukli Narjis , Baril Laurence , Vallès Xavier
Published: May 2020

Objectives

To describe the epidemiological situation of the HIV/AIDS epidemic and to identify the main drivers for vulnerability in Madagascar.

Design

Literature review, qualitative research and situational analysis.

Data sources

Search of electronic bibliographic databases, national repositories of documentation from 1998 to 2018. Search keywords included Madagascar, HIV, sexually transmitted infections, men who have sex with men (MSM), sex workers (SWs), transactional sex (TS), injecting drug users (IDUs), vulnerability and sexual behaviour. Qualitative sources were interviews and focus group discussions.

Review methods

Studies focused on HIV and/or vulnerability of HIV in Madagascar in general, and key populations (KPs) and HIV/AIDS response were taken into account. National reports from key HIV response actors were included.

Results

Madagascar is characterised by a low HIV/AIDS epidemic profile in the general population (GP) (0.3%) combined with a high prevalence of HIV among KPs (SWs, MSM and IDUs).

An increase in HIV prevalence among KP has been observed during recent years. Hospital-based data suggest an increase in HIV prevalence among the GP. The vulnerability traits are inconsistent use of condoms, multipartner relationships and other contextual factors like widespread TS and gender inequality. A high prevalence/incidence of sexually transmitted infections could indicate a high vulnerability to HIV/AIDS. However, there are no reports of HIV prevalence of >1% in antenatal consultation.

Conclusion

There is not enough evidence to make a conclusion about the HIV epidemiological situation in Madagascar due to the scarcity of the epidemiological data. However, Madagascar may be closer to a turning point towards a high-prevalence epidemic with severe consequences, particularly when taking into account its socioeconomical fragility and underlying vulnerabilities. More precise epidemiological data and improved HIV/AIDS diagnosis and case management should be a public health priority.
How are vets finding solace in nature?
Authors: Higham Laura
Published: May 2020

The Covid‐19 lockdown is taking its toll on individuals, families, communities and businesses across the world. But, as founder and coordinator of Vet Sustain Laura Higham explains, we can all find consolation in nature during these testing times.
Yrast band in the heavy N = Z nucleus $$^{88}$$Ru: $$\alpha $$-cluster approach
Authors: Mohr Peter
Published: May 2020

The yrast band in the heavy $$N = Z$$

N
=
Z

nucleus $$^{88}$$

88

Ru is studied in the framework of the $$\alpha $$
α
-cluster model in combination with double-folding potentials. It is found that the excitation energies of the yrast band in $$^{88}$$

88

Ru can be nicely described within the $$\alpha $$
α
-cluster approach using a smooth and mildly L-dependent adjustment of the potential strength. This result is similar to well-established $$\alpha $$
α
-cluster states in nuclei with a (magic core $$\otimes $$
⊗
$$\alpha $$
α
) structure. Contrary, the yrast bands in neighboring $$N \ne Z$$

N
≠
Z

nuclei deviate from such a typical $$\alpha $$
α
-cluster behavior. Finally, the $$\alpha $$
α
-cluster model predicts reduced transition strengths of about 10 Weisskopf units for intraband transitions between low-lying states in the yrast band of $$^{88}$$

88

Ru.
Investigation of the Higgs boson anomalous FCNC interactions in the simple 3-3-1 model
Authors: Huong D. T. , Duy N. T.
Published: May 2020

We study phenomenological constraints on the simple 3-3-1 model with flavor-violating Yukawa couplings. Both Higgs triplets couple to leptons and quarks, which generates flavor-violating signals in both lepton and quark sectors. We have shown that this model allows for a large Higgs lepton flavor-violating rate decay$$h \rightarrow \mu \tau $$h→μτand also may reach perfect agreement with other experimental constraints such as$$\tau \rightarrow \mu \gamma $$τ→μγand$$(g-2)_\mu $$(g-2)μ. The contributions of flavor-changing neutral current couplings, Higgs–quark–quark couplings, mixing to the mesons are investigated. Br$$(h \rightarrow q q^\prime )$$(h→qq′)can be enhanced acknowledging the measurements of meson mixing. The branching ratio for$$t \rightarrow q h$$t→qhcan reach up to$$10^{-3}$$10-3, but it could be as low as$$10^{-8}$$10-8.
An implicit function theorem for sprays and applications to Oka theory
Authors: Kusakabe Yuta
Published: May 2020

We solve fundamental problems in Oka theory by establishing an implicit function theorem for sprays. As the first application of our implicit function theorem, we obtain an elementary proof of the fact that approximation yields interpolation. This proof and Lárusson’s elementary proof of the converse give an elementary proof of the equivalence between approximation and interpolation. The second application concerns the Oka property of a blowup. We prove that the blowup of an algebraically Oka manifold along a smooth algebraic center is Oka. In the appendix, equivariantly Oka manifolds are characterized by the equivariant version of Gromov’s condition [Formula: see text], and the equivariant localization principle is also given.
Mean field equations on a closed Riemannian surface with the action of an isometric group
Authors: Yang Yunyan , Zhu Xiaobao
Published: May 2020

Let [Formula: see text] be a closed Riemannian surface, [Formula: see text] be an isometric group acting on it. Denote a positive integer [Formula: see text], where [Formula: see text] is the number of all distinct points of the set [Formula: see text]. A sufficient condition for existence of solutions to the mean field equation [Formula: see text] is given. This recovers results of Ding–Jost–Li–Wang, Asian J. Math. (1997) 230–248 when [Formula: see text] or equivalently [Formula: see text], where Id is the identity map.
Acupuncture for Pain Management: Molecular Mechanisms of Action
Authors: Chen Teng , Zhang Wen Wen , Chu Yu-Xia , Wang Yan-Qing
Published: May 2020

Acupuncture reduces pain by activating specific areas called acupoints on the patient’s body. When these acupoints are fully activated, sensations of soreness, numbness, fullness, or heaviness called De qi or Te qi are felt by clinicians and patients. There are two kinds of acupuncture, manual acupuncture and electroacupuncture (EA). Compared with non-acupoints, acupoints are easily activated on the basis of their special composition of blood vessels, mast cells, and nerve fibers that mediate the acupuncture signals. In the spinal cord, EA can inhibit glial cell activation by down-regulating the chemokine CX3CL1 and increasing the anti-inflammatory cytokine interleukin-10. This inhibits P38 mitogen-activated protein kinase and extracellular signal-regulated kinase pathways, which are associated with microglial activation of the C-Jun N-terminal kinase signaling pathway and subsequent astrocyte activation. The inactivation of spinal microglia and astrocytes mediates the immediate and long-term analgesic effects of EA, respectively. A variety of pain-related substances released by glial cells such as the proinflammatory cytokines tumor necrosis factor [Formula: see text], interleukin-1[Formula: see text], interleukin-6, and prostaglandins such as prostaglandins E2 can also be reduced. The descending pain modulation system in the brain, including the anterior cingulated cortex, the periaqueductal gray, and the rostral ventromedial medulla, plays an important role in EA analgesia. Multiple transmitters and modulators, including endogenous opioids, cholecystokinin octapeptide, 5-hydroxytryptamine, glutamate, noradrenalin, dopamine, [Formula: see text]-aminobutyric acid, acetylcholine, and orexin A, are involved in acupuncture analgesia. Finally, the “Acupuncture [Formula: see text]” strategy is introduced to help clinicians achieve better analgesic effects, and a newly reported acupuncture method called acupoint catgut embedding, which injects sutures made of absorbable materials at acupoints to achieve long-term effects, is discussed.
Link crossing number is NP-hard
Authors: de Mesmay Arnaud , Schaefer Marcus , Sedgwick Eric
Published: May 2020

We show that determining the crossing number of a link is NP-hard. For some weaker notions of link equivalence, we also show NP-completeness.
Stability of Vibrating Functionally Graded Nanoplates with Axial Motion Based on the Nonlocal Strain Gradient Theory
Authors: Shen J. P. , Wang P. Y. , Gan W. T. , Li C.
Published: May 2020

Considering both the nonlocal scale and material length scale effects, we investigate vibration and stability behaviors of functionally graded nanoplates with axial motion in order to model the two-dimensional nanobelt in nanoengineering. The nonlocal strain gradient theory is applied and the differential nonlocal strain gradient constitutive relation is adopted. Using the physical neutral plane of a functionally graded thin plate, we derive the governing equation of motion for the functionally graded nanoplate with axial motion via Hamilton’s principle, where the kinematic characteristics are introduced into the dynamic behaviors. The governing equation is numerically solved using the Galerkin method. Effects of the nonlocal scale and material length scale parameters, axial velocity, gradient index, biaxial pre-tensions and aspect ratio are discussed. The results demonstrate that complex frequencies of the functionally graded nanoplate with axial motion decrease with an increase of axial velocity in the subcritical region, while the moving nanoplate experiences a divergent instability or flutter instability in the supercritical region. Natural frequency and critical speed decrease with the increase of the nonlocal scale parameter while increase with the increase of the material length scale parameter, reflecting the nonlocal softening and strain gradient hardening mechanisms, respectively. Besides, natural frequency and critical speed increase with the increase of the biaxial pre-tensions and aspect ratio, but decrease with the increase of the gradient index. In particular, the influences of the gradient index and size or weight of functionally graded nanoplates on the critical speed are explored.
Variable spot size optical system for a dual-wavelength laser therapy device
Authors: Dong Ningning , Cui Jinjiang , Xu Jiangen
Published: May 2020

The majority of existing high-power laser therapeutic instruments employ a single wavelength for a single target; thus, they do not meet the requirements for clinical treatment. Therefore, this study designs an optical system for a dual-wavelength high-power laser therapeutic device with a variable spot size. The waist of the short arm of the optical cavity and the G1G2 parameter (G-parameter equivalent cavity method) is calculated using MATLAB software, the spot size and divergence angle on the lens are calculated using an ABCD matrix, and the distance between the treatment spot at different spot sizes and the transformation lens is calculated in order to design the treatment handpiece. Experiments are conducted to analyze the stability at an output power of 532 nm before beam combination and the power loss after beam combination. The results show that the output power stability of the 532-nm beam varies by less than 2% over 150 min, and the loss of both wavelengths is less than 20%, which meets the clinical requirements of the system. The safety performance can meet the requirements of national general standards for medical electrical safety. The proposed dual-wavelength laser therapy instrument has both visible wave and near-infrared wave characteristics; thus, it can accurately target both superficial vessels and vessels with a larger diameter and deeper position. This therapeutic device has the advantages of simple operation, stable and reliable laser output, high security and strong anti-interference ability, and meets the comprehensive clinical treatment demands of vascular diseases.
Vertex irregular reflexive labeling of disjoint union of gear and book graphs
Authors: Alfarisi Ridho , Ryan Joe , Siddiqui Muhammad Kamran , Dafik  , Agustin Ika Hesti
Published: May 2020

We define [Formula: see text] and [Formula: see text] for [Formula: see text], where [Formula: see text]. The labeling [Formula: see text] is called a vertex irregular reflexive [Formula: see text]-labeling if any vertices have distinct weight which [Formula: see text] for any vertices in a graph [Formula: see text]. The weight of a vertex [Formula: see text] is defined as the sum of the labels of vertex and the labels of all edges incident this vertex. The smallest [Formula: see text] for which such labeling exists is called reflexive vertex strength of [Formula: see text], denoted by [Formula: see text]. In this paper, we determine the reflexive vertex strength of gear graphs, book graphs, triangular book graph and the disjoint union of gear graphs.
Bat-Grey Wolf Optimizer and kernel mapping for automatic incremental clustering
Authors: Vidyadhari C. , Sandhya N. , Premchand P.
Published: May 2020

The technical advancement in information systems contributes towards the massive availability of the documents stored in the electronic databases such as e-mails, internet and web pages. Therefore, it becomes a complex task for arranging and browsing the required document. This paper proposes an approach for incremental clustering using the Bat-Grey Wolf Optimizer (BAGWO). The input documents are initially subjected to the pre-processing module to obtain useful keywords, and then the feature extraction is performed based on wordnet features. After feature extraction, feature selection is carried out using entropy function. Subsequently, the clustering is done using the proposed BAGWO algorithm. The BAGWO algorithm is designed by integrating the Bat Algorithm (BA) and Grey Wolf Optimizer (GWO) for generating the different clusters of text documents. Hence, the clustering is determined using the BAGWO algorithm, yielding the group of clusters. On the other side, upon the arrival of a new document, the same steps of pre-processing and feature extraction are performed. Based on the features of the test document, the mapping is done between the features of the test document, and the clusters obtained by the proposed BAGWO approach. The mapping is performed using the kernel-based deep point distance and once the mapping terminated, the representatives are updated based on the fuzzy-based representative update. The performance of the developed BAGWO outperformed the existing techniques in terms of clustering accuracy, Jaccard coefficient, and rand coefficient with maximal values 0.948, 0.968, and 0.969, respectively.
The Portuguese Republic and the People’s Republic of China: Impact and Trends of Economic Diplomacy
Authors: José Leandro Francisco B. S. , Henriques Danilo Lemos
Published: May 2020

This paper will examine the interplay and relationship between bilateral diplomatic relations and economic relations through the lens of political factors, examining the concrete case of the Republic of Portugal and the People’s Republic of China. It will consider their common past — the nations’ historical similarities, their common aims and ideological differences, and analyze the alignment and the synergy developed in the modern era in developing common platforms of aims and will, in terms of political agenda-setting, such as through the issue of the status of the territory of Macao and the relationship with Portuguese-speaking countries (PSCs). It further analyzes the past few decades through the signing of diplomatic protocols, engaged bilateral and multilateral economic diplomacies, and growing commerce and trade links to identify the key trends and extrapolate relevant correlations. We examine the progresses in the relationship between the advancement of Sino-Portuguese diplomatic relations and the development of economic interplay post the 1979 period, following the formal establishment of bilateral diplomatic relations. We argue in favor of an existing positive correlation between acts of economic diplomacy and the development of bilateral economic relations. This paper presents a methodological, theoretical-inductive, and constructivist perspective, combining qualitative, quantitative, and non-participated observation.
Mobility and Alterity in Iberian Late Prehistoric Archaeology: Current Research on the Neolithic–Early Bronze Age (6000–1500 BCE)
Authors: Lillios Katina T.
Published: May 2020

Archaeological investigations of late prehistoric Iberia between the Neolithic and Bronze Age (6000–1500 BCE) have long been a battleground between indigenist and exogenous models, and understandings of mobility and alterity have played an important role in these debates. Prior to the development of radiocarbon dating, key cultural transformations, such as megaliths, copper metallurgy, fortified hilltop settlements, and Beakers, were generally associated with nonlocal peoples, migrants, or colonizers. With the incorporation of radiocarbon dating to Iberian archaeological contexts in the 1980s and the determination of the antiquity of many of these cultural changes, the pendulum swung in the other direction, with a marked shift toward viewing autochthonous origins for these watershed transitions. In recent years, developments in strontium isotope analyses, genetics, and raw material characterization studies have provided new evidence for the mobility of peoples and things, and diffusionist models, sometimes without critical theorization, have once again reemerged.
Glucagon-dependent suppression of mTORC1 is associated with upregulation of hepatic FGF21 mRNA translation
Authors: Welles Jaclyn E. , Dennis Michael D. , Jefferson Leonard S. , Kimball Scot R.
Published: May 2020

Fibroblast growth factor 21 (FGF21) is a peptide hormone that acts to enhance insulin sensitivity and reverse many of the metabolic defects associated with consumption of a high-fat diet. Recent studies show that the liver is the primary source of FGF21 in the blood and that hepatic FGF21 expression is upregulated by glucagon. Interestingly, glucagon acts to upregulate FGF21 production by primary cultures of rat hepatocytes and H4IIE and HepG2 hepatocarcinoma cells independent of changes in FGF21 mRNA abundance, suggesting that FGF21 protein expression is regulated posttranscriptionally. Based on these observations, the goal of the present study was to assess whether or not FGF21 mRNA is translationally regulated. The results show that FGF21 mRNA translation and secretion of the hormone are significantly upregulated in H4IIE cells exposed to 25 nM glucagon, independent of changes in FGF21 mRNA abundance. Furthermore, the glucagon-induced upregulation of FGF21 mRNA translation is associated with suppressed activity of the mechanistic target of rapamycin in complex 1 (mTORC1). Similarly, the results show that rapamycin-induced suppression of mTORC1 leads to upregulation of FGF21 mRNA translation with no change in FGF21 mRNA abundance. In contrast, activation of mTORC1 by refreshing the culture medium leads to downregulation of FGF21 mRNA translation. Notably, refeeding fasted rats also leads to downregulation of FGF21 mRNA translation concomitantly with activation of mTORC1 in the liver. Overall, the findings support a model in which glucagon acts to upregulate FGF21 production by hepatocytes through suppression of mTORC1 and subsequent upregulation of FGF21 mRNA translation.
Microbial metabolite indole-3-propionic acid supplementation does not protect mice from the cardiometabolic consequences of a Western diet
Authors: Lee Dustin M. , Ecton Kayl E. , Trikha S. Raj J. , Wrigley Scott D. , Thomas Keely N. , Battson Micah L. , Wei Yuren , Johnson Sarah A. , Weir Tiffany L. , Gentile Christopher L.
Published: May 2020

The gut microbiota has been shown to mediate host health. Emerging data implicate gut microbial metabolites of tryptophan metabolism as potential important mediators. We examined the effects of indole-3-propionic acid in Western diet-fed mice and found no beneficial cardiometabolic effects. Our data do not support the supposition that indole-3-propionic acid (IPA) mediates beneficial metabolic effects downstream of the gut microbiota and may be potentially deleterious in higher circulating levels.
Chemogenetic activation of intracardiac cholinergic neurons improves cardiac function in pressure overload-induced heart failure
Authors: Dyavanapalli Jhansi , Hora Aloysius James , Escobar Joan B. , Schloen John , Dwyer Mary Kate , Rodriguez Jeannette , Spurney Christopher F. , Kay Matthew W. , Mendelowitz David
Published: May 2020

Intracardiac ganglia form the final common pathway for the parasympathetic innervation of the heart. This study has used a novel chemogenetic approach within transgenic ChAT-Cre rats [expressing only Cre-recombinase in choline acetyl transferase (ChAT) neurons] to selectively increase intracardiac cholinergic parasympathetic activity to the heart in a pressure overload-induced heart failure model. The findings from this study confirm that selective activation of intracardiac cholinergic neurons lessens cardiac dysfunction and mortality seen in heart failure, identifying a novel downstream cardiac-selective target for increasing cardioprotective parasympathetic activity in heart failure.
Chronic cigarette smoke exposure triggers a vicious cycle of leukocyte and endothelial-mediated oxidant stress that results in vascular dysfunction
Authors: El-Mahdy Mohamed A. , Abdelghany Tamer M. , Hemann Craig , Ewees Mohamed G. , Mahgoup Elsayed M. , Eid Mahmoud S. , Shalaan Mahmoud T. , Alzarie Yasmin A. , Zweier Jay L.
Published: May 2020

In a chronic model of smoking-induced cardiovascular disease, we define underlying mechanisms of smoking-induced vascular endothelial dysfunction (VED). Smoking exposure triggered VED and hypertension and led to vascular macrophage infiltration with concomitant increase in superoxide and NADPH oxidase levels as early as 16 wk of exposure. This oxidative stress was accompanied by tetrahydrobiopterin depletion, resulting in endothelial nitric oxide synthase uncoupling with further superoxide generation triggering a vicious cycle of oxidative stress and VED.
Monophosphoryl lipid A pretreatment suppresses sepsis- and LPS-induced proinflammatory cytokine production in the medullary thick ascending limb
Authors: Watts Bruns A. , Tamayo Esther , Sherwood Edward R. , Good David W.
Published: May 2020

Sepsis is the leading cause of acute kidney injury in critically ill patients. Tumor necrosis factor-α (TNF-α) has been implicated in the pathogenesis of septic kidney injury; however, the sites and mechanisms of renal TNF-α production during sepsis remain to be defined. In the present study, we showed that TNF-α expression is increased in medullary thick ascending limbs (MTALs) of mice with sepsis induced by cecal ligation and puncture. Treatment with lipopolysaccharide (LPS) for 3 h in vitro also increased MTAL TNF-α production. Sepsis and LPS increased MTAL TNF-α expression through activation of the myeloid differentiation factor 88 (MyD88)-IL-1 receptor-associated kinase 1-ERK signaling pathway. Pretreatment with monophosphoryl lipid A (MPLA), a nontoxic immunomodulator that protects against bacterial infection, eliminated the sepsis- and LPS-induced increases in MTAL TNF-α production. The suppressive effect of MPLA on TNF-α was mediated through activation of a phosphatidylinositol 3-kinase-dependent pathway that inhibits MyD88-dependent ERK activation. This likely involves MPLA-phosphatidylinositol 3-kinase-mediated induction of Tollip, which negatively regulates the MyD88-ERK pathway by inhibiting activation of IL-1 receptor-associated kinase 1. These regulatory mechanisms are similar to those previously shown to mediate the effect of MPLA to prevent sepsis-induced inhibition of MTAL [Formula: see text] absorption. These results identify the MTAL as a site of local TNF-α production in the kidney during sepsis and identify molecular mechanisms that can be targeted to attenuate renal TNF-α expression. The ability of MPLA pretreatment to suppress MyD88-dependent ERK signaling in the MTAL during sepsis has the dual beneficial effects of protecting tubule transport functions and attenuating harmful proinflammatory responses.
Design of Wideband Absorber Based on Dual-Resistor-Loaded Metallic Strips
Authors: Zhang Mingxi , Zhang Binchao , Liu Xiaochun , Sun Shining , Jin Cheng
Published: May 2020

A method for designing a dual-polarized wideband absorber with low profile by using dual-resistor-loaded metallic strips is proposed in this paper. Each unit cell consists of a resistive sheet with dual-resistor-loaded metallic strips and an underlying conducting plate. Two-dimensional arrays of two unequal metallic strips are printed on the dielectric substrate, and two resistors are embedded in the metallic strips. By properly designing the resonant frequencies of these metallic strips, a wide absorption band with three resonances is obtained. An equivalent circuit model is introduced, and the current distributions are examined to understand the physical mechanism of the proposed absorber. An example of the absorber is fabricated and measured to verify our designed concept. The measured results show that the wideband absorption performance with a fractional bandwidth of 129% under the normal incidence and the stable angular response are achieved. In addition, the proposed absorber has a low profile with 0.08λL, where λL is the wavelength at the lowest operating frequency.
Applicability of a Single Depth Sensor in Real-Time 3D Clothes Simulation: Augmented Reality Virtual Dressing Room Using Kinect Sensor
Authors: Adikari Sasadara B. , Ganegoda Naleen C. , Meegama Ravinda G. N. , Wanniarachchi Indika L.
Published: May 2020

A busy lifestyle led people to buy readymade clothes from retail stores with or without fit-on, expecting a perfect match. The existing online cloth shopping systems are capable of providing only 2D images of the clothes, which does not lead to a perfect match for the individual user. To overcome this problem, the apparel industry conducts many studies to reduce the time gap between cloth selection and final purchase by introducing “virtual dressing rooms.” This paper discusses the design and implementation of augmented reality “virtual dressing room” for real-time simulation of 3D clothes. The system is developed using a single Microsoft Kinect V2 sensor as the depth sensor, to obtain user body parameter measurements, including 3D measurements such as the circumferences of chest, waist, hip, thigh, and knee to develop a unique model for each user. The size category of the clothes is chosen based on the measurements of each customer. The Unity3D game engine was incorporated for overlaying 3D clothes virtually on the user in real time. The system is also equipped with gender identification and gesture controllers to select the cloth. The developed application successfully augmented the selected dress model with physics motions according to the physical movements made by the user, which provides a realistic fitting experience. The performance evaluation reveals that a single depth sensor can be applied in the real-time simulation of 3D cloth with less than 10% of the average measurement error.
Icariin Alleviates Glucocorticoid‐Induced Osteoporosis through EphB4/Ephrin‐B2 Axis
Authors: Huang Mi , Wang Ying , Peng Rui
Published: May 2020

Purpose. Glucocorticoid (GC) is the most important risk factor for osteoporosis (OP); in the present study, we examined the potential mechanism of icariin, a natural bioactive compound isolated from the traditional Chinese herbal Epimedium, for GC‐induced OP to explore its potential therapeutic effect. Methods. We used a GC‐induced OP mice model and treated with icariin. Pathological changes were measured by H&E staining, and the effects of icariin on osteoblasts and osteoclasts were measured by immunohistochemistry (IHC) staining and western blot (WB) analyses, while trabecular bone parameters were detected by micro‐CT imaging in vivo. Results. The results showed that in GC‐induced OP symptoms, icariin treatment significantly increased the density of the trabecular bone when exposed to GC, revealed by H&E staining and micro‐CT imaging. IHC staining showed that GC‐induced OP had a lower EphB4 expression and higher Ephrin‐B2 expression, but icariin could promote EphB4 while suppressing Ephrin‐B2 expression. The WB results also provided evidence of the same protein expression trend, showing that the osteoblast marker OCN and the EphB4 downstream factor RhoA in the GC group were decreased, while both OCN and RhoA expression were significantly increased and the Ephrin‐B2 downstream factor Grb4 in in GC group was increased after icariin treatment. Conclusion. Icariin could improve the characteristics of OP through regulating the balance of the EphB4/Ephrin‐B2 pathway. Further preclinical trial is needed to provide certainty of clinical benefits for OP patients.
Discrete Dynamics-Based Parameter Analysis and Optimization of Fuzzy Controller for Inverted Pendulum Systems Based on Chaos Algorithm
Authors: Xia Xingguo , Xia Jianwei , Gang Mingyi , Zhang Qingfeng , Wang Jing
Published: May 2020

In order to reduce the difficulty in the selection of the quantization factor and the proportion factor in the general fuzzy controller, a controller with the novel algorithm based on the Logistic chaotic variable is proposed in this paper. By introducing the chaotic variable factor into the global search, the suboptimal solution can be obtained and the optimization interval reduced. The global optimal solution is obtained in the vicinity of the suboptimal solution under an integrated performance index. Finally, the control scheme is applied to the control of a double inverted pendulum model. The simulated results show the effectiveness of the proposed method.
Prediction of the Influential Factors on Eating Behaviors: A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks
Authors: Kheirollahpour Maryam M. , Danaee Mahmoud M. , Merican Amir Faisal A. F. , Shariff Asma Ahmad A. A.
Published: May 2020

The importance of eating behavior risk factors in the primary prevention of obesity has been established. Researchers mostly use the linear model to determine associations among these risk factors. However, in reality, the presence of nonlinearity among these factors causes a bias in the prediction models. The aim of this study was to explore the potential of a hybrid model to predict the eating behaviors. The hybrid model of structural equation modelling (SEM) and artificial neural networks (ANN) was applied to evaluate the prediction model. The SEM analysis was used to check the relationship of the emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) and their effect on different categories of eating behavior patterns (EBP). In the second step, the input and output required for ANN analysis were obtained from SEM analysis and were applied in the neural network model. 340 university students participated in this study. The hybrid model (SEM-ANN) was conducted using multilayer perceptron (MLP) with feed-forward network topology. Moreover, Levenberg–Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The tangent/sigmoid function was used for the input layer, while the linear function was applied for the output layer. The coefficient of determination (R2) and mean square error (MSE) were calculated. Using the hybrid model, the optimal network happened at MLP 3-17-8. It was proved that the hybrid model was superior to SEM methods because the R2 of the model was increased by 27%, while the MSE was decreased by 9.6%. Moreover, it was found that BSC, BAS, and EES significantly affected healthy and unhealthy eating behavior patterns. Thus, a hybrid approach could be suggested as a significant methodological contribution from a machine learning standpoint, and it can be implemented as software to predict models with the highest accuracy.
Antibacterial Activity and Metabolomics Profiling of Torch Ginger (Etlingera elatior Jack) Flower Oil Extracted Using Subcritical Carbon Dioxide (CO2)
Authors: Anzian Aliaa , Muhialdin Belal J. , Mohammed Nameer Khairullah , Kadum Hana , Marzlan Anis Asyila , Sukor Rashidah , Meor Hussin Anis Shobirin
Published: May 2020

The aim of this study was to identify the bioactive compound and evaluate the antibacterial activity of torch ginger flower oil extracted using subcritical carbon dioxide. The antibacterial activity was evaluated in agar diffusion assay, while MIC and MBC were determined using the microdilution broth assay. The essential oil was subjected to metabolomics profiling using GC‐MS and 1H‐NMR techniques. The results demonstrated strong antibacterial activity towards Salmonella typhimurium, Staphylococcus aureus, and Escherichia coli. The MIC values were 0.0625, 0.25, and 0.25 mg/mL, and the MBC values were 0.25, 0.5, and 1 mg/mL towards S. typhimurium, S. aureus, and E. coli, respectively. A total of 33 compounds were identified using GC‐MS including 15 compounds (45%) known for their antimicrobial activity. In addition, sixteen metabolites were identified using NMR analysis and 8 out of the sixteen metabolites (50%) have antibacterial activity. The extracted oil demonstrated broad range for antibacterial activity and has high potential for applications in pharmaceutical and food industries. Practical Applications. The oil extracted from the torch ginger flower was found very stable and has promising applications as antibacterial agent for food and pharmaceutical industries.