bluuebunny/crossref_metadata_2025 huggingface dataset:
A Joint Experimental and Large Eddy Simulation Characterization of the Liquid Fuel Spray in a Swirl Injector
Authors: Vignat Guillaume , Rajendram Soundararajan Preethi , Durox Daniel , Vié Aymeric , Renaud Antoine , Candel Sébastien
Published: January 2021

The quality of liquid fuel spray injection determines to a large extent the performance of aero-engine combustors. This investigation focuses on the detailed characterization of the liquid fuel spray in a test rig targeted at aero-engine applications. The liquid fuel is injected as a hollow cone by a simplex atomizer and the injector comprises a radial swirler. Two features of the droplet distribution are less commonly found. First, the distributions of droplet diameters exhibit nonaxisymmetric patterns, which are investigated for three types of swirlers. Second, it is found that the size-conditioned velocity distributions feature a single wide peak for small droplets and become bimodal for the largest droplets, with a first peak at low velocities, and a second one at higher velocities. Experiments are complemented with large eddy simulations and Lagrangian particle tracking. The spray interacts with the lateral injector surface and requires a droplet–wall interaction model for the liquid film. Simulations do not retrieve the lack of rotational symmetry that is found experimentally indicating that this feature is not linked to the nature of the flow. This is also consistent with further experiments with a different atomizer confirming that this is due to imperfections in the atomizer geometry. Another result is that certain swirler designs are more robust to atomizer imperfections. Simulations accounting for the liquid film yield a bimodal distribution for the droplets' axial velocity distribution which is not obtained without this model, indicating that it is important to represent the droplet–wall interaction.
Novel Cyclo-Nonstationary Indicators for Monitoring of Rotating Machinery Operating Under Speed and Load Varying Conditions
Authors: Mauricio Alexandre , Helm Dustin , Timusk Markus , Antoni Jerome , Gryllias Konstantinos
Published: January 2021

Condition monitoring arises as a valuable industrial process in order to assess the health of rotating machinery, providing early and accurate warning of potential failures and allowing for the planning and effective realization of preventative maintenance actions. Nowadays, machinery (gas turbines, wind turbines, etc.) manufacturers adopt new business models, providing not only the equipment itself but also additionally taking on responsibilities of condition monitoring, by embedding sensors and health monitoring systems within each unit and prompting maintenance actions when necessary. Among others, rolling element bearings are one of the most critical components in rotating machinery. In complex machines, the failure indications of an early bearing damage are weak compared to other sources of excitations (e.g., gears, shafts, rotors). Vibration analysis is most widely used and various methods have been proposed, including analysis in the time and frequency domain. In a number of applications, changes in the operating conditions (speed/load) influence the vibration sources and change the frequency and amplitude characteristics of the vibroacoustic signature, making them nonstationary. Under changing environments, where speed and load vary, the assumption of quasi-stationary is not appropriate and as a result, a number of time-frequency and time-order representations have been introduced, such as the Short Time Fourier Transform and the Wavelets. Recently, an emerging interest has been focused on modeling rotating machinery signals as cyclostationary, which is a particular class of nonstationary stochastic processes. The classical cyclostationary tools, such as the Cyclic Spectral Correlation Density (CSCD) and the Cyclic Modulation Spectrum (CMS), can be used in order to extract interesting information about the cyclic behavior of cyclostationary signals, only under the assumption that the speed of machinery is constant or nearly constant. Global diagnostic indicators have been proposed as a measure of cyclostationarity under steady operating conditions. In order to overcome this limitation, a generalization of both SCD and CMS functions has been proposed displaying cyclic Order versus Frequency as well as diagnostic indicators of cyclo-nonstationarity in order to cover the speed-varying operating conditions. The scope of this paper is to propose a novel approach for the analysis of cyclo-nonstationary signals based on the generalization of indicators of cyclo-nonstationarity in order to cover the simultaneous and independently varying speed and load operating conditions. The effectiveness of the approach is evaluated on simulated and real signals captured on a dedicated test rig.
Laser Sharpening of Carbon Fiber Microelectrode Arrays for Brain Recording
Authors: Dong Tianshu , Chen Lei , Shih Albert
Published: January 2021

Microwire microelectrode arrays (MEAs) are implanted in the brain for recording neuron activities to study the brain function. Among various microwire materials, carbon fiber stands out due to its small diameter (5–10 μm), relatively high Young's modulus, and low electrical resistance. Microwire tips in MEAs are often sharpened to reduce the insertion force and prevent the thin microwires from buckling. Currently, carbon fiber MEAs are sharpened by either torch burning, which limits the positions of wire tips to a water bath surface plane, or electrical discharge machining, which is difficult to implement to the nonelectrically conductive carbon fiber with parylene-C insulation. A laser-based carbon fiber sharpening method proposed in this study enables the fabrication of carbon fiber MEAs with sharp tips and custom lengths. Experiments were conducted to study effects of laser input voltage and transverse speed on carbon fiber tip geometry. Results of the tip sharpness and stripped length of the insulation as well as the electrochemical impedance spectroscopy measurement at 1 kHz were evaluated and analyzed. The laser input voltage and traverse speed have demonstrated to be critical for the sharp tip, short stripped length, and low electrical impedance of the carbon fiber electrode for brain recording MEAs. A carbon fiber MEA with custom electrode lengths was fabricated to validate the laser-based approach.
Association Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I
Authors: Ibrahimy Alaaddin , Huang Chi-Wen Christina , Bezuidenhout Abraham F. , Allen Philip A. , Bhadelia Rafeeque A. , Loth Francis
Published: January 2021

Cough-associated headaches (CAHs) are thought to be distinctive for Chiari malformation type I (CMI) patients and have been shown to be related to the motion of cerebrospinal fluid (CSF) near the foramen magnum (FM). We used computational fluid dynamics (CFD) to compute patient-specific resistance to CSF motion in the spinal canal for CMI patients to determine its accuracy in predicting CAH. Fifty-one symptomatic CMI patients with cerebellar tonsillar position (CTP) ≥ 5 mm were included in this study. The patients were divided into two groups based on their symptoms (CAH and non-CAH) by review of the neurosurgical records. CFD was utilized to simulate CSF motion, and the integrated longitudinal impedance (ILI) was calculated for all patients. A receiver operating characteristic (ROC) curve was evaluated for its accuracy in predicting CAH. The ILI for CMI patients with CAH (776 dyn/cm5, 288—1444 dyn/cm5; median, interquartile range) was significantly larger compared to non-CAH (285 dyn/cm5, 187–450 dyn/cm5; p = 0.001). The ILI was more accurate in predicting CAH in CMI patients than the CTP when the comparison was made using the area under the ROC curve (AUC) (0.77 and 0.70, for ILI and CTP, respectively). ILI ≥ 750 dyn/cm5 had a sensitivity of 50% and a specificity of 95% in predicting CAH. ILI is a parameter that is used to assess CSF blockage in the spinal canal and can predict patients with and without CAH with greater accuracy than CTP.
Hidden destruction of older forests threatens Brazil’s Atlantic Forest and challenges restoration programs
Authors: Rosa Marcos R. , Brancalion Pedro H. S. , Crouzeilles Renato , Tambosi Leandro R. , Piffer Pedro R. , Lenti Felipe E. B. , Hirota Márcia , Santiami Edson , Metzger Jean Paul
Published: January 2021

Native forest spatiotemporal dynamics must be included into restoration programs to better estimate their expected benefits.
The Antibiotic Negamycin Crosses the Bacterial Cytoplasmic Membrane by Multiple Routes
Authors: Hörömpöli Daniel , Ciglia Catherine , Glüsenkamp Karl-Heinz , Haustedt Lars Ole , Falkenstein-Paul Hildegard , Bendas Gerd , Berscheid Anne , Brötz-Oesterhelt Heike
Published: January 2021

Negamycin is a natural pseudodipeptide antibiotic with promising activity against Gram-negative and Gram-positive bacteria, including
Enterobacteriaceae
,
Pseudomonas aeruginosa
, and
Staphylococcus aureus
, and good efficacy in infection models. It binds to ribosomes with a novel binding mode, stimulating miscoding and inhibiting ribosome translocation.
In Vivo
Targeting of Escherichia coli with Vancomycin-Arginine
Authors: Neville Lewis F. , Shalit Itamar , Warn Peter A. , Scheetz Marc H. , Sun Jiuzhi , Chosy Madeline B. , Wender Paul A. , Cegelski Lynette , Rendell Jacob T.
Published: January 2021

The ability of vancomycin-arginine (V-r) to extend the spectrum of activity of glycopeptides to Gram-negative bacteria was investigated. Its MIC toward
Escherichia coli
, including β-lactamase expressing Ambler classes A, B, and D, was 8 to 16 μg/ml.
Tetracycline Resistance Mediated by
tet
(M) Has Variable Integrative Conjugative Element Composition in Mycoplasma hominis Strains Isolated in the United Kingdom from 2005 to 2015
Authors: Chalker Victoria J. , Sharratt Martin G. , Rees Christopher L. , Bell Oliver H. , Portal Edward , Sands Kirsty , Payne Matthew S. , Jones Lucy C. , Spiller Owen B.
Published: January 2021

A minimal genome and absent bacterial cell wall render
Mycoplasma hominis
inherently resistant to most antimicrobials except lincosamides, tetracyclines, and fluoroquinolones. Often dismissed as a commensal (except where linked to preterm birth), it causes septic arthritis in immunodeficient patients and is increasingly associated with transplant failure (particularly lung) accompanying immunosuppression.
Draft Genome Sequence of the Type Strain Lysobacter capsici VKM B-2533
Authors: Tarlachkov Sergey V. , Kudryakova Irina V. , Afoshin Alexey S. , Tutukina Maria N. , Leontyevskaya Elena A. , Vasilyeva Natalia V.
Published: January 2021

Lysobacter capsici
VKM B-2533
T
is a promising strain for isolation of new lytic agents. Here, we report a draft genome sequence of this strain, consisting of 131 scaffolds with a total length of 6,196,943 bp. The results obtained will enable us to find and study biologically active compounds important for biomedicine.
Complete Genome Sequence of Vibrio cholerae O1 El Tor Strain C6706
Authors: Weng Yuding , Bina X. Renee , Bina James E.
Published: January 2021

Vibrio cholerae
is a global health threat and a model enteric pathogen that causes the human disease cholera. Here, we report the complete genome sequence of the seventh pandemic
V. cholerae
O1 El Tor strain C6706.
Supplemental Material: Protolith affiliation and tectonometamorphic evolution of the Gurla Mandhata core complex, NW Nepal Himalaya
Authors: Godin L. , al. et
Published: January 2021

Analytical procedures, back-scattered electron imagery, X-ray ion microprobe chemical maps, geochemistry results, and U-Th/Pb analytical results.
Recalcitrant infective scleritis masquerading an autoimmune necrotising scleritis: a primary presentation of biopsy-proven granulomatosis with polyangiitis
Authors: Agarwal Rinky , Tripathi Manasi , Kashyap Seema , Sharma Sanjay
Published: January 2021

Infectious scleritis is a rare but important cause of scleral inflammation. It is usually associated with an underlying ocular (prior ocular surgery or trauma) or systemic risk factor. A 53-year-old apparently systemically healthy woman presenting with spontaneous-onset pain, redness and watering in the left eye for 10 days was diagnosed with culture-provenPseudomonas aeruginosaanterior scleritis. However, she was non-responsive to organism-sensitive antibiotics and scleral graft was performed twice, which showed graft re-infection. On repeated extensive systemic evaluations, the patient was diagnosed with biopsy-proven granulomatosis with polyangiitis (GPA). The patient was started on mycophenolate mofetil for both induction and maintenance phases and showed dramatic improvement with no recurrence till 1 year follow-up. High index of suspicion for autoimmune disorders, especially GPA, must be maintained for unilateral relentless infective scleritis masquerading as autoimmune necrotising scleritis. Mycophenolate mofetil holds a promising role for inducing as well as maintaining disease remission in ocular GPA.
Uncommon cause of cardiac tamponade in a young man
Authors: Narayan Ananthu , Ojha Vineeta , Arava Sudheer , Ray Animesh
Published: January 2021

We report a rare case of cardiac angiosarcoma in a young boy who presented with cardiac tamponade. His initial symptoms were non-specific. He was initially being managed in the line of fungal infection, with a possibility of malignancy. Cardiac imaging was also not conclusive and he worsened on antibiotics and antifungals and succumbed to the illness. After his death tissue biopsy from heart and lung was done and histopathological examination revealed the diagnosis of metastatic angiosarcoma. The case highlights the importance of considering the diagnosis of cardiac angiosarcoma in the patients presenting with haemorrhagic pericardial effusion and non-specific symptoms.
Do gastroenterologists have medical inertia towards coeliac disease? A UK multicentre secondary care study
Authors: Taylor Matthew A , Blanshard Rebecca J , Naylor Gregory , Penny Hugo A , Mooney Peter D , Sanders David S
Published: January 2021

Objective

This study aimed to assess if there is secondary care medical inertia towards coeliac disease (CD).

Design

Group (1): Time from primary care presentation to diagnostic endoscopy was quantified in 151 adult patients with a positive endomysial antibody test and compared with 92 adult patients with histologically proven inflammatory bowel disease (IBD). Group (2): Across four hospitals, duodenal biopsy reports for suspected CD were reviewed (n=1423). Group (3): Clinical complexity was compared between known CD (n=102) and IBD (n=99) patients at their respective follow-up clinic appointments. Group (4): 50 gastroenterologists were questioned about their perspective on CD and IBD.

Results

Group (1): Suspected coeliac patients waited significantly longer for diagnostic endoscopy following referral (48.5 (28–89) days) than suspected patients with IBD (34.5 (18–70) days; p=0.003). Group (2): 1423 patients underwent diagnostic endoscopy for possible CD, with only 40.0% meeting guidelines to take four biopsies. Increased diagnosis of CD occurred if guidelines were followed (10.1% vs 4.6% p<0.0001). 12.4% of newly diagnosed CD patients had at least one non-diagnostic gastroscopy in the 5 years prior to diagnosis. Group (4): 32.0% of gastroenterologists failed to identify that CD has greater prevalence in adults than IBD. Moreover, 36.0% of gastroenterologists felt that doctors were not required for the management of CD.

Conclusion

Prolonged waiting times for endoscopy and inadequacies in biopsy technique were demonstrated suggesting medical inertia towards CD. However, this has to be balanced against rationalising care accordingly. A Coeliac UK National Patient Charter may standardise care across the UK.
Artificial intelligence-based prediction of transfusion in the intensive care unit in patients with gastrointestinal bleeding
Authors: Levi Riccardo , Carli Francesco , Arévalo Aldo Robles , Altinel Yuksel , Stein Daniel J , Naldini Matteo Maria , Grassi Federica , Zanoni Andrea , Finkelstein Stan , Vieira Susana M , Sousa João , Barbieri Riccardo , Celi Leo Anthony
Published: January 2021

Objective

Gastrointestinal (GI) bleeding commonly requires intensive care unit (ICU) in cases of potentialhaemodynamiccompromise or likely urgent intervention. However, manypatientsadmitted to the ICU stop bleeding and do not require further intervention, including blood transfusion. The present work proposes an artificial intelligence (AI) solution for the prediction of rebleeding in patients with GI bleeding admitted to ICU.

Methods

A machine learning algorithm was trained and tested using two publicly available ICU databases, the Medical Information Mart for Intensive Care V.1.4 database and eICU Collaborative Research Database using freedom from transfusion as a proxy for patients who potentially did not require ICU-level care. Multiple initial observation time frames were explored using readily available data including labs, demographics and clinical parameters for a total of 20 covariates.

Results

The optimal model used a 5-hour observation period to achieve an area under the curve of the receiving operating curve (ROC-AUC) of greater than 0.80. The model was robust when tested against both ICU databases with a similar ROC-AUC for all.

Conclusions

The potential disruptive impact of AI in healthcare innovation is acknowledge, but awareness of AI-related risk on healthcare applications and current limitations should be considered before implementation and deployment. The proposed algorithm is not meant to replace but to inform clinical decision making. Prospective clinical trial validation as a triage tool is warranted.
Study protocol for a multicentre, 2×2 factorial, randomised, controlled trial evaluating the interest of intravenous iron and tranexamic acid to reduce blood transfusion in hip fracture patients (the HiFIT study)
Authors: Lasocki Sigismond , Loupec Thibault , Parot-Schinkel Elsa , Vielle Bruno , Danguy des Déserts Marc , Roquilly Antoine , Lahlou-Casulli Maria , Collange Vincent , Desebbe Olivier , Duchalais Alexis , Drugeon Bertrand , Bouzat Pierre , Garrigue Delphine , Mounet Benjamin , Hamard Franck , David Jean-Stéphane , Leger Maxime , Rineau Emmanuel
Published: January 2021

Introduction

Blood transfusion and anaemia are frequent and are associated with poor outcomes in patients with hip fracture (HF). We hypothesised that preoperative intravenous iron and tranexamic acid (TXA) may reduce the transfusion rate in these patients.

Methods and analysis

The HiFIT study is a multicentre, 2×2 factorial, randomised, double-blinded, controlled trial evaluating the effect of iron isomaltoside (IIM) (20 mg/kg) vs placebo and of TXA (intravenously at inclusion and topically during surgery) versus placebo on transfusion rate during hospitalisation, in patients undergoing emergency surgery for HF and having a preoperative haemoglobin between 95 and 130 g/L. 780 patients are expected. The primary endpoint is the proportion of patients receiving an allogenic blood transfusion of packed red blood cells from the day of surgery until hospital discharge (or until D30 if patient is still hospitalised). Enrolment started on March 2017 in 11 French hospitals. The study was stopped between July 2017 and August 2018 (because of investigation of serious AEs with IIM in Spain) and slowed down since March 2020 (COVID-19 crisis). The expected date of final follow-up is May 2022. Analyses of the intent-to-treat and per-protocol populations are planned.

Ethics and dissemination

The HiFIT trial protocol has been approved by the Ethics Committee of Comité de Protection des Personnes Ouest II and the French authorities (ANSM). It will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. The HiFIT trial will be the largest study evaluating iron and TXA in patients with HF.

Trial registration number

clinicalTrials.gov identifier:NCT02972294; EudraCT Number 2016-003087-40.
Experiences of pregnant mothers using a social media based antenatal support service during the COVID-19 lockdown in the UK: findings from a user survey
Authors: Chatwin John , Butler Danielle , Jones Jude , James Laura , Choucri Lesley , McCarthy Rose
Published: January 2021

Objectives

The COVID-19 pandemic has seen unprecedented restrictions on face-to-face healthcare encounters. This has led to an increase in the use of online healthcare resources by service users. Pregnant women have always been a group particularly motivated to seek out information online. The objective of this study was to explore the experiences of mothers who were using an existing National Health Service social media based antenatal support service during the early stages of the UK COVID-19 lockdown.

Design

A short online survey with four closed questions (scale response) and one open-ended free-text question was given to pregnant women who were using the online service 3 weeks after the start of the UK lockdown. Descriptive statistics are used to present the closed question data. Thematic analysis was applied to the free-text responses.

Results

320 women were sent the survey. 156 completed it (49% response rate). Participants provided information relating to frequency of use, information access, relative level of antenatal care and ease of contact. 105 (66%) participants completed the open-ended free-text question. Key themes to emerge related to: (1) information provision and verification; (2) managing and reducing feelings of isolation; (3) service specific issues, including crisis adaptations; and (4) impact on routine care.

Conclusions

The study suggests that that pregnant mothers found a social media based approach well positioned to provide antenatal care and support during the COVID-19 pandemic.
Monitoring of metabolic adverse events of second-generation antipsychotics in a naive paediatric population followed in mental health outpatient and inpatient clinical settings: MEMAS prospective study protocol
Authors: Menard Marie-Line , Ilies Drigissa , Abadie Pascale , Jean-Baptiste Thaïna , Choquette Rachel , Huet Anne-Sophie , Ben Amor Leila
Published: January 2021

Introduction

Second-generation antipsychotics (SGAs) are widely used in the paediatric population. It is currently established that SGAs may induce metabolic adverse events (AEs) such as weight gain, perturbation of blood lipids or glucose with risk of potential cardiovascular morbidity and mortality. The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in children (CAMESA) has published recommendations for monitoring the metabolic AEs of SGAs. Factors that may be associated with the onset of SGA’s metabolic AEs and long-term consequences are less studied in the literature. The objectives of our research are to evaluate some factors that can influence the development of the SGA’s metabolic AEs and to study clinical adherence to CAMESA guidelines.

Methods and analysis

The Monitoring des Effets Métaboliques des Antipsychotiques de Seconde Génération study is a multicenter, prospective, longitudinal observational study with repeated measures of metabolic monitoring over 24 months. Two recruiting centres have been selected for patients under 18 years of age, previously naive of antipsychotics, starting an SGA or who have started an SGA for less than 4 weeks regardless of the diagnosis that motivated the prescription. Assessments are performed for anthropometric measures, blood pressure, blood tests at baseline and 1, 2, 3, 6, 9, 12 and 24 months of follow-up.

Ethics and dissemination

The study protocol was approved by the CHU Sainte-Justine’s Research Ethics Board (MP-21-2016-1201) in 2016 and obtained institutional suitability for the ‘Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’Île-de-Montréal’ Research Center in May 2018. For all participants, written consent will be obtained from parents/caregivers as well as the participant’s assent in order to enable their participation in this research project. The results of this research will be published.

Trial registration number

ClinicalTrials.gov (numberNCT04395326).
Impact of air pollution on renal outcomes: a systematic review and meta-analysis protocol
Authors: Hamroun Aghilès , Camier Aurore , Bigna Jean Joel , Glowacki François
Published: January 2021

Introduction

Chronic kidney disease is a serious and a frequent disease associated with a high risk of morbi-mortality. Although several risk factors have already been well addressed, mostly diabetes and hypertension, many remain underappreciated, such as chronic exposure to air pollution.

Methods and analysis

We will search EMBASE, PubMed, Web of Science, Cochrane Library and CINAHL database, from inception to 31 March 2020, for relevant records using a combination of keywords related to the type of exposure (ozone, carbon monoxide, nitrogen oxides and dioxide, sulfur dioxide, PM2.5, PMcoarseand PM10) and to the type of outcome (chronic kidney disease, end-stage renal/kidney disease, kidney failure, proteinuria/albuminuria, renal function, renal transplant, kidney graft, kidney transplant failure, nephrotic syndrome and kidney cancer). The review will be reported according to the guidelines of the Meta-analysis Of Observational Studies in Epidemiology. Two independent reviewers will select studies without design or language restrictions, using original data and investigating the association between exposure to one or more of the prespecified air pollutants and subsequent risk of renal outcomes. Using random-effects meta-analyses, we will present pooled summary statistics (HR, OR or beta-coefficients with their respective 95% CI) associated with a standardised increase in each pollutant level. The results will be presented by air pollutant and outcome. Heterogeneity will be assessed using the χ2test on Cochran’s Q statistic and quantified by calculating I2. The Egger’s test and visual inspection of funnel plots will be used to assess publication bias.

Ethics and dissemination

Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the associations between various air pollutants’ exposure and renal outcomes. The final report will be published in an international peer-reviewed journal.

PROSPERO registration number

CRD42020187956.
Spatial analysis of the prevalence of obesity and overweight among women in Ghana
Authors: Asosega Killian Asampana , Adebanji Atinuke Olusola , Abdul Iddrisu Wahab
Published: January 2021

Objective

Identifying hot spots for the overweight aids in effective public health interventions due to the associated public health burden and morbidities. This study, therefore aimed to explore and determine the spatial disparities in the overweight/obesity prevalence among women in Ghana. The study also aims at modelling the average body mass index (BMI) values using the spatial regression and the performance compared with the standard regression model.

Design

This is a cross-sectional study using data from the 2014 Ghana Demographic and Health Survey (GDHS).

Setting

The study was set in Ghana.

Participants and methods

Data on 4393 non-pregnant women aged 15–49 years from the 2014 GDHS. Both global (Moran’s I) and the local indicators for spatial dependence were examined through the mapped BMI values across the country by clusters. An estimated spatial lag model was used to explain the spatial differences in the average body sizes of women.

Results

The overall prevalence of overweight/obesity among reproductive women in Ghana was 35.4%, and this was highly prevalent among educated women (p<0.001), those from wealthy households (p<0.001) and dwelling in an urban setting (p<0.001). Significant clustering (Moran’s I=0.3145, p<0.01) of overweight/obesity was observed with hot spots (clustering) in Greater Accra, Central, Western and Ashanti regions. The spatial lag model was the best fit based on the Likelihood ratio test and the Akaike information criterion and Bayesian information criterion values. The mean age of women and household wealth were significant factors accounting for the increase in the average cluster body size (BMI) of women and the spatial differences.

Conclusion

The prevalence of overweight/obesity was high and spatially clustered in the southern, middle and coastal regions. Geographic specific and effective public health interventions and strategies are needed to address the growing morbidity burden associated with the rise in the average body sizes of reproductive women.
Incidence of omental metastasis in uterine serous carcinoma: study protocol for a systematic review and meta-analysis
Authors: Hu Cui , Zhang Lin-Lin , Cheng Yu , Xue Fei-Xue , Jia Ya , Zhao-Juan Qin , Yi Du , Qian-Wen Zhang , Yue-Dong He , Ai Zheng , Xu Yu
Published: January 2021

Introduction

Uterine serous carcinoma accounts for only about 10% of all endometrial cancers but this subtype is the most common amongst non-endometrioid endometrium cancers and contributes to more than half of recurrence and deaths attributed to endometrial cancers. A more extensive surgical staging and adjuvant therapies for uterine serous carcinoma are recommended by many guidelines. However, guidelines vary on recommendations for the methods that should be used for omentum assessment in uterine serous carcinoma and the previously reported incidence of omental metastasis in uterine serous carcinoma had a wide range because of the heterogeneity among these studies. As far as we know, there are no systematic review and meta-analysis available on this topic. The aim of our proposed study is to statistically synthesise the data examining the incidence of omental metastasis in uterine serous carcinoma.

Methods and analysis

Systematic searches of three databases (PubMed, Embase and Web of Science) will be performed using prespecified search strategies. We will include original studies that reported incidence of omental metastasis in uterine serous carcinoma and are published before 30 August 2020. Our different investigators will independently conduct the eligible study selection, assess the quality of included studies and extract the needed data. If appropriate, the relevant data will be pooled through a random-effect or fixed-effect meta-analysis based on the heterogeneity among included studies. We will evaluate the overall quality of evidence using appropriate methods.

Ethics and dissemination

This proposed study will be based on published data, and thus, there is no requirement for ethics approval. We aim to publish the results of this study in a peer-reviewed journal with good visibility for the fields of gynaecology and gynecologic oncology.

PROSPERO registration number

CRD42020200891.
Cytokine adsorption in patients with severe COVID-19 pneumonia requiring extracorporeal membrane oxygenation: protocol for a randomised, controlled, open-label intervention, multicentre trial
Authors: Rieder Marina , Schubach Fabian , Schmoor Claudia , von Spee-Mayer Caroline , Wengenmayer Tobias , Rilinger Jonathan , Staudacher Dawid , Bode Christoph , Duerschmied Daniel , Supady Alexander
Published: January 2021

Introduction

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a last resort treatment option in patients with severe COVID-19 related acute respiratory distress syndrome (ARDS). Mortality in these critically ill patients is high. Elevated interleukin-6 (IL-6) levels in these severe courses are associated with poor outcome. Extracorporeal cytokine adsorption is an approach to lower elevated IL-6 levels. However, there is no randomised controlled data on the efficacy of cytokine adsorption and its effect on patient outcome in severe COVID-19 related ARDS requiring V-V ECMO support.

Methods and analysis

We here report the protocol of a 1:1 randomised, controlled, parallel group, open-label intervention, superiority multicentre trial to evaluate the effect of extracorporeal cytokine adsorption using the CytoSorb device in severe COVID-19 related ARDS treated with V-V ECMO. We hypothesise that extracorporeal cytokine adsorption in these patients is effectively reducing IL-6 levels by 75% or more after 72 hours as compared with the baseline measurement and also reducing time to successful V-V ECMO explantation. We plan to include a total of 80 patients at nine centres in Germany.

Ethics and dissemination

The protocol of this study was approved by the ethical committee of the University of Freiburg as the leading institution (EK 285/20). Additional votes will be obtained at all participating centres.

Trial registration numbers

NCT04385771and DRKS 00021248.
Electronic application to improve management of infections in low-income neonatal units: pilot implementation of the NeoTree beta app in a public sector hospital in Zimbabwe
Authors: Gannon Hannah , Chimhuya Simbarashe , Chimhini Gwendoline , Neal Samuel R , Shaw Liam P , Crehan Caroline , Hull-Bailey Tim , Ferrand Rashida A , Klein Nigel , Sharland Michael , Cortina Borja Mario , Robertson Valerie , Heys Michelle , Fitzgerald Felicity C
Published: January 2021

There are 2. 4 million annual neonatal deaths worldwide. Simple, evidence-based interventions such as temperature control could prevent approximately two-thirds of these deaths. However, key problems in implementing these interventions are a lack of newborn-trained healthcare workers and a lack of data collection systems. NeoTree is a digital platform aiming to improve newborn care in low-resource settings through real-time data capture and feedback alongside education and data linkage. This project demonstrates proof of concept of the NeoTree as a real-time data capture tool replacing handwritten clinical paper notes over a 9-month period in a tertiary neonatal unit at Harare Central Hospital, Zimbabwe. We aimed to deliver robust data for monthly mortality and morbidity meetings and to improve turnaround time for blood culture results among other quality improvement indicators. There were 3222 admissions and discharges entered using the NeoTree software with 41 junior doctors and 9 laboratory staff trained over the 9-month period. The NeoTree app was fully integrated into the department for all admission and discharge documentation and the monthly presentations became routine, informing local practice. An essential factor for this success was local buy-in and ownership at each stage of the project development, as was monthly data analysis and presentations allowing us to rapidly troubleshoot emerging issues. However, the laboratory arm of the project was negatively affected by nationwide economic upheaval. Our successes and challenges piloting this digital tool have provided key insights for effective future roll-out in Zimbabwe and other low-income healthcare settings.
Engaging community pharmacists in quality improvement (QI): a qualitative case study of a partnership between a Higher Education Institute and Local Pharmaceutical Committees
Authors: Latif Asam , Gulzar Nargis , Lowe Fiona , Ansong Theo , Gohil Sejal
Published: January 2021

Background

Quality improvement (QI) involves the use of systematic tools and methods to improve the quality of care and outcomes for patients. However, awareness and application of QI among healthcare professionals is poor and new strategies are needed to engage them in this area.

Objectives

This study describes an innovative collaboration between one Higher Educational Institute (HEI) and Local Pharmaceutical Committees (LPCs) to develop a postgraduate QI module aimed to upskill community pharmacists in QI methods. The study explores pharmacist engagement with the learning and investigates the impact on their practice.

Methods

Details of the HEI–LPCs collaboration and communication with pharmacist were recorded. Focus groups were held with community pharmacists who enrolled onto the module to explore their motivation for undertaking the learning, how their knowledge of QI had changed and how they applied this learning in practice. A constructivist qualitative methodology was used to analyse the data.

Results

The study found that a HEI–LPC partnership was feasible in developing and delivering the QI module. Fifteen pharmacists enrolled and following its completion, eight took part in one of two focus groups. Pharmacists reported a desire to extend and acquire new skills. The HEI–LPC partnership signalled a vote of confidence that gave pharmacists reassurance to sign up for the training. Some found returning to academia challenging and reported a lack of time and organisational support. Despite this, pharmacists demonstrated an enhanced understanding of QI, were more analytical in their day-to-day problem-solving and viewed the learning as having a positive impact on their team’s organisational culture with potential to improve service quality for patients.

Conclusions

With the increased adoption of new pharmacist’s roles and recent changes to governance associated with the COVID-19 pandemic, a HEI–LPC collaborative approach could upskill pharmacists and help them acquire skills to accommodate new working practices.
Flag-Transitive 3- (v, k,3) Designs and PSL(2,q) Groups
Authors: Dai Shaojun , Li Shangzhao
Published: January 2021

This article is a contribution to the study of the automorphism groups of 3-[Formula: see text] designs. Let [Formula: see text] be a non-trivial 3-[Formula: see text] design. If a two-dimensional projective linear group [Formula: see text] acts flag-transitively on [Formula: see text], then [Formula: see text] is a 3-[Formula: see text] or 3-[Formula: see text] design.
n-Derivations of the Extended Schrödinger–Virasoro Lie Algebra
Authors: Zhong Yongyue , Tang Xiaomin
Published: January 2021

Let [Formula: see text] be the extended Schrödinger–Virasoro Lie algebra and [Formula: see text] an integer. A map [Formula: see text] is called an [Formula: see text]-derivation if it is a derivation in one variable while other variables fixed. We investigate [Formula: see text]-derivations of the extended Schrödinger–Virasoro Lie algebra [Formula: see text]. The main result when [Formula: see text] is then applied to characterize the linear commuting maps and the commutative post-Lie algebra structures on [Formula: see text].
China’s Geopolitical Strategy in the Strait of Hormuz
Authors: Meresin Alexander Texas
Published: January 2021

The purpose of this paper is to analyze China’s geopolitical strategy in the Strait of Hormuz using secondary data of the topic and the concept of Natural Resources War. The Strait is very important to all the importing oil countries from Middle East including China as the only way in and out. At the same time, the Strait is also vulnerable with any kind of attacks that become challenge and threat to all the countries. It is the United States (US) as the one and only superpower which guarantee the security of the Strait and all the ships from importing oil countries. Recently with a lot of issues occurred in the region, the US seemed to be overwhelmed and asked every country to protect their own ships. With the status of one of the superpower countries and the power of its economy, China should be able to have the same role as the US. This paper contends that the lack of power of China’s military, dependence on the US security and Iran conflict with the US are the reasons why China is not showing some significant roles in Middle East related to its geopolitical strategy specifically in the Strait of Hormuz.
An Interview with Dr. Thorsten Joachims, Winner of ACM SIGKDD 2020 Innovation Award
Authors: Joachims Dr. Thorsten
Published: January 2021

Thorsten Joachims, Ph.D. is the recipient of the 2020 ACM SIGKDD Innovation Award, the highest honor for technical excellence in the field of knowledge discovery and data mining. The Innovation Award is conferred annually on an individual or group of collaborators whose outstanding technical innovations have greatly influenced the direction of research and development in the field.
A Report on the First Workshop on Document Intelligence (DI) at NeurIPS 2019
Authors: Motahari Hamid , Duffy Nigel , Bennett Paul , Bedrax-Weiss Tania
Published: January 2021

The first workshop on Document Intelligence (DI-2019) was held on December 14, 2019 at NeurIPS 2019 conference in Vancouver, Canada. The report summarizes the workshop, with a summary of the talks, papers and posters presented, and discusses common themes, issues and open questions that came up in the workshop.
Adversarial Attacks and Defenses on Graphs
Authors: Jin Wei , Li Yaxing , Xu Han , Wang Yiqi , Ji Shuiwang , Aggarwal Charu , Tang Jiliang
Published: January 2021

Deep neural networks (DNNs) have achieved significant performance in various tasks. However, recent studies have shown that DNNs can be easily fooled by small perturbation on the input, called adversarial attacks.
The Safety and Efficacy of Lansoprazole plus Metoclopramide among Neonates with Gastroesophageal Reflux Disease Resistant to Conservative Therapy and Monotherapy: A Clinical Trial
Authors: Taheri Peymaneh Alizadeh , Validad Elahe , Eftekhari Kambiz
Published: January 2021

Background. Gastroesophageal reflux disease (GERD) is one of the most common problems in neonates. The main clinical manifestations of neonatal GERD are frequent regurgitation or vomiting associated with irritability, crying, anorexia or feeding refusal, failure to thrive, arching of the back, and sleep disturbance. Aims. The efficacy and safety of ranitidine plus metoclopramide and lansoprazole plus metoclopramide in reducing clinical GERD symptoms based on I-GERQ-R scores in neonatal GERD resistant to conservative and monotherapy. Study Design. This study was a randomized clinical trial of term neonates with GERD diagnosis (according to the final version of the I-GERQ-R), resistant to conservative and monotherapy admitted to Bahrami Children Hospital during 2017-2019. Totally, 120 term neonates (mean age

10.91
±
7.17

days; girls 54.63%) were randomly assigned to a double-blind trial with either oral ranitidine plus metoclopramide (group A) or oral lansoprazole plus metoclopramide (group B). The changes of the symptoms and signs were recorded after one week and one month. At the end, fifty-four neonates in each group completed the study and their data were analyzed. Results. There was no significant difference in demographic and baseline characteristics between the two groups. The response rate of “lansoprazole plus metoclopramide” was significantly higher than “ranitidine plus metoclopramide” (

7.44
±
3.86

score vs.

9.3
±
4.57

score,

p
=
0.018

) after one week and (

2.41
±
3.06

score vs.

4.5
±
4.12

score,

p
=
0.003

) after one month (primary outcome). There were no drug adverse effects in either group during intervention (secondary outcome). Conclusions. The response rate was significant in each group after one week and one month of treatment, but it was significantly higher in the “lansoprazole plus metoclopramide” group compared with the “ranitidine plus metoclopramide” group. The combination of each acid suppressant with metoclopramide led to a higher response rate in comparison with monotherapy used before intervention. This study has been registered at the Iranian Registry of Clinical Trails (RCT20160827029535N3).
Development of a New Equation for the Prediction of Resting Metabolic Rate in Sri Lankan Adults
Authors: Fairoosa Pathima , Lanerolle Pulani , De Lanerolle-Dias Maduka , Wickramasinghe V. Pujitha , Waidyatilaka Indu
Published: January 2021

Resting metabolic rate (RMR) is the key determinant of the energy requirement of an individual. Measurement of RMR by indirect calorimetry is not feasible in field settings and therefore equation-based calculations are used. Since a valid equation is not available for Sri Lankans, it is important to develop a new population-specific equation for field use. The study objective was to develop a new equation for the prediction of RMR in healthy Sri Lankans using a reference method, indirect calorimetry. RMR data were collected from fifty-seven (male 27) adults aged 19 to 60 years. They were randomly assigned to validation (n = 28) and cross-validation (n = 19) groups using the statistical package R (version 3.6.3). Height, weight, and RMR were measured. Multivariable fractional polynomials (MFP) were used to determine explanatory variables and their functional forms for the model. A variable shrinkage method was used to find the best fit predictor coefficients of the equation. The developed equation was cross-validated on an independent group. Weight and sex code (male = 1; female = 0) were identified as reliable independent variables. The new equation developed was RMR (kcal/day) = 284.5 + (13.2 x weight) + (133.0 x sex code). Independent variables of the prediction equation were able to predict 88.5% of the variance. Root mean square error (RMSE) of the prediction equation in validation and cross-validation was 88.11 kcal/day and 79.03 kcal/day, respectively. The equation developed in this study is suitable for predicting RMR in Sri Lankan adults.
Hydromagnetic Flow of Prandtl Nanofluid Past Cylindrical Surface with Chemical Reaction and Convective Heat Transfer Aspects
Authors: Sooppy Nisar Kottakkaran , Bilal S. , Shah Imtiaz Ali , Awais M. , Khalil-Ur-Rehman  , Khan Ilyas , Thonthong Phatiphat
Published: January 2021

Thermodynamical attributes of non-Newtonian fluids over stretched surfaces have gained pervasive essence due to extensive utilization in extruding plastic sheet procedures, liquid film condensation, glass blowing, paper production, biopolymer cylinder coatings, and so forth. So, currently communication is aimed to candidly explicate flow characteristic of Prandtl fluid generated by axial stretching of cylindrical surface. Mathematical modelling by using conservation laws of momentum, energy and concentration fields containing the aspects of magnetic field, convective heating, and chemical reaction are presented initially in the form of partial differential expressions. Later on, these attained PDEs are transmuted into nonlinear ordinary differential equations with implementation of similarity variables. Numerical approach renowned as shooting technique with improved coefficient of the Runge–Kutta (R–K) method by Cash and Karp is used to access accurate solution. Linear curved fitting analysis is also performed to analyze results. Influence of flow-controlling parameters on associated profiles is revealed through graphical visualization. Stream line plots representing flow behavior of Prandtl fluid versus different magnitudes of the curvature parameter are adorned. Variation in friction drag force at wall, heat flux, and concentration gradient are evaluated through numerical data and with interpolation of linear curved fittings. It is deduced from results that increasing curvature parameter momentum and temperature distributions enriches whereas skin-friction coefficient depicts reverse pattern. It is also inferred that temperature shows incrementing deviation in the absence of chemical reaction whereas concentration profiles exhibit reduction with consideration of influence of chemical reaction parameter. Magnetic field tends to reduce the velocity and create thinness of boundary layer thickness.