bluuebunny/crossref_metadata_2025 huggingface dataset:
Complete Genome Sequence of an Alphacoronavirus from Common Vampire Bats in Peru
Authors: Bergner Laura M. , Orton Richard J. , Streicker Daniel G.
Published: August 2020

Bats host diverse coronaviruses, including taxa capable of pandemic spread in humans. We report the genome of an alphacoronavirus from a neotropical bat species (
Desmodus rotundus
) in Peru, which contributes to our understanding of bat coronaviruses in nature.
Generation of Viable Candida albicans Mutants Lacking the “Essential” Protein Kinase Snf1 by Inducible Gene Deletion
Authors: Mottola Austin , Schwanfelder Sonja , Morschhäuser Joachim
Published: August 2020

Essential genes are those that are indispensable for the viability and growth of an organism. Previous studies indicated that the protein kinase Snf1, a central regulator of metabolic adaptation, is essential in the pathogenic yeast
Candida albicans
, because no homozygous
snf1
deletion mutants of
C. albicans
wild-type strains could be obtained by standard approaches. In order to investigate the lethal consequences of
SNF1
deletion, we generated conditional mutants in which
SNF1
could be deleted by forced, inducible excision from the genome. Unexpectedly, we found that
snf1
null mutants were viable and could grow slowly under optimal conditions. The growth phenotypes of the
snf1
Δ mutants explain why such mutants were not recovered in previous attempts. Our study demonstrates that inducible gene deletion is a powerful method for assessing gene essentiality in
C. albicans
.
School absence and achievement in children with isolated orofacial clefts
Authors: Fitzsimons Kate J , Deacon Scott A , Copley Lynn P , Park Min Hae , Medina Jibby , van der Meulen Jan H
Published: August 2020

Objectives

To examine school absence and academic achievement among 7-year-old children with isolated orofacial clefts in England.

Design

Analysis of educational data linked to national cleft registry and administrative hospital data.

Setting

English state schools.

Patients

3523 children with isolated clefts aged 7 years between 2006 and 2014.

Main outcome measures

Annual school absence and reaching the national ‘expected level’ according to teacher-assessed academic achievement.

Results

Children with isolated clefts had higher mean annual school absence (10.5 days) than their peers in the national population (8.9 days). Total absence was higher in children with a cleft lip and palate (CLP; 11.3 days) or with a cleft palate only (CPO; 10.5 days) than in children with a cleft lip only (CLO; 9.5 days). The percentage reaching the expected academic level decreased with increasing school absence (from 77.4% (923/1192) with annual school absence ≤5 days to 43.4% (193/445) with annual school absence >20 days). However, differences in school absence did not explain that children with CPO (65.9% reaching expected level) or CLP (66.1% reaching expected level) had poorer levels of academic achievement than children with CLO (73.5% reaching expected level). Children with a cleft were twice as often recognised as having special education needs (40.5%) than their peers (21.6%).

Conclusions

School absence and cleft type are both independently associated with school attainment at 7 years. Children with an isolated cleft, especially when the palate is involved, and those with high levels of school absence may benefit from increased support addressing their educational needs.
P39 Pharmacy preparations for the birth of twins to an ebola survivor
Authors: Marra Fiona , Robertson Gayle , Gallagher Joanne , Mulholland Peter
Published: August 2020

Background

A 43 year old patient previously treated for re-activation of Ebola Virus Disease1 presented to hospital with a twin pregnancy. As a conservative precaution, Remdesivir was obtained for potential use in the mother and the neonates.

Method

All literature was reviewed on the drug in trial and restricted license, along with drugs previously administered in this patient. The recommendation was made to consider Remdesivir and Favipiravir. The patient had received Remdesivir with probable benefit in the past. As the drug is unlicensed, the clinical team from Gilead, California were closely involved. Details of drug dosage and side effects were provided following a non-disclosure agreement. Preparations were made for an import licence following approval by NHS Greater Glasgow and Clyde health board and the Medicines and Healthcare products Regulatory Agency to import the product from California into the UK.

Temperature monitored storage was arranged in advance and the drug appropriately stored. The pharmacy manual was supplied by Gilead and worksheets were prepared in advance.2 A small team of out of hours aseptic pharmacists and technicians were briefed in order to facilitate immediate supply if required. Based on published data, there were no known drug interactions and no contra-indications to breastfeeding.3

Outcome

In the weeks leading up to the delivery the infectious diseases pharmacist, aseptic lead pharmacist and neonatal pharmacist were on call for that period to then cascade requirements down to other pharmacy staff, if required out of hours. The twins were delivered safely with no issues for the neonates or the mother.

References

Jacobs M, et al. Late Ebola virus relapse causing meningoencephalitis: a case report, Lancet 2016;388:498–503

GS-5734 for Injection Pharmacy Manual rev 2.1, Gilead Sciences Inc, Foster City CA94404

WHO R&D Blueprint – Ad-hoc Expert Consultation on clinical trials for Ebola Therapeutics, http://www.who.int/ebola/drc-2018/summaries-of-evidence-experimental-therapeutics.pdf?ua=1 accessed 20th May 2019
SP5 Tenfold medication errors in children – Welsh paediatric surveillance unit study 2017–9
Authors: Tse Yincent , Tuthill David
Published: August 2020

Aims

To establish the incidence and characteristics of tenfold or greater and a tenth or less medication errors in children <16 years in Wales to help inform patient safety on a population level.

Method

Population-based incidence study in Wales, UK, from June 2017 - May 2019 (24 months). Cases were reported from paediatricians and hospital pharmacists using the monthly Welsh Paediatric Surveillance Unit (WPSU).

Results

46 confirmed incidents in 44 children from 63 notifications were identified. Cases came from 8 hospitals in Wales with 29 (63%) from the sole tertiary hospital. Median age was 1.7 (range 1 week to 15) years and weight 10 kg (0.6 to 59).

39 (85%) were overdosing (up to 1000x fold error) and 7 underdosing. 40 different medications were involved, 16 (37%) intravenous. Of 29 cases involving enteral medication, 26 (90%) were liquid formulations. Three cases were discharge medication prescribed or dispensed incorrectly and administrated at home. Stage of errors were primarily in prescribing 37 (80%), administration 7 (16%) and dispensing 2 (4%).

18 (42%) cases reached the patient, 10 from prescribing. Seven cases were spotted after multiple doses were given. Six errors resulted in harm, three which required intensive care treatment. No deaths or permanent disabilities were reported. Half (23/46) of all errors reported and two-thirds (12/18) of cases that reached the child occurred in <10 kg children.

Several human factor themes were identified: Prescribing confusion between gram milligram and microgram (none reached patient, n=7), confusing between mg and mg/kg (n=6 including 3 underdosing errors), leading zero errors (e.g. 0.1 vs 0.001 mg, n=6) and prescribing reconciliation errors where admitting doctor attempted to prescribe chronic medication in mg by reversing calculating liquid dosage expressed in mL (n=4).

During this study period 164,000 hospital admissions occurred in children <16 years in Wales. Our data estimates a tenfold error incidence of 1:3600 paediatric admissions, with drug reaching the child in 1:9000 admissions.

Conclusion

In this unique first ever population surveillance study, tenfold errors in children occurred at every stage of medication process and in the full range of care settings. Errors found were very different from those obtained from tertiary hospital single centre study and UK National Reporting and Learning System (NRLS). Strategies for error reduction will be more productive if designed across a whole national healthcare system.
Chemoradiation therapy for oesophageal cancer with airway stenosis under mechanical ventilation with light sedation using dexmedetomidine alone
Authors: Gondo Takashi , Sonoo Tomohiro , Hashimoto Hideki , Nakamura Kensuke
Published: August 2020

For malignant tumours, treatment is rarely indicated in cases requiring mechanical ventilation management because such intensive care would engender a decrease in performance status. However, light sedation using dexmedetomidine might enable chemoradiation while accommodating activities of daily living. We experienced two cases of fatal tracheal invasion and airway stenosis of stage Ⅳ oesophageal cancer that were treated with chemoradiation or radiation under mechanical ventilation (one case was differential lung ventilation.) with dexmedetomidine alone and rehabilitation was performed under a ventilator. Early mobilisation by light sedation with dexmedetomidine can inhibit performance status decline attributable to mechanical ventilation. Bridging tracheal intubation with light sedation by dexmedetomidine for temporary chemoradiation therapy to reduce tumour volume might present a good alternative for patients with malignant tumour.
Assessment and improvement of junior doctor handover in the emergency department
Authors: Sykes Mark , Garnham Jack , Kostelec Pablo Martin , Hall Hazel , Mitra Anu
Published: August 2020

Introduction

Effective handover between junior doctors is widely accepted as essential for patient safety. The British Medical Association in association with the National Health Service (NHS) National Patient Safety Agency and NHS Modernisation Agency have produced clear guidance regarding the contents and setting for a safe and efficient handover. We aimed to understand current junior doctor’s opinions on the handover process in a London emergency department (ED), with subsequent assessment, and any necessary improvement, of handover practices within the department.

Methods

In a London ED, a baseline survey was completed by the senior house officer (SHO) cohort to gauge current opinions of the existing handover process. Concurrently, a blinded prospective audit of handover practises was conducted. Multiple improvement strategies were subsequently implemented and assessed via Plan–Do–Study–Act (PDSA) cycles. A standard operating procedure was initially introduced and ‘rolled out’ throughout the department. This intervention was followed by development of an electronic handover note to ease completion of a satisfactory handover. Additional surveys were conducted to continually assess SHO opinion on how the handover process was developing. The final improvement strategy was formal handover teaching at the SHO induction.

Results

Baseline audit and SHO survey highlighted several opportunities for improvement. 5 handover components were deemed essential: (1) documented handover note; (2) doctor’s names; (3) history of presenting complaint; (4) ED actions; and (5) ongoing plan. The frequency of these components saw significant improvement by completion of the final PDSA. Following SHO rotation, all of the essential components fell, only to recover after the next improvement strategy.

Conclusions

Junior doctors in a London ED were not satisfied with the current SHO handover process, and handover practices were not adequate. While the rotational nature of the SHO cohort makes sustained change challenging, implementation of thoughtful and realistic improvement strategies can significantly improve handover quality.
Microsatellite frameshift variants inSGO1of gastric cancer are not always associated with MSI status
Authors: Sugiyama Tomohiro , Iwaizumi Moriya , Taniguchi Terumi , Suzuki Satoshi , Tani Shinya , Yamade Mihoko , Hamaya Yasushi , Osawa Satoshi , Furuta Takahisa , Miyajima Hiroaki , Ohta Tsutomu , Baba Satoshi , Sugimura Haruhiko , Maekawa Masato , Sugimoto Ken
Published: August 2020

Aims

Although frameshift variants in the microsatellite area of shugoshin 1 (SGO1) have been reported in the context of microsatellite instability-high (MSI-H)/deficient mismatch repair gastrointestinal cancer, most have been evaluated only in early stage I–III patients, and only two of its five microsatellite regions have been evaluated. Therefore, we investigated the frequency and MSI status of microsatellite frameshift variants in gastric cancer cases, including stage IV.

Methods

In a total of 55 cases, 30 gastric cancer resection and 25 non-resection cases, DNA was extracted from both tumour and normal parts and PCR was performed. The variant was confirmed by TA cloning, and MSI was evaluated using GeneMapper software.

Results

A frameshift variant of c.973delA was observed in 16 of the 45 evaluable cases. Its frequency was 35.6%. Of the 25 cases that could be assessed for MSI status, two cases of MSI-H were associated with the c.973delASGO1variant. However, c.973delASGO1variant was also observed in four cases of microsatellite stable.

Conclusion

Our study shows thatSGO1frameshift variants are not always associated with MSI status.
How to overcome lockdown: selective isolation versus contact tracing
Authors: White Lucie , van Basshuysen Philippe
Published: August 2020

At this stage of the COVID-19 pandemic, two policy aims are imperative: avoiding the need for a general lockdown of the population, with all its economic, social and health costs, and preventing the healthcare system from being overwhelmed by the unchecked spread of infection. Achieving these two aims requires the consideration of unpalatable measures. Julian Savulescu and James Cameron argue that mandatory isolation of the elderly is justified under these circumstances, as they are at increased risk of becoming severely ill from COVID-19, and are thus likely to put disproportionate strain on limited healthcare resources. However, their arguments for this strategy are contingent on the lack of viable alternatives. We suggest that there is a possible alternative: a mandatory, centralised contact-tracing app. We argue that this strategy is ethically preferable to the selective isolation of the elderly, because it does not target members of a certain group, relying instead on the movements of each individual, and because it avoids the extended isolation of certain members of the society. Although this type of contact-tracing app has its drawbacks, we contend that this measure warrants serious consideration.
Evaluation of biochars as carriers for Rhizobium leguminosarum
Authors: Hardy Kimberly , Knight J. Diane
Published: August 2020

Peat is the standard carrier material used for commercial microbial inoculants produced in Canada and the United States. Peat is a slowly renewable resource and its production is extremely vulnerable to variable weather conditions. Furthermore, it may not be widely available in all countries. We investigated the potential to develop biochar as a carrier material. Our goal was to evaluate if different biochars perform comparably in supporting rhizobial survival, and what characteristics contribute to their ability to support rhizobial survival. Evaluation included characterization of the biochars, assessment of biochar phytotoxicity, survival of Rhizobium on biochars, and growth chamber evaluation of two biochars as Rhizobium carriers for inoculating pea. Of the original nine biochars evaluated, six supported Rhizobium leguminosarum for 84 days at 4 °C; of this six, two supported numbers >1 × 106 cfu·(g biochar)−1. The only characteristics that correlated with survival were C/N ratio and percent C. The two biochars evaluated delivered R. leguminosarum to pea that initiated nodulation, biomass production, and biomass N at levels higher than a noninoculated control and heat-killed inoculated biochars. We demonstrate that there is considerable potential to develop biochar as a carrier for rhizobial inoculants.
Inadequate treatment of taxonomic information prevents replicability of most zoological research
Authors: Monckton S.K. , Johal S. , Packer L.
Published: August 2020

We evaluated the quality of information about taxonomic identifications in 710 papers published in seven zoological journals in 2017. We found that only 10.7% of papers cited identification methods, 29.2% made available specimen-level material for later verification, and 6.9% indicated taxon concepts applied to studied animals. Only 4.0% provided details about all three practices, while almost two-thirds provided none. Invertebrate papers were more likely than vertebrate papers to provide identification methods and deposit vouchers, but taxon concepts were rarely provided, and none of the three practices were common in any category. In short, our data suggest that most zoological research is irreplicable. To address this problem, journals should require submitted manuscripts to meet the following guidelines: (1) methods used to identify studied taxa must be stated; (2) literature supporting these identifications must be cited; (3) taxon concept(s) applied to species-level taxa must be indicated; (4) specimen-level material should be available for later examination. We argue that research which falls short of these guidelines is not replicable. We provide recommendations for how authors can better document how studied animals are identified and permit others to verify their identifications, which is necessary for transparent, replicable, and ultimately scientific zoological research.
Parton-shower effects in Higgs production via vector-boson fusion
Authors: Jäger Barbara , Karlberg Alexander , Plätzer Simon , Scheller Johannes , Zaro Marco
Published: August 2020

We present a systematic investigation of parton-shower and matching uncertainties of perturbative origin for Higgs-boson production via vector-boson fusion. To this end we employ different generators at next-to-leading order QCD accuracy matched with shower Monte Carlo programs, , and , and a next-to-next-to-leading order QCD calculation. We thoroughly analyse the intrinsic sources of uncertainty within each generator, and then compare predictions among the different tools using the respective recommended setups. Within typical vector-boson fusion cuts, the resulting uncertainties on observables that are accurate to next-to-leading order are at the 10% level for rates and even smaller for shapes. For observables sensitive to extra radiation effects uncertainties of about 20% are found. We furthermore show how a specific recoil scheme is needed when is employed, in order not to encounter unphysical enhancements for these observables. We conclude that for vector-boson fusion processes an assessment of the uncertainties associated with simulation at next-to-leading order matched to parton showers based only on the variation of renormalisation, factorisation and shower scales systematically underestimates their true size.
Determination of Antiepileptic Drugs Withdrawal Through EEG Hjorth Parameter Analysis
Authors: Ouyang Chen-Sen , Yang Rei-Cheng , Wu Rong-Ching , Chiang Ching-Tai , Lin Lung-Chang
Published: August 2020

The decision to continue or to stop antiepileptic drug (AED) treatment in patients with prolonged seizure remission is a critical issue. Previous studies have used certain risk factors or electroencephalogram (EEG) findings to predict seizure recurrence after the withdrawal of AEDs. However, validated biomarkers to guide the withdrawal of AEDs are lacking. In this study, we used quantitative EEG analysis to establish a method for predicting seizure recurrence after the withdrawal of AEDs. A total of 34 patients with epilepsy were divided into two groups, 17 patients in the recurrence group and the other 17 patients in the nonrecurrence group. All patients were seizure free for at least two years. Before AED withdrawal, an EEG was performed for each patient that showed no epileptiform discharges. These EEG recordings were classified using Hjorth parameter-based EEG features. We found that the Hjorth complexity values were higher in patients in the recurrence group than in the nonrecurrence group. The extreme gradient boosting classification method achieved the highest performance in terms of accuracy, area under the curve, sensitivity, and specificity (84.76%, 88.77%, 89.67%, and 80.47%, respectively). Our proposed method is a promising tool to help physicians determine AED withdrawal for seizure-free patients.
The study on surface grinding process of TI–6AL–4V alloy with resinoid cBN grinding wheel
Authors: Hung Phi-Trong , Dung Hoang-Tien , Trung Nguyen-Kien , Son Truong-Hoanh
Published: August 2020

The grinding process of Titanium (Ti) alloys is extremely difficult as the cutting temperature is much higher than other machining processes due to the low thermal conductivity, high chemical reactivity, and rapid work hardening during machining of Ti alloys. This research investigates the effect of technology parameters on the surface roughness in the surface grinding of Ti–6Al–4V (Ti64) alloy with resinoid cBN grinding wheel. The experimental results show that the surface roughness is significantly affected by the feed rate, depth of cut (DOC) and cooling condition. Increasing feed rate or DOC all provides the higher surface roughness. The surface roughness obtained in the wet grinding is higher than those of the dry cutting. The scanning electron microscopy (SEM) images of Ti64 surfaces show that the machining surface with fewer defects can be produced with wet grinding process.
Designing a shaped balloon machine with a waterwheel mechanism
Authors: Lu Chien-Yu , Hsueh Kai-Yi , Lee Lian-Wang , Tai Ching-Chou , Su Te-Jen
Published: August 2020

This paper explores the mechanism design of a balloon machine representing a vending machine where consumers can select their desired shapes, as well as avoid bursting caused by manual inflation. Inside the machine, balloons are placed on the mechanism designed based on a waterwheel which rotates at a constant speed generated by motion among different sizes of gears. When rotating to the corresponding shaped balloon, the inflator will move under the opening to pull it out from the display point and start to inflate the balloon for the set number of seconds. After the inflation is completed, the glass door will open and the customer can take out their balloon. The main purpose of our development and design of the balloon machine is to improve the general balloon blowing and it is easy to prevent over-exposure and blast. The balloon machine can automatically inflate and detect the blowing time to improve the shortcomings of the balloon’s blast. In this way, it can effectively decrease sudden explosions and the number of frightened people.
An effective method for identifying the key factors of railway accidents based on the network model
Authors: Li Keping , Pan Yu
Published: August 2020

In the analysis of railway accidents, the identification of key factors is an essential step for effective monitoring and daily maintenance of railway system. The existing key factor identification methods are generally based on the importance of ranking, which cannot achieve effective identification and verification because the classification of accident causal factors is not considered. Based on the complex network model, this paper proposes a heterogeneous network model which is suitable for the classification of accident causal factors to find the key causal factors of railway accident. The proposed model considers the causal factors of different types of railway accidents separately. Here, the accident causal factors are taken as the nodes, and their relationships are considered as the edges. The key factors will be determined through the extraction of the key nodes. Furthermore, an improved SIS propagation model is used to verify the effectiveness of the proposed method. Because of the strong network heterogeneity, it is proved that the proposed method is suitable for finding the key nodes in heterogeneous networks. Morever, the results show that the key nodes found by using the proposed method have more important impacts due to their faster propagation in the SIS model.
Trotter errors in digital adiabatic quantum simulation of quantum ℤ2 lattice gauge theory
Authors: Cui Xiaopeng , Shi Yu
Published: August 2020

Trotter decomposition is the basis of the digital quantum simulation. Asymmetric and symmetric decompositions are used in our GPU demonstration of the digital adiabatic quantum simulations of (2[Formula: see text]+[Formula: see text]1)-dimensional quantum [Formula: see text] lattice gauge theory. The actual errors in Trotter decompositions are investigated as functions of the coupling parameter and the number of Trotter substeps in each step of the variation of coupling parameter. The relative error of energy is shown to be equal to the Trotter error usually defined in terms of the evolution operators. They are much smaller than the order-of-magnitude estimation. The error in the symmetric decomposition is much smaller than that in the asymmetric decomposition. The features of the Trotter errors obtained here are useful in the experimental implementation of digital quantum simulation and its numerical demonstration.
A Fuzzy Logic-Based Method to Avert Intrusions in Wireless Sensor Networks Using WSN-DS Dataset
Authors: Singh Neha , Virmani Deepali , Gao Xiao-Zhi
Published: August 2020

Intrusion is one of the biggest problems in wireless sensor networks. Because of the evolution in wired and wireless mechanization, various archetypes are used for communication. But security is the major concern as networks are more prone to intrusions. An intrusion can be dealt in two ways: either by detecting an intrusion in a wireless sensor network or by preventing an intrusion in a wireless sensor network. Many researchers are working on detecting intrusions and less emphasis is given on intrusion prevention. One of the modern techniques for averting intrusions is through fuzzy logic. In this paper, we have defined a fuzzy rule-based system to avert intrusions in wireless sensor network. The proposed system works in three phases: feature extraction, membership value computation and fuzzified rule applicator. The proposed method revolves around predicting nodes in three categories as “red”, “orange” and “green”. “Red” represents that the node is malicious and prevents it from entering the network. “Orange” represents that the node “might be malicious” and marks it suspicious. “Green” represents that the node is not malicious and it is safe to enter the network. The parameters for the proposed FzMAI are packet send to base station, energy consumption, signal strength, a packet received and PDR. Evaluation results show an accuracy of 98.29% for the proposed system. A detailed comparative analysis concludes that the proposed system outperforms all the other considered fuzzy rule-based systems. The advantage of the proposed system is that it prevents a malicious node from entering the system, thus averting intrusion.
Improved Redox Cycling Durability in Alternative Ni Alloy-Based SOFC Anodes
Authors: Ishibashi Yusuke , Matsumoto Kohei , Futamura Shotaro , Tachikawa Yuya , Matsuda Junko , Lyth Stephen M. , Shiratori Yusuke , Taniguchi Shunsuke , Sasaki Kazunari
Published: August 2020

Repeated reduction and oxidation of metallic nickel in the anodes of solid oxide fuel cell (SOFC) causes volume changes and agglomeration. This disrupts the electron conducting network, resulting in deterioration of the electrochemical performance. It is therefore desirable to develop more robust anodes with high redox stability. Here, new cermet anodes are developed, based on nickel alloyed with Co, Fe, and/or Cr. The stable phases of these different alloys are calculated for oxidizing and reducing conditions, and their electrochemical characteristics are evaluated. Whilst alloying causes a slight decrease in power generation efficiency, the Ni-alloy based anodes have significantly improved redox cycle durability. Microstructural observation reveals that alloying results in the formation of a dense oxide film on the surface of the catalyst particle (e.g. Co-oxide or a complex Fe–Ni–Cr oxide). These oxide layers help suppress oxidation of the underlying nickel catalyst particles, preventing oxidation-induced volume changes/agglomeration, and thereby preserving the electron conducting pathways. As such, the use of these alternative Ni-alloy based cermets significantly improves the redox stability of SOFC anodes.
Evidence for placental-derived iron-nitrosyls in the circulation of the fetal lamb and against a role for nitrite in mediating the cardiovascular transition at birth
Authors: Blood Arlin B. , Liu Taiming , Mukosera George , Hanson Shawn F. , Terry Michael H. , Schroeder Hobe , Power Gordon G.
Published: August 2020

Circulating metabolites of nitric oxide, such as nitrite, iron nitrosyls (FeNO), and nitrosothiols, have vasodilatory bioactivity. In both human and sheep neonates, plasma concentrations of these NO metabolite (NOx) concentrations fall >50% within minutes after birth, raising the possibility that circulating NOx plays a role in maintaining low fetal vascular resistance and in the cardiovascular transition at birth. To test whether the fall in plasma NOx concentrations at birth is due to either ligation of the umbilical cord or oxygenation of the fetus to newborn levels, plasma NOx concentrations were measured during stepwise delivery of near-term fetal lambs. When fetal lambs were intubated and mechanically ventilated with 100% O2 to oxygenate the arterial blood while still in utero with the umbilical circulation still intact, there was no change in plasma NOx levels. In contrast, when the umbilical cord was ligated while fetal lambs were mechanically ventilated with O2 levels that maintained fetal arterial blood gases, plasma NOx levels decreased by nearly 50%. Characterization of the individual NOx species in plasma revealed that the overall fall in NOx at birth was attributable mainly to FeNO compounds. Finally, when the typical fall in NOx after birth was prevented by intravenous nitrite infusion, birth-related changes in blood pressure, heart rate, and carotid flow changes were little affected, suggesting the cardiovascular transition at birth is not dependent on a fall in plasma NOx. In conclusion, this study shows FeNO is released from the placenta and that its decline accounts for most of the measured fall in plasma NOx at birth.
A Computationally Efficient Method for Hybrid EEG‐fNIRS BCI Based on the Pearson Correlation
Authors: Hasan Mustafa A. H. , Khan Muhammad U. , Mishra Deepti
Published: August 2020

A hybrid brain computer interface (BCI) system considered here is a combination of electroencephalography (EEG) and functional near‐infrared spectroscopy (fNIRS). EEG‐fNIRS signals are simultaneously recorded to achieve high motor imagery task classification. This integration helps to achieve better system performance, but at the cost of an increase in system complexity and computational time. In hybrid BCI studies, channel selection is recognized as the key element that directly affects the system’s performance. In this paper, we propose a novel channel selection approach using the Pearson product‐moment correlation coefficient, where only highly correlated channels are selected from each hemisphere. Then, four different statistical features are extracted, and their different combinations are used for the classification through KNN and Tree classifiers. As far as we know, there is no report available that explored the Pearson product‐moment correlation coefficient for hybrid EEG‐fNIRS BCI channel selection. The results demonstrate that our hybrid system significantly reduces computational burden while achieving a classification accuracy with high reliability comparable to the existing literature.
Dynamic Hip Screw with Trochanter‐Stabilizing Plate Compared with Proximal Femoral Nail Antirotation as a Treatment for Unstable AO/OTA 31‐A2 and 31‐A3 Intertrochanteric Fractures
Authors: Fu Chun-Wei , Chen Ji-Ying , Liu Yueh-Ching , Liao Kuang-Wen , Lu Yung-Chang
Published: August 2020

Background. The dynamic hip screw (DHS) with the addition of an angular stable trochanter‐stabilizing plate (TSP) has been considered the ideal treatment for the unstable intertrochanteric fracture type. However, there have been few comparisons between DHS+TSP augmentation with intramedullary (IM) nailing. The aim of this retrospectively registered study was to compare the clinical outcomes of patients with the unstable type of intertrochanteric fractures treated with DHS+TSP or IM nailing (proximal femoral nail antirotation (PFNA)). Methods. From June 2013 to April 2018, 358 patients with proximal femur fracture AO/OTA type 31A2 and 31A3 treated with PFNA or DHS+TSP and followed for ≥10 months postoperatively were included. The surgical‐dependent outcome evaluation included the operation time, intraoperative blood loss, postoperative decrease in hemoglobin, and blood transfusion amount. Functional status was also measured. Radiographic findings and postoperative complications were recorded and analyzed. Result. The operation time was significantly shorter in the DHS+TSP group than that in the PFNA group for both A2 and A3 fractures (A2 type: 84.0 vs.96.4 min; p < 0.05; A3 type: 102.4 vs.116.1 min; p < 0.05). Postoperative decrease in hemoglobin was more significant in the PFNA group than that in the DHS+TSP group for both fracture types (A2 type: −1.88 vs. −1.29 (mg/dL); p < 0.05; A3 type: −1.63 vs. −1.04 (mg/dL); p < 0.05). However, the patients treated with DHS+TSP had significantly more residual pain than those treated with PFNA during the final follow‐up (Visual Analog Scale score, A2 type: 28.4 vs.23.2; p < 0.05; A3 type: 27.5 vs.23.6; p < 0.05) and complained of greater implant irritation. Conclusion. We found that DHS+TSP was associated with less operation time and less postoperative decrease in hemoglobin but more residual pain and implant irritation than those of PFNA. As a treatment for unstable intertrochanteric fracture, DHS+TSP provided ideal surgical outcomes which were not inferior to the PFNA.
Retrospective Review of Loop Electrosurgical Excision Procedure (LEEP) Outcomes at a Tertiary Hospital in Zambia
Authors: Kasongo Nancy , Kasungu Chiza , Miyoba Nixon , Nyirenda Herbert T. , Kumoyo Muleta
Published: August 2020

There is a lack of knowledge on the histologic outcomes of loop electrosurgical excision procedure (LEEP) biopsies in the diagnosis, treatment, and prevention of cervical cancer in Zambia. This study determined the outcomes of LEEP biopsies and associated factors at a tertiary hospital. We conducted a retrospective chart review of patients evaluated at a tertiary hospital cervical cancer screening centre. From the database, we identified patients who underwent LEEP between January 2015 and June 2018. We extracted demographic data, HIV data, and LEEP biopsy results. A P value less than 0.05 was considered statistically significant. 137 charts were identified, and 114 were included in the final analysis. 23 were excluded for missing histology. The mean age of participants was 36.3 ± 9.6. Histology outcomes revealed that 37% had cervicitis, while CIN 1, 2, and 3 contributed to 27%, 14%, and 3%, respectively. Squamous cell cancer was present in 8% (age groups 35–49) and was three times higher (13%) in HIV-positive compared to HIV-negative participants (3.8%). Normal histology accounted for 11%. Increasing age (P=0.029), less than tertiary education (P=0.0011), and being married (P=0.017) increased the chances of having cancer in the chi-square analysis, while single women had lower odds of having CIN 1 (OR = 0.012) in the multinomial logistic regression. There is a need for increased cervical cancer screening and training in precancer treatment and holistic consideration of other factors like age in addition to the positive VIA test in advising patients on treatment options.
Myonecrosis in a Sickle Cell-Diseased Patient: A Case Report and Literature Review
Authors: Almomen Ali Wasel , Tawfeeq Yaser Mansour , Almuhaisin Ahmed Khalid , Altalib Abdulraheem Ayman
Published: August 2020

Myonecrosis is a condition that results in muscle tissue necrosis, and it is rarely seen in sickle cell patients and often missed because more common manifestations of sickle cell can overlap like vaso-occlusive crises (VOC), which results in pain in the extremities or spine; also osteomyelitis is commonly seen in sickle cell patients. In this article, we present a case of myonecrosis in a sickle cell-diseased patient who presented with left acute atraumatic left foot pain and MRI with contrast showing characteristic image of muscle infarction supportive therapy initiated, and 2-year follow-up did not reveal any physical disabilities; further study and follow-up are needed to know the nature of the disease and avoid improper management of those patients.
Silencing ARAF Suppresses the Malignant Phenotypes of Gallbladder Cancer Cells
Authors: Lin Weiguo , Tong Chenhao , Zhang Weiguang , Cen Wenda , Wang Yali , Li Jiandong , Zhu Zhiyang , Yu Jianhua , Lu Baochun
Published: August 2020

ARAF is a member of the RAF kinase family that is necessary for mitogen‐activated protein kinase (MAPK) activation in various malignancies, including lung, colorectal, pancreatic, and breast cancers. As the most common biliary tract tumor, gallbladder cancer (GBC) seriously harms human health while the function of ARAF in GBC remains elusive. Here, we found that ARAF expression was upregulated in gallbladder cancer tissues. In vitro, ARAF silencing mediated by RNA interference effectively inhibited cell proliferation, colony formation, migration, and invasion of GBC cells. Moreover, knocking down ARAF suppressed tumor growth in vivo. Our results indicated that ARAF functions as an oncogene in GBC and, thus, could be a potential therapeutic target for GBC.
Optimal Trajectory Planning of Grinding Robot Based on Improved Whale Optimization Algorithm
Authors: Wang Ting , Xin Zhijie , Miao Hongbin , Zhang Huang , Chen Zhenya , Du Yunfei
Published: August 2020

Robot will be used in the grinding industry widely to liberate human beings from harsh environments. In the grinding process, optimal trajectory planning will not only improve the processing quality but also improve the machining efficiency. The aims of this study are to propose a new algorithm and verify its efficiency in achieving the optimal trajectory planning of the grinding robot. An objective function has been defined terms of both time and jerk. Improved whale optimization algorithm (IWOA) is proposed based on whale optimization algorithm (WOA) and differential evolution algorithm (DE). Mutation operation and selection operation of DE are imitated in the part of initialization to process the population initialized by WOA, and then, the search tasks of WOA are performed. Motion with a constant velocity of the end-effector is considered during fine grinding. The continuity of acceleration and velocity will be achieved by minimizing jerk, and at the same time, smooth robot movement can be obtained. Cubic spline interpolation is implemented. A six-axis industrial robot is used for this research. Results show that optimal trajectory planning based on IWOA is more efficient than others. This method presented in this paper may have some indirect significance in robot business.
Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data
Authors: Tessema Zemenu Tadesse , Akalu Temesgen Yihunie
Published: August 2020

Background. Although there is an increase in having antenatal care (ANC), still many women lack recommended ANC contacts in Ethiopia. Therefore, this study was aimed at determining spatial patterns and associated factors of not having ANC visits using the Ethiopian Demographic and Health Survey (EDHS) 2016 data. Methods. A two-stage stratified cluster sampling technique was employed based on EDHS data from January 18 to June 27, 2016. A total of 7,462 women were included in the study. ArcGIS version 10.7 software was used to visualize the spatial distribution. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for not having ANC visits in Ethiopia. A multivariable multilevel logistic regression model was used to identify individual- and community-level determinants of not having antenatal care. Model comparison was checked using the likelihood test and goodness of fit was assessed by the deviance test. Results. The primary clusters’ spatial window was located in Somalia, Oromia, Afar, Dire Dawa, and Harari regions with the log-likelihood ratio (LLR) of 133.02, at p<0.001 level of significance. In this study, Islam religion (adjusted odds ratio (AOR) = 0.7 with 95% confidence interval (CI) (0.52,0.96)), mother education being primary (AOR = 0.59, 95% CI (0.49,0.71)), distance from health facility being a big problem (AOR = 0.76, CI (0.65,0.89)), second birth order (AOR = 1.35, CI (1.03, 1.76)), richer wealth index (AOR = 0.65, CI (0.51,0.82)), rural residence (AOR = 2.38, CI (1.54,3.66)), and high community media exposure (AOR = 0.68, CI (0.52,0.89)) were determinants of not having antenatal care in Ethiopia. Conclusion. The spatial distribution of ANC in Ethiopia is non-random. A higher proportion of not having ANC is found in northeast Amhara, west Benishangul Gumuz, Somali, Afar, north, and northeast SNNPR. On the other hand, a low proportion of not having ANC was found in Tigray, Addis Ababa, and Dire Dawa. In Ethiopia, not having antenatal care is affected by both individual- and community-level factors. Prompt attention by the Federal Ministry of Health is compulsory to improve ANC especially in rural residents, uneducated women, poor households, and regions like Oromia, Gambella, and Somalia.
Craniofacial Anomaly Association with the Internal Malformations in the Pediatric Age Group in Al‐Fallujah City‐Iraq
Authors: Farhan Thaer M. , Al-Abdely Basim A. , Abdullateef Abdulrahman N. , Jubair Abdulhameed S.
Published: August 2020

Context. Craniofacial anomalies (CFA) are a major cause of infant mortality and childhood morbidity. They may be simple or multiple and vary in their clinical importance. Objectives. To estimate the prevalence of craniofacial anomalies among Iraqi people and its association with other congenital malformations. Methods. A hospital‐based cohort study. It was conducted in Iraq, Fallujah city from Jan 2019‐April 2019. The pediatric age group below 16 years attending the consultation clinic. Results. The prevalence rate of craniofacial anomalies was 2%. There were 43 (54%) males and 37 (46%) females. A 55 cases (69%) out of total 80 cases have an association with other internal congenital malformations, and 25 cases (31%) have no association. Those associated internal malformations were categorized according to their types into congenital heart disease 33(60%), Renal diseases 9 (16%), CNS anomalies 8(15%), and GIT anomalies 5(9%). Conclusions. Craniofacial anomalies showed a relatively higher prevalence rate in comparison to other studies worldwide. It was found that the majority of craniofacial anomalies might be associated with other congenital systemic malformations. Furthermore, the necessary actions to identify the frequency and risk factors associated with craniofacial anomalies in the Iraqi population are emphasized to put a better strategy to establish future preventive programs and treatment.
The Association between Inflammation and Pulse Wave Velocity in Dyslipidemia: An Evidence-Based Review
Authors: Aminuddin Amilia , Lazim Md Rizman M. L. M. , Hamid Adila A. , Hui Chua K. , Mohd Yunus Mohd H. , Kumar Jaya , Ugusman Azizah
Published: August 2020

Dyslipidemia is associated with increased arterial stiffness (AS) which may lead to hypertension. Among the methods to assess AS are carotid-femoral and brachial-ankle pulse wave velocity. Dyslipidemia is also known to trigger inflammation. C-reactive protein (CRP) is one of the commonest inflammatory markers measured in the clinical setting. However, the association between inflammation and pulse wave velocity (PWV) in people with dyslipidemia is less studied. Therefore, this review investigated the association between inflammation (as measured by CRP) and PWV in dyslipidemia patients. The search of the literature was conducted via PubMed and Scopus database. The keywords used were “aortic stiffness” OR “arterial stiffness” OR “pulse wave velocity” OR “vascular stiffness” OR “carotid femoral pulse wave velocity” OR “pulse wave analysis” AND “inflammation” OR “c reactive protein” OR “c-reactive protein” OR “high sensitivity c reactive protein” AND “dyslipidemia” OR “hyperlipidemia” OR “hypercholesterolemia” OR “hyperlipoproteinemia” OR “hypertriglyceridemia”. The following criteria were used: (1) only full-length original articles published in English language, (2) articles that reported the association between arterial stiffness measured as carotid-femoral PWV (cfPWV) or brachial-ankle PWV (baPWV) and CRP or high-sensitivity CRP, and (3) study involving human subjects. The search identified 957 articles published between 1980 and February 2020. Only eight articles fulfilled the inclusion criteria and were used for data extraction. Five of the studies were cross-sectional studies while another three studies were interventional studies. Seven out of eight papers found a significant positive association between AS and CRP, and the correlation ranged from mild to moderate association (Pearson r=0.33 to r=0.624). In conclusion, inflammation is associated with increased PWV in patients with dyslipidemia. This supports the involvement of inflammation in the development of AS in dyslipidemia.
Three-Dimensional Echocardiography in Evaluating LA Volumes and Functions in Diabetic Normotensive Patients without Symptomatic Cardiovascular Disease
Authors: Hamza Mohamed , Mamdouh Ahmed , Ezzeldin Dina , Tawfik Adnan , Nayel Ahmed
Published: August 2020

Background. Cardiovascular complications are the most serious threat to diabetic patients. Associated metabolic and microvascular changes are the main cause of cardiac function affection, and the earliest cardiac change is diastolic dysfunction. Assessment of LA function changes is a key to determine early heart damage of diabetic patients.Objectives. To evaluate the effect of diabetes mellitus on left atrial volumes and functions by using real-time 3-dimensional echocardiography in normotensive patients free from cardiovascular disease.Methods. The study included 110 individuals, 50 controls and 60 patients with diabetes mellitus, 30 patients with type 1 diabetes mellitus and 30 patients with type 2 diabetes mellitus. 2-dimensional echocardiography was used to assess the LA maximum volume and LA phasic volumes, and LA maximum volume indexed to body surface area were measured by 3D echocardiography. LA functions (LA total stroke volume, LA active stroke volume, and LA active emptying fraction) were obtained from RT3D volumetric analysis.Results. The results of the analysis revealed that type 2 diabetes mellitus showed enlargedVmax,Vmin, and LAVi with an increased LA total stroke volume and decreased active emptying fraction, while type 1 diabetics showed only decreased in active emptying fraction. The LA maximum volume indexed to body surface area (LAVi) was significantly higher in type 2 diabetic patients as compared to normal controls which was23.55±3.37 ml/m2versus 20.30.Conclusion. Patients with type 2 diabetes mellitus have an increased LA volume with impaired compliance and contractility, while patients with type 1 diabetes mellitus have only impaired contractility compared to nondiabetic subjects.