bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between severity of depressive symptoms and chronic knee pain in Korean adults aged over 50 years: a cross-sectional study using nationally representative data
Authors: Han Su-Bin , Lee Sook-Hyun , Ha In-Hyuk , Kim Eun-Jung
Published: December 2019

Objectives

To identify the association between the presence and severity of depressive symptoms and those of chronic knee pain.

Design

A retrospective cross-sectional study.

Participants

We used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-2) performed in 2014. Overall, 7550 patients were included in the KNHANES VI-2.

Outcome measures

Participants were asked whether they had chronic knee pain, and each answer was either ‘yes’ or ‘no’. Patient Health Questionnaire-9 (PHQ-9) was used as a screening tool for depressive symptoms, and PHQ-9 scores of 10 or higher was classified as the depressed group. In total, 527 patients reported that they had pain in their knee, of whom 91 also had depressive symptoms.

Results

The prevalence of chronic knee pain in the Korean population aged over 50 years was 19.8%. Multiple logistic regression was conducted after adjustment for sex, age, smoking, alcohol drinking, education level, household income, physical activity, sleep duration and comorbidity. The analysis revealed a significant association between depressive symptoms and chronic knee pain (adjusted OR=2.333, p<0.001). In contrast, the severity of depressive symptoms was linearly correlated with the intensity of chronic knee pain (p for trend <0.001). In participants with no chronic knee pain (Numerical Rating Scale; NRS=0) or mild chronic knee pain (NRS=1–4), the prevalence of moderate and severe depressive symptoms was 3.4% and 0.6%, respectively. However, in those with severe chronic knee pain (NRS=8–10), there was a higher prevalence of moderate and severe depressive symptoms (10.1% and 5.8%, respectively) (p<0.001).

Conclusions

A strong association was observed between the presence and severity of depressive symptoms and the presence of chronic knee pain. The association became stronger with higher levels of depressive symptoms, indicating a positive correlation between depressive symptoms severity and chronic knee pain.
Cohort profile: patient characteristics and quality-of-life measurements for newly-referred patients with atrial fibrillation—Keio interhospital Cardiovascular Studies-atrial fibrillation (KiCS-AF)
Authors: Ikemura Nobuhiro , Spertus John A , Kimura Takehiro , Mahaffey Kenneth , Piccini Jonathan P , Inohara Taku , Ueda Ikuko , Tanimoto Kojiro , Suzuki Masahiro , Nakamura Iwao , Akaishi Makoto , Mitamura Hideo , Fukuda Keiichi , Takatsuki Seiji , Kohsaka Shun
Published: December 2019

Purpose

Besides the high rates of morbidity and mortality, atrial fibrillation (AF) is also associated with impairment of quality-of-life (QOL). However, reports covering non-selected AF population within Asian countries remain scarce. The objective of the Keio interhospital Cardiovascular Studies-atrial fibrillation (KiCS-AF) registry is to clarify the baseline and QOL profiles of the AF patients at the time of initial referral to identify areas for improvement and country-specific gaps.

Participants

The KiCS-AF registry is a multicentre, prospective cohort study designed to specifically recruit AF patients newly referred to the 11 network hospitals within the Kanto area of Japan. The registry completed its enrolment in June 2018. All patients were requested to answer the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire both at baseline and 1 year, with planned clinical follow-up for 5 years. The registry also assessed individual treatment strategies including rate and rhythm control, stroke prophylaxis, and their impacts on patient-reported QOL.

Findings to date

As of December 2016, 2464 AF patients were registered; their mean age was 67.1 years (SD, 11.7), majority (69.7%; n=1717) were men and 49.2% presented with paroxysmal AF. The mean CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age ≥75 years, diabetes, stroke including vascular disease, age 65-74 years, and sex category [female]) score was 2.3 (SD, 1.6) and oral anticoagulant therapy was used for 88.6% of patients with CHA2DS2-VASc scores ≥2. The median AFEQT-overall summary score was 79.1 (IQR, 66.6–89.1). Roughly 50% had significantly impaired QOL (ie, AFEQT <80) at baseline. Currently, 2307 eligible patients (93.6%) have completed the 1-year follow-up, of which 2072 patients (89.8%) answered the second AFEQT questionnaire.

Future plans

The KiCS-AF allowed for extensive investigation of AF-related QOL in a non-selected population with long-term follow-up using a rigorously validated QOL assessment tool. Almost half of patients had impaired QOL at baseline. Further investigations aimed at providing care and improving patient-reported QOL are required.
Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol
Authors: Yadav Lalit , Gill Tiffany K , Taylor Anita , Jasper Unyime , De Young Jen , Visvanathan Renuka , Chehade Mellick J
Published: December 2019

Introduction

Older people with hip fractures often require long-term care and a crucial aspect is the provision of quality health information to patients and their carers to support continuity of care. If patients are well informed about their health condition and caring needs, particularly posthospital discharge into the community setting, this may support recovery and improve quality of life. As internet and mobile access reach every household, it is possible to deliver a new model of service using a digital education platform as a personal health hub where both patients and their providers of care can establish a more efficient information integration and exchange process. This protocol details proposed research, which aims to develop a ‘model of care’ by using a digital health solution that will allow delivery of high quality and patient-centred information, integrated into the existing process delivered within the community setting.

Methods and analysis

This phase of the study uses a pragmatic mixed-methods design and a participatory approach through engagement of patients, their carers and healthcare providers from multiple disciplines to inform the development of a digital health platform. Quantitative methods will explore health literacy and e-health literacy among older people with hip fractures admitted to the two public tertiary care hospitals in Adelaide, South Australia. Qualitative methods will provide an understanding of aspects of content and context required for the digital health platform to be developed in order to deliver quality health information. The study will use appropriate theoretical frameworks and constructs to guide the design, analysis and overall conduct of the research study. The scope of the study intends to ultimately empower patients and their carers to improve self-management and to better use coordinated services at the community level. This could prevent further falls including associated injuries or new fractures; reduce new hospital admissions and improve confidence and engagement by limiting the psychologically restrictive ‘fear of falls’.

Ethics and dissemination

The study has been approved by the Human Research Ethics Committee of the Central Adelaide Local Health Network, South Australia (SA) Health, Government of South Australia and the University of Adelaide Human Research Ethics Committee. Findings from the study will be published in suitable peer-reviewed journals and disseminated through workshops or conferences.
Sociodemographic, labour market marginalisation and medical characteristics as risk factors for reinfarction and mortality within 1 year after a first acute myocardial infarction: a register-based cohort study of a working age population in Sweden
Authors: Wang Mo , Vaez Marjan , Dorner Thomas Ernst , Rahman Syed Ghulam , Helgesson Magnus , Ivert Torbjörn , Mittendorfer-Rutz Ellenor
Published: December 2019

Objectives

Research covering a wide range of risk factors related to the prognosis during the first year after an acute myocardial infarction (AMI) is insufficient. This study aimed to investigate whether sociodemographic, labour market marginalisation and medical characteristics before/at AMI were associated with subsequent reinfarction and all-cause mortality.

Design

Population-based cohort study.

Participants

The cohort included 15 069 individuals aged 25–64 years who had a first AMI during 2008–2010.

Primary and secondary outcome measures

The outcome measures consisted of reinfarction and all-cause mortality within 1 year following an AMI, which were estimated by univariate and multivariable HRs and 95% CIs by Cox regression.

Results

Sociodemographic characteristics such as lower education showed a 1.1-fold and 1.3-fold higher risk for reinfarction and mortality, respectively. Older age was associated with a higher risk of mortality while being born in non-European countries showed a lower risk of mortality. Labour market marginalisation such as previous long-term work disability was associated with a twofold higher risk of mortality. Regarding medical characteristics, ST-elevation myocardial infarction was predictive for reinfarction (HR: 1.14, 95% CI: 1.07 to 1.21) and all-cause mortality (HR: 3.80, 95% CI: 3.08 to 4.68). Moreover, diabetes mellitus, renal insufficiency, stroke, cancer and mental disorders were associated with a higher risk of mortality (range of HRs: 1.24–2.59).

Conclusions

Sociodemographic and medical risk factors were identified as risk factors for mortality and reinfarction after AMI, including older age, immigration status, somatic and mental comorbidities. Previous long-term work disability and infarction type provide useful information for predicting adverse outcomes after AMI during the first year, particularly for mortality.
Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study
Authors: Koh Youlin , Stehli Julia , Martin Catherine , Brennan Angela , Dinh Diem T , Lefkovits Jeffrey , Zaman Sarah
Published: December 2019

Objective

Women have reported higher mortality and major adverse cardiovascular events (MACE) following acute coronary syndromes (ACSs) compared with men. With this in mind, we aimed to identify predictors of poor quality of life (QoL) post-ACS as our primary outcome. We examined predictors of MACE, major cerebrovascular events and major bleeding as our secondary outcome.

Design

Prospective cohort study.

Setting

30 metropolitan centres across the Victorian Cardiac Outcomes Registry network.

Participants

16 517 patients treated with percutaneous coronary intervention (PCI) for ACS (22.9% females). Selection/inclusion criteria: consecutive patients with successful or attempted PCI for ACS from 2013 to 2016, alive at 30 days post-PCI. Exclusion criteria: patients not fulfilling ACS criteria. At 30 days, 2497 (64.7% females) completed the QoL EQ-5D-3L instrument.

Primary and secondary outcome measures

QoL, assessed using the EuroQo-5Dimensions (EQ-5D-3L) instrument by telephone at 30 days. Independent predictors of QoL were identified by univariate and multivariate logistic regression analyses.

Results

Women were significantly older with more diabetes, cerebrovascular disease and renal failure. Regarding the primary outcome, female sex was independently associated with moderate/severe impairment in all EQ-5D-3L domains including mobility (OR 2.38, 95% CI 2.06 to 2.75, p<0.001), personal care (OR 2.14, 95% CI 1.73 to 2.66, p<0.001), activities of daily living (OR 1.84, 95% CI 1.63 to 2.08, p<0.001), pain/discomfort (OR 1.44, 95% CI 1.24 to 1.67, p<0.001) and anxiety/depression (OR 1.49, 95% CI 1.30 to 1.70, p<0.001). Women had significantly lower self-rated Visual Analogue Scale scores (80.0 for both groups, IQR 60-85 vs 70-90, p<0.001). There was no significant difference between the sexes in secondary outcomes.

Conclusions

Female sex was a predictor of poorer QoL following PCI for ACS including significantly higher pain, anxiety and depression. This was independent of age, comorbidities and ACS presentation. There is a clinical need for a tailored approach in female ACS management, for example, emphasis on management of depressive and anxiety symptoms.
Saving 20 000 Days and Beyond: a realist evaluation of two quality improvement campaigns to manage hospital demand in a New Zealand District Health Board
Authors: Middleton Lesley , Dowdle Diana , Villa Luis , Gray Jonathon , Cumming Jacqueline
Published: December 2019

Background

The current paper reports on a realist evaluation of two consecutive quality improvement campaigns based on the Institute for Healthcare Improvement’s Breakthrough Series. The campaigns were implemented by a District Health Board to manage hospital demand in South Auckland, New Zealand. A realist evaluation design was adopted to investigate what worked in the two campaigns and under what conditions.

Methods

A mixed-methods approach was used, involving three phases of data collection. During the first phase, a review of campaign materials and relevant literature, as well as key informant interviews were undertaken to generate an initial logic model of how the campaign was expected to achieve its objective. In phase II, the model was tested against the experiences of participants in the first campaign via a questionnaire to all campaign participants, interviews with campaign sponsors and collaborative team leaders and a review of collaborative team dashboards. In phase III, the refined model was tested further against the experiences of participants in the second campaign through interviews with collaborative team leaders, case studies of four collaborative teams and a review of the overall system-level dashboard.

Results

The evaluation identified four key mechanisms through which the campaigns’ outcomes were achieved. These were characterised as ‘an organisational preparedness to change’, ‘enlisting the early adopters’, ‘strong collaborative teams’ and ‘learning from measurement’. Contextual factors that both enabled and constrained the operation of these mechanisms were also identified.

Conclusions

By focusing on the explication of a theory of how the campaigns achieved their outcomes and under what circumstances, the realist evaluation reported in this paper provides some instructive lessons for future evaluations of quality improvement initiatives.
Three-dimensional and four-dimensional flow assessment in congenital heart disease
Authors: Warmerdam Evangeline , Krings Gregor J , Leiner Tim , Grotenhuis Heynric B
Published: December 2019

Congenital heart disease (CHD) is the most common form of congenital defects, with an incidence of 8 per 1000 births. Due to major advances in diagnostics, perioperative care and surgical techniques, the survival rate of patients with CHD has improved dramatically. Conversely, although 70%–95% of infants with CHD survive into adulthood, the rate of long-term morbidity, which often requires (repeat) intervention, has increased. Recently, the role of altered haemodynamics in cardiac development and CHD has become a subject of interest. Patients with CHD often have abnormal blood flow patterns, either due to the primary cardiac defect or as a consequence of the surgical intervention(s). Research suggests that these abnormal blood flow patterns may contribute to diminished cardiac and vascular function. Serial assessment of haemodynamic parameters in patients with CHD may allow for improved understanding of the often complex haemodynamics in these patients and thereby potentially guide the timing and nature of interventions with the aim of preventing progression of cardiovascular deterioration. In this article we will discuss two novel non-invasive four-dimensional (4D) techniques to evaluate cardiovascular haemodynamics: 4D-flow cardiac magnetic resonance and computational fluid dynamics. This review focuses on the additional value of these two modalities in the evaluation of patients with CHD with abnormal flow patterns, who could benefit from advanced haemodynamic evaluation: patients with coarctation of the aorta, bicuspid aortic valve, tetralogy of Fallot and patients after Fontan palliation.
Intravenous thrombolysis with 0.9 mg/kg alteplase for acute ischaemic stroke: a network meta-analysis of treatment delay
Authors: Chen Xi , Shen Yu , Huang Chengfang , Geng Yu , Yu Yunxian
Published: December 2019

Objectives

The aim of this study was to evaluate the effect of alteplase in intravenous thrombolysis of acute ischaemic stroke (AIS) regarding the different time windows of treatment (<3 hours, 3–4.5 hours, >4.5 hours).

Methods

A systematic literature search was conducted from PubMed, Cochrane Library and Embase. 12 clinical randomised controlled trials with 3402 patients with AIS met the inclusion criteria. The primary, secondary and tertiary outcomes were modified Rankin Scale (mRS) scores 0–1, mortality at 90th day after treatment and symptomatic intracerebral haemorrhage within 36 hours, respectively. Network meta-analysis and conventional meta-analysis were carried out for calculating odds ratio (OR), the surface under cumulative ranking curve (SUCRA) and the probabilities of being the best.

Results

For mRS, alteplase regardless of time delay was significantly more effective than placebo (OR 1.33–2.17). However, alteplase used within 3 hours after AIS occurrence (SUCRA=98.3%) was significantly more effective (OR=1.64) than that at 3–4.5 hours (SUCRA=43%) and showed the trend of priority (OR=1.47) compared with that beyond 4.5 hours (SUCRA=58%). For the mortality, compared with placebo (SUCRA=64.7%), alteplase within 3 hours was similar to that of 3–4.5 hours whereas alteplase beyond 4.5 hours (SUCRA=7.3%) showed the trend of significantly increasing 85% mortality. For the tertiary outcome, alteplase within 3 hours (SUCRA=19.0%) was comparable with placebo (SUCRA=99.9%) whereas alteplase beyond 3 hours significantly increased (OR 5.89–6.67) the symptomatic intracerebral haemorrhage.

Conclusions

Alteplase within 3 hours should be recommended as the best treatment delay for its best efficacy among all the intervention and equivalent safety compared with placebo. Alteplase beyond 3 hours was less effective compared with that within 3 hours and increased the risk of mortality on 3 months as well as symptomatic intracerebral haemorrhage at 36 hours. More head-to-head clinical trials are needed to confirm those findings.
Numerical study on structures formed by the deposition and solidification of a single molten droplet
Authors: Li Wenbin , Zhang Ying , Chen Yue , Li Peisheng , Ma Chunhong
Published: December 2019

The formed structure is of importance in determining the surface quality of a component made by droplet-based 3D printing. In the present work, the molten droplet solicitation process was simulated under an axisymmetric system where the smallest length scale and time scale were fully resolved. Evolutions of sharp droplet interfaces were captured through the front tracking method. Parametric studies have been carried out to explore how the dynamic metrics, which include the Ohnesorge number (Oh) and Weber number (We), can affect the structure of depositing droplet. The effect of the superheat parameter on the cooling rate was also investigated in the final section. Numerical results show that the inertial resisting force is critical dynamics in the variation of horizontal dimensionless length at the early deposition process. Three levels of Oh numbers and stages of We numbers were classified according to the deformation behavior. Flattening degree under different Oh number and We number cases were both fitted well by the exponential function. This paper also reveals that the variation law of the cooling rate and solidification time is affected by the superheat parameter, resulting in a feasible and promising method to predict droplet deformation time through the fully resolved numerical simulations during the manufacturing process.
Contact simulation analysis of double cylindrical asperities using the finite element method
Authors: Wang Lihua , Chen Liheng , Huang Yayu , Yao Tingqiang , Wang Chunfeng
Published: December 2019

To analyze the microcontact characteristics of the rough joint surface obtained by grinding more accurately, a frictionless contact model of double cylindrical asperities was established. The contact characteristics of double cylindrical asperities with different peak distance and different heights were analyzed using the finite element method. The relationship between contact load, contact pressure, contact area, and contact displacement were studied. And the effect of double asperities on the stress state of the cylindrical asperity contact zone was revealed. The results show that, in the elastic contact stage, the contact load, contact stress, contact pressure, and contact area decreased with an increase in the peak distance, and the corresponding values are smaller than that of single peak asperity contact. In the elastoplastic stage, because of the interaction of the double asperities, the change of the contact pressure with the contact displacement on the double asperities contact is larger than the corresponding value of the single peak asperity under the same conditions. The research can be applied into the model of anisotropic interface and provide theoretical foundations for the study on contact characteristics of grinding interface.
Application of a new hybrid method for solving singular fractional Lane–Emden-type equations in astrophysics
Authors: Ma Wen-Xiu , Mousa Mohamed M. , Ali Mohamed R.
Published: December 2019

In this research, a hybrid numerical method combining cosine and sine (CAS) wavelets and Green’s function approach is created to acquire the arrangements of fractional Lane–Emden Problem. The suggested methodology for detecting the solution of nonlinear equations dependent on variations of germinal algorithms is applied on nonlinear fractional Lane–Emden Problem under some smooth conditions and results in an iterative scheme of nonlinear equations Because of its efficiency, this technique is applied on a large variety of equations from the boundary value problems to the optimization. This paper is extending the suggested methodology technique for fractional Lane–Emden Problem. Moreover, the feature of the present novel method is utilized to convert the problem under observance into a system of algebraic equations that can be illuminated by suitable algorithms. A rapprochement of results has likewise been obtained using the present strategy and those reported using other techniques seem to indicate the precision and computational efficiency to establish the suitability of the Green-CAS wavelet method.
Tuning the morphology of mesoscopic structures of porphyrin macrocycles functionalized by an antimicrobial peptide
Authors: Cimino Rita , Grelloni Elisa , Magna Gabriele , Monti Donato , Stefanelli Manuela , Gatto Emanuela , Placidi Ernesto , Biscaglia Francesca , Gobbo Marina , Venanzi Mariano
Published: December 2019

The aggregation properties of two peptide–porphyrin conjugates were investigated by optical spectroscopy and microscopy imaging with nanometer resolution. Specifically, a tetraphenylporphyrin platform was functionalized by (L)-magainin, a 23-residue long antimicrobial peptide, and by a (L)-magainin analogue differing from the parent peptide by a single residue substitution, [Formula: see text] an Ala vs. Phe replacement in the position 5 of the peptide chain. Spectroscopic and microscopy results show that this single-site substitution has a small effect on the secondary structure attained by the two peptide analogues, but deeply affects the morphology of the mesoscopic structures deposited on hydrophilic mica from methanol/water solutions. In particular, only the Ala-substituted peptide-porphyrin conjugate was shown to be able to form micrometric fibrils, coating homogeneously a hydrophilic mica surface. These results pave the way for potential applications of porphyrin-peptide compounds in localized photodynamic therapy and for designing solid-state stereoselective sensors.
Performance Evaluation of Battery Thermal Management System in Electric Vehicle using Induction Heater (Part 1: Parallel System)
Authors: Raza Waseem , Ko Gwang Soo , Park Youn Cheol
Published: December 2019

The fast evolving Electric vehicles (EVs) have become popular due to their zero-emission, fuel economy and better technology. However, the performance and life of batteries are very sensitive to temperature, it is important to maintain the proper temperature range. The battery thermal management system (BTMS) plays an important role in the performance of EVs. In this context, this study is conducted to evaluate the thermal performance of a battery with a parallel system using an induction heater. The GT-Suite software is used for simulation and evaluation. Mixture of water and ethylene glycol 50:50 is used as a working fluid and controlled by pump and valves. The heating rate of battery was analyzed by changing the capacity of induction heater 2, 4 and 6[Formula: see text]kW and the flow rate of fluid was 2, 3, 5, 7, 10 and 27 LPM. The simulation work predicts that the battery heating rate increases with the increase in fluid flow. The study concluded that the battery heating rate is maximum with a flow rate of 27 LPM which is the highest amount of LPM, indicating that the rise in flow rate causes the increase in heating rate of the system which is also affected by induction heater capacity.
Key controls on hydrocarbon retention and leakage from structural traps in the Hammerfest Basin, SW Barents Sea: implications for prospect analysis and risk assessment
Authors: Edmundson Isabel , Rotevatn Atle , Davies Roy , Yielding Graham , Broberg Kjetil
Published: December 2019

Evidence of hydrocarbon leakage has been well documented across the SW Barents Sea and is commonly associated with exhumation in the Cenozoic. While fault leakage is thought to be the most likely cause, other mechanisms are possible and should be considered. Further study is required to understand what specific mechanism(s) facilitate such leakage, and why this occurs in some locations and not others. In a case study of the Snøhvit Field, we use seismic and well data to quantify fault- and top-seal strength based on mechanical and capillary threshold pressure properties of fault and cap rocks. Magnitude and timing of fault slip are measured to acknowledge the role that faults play in controlling fluid flow over time. Results based on theoretical and
in situ
hydrocarbon column heights strongly indicate that across-fault and top-seal breach by capillary threshold pressure, and top-seal breach by mechanical failure are highly unlikely to have caused hydrocarbon leakage. Instead, top-seal breach caused by tectonic reactivation of identified faults is likely to have facilitated hydrocarbon leakage from structural traps. The results of this case study acknowledge the different mechanisms by which hydrocarbons can leak from a structural trap. Employing both a holistic and quantitative approach to assessing different seal capacities reduces the likelihood that a particular cause of hydrocarbon leakage is overlooked. This is particularly relevant for the Snøhvit Field in its dual capacity as a producing gas field and as a carbon sequestration site since both systems rely on a thorough understanding of seal capacity and leakage potential.
Line length balancing to evaluate multi-phase submarine landslide development: an example from the Storegga Slide, Norway
Authors: Bull Suzanne , Cartwright Joseph A.
Published: December 2019

This study shows how simple structural restoration of a discrete submarine landslide lobe can be applied to large-scale, multi-phase examples to identify different phases of slide-lobe development and evaluate their mode of emplacement. We present the most detailed analysis performed to date on a zone of intense contractional deformation, historically referred to as the compression zone, from the giant, multi-phase Storegga Slide, offshore Norway. 2D and 3D seismic data and bathymetry data show that the zone of large-scale (>650 m thick) contractional deformation can be genetically linked updip with a zone of intense depletion across a distance of 135 km. Quantification of depletion and accumulation along a representative dip-section reveals that significant depletion in the proximal region is not accommodated in the relatively mild amount (
c.
5%) of downdip shortening. Dip-section restoration indicates a later, separate stage of deformation may have involved removal of a significant volume of material as part of the final stages of the Storegga Slide, as opposed to the minor volumes reported in previous studies.
Impact of sea-level fluctuations on the sedimentation patterns of the SE African margin: implications for slope instability
Authors: Micallef Aaron , Georgiopoulou Aggeliki , Green Andrew , Maselli Vittorio
Published: December 2019

The sheared-passive margin offshore Durban (South Africa) is characterized by a narrow continental shelf and steep slope hosting numerous submarine canyons. Supply of sediment to the margin is predominantly terrigenous, dominated by discharge from several short but fast-flowing rivers. International Ocean Discovery Program Expedition 361 provides a unique opportunity to investigate the role of sea-level fluctuations on the sedimentation patterns and slope instability along the South African margin. We analysed >300 sediment samples and downcore variations in
P
-wave, magnetic susceptibility, bioturbation intensity and bulk density from site U1474, as well as regional seismic reflection profiles to: (1) document an increase in sand input since the Mid-Pliocene; (2) associate this change to a drop in sea-level and extension of subaerial drainage systems towards the shelf-edge; (3) demonstrate that slope instability has played a key role in the evolution of the South Africa margin facing the Natal Valley. Furthermore, we highlight how the widespread occurrence of failure events reflects the tectonic control on the morphology of the shelf and slope, as well as bottom-current scour and instability of fan complexes. This information is important to improve hazard assessment in a populated coastal region with growing offshore hydrocarbon activities.
Morphology and spatio-temporal distribution of lacustrine mass-transport deposits in Wörthersee, Eastern Alps, Austria
Authors: Daxer Christoph , Sammartini Maddalena , Molenaar Ariana , Piechl Thomas , Strasser Michael , Moernaut Jasper
Published: December 2019

In lakes, landslides can be studied in high resolution due to their accessibility and limited size. Here, we investigate mass-transport deposits in glacigenic Wörthersee (Eastern European Alps) by integration of seismic, sediment core and multibeam bathymetric data. Two outstanding landslide events were revealed: the first occurred in the Late Glacial, leading to multiple deposits of up to 15 m thickness; they consist of sandy turbidites and mudclast conglomerates, which are overlain by a 2.5 m thick megaturbidite. The extensive, likely earthquake-triggered failure linked to this event was preconditioned by rapid sedimentation of fine-grained glaciolacustrine sediments and associated build-up of excess pore pressure. The second event was presumably triggered by a major earthquake (M
w
≈7) in AD 1348 and comprises a mass-transport complex and several landslides, which led to a
c.
30 cm thick turbidite. In total, 62 landslides are imaged in the multibeam map, 6 of which are most likely human-induced. Some of these show horseshoe-type compressional ridges and frontal breaching, whereas others exhibit an extensive zone of rafted blocks. We attribute these morphological differences to four main factors: (1) slope gradient and changes therein; (2) preconditioning of the impacted zone; (3) volume of remobilized sediment; and (4) type of impactor.
Estimation of human damage and economic loss of buildings related to tsunami inundation in the city of Augusta, Italy
Authors: Pagnoni Gianluca , Armigliato Alberto , Tinti Stefano
Published: December 2019

We propose a methodology to assess tsunami risk in terms of human damage (HD: the quantification of people affected/killed by the tsunami) and economic loss (EL: the loss of the economic value of constructions damaged/destroyed by the tsunami). The methodology makes a combined use of detailed information on buildings, demography and reasonable tsunami inundation heights (IH). First, after defining the tsunami inundation area, we estimate the level of damage to each building within this area, which depends on the building vulnerability and on the flow depth (FD) affecting the building. To estimate the HD, by making use of census data, we infer the number of people present in each residential building of the inundated area. Then, based on FD and building damage, we evaluate the level of people exposure. Finally, we provide an estimate of fatalities. The EL is computed for two types of constructions (residential and trade/industrial) by using data on inundation and data from the real estate market. The methodology is applied to the town of Augusta (eastern Sicily coast, Italy), which, according to historical accounts, was affected by several tsunamis in the course of its history. The results are discussed in terms of the level of damage to buildings, the number of fatalities and the loss of economic value of the building stock for different tsunami sizes. This latter is prescribed through a simple bathtub approach: that is, by assuming uniform IHs with the maximum IH chosen to be consistent with historical data. Partial collapse occurs only above 6 m for residential buildings and above 8 m for trade/industrial buildings. Approximately 47% of the people living in Augusta are potentially affected by the tsunami inundation. For the highest selected IH (10 m), 70% of the people in the inundated area are effectively exposed and the fatalities are estimated at about 47%. The number of people involved increases linearly with the IH, while the number of fatalities increases following a quasi-quadratic law. Finally, the EL is also found to vary linearly with the IH, and the estimated loss in the case of the worst IH (10 m) is around 11% of the gross domestic product (GDP) of the entire province of Siracusa, to which Augusta belongs.
Susceptibility to high-altitude pulmonary edema is associated with increased pulmonary arterial stiffness during exercise
Authors: Mulchrone A. , Moulton H. , Eldridge M. W. , Chesler N. C.
Published: December 2019

High-altitude pulmonary edema (HAPE), a reversible form of capillary leak, is a common consequence of rapid ascension to high altitude and a major cause of death related to high-altitude exposure. Individuals with a prior history of HAPE are more susceptible to future episodes, but the underlying risk factors remain uncertain. Previous studies have shown that HAPE-susceptible subjects have an exaggerated pulmonary vasoreactivity to acute hypoxia, but incomplete data are available regarding their vascular response to exercise. To examine this, seven HAPE-susceptible subjects and nine control subjects (HAPE-resistant) were studied at rest and during incremental exercise at sea level and at 3,810 m altitude. Studies were conducted in both normoxic (inspired Po2= 148 Torr) and hypoxic (inspired Po2= 91 Torr) conditions at each location. Here, we report an expanded analysis of previously published data, including a distensible vessel model that showed that HAPE-susceptible subjects had significantly reduced small distal artery distensibility at sea level compared with HAPE-resistant control subjects [0.011 ± 0.001 vs. 0.021 ± 0.002 mmHg−1; P < 0.001). Moreover, HAPE-susceptible subjects demonstrated constant distensibility over all conditions, suggesting that distal arteries are maximally distended at rest. Consistent with having increased distal artery stiffness, HAPE-susceptible subjects had greater increases in pulmonary artery pulse pressure with exercise, which suggests increased proximal artery stiffness. In summary, HAPE-susceptible subjects have exercise-induced increases in proximal artery stiffness and baseline increases in distal artery stiffness, suggesting increased pulsatile load on the right ventricle.

NEW & NOTEWORTHY In comparison to subjects who appear resistant to high-altitude pulmonary edema, those previously symptomatic show greater increases in large and small artery stiffness in response to exercise. These differences in arterial stiffness may be a risk factor for the development of high-altitude pulmonary edema or evidence that consequences of high-altitude pulmonary edema are long-lasting after return to sea level.
Conditioned Medium from Adipose-Derived Stem Cell Inhibits Jurkat Cell Proliferation through TGF-β1 and p38/MAPK Pathway
Authors: Wang Xiuxia , Wang Yinmin , Zhou Xianyu , Liu Fei
Published: December 2019

Background.Since the first report on the immunomodulatory and immunosuppressive properties of Adipose-Derived Stem Cells (ADSCs), many studies have elucidated the underlying molecular mechanism of their suppressive activity on mixed lymphocyte reaction (MLR). However, a gap exists in our understanding of the molecular mechanism of ADSC-conditioned medium (ADSC-CM) on MLR.Methods.ADSCs were isolated from Human Adipose Tissues, and Enzyme-linked Immunosorbent Assay (ELISA) was used to identify the concentration of transforming growth factorβ1 (TGF-β1) in ADSC-CM. The transcript abundance of TGF-β1, as well as that of insulin-like growth factor binding protein 3 (IGF-BP3), was evaluated using qRT-PCR on Jurkat cells cultured in ADSC-CM for 24 hours. The proliferation of the Jurkat cells was assessed using cell cycle assay. Western blotting was performed to identify potential signaling molecules involved in the ADSC-CM-induced inhibition of Jurkat cell proliferation.Results.The findings confirm that the isolated ADSCs demonstrate classic ADSC characteristics. The level of TGF-β1 was found to be low in ADSC-CM, as assessed by ELISA. Jurkat cells grown in ADSC-CM show reduced gene expression of TGF-β1 and IGF-BP3 compared with that of the control group. Furthermore, western blotting of ADSC-CM grown Jurkat cells that were blocked at the G0/G1 stage indicates that ADSC-CM decreases the protein expression of pP38 in a dose-dependent manner.Conclusion.ADSC-CM can inhibit Jurkat cell proliferation through the TGF-β1-p38 signaling pathway.
Cryoablation of a Symptomatic Chest Wall Desmoid Tumor Underneath a Silicone Breast Implant
Authors: Kulkarni Siddhant S. , Deipolyi Amy R. , Bryce Yolanda C. D. , Erinjeri Joseph P.
Published: December 2019

Desmoid tumors are locally aggressive tumors that have a high rate of reoccurrence, even after resection. Percutaneous cryoablation is an effective alternative treatment with less associated risk. A patient in the fifth decade of life with a history of ductal carcinoma-in-situ, status post bilateral mastectomy and silicone implant placement, presented with a palpable mass in the left breast, core biopsy proven to be a desmoid tumor underneath the implant. The patient underwent two cryoablation procedures in a six-month period. During both procedures part of the implant was included in the ablation zone without any negative effects on the implant. Cryoablation is a feasible treatment option for desmoid tumors adjacent to silicone breast implants.
Gait Biomarkers Classification by Combining Assembled Algorithms and Deep Learning: Results of a Local Study
Authors: Sánchez-DelaCruz Eddy , Weber Roberto , Biswal R. R. , Mejía Jose , Hernández-Chan Gandhi , Gómez-Pozos Heberto
Published: December 2019

Machine learning, one of the core disciplines of artificial intelligence, is an approach whose main emphasis is analytical model building. In other words, machine learning enables an automaton to make its own decisions based on a previous training process. Machine learning has revolutionized every research sector, including health care, by providing precise and accurate decisions involving minimal human interventions through pattern recognition. This is emphasized in this research, which addresses the issue of “support for diabetic neuropathy (DN) recognition.” DN is a disease that affects a large proportion of the global population. In this research, we have used gait biomarkers of subjects representing a particular sector of population located in southern Mexico to identify persons suffering from DN. To do this, we used a home-made body sensor network to capture raw data of the walking pattern of individuals with and without DN. The information was then processed using three sampling criteria and 23 assembled classifiers, in combination with a deep learning algorithm. The architecture of the best combination was chosen and reconfigured for better performance. The results revealed a highly acceptable classification with greater than 85% accuracy when using these combined approaches.
Safety Risk Analysis of Unmanned Ships in Inland Rivers Based on a Fuzzy Bayesian Network
Authors: Zhang Xiuxia , Zhang Qingnian , Yang Jie , Cong Zhe , Luo Jing , Chen Huanwan
Published: December 2019

Risk factor identification is the basis for risk assessment. To quantify the safety risks of unmanned vessels in inland rivers, through analysis of previous studies, the safety risk impact factor framework of unmanned vessels in inland rivers is established based on three aspects: the ship aspect, the environmental aspect, and the management and control aspect. Relying on Yangtze River, a fuzzy Bayesian network of the sailing safety risk of unmanned ships in inland rivers is constructed. The proposed safety risk model has considered different operational and environmental factors that affect shipping operations. Based on the fuzzy set theory, historical data, and expert judgments and on previous works are used to estimate the base value (prior values) of various risk factors. The case study assessed the safety risk probabilities of unmanned vessels in Yangtze River. By running uncertainty and sensitivity analyses of the model, a significant change in the likelihood of the occurrence of safety risk is identified, and suggests a dominant factor in risk causation. The research results can provide effective information for analyzing the current safety status for navigation systems of unmanned ships in inland rivers. The estimated safety risk provides early warning to take appropriate preventive and mitigative measures to enhance the overall safety of shipping operations.
Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults—A Systematic Review and Meta-Analysis
Authors: Dahmarde Hamid , Parooie Fateme , Salarzaei Morteza
Published: December 2019

Objective. The present systematic review and meta-analysis were conducted to investigate the accuracy of ultrasound in the diagnosis of pneumothorax in neonates and adults.Method. The searches were conducted by two independent researchers (MS and HD) to find the relevant studies published from 01/01/2009 until the end of 01/01/2019. We searched for published literature in the English language in MEDLINE via PubMed, Embase™ via ovid, the Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS, and we searched OpenGrey (http://www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (http://who.int/ictrp) for unpublished literature and ongoing studies. The keywords used in the search strategy were pneumothorax or ultrasound or chest ultrasonography or neonate or adult or aerothorax or sensitivity or specificity or diagnostic accuracy. The list of previous study resources and systematic reviews was also searched for identifying the published studies (MS and HD). Analyses were performed using Meta-Disc 1.4.Results. In total, 1,565 patients (255 neonates, 1212 adults, and 101 pediatrics suspected of pneumothorax) were investigated in 10 studies. The overall specificity of chest ultrasound in the diagnosis of pneumothorax in both populations of adults and neonates was 85.1% at the confidence interval of 95 percent (95% CI 81.1%–88.5%). At the confidence interval of 95 percent, the sensitivity was 98.6% (95% CI 97.7%–99.2%). The diagnostic odds ratio was 387.72 (95% CI 76.204–1972.7). For the diagnosis of pneumothorax in neonates, the ultrasound sensitivity was 96.7% at the confidence interval of 95 percent (95% CI 88.3%–99.6%). At the confidence interval of 95 percent, the specificity was 100% (95% CI 97.7%–100%). For the diagnosis of pneumothorax in adults, the ultrasound sensitivity was 82.9% at the confidence interval of 95 percent (95% CI 78.3–86.9%). At the confidence interval of 95 percent, the specificity was 98.2% (95% CI 97.0%–99.0%). The diagnostic odds ratio was 423.13 (95% CI 45.222–3959.1). Analyzing studies indicated that the sensitivity of “absence lung sliding” sign for the diagnosis of pneumothorax was 87.2% (95% CI 77.7–93.7), and specificity was 99.4% (95% CI 96.5%–100%). DOR was 556.74 (95% CI 100.03–3098.7). The sensitivity of “lung point” sign for the diagnosis of pneumothorax was 82.1% (95% CI 71.7%–89.8%), and the specificity was 100% (at the confidence interval of 95% CI 97.6%–100%). DOR was 298.0 (95% CI 58.893–1507.8).Conclusion. The diagnosis of pneumothorax using ultrasound is accurate and reliable; additionally, it can result in timely diagnoses specifically in neonatal pneumothorax. Using this method facilitates the therapy process; lack of ionizing radiation and easy operation are benefits of this imaging technique.
Determinants of Change in Fertility among Women in Rural Areas of Uganda
Authors: Ariho Paulino , Nzabona Abel
Published: December 2019

Fertility among rural women in Uganda continues to decline. Studies on fertility in Uganda have focused on the overall fertility in the country. In this study, we focus on determinants of change in fertility among rural women in Uganda using a multivariate Poisson decomposition technique to quantify the contribution of changes in the socioeconomic and demographic composition of women which we also refer to as the characteristic effects and changes in their fertility behavior (the coefficients’ effects or risk of childbearing) to the overall reduction in fertility among women in rural areas during the 2006–2016 period. The “characteristics effects” are used to mean the effect of changing composition of women by the socioeconomic and demographic characteristics between 2006 and 2016. On the other hand, fertility behavior also presented as coefficients’ effects mean changes in the risk or likelihood of giving birth to children by the rural women between the two survey years. Our findings indicate that the mean number of children ever born (MCEB) reduced from 4.5 to 3.9 in 2006 and this reduction was associated with both the changes in composition of women and fertility behavior. The composition of women contributed to 42% while the fertility behavior contributed to 58% of the observed reduction. The education level attained and the age at first sex showed significant contributions on both components of the decomposition. The observed decline in fertility is largely associated with the variation in the risk of childbearing among the rural women. The variation in the risk of childbearing by education and age at first sex of the rural women showed to be the biggest contribution to the observed change in fertility. Continued improvements in access, attendance, and completion of secondary schools by women in rural areas will be the key drivers to Uganda’s overall transition to low fertility. Furthermore, with improved access to mass media in the rural areas, there can be changes in attitudes and large family size preferences which can create a conducive environment for the utilization of family planning services in the rural communities. Efforts should therefore focus on applying appropriate methods to deliver packaged family planning messages to these communities.