bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication of dimension controlled BiFeO3 microcrystal
Authors: Li Ya-Yun , Shang Shao-Ke , Xia Yu , Si Yun-Hui , Xiong Xin-Bo , Zeng Xie-Rong , Zhou Ji
Published: March 2019

In this research, the effect of different KOH concentrations on the bismuth ferrite (BiFeO3) phase formation and microcrystal size was discussed. Pure phase BiFeO3 microcrystals were successfully synthesized through controlling different KOH concentrations during the hydrothermal process. The diverse sizes of pristine BiFeO3 microcrystals were characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Their photocatalytic activity was studied by photocatalytic degradation of methylene blue (MB) in aqueous solution under visible light irradiation. The results reveal that the composition and particle size of BiFeO3 microcrystals phase can be controlled with different mineralizer conditions. This work is able to provide a new perspective on the fabrication research of different dimension BiFeO3 microcrystals.
Reinvestigate the Bid–Ask Bounce Effect and Pricing of Idiosyncratic Volatility: The Case of the Australian Market
Authors: Liu Bin , Tan Monica , Cam Marie-Anne
Published: March 2019

We investigate the bid–ask bounce effect on estimation of idiosyncratic volatility (IVOL) from asset pricing perspective using a comprehensive country-specific sample. We find that the idiosyncratic volatility–return relationship remains significant while controlling for stock size. However, the explanatory power of IVOL disappears completely when stock liquidity is controlled for. These findings support our argument that the bid–ask bounce effect on pricing of IVOL is strongly influenced by stock liquidity. Our results indicate that mid-price is the “true” price to measure IVOL of the least liquid stocks in the Australian stock market.
Finite type epimorphisms of rings
Authors: Tarizadeh Abolfazl
Published: March 2019

In this paper, we study the structure of finite type epimorphisms of rings.
The determination of phosphate in rocks and iron ores using inductively coupled plasma with optical emission spectroscopy (ICP-OES)
Authors: Mostert M. M. R.
Published: March 2019

Phosphate is a minor but important constituent of iron ores and is especially undesirable in the production of steel where it is considered a penalty element and is therefore tightly controlled. Iron ore quality must be determined at source, which means that deleterious elements must be accurately determined as an ongoing process. This demands fast, reliable analytical methods for the determination of, amongst others, phosphorus. However, such analysis is severely hampered by the following factors: the standard analytical method employed is X-ray fluorescence (XRF), but the measurements for phosphorus are seriously affected by matrix and inter-element interferences. An alternative technique is inductively coupled plasma with optical emission spectroscopy (ICP-OES), but there are also complications in using ICP-OES. The abundance of phosphorus in rocks is very low, generally under 0.5% wt. ICP-OES is also very insensitive to phosphorus and therefore must use the most sensitive spectral lines for quantification, and, there are serious spectral interferences on these lines by Fe and Cu. This study examines several analytical approaches for the determination of phosphate, using preparation by fusion and analysis by ICP-OES, demonstrating that suitable mathematical procedures and software applications can produce good results for phosphates, comparable to inter-laboratory tests or XRF.
Identity by any other name
Authors: Helland Pat
Published: March 2019

The complex cacophony of intertwined systems.
Know your algorithms
Authors: Neville-Neil George V.
Published: March 2019

Stop using hardware to solve software problems.
Elevated plasma homocysteine and cysteine are associated with endothelial dysfunction across menopausal stages in healthy women
Authors: Keller Amy C. , Klawitter Jelena , Hildreth Kerry L. , Christians Uwe , Putnam Kelly , Kohrt Wendy M. , Reusch Jane E. B. , Moreau Kerrie L.
Published: March 2019

Hyperhomocysteinemia is associated with endothelial dysfunction and increased cardiovascular disease (CVD). We determined whether elevated homocysteine (Hcy) and markers of Hcy metabolism were associated with the previously reported endothelial dysfunction across stages of the menopause transition. Brachial artery flow-mediated dilation (FMD) and plasma concentrations of Hcy, cysteine, and methionine were measured in healthy women ( n = 128) 22–70 yr of age categorized as premenopausal ( n = 35), perimenopausal (early: n = 16; late: n = 21), and postmenopausal (early: n = 21; late: n = 35). Dietary intake of micronutrients involved in Hcy metabolism (e.g., vitamins B6, B12, folate) was assessed in a subpopulation of women. Hcy and cysteine concentrations were progressively higher, and methionine was progressively lower across menopausal stages (all P < 0.005). The higher Hcy and cysteine concentrations correlated with lower circulating estradiol levels ( r = −0.49 and −0.50, respectively, both P < 0.001). FMD was inversely correlated with Hcy ( r = −0.25, P = 0.004) and cysteine ( r = −0.39, P < 0.001) and positively correlated with methionine concentrations ( r = 0.25, P = 0.005). Dietary intake of vitamins B6 and B12 (both P < 0.05) were lower in postmenopausal women. Vitamin B12 intake correlated with FMD ( r = 0.22, P = 0.006). These data suggest that declines in estradiol across stages of the menopause transition may lead to elevations in Hcy and cysteine that may contribute to endothelial dysfunction in postmenopausal women. Future studies should examine whether targeting Hcy metabolism during the perimenopausal to early postmenopausal period with interventions, including diet, attenuates or reverses the decline in endothelial function in women.

NEW & NOTEWORTHY Declines in circulating estradiol across the stages of the menopausal transition may lead to elevations in Hcy and cysteine concentrations that may contribute to endothelial dysfunction. Abnormalities in the Hcy metabolic pathways, possibly related to dietary deficiencies of vitamins B12 and B6 and folate, may contribute to elevations in Hcy and cysteine concentrations. Findings also suggest that higher cysteine levels may be more damaging to the vascular endothelium than Hcy.
Seven days of cold acclimation substantially reduces shivering intensity and increases nonshivering thermogenesis in adult humans
Authors: Gordon Kyle , Blondin Denis P. , Friesen Brian J. , Tingelstad Hans Christian , Kenny Glen P. , Haman François
Published: March 2019

Daily compensable cold exposure in humans reduces shivering by ~20% without changing total heat production, partly by increasing brown adipose tissue thermogenic capacity and activity. Although acclimation and acclimatization studies have long suggested that daily reductions in core temperature are essential to elicit significant metabolic changes in response to repeated cold exposure, this has never directly been demonstrated. The aim of the present study is to determine whether daily cold-water immersion, resulting in a significant fall in core temperature, can further reduce shivering intensity during mild acute cold exposure. Seven men underwent 1 h of daily cold-water immersion (14°C) for seven consecutive days. Immediately before and following the acclimation protocol, participants underwent a mild cold exposure using a novel skin temperature clamping cold exposure protocol to elicit the same thermogenic rate between trials. Metabolic heat production, shivering intensity, muscle recruitment pattern, and thermal sensation were measured throughout these experimental sessions. Uncompensable cold acclimation reduced total shivering intensity by 36% ( P = 0.003), without affecting whole body heat production, double what was previously shown from a 4-wk mild acclimation. This implies that nonshivering thermogenesis increased to supplement the reduction in the thermogenic contribution of shivering. As fuel selection did not change following the 7-day cold acclimation, we suggest that the nonshivering mechanism recruited must rely on a similar fuel mixture to produce this heat. The more significant reductions in shivering intensity compared with a longer mild cold acclimation suggest important differential metabolic responses, resulting from an uncompensable compared with compensable cold acclimation.

NEW & NOTEWORTHY Several decades of research have been dedicated to reducing the presence of shivering during cold exposure. The present study aims to determine whether as little as seven consecutive days of cold-water immersion is sufficient to reduce shivering and increase nonshivering thermogenesis. We provide evidence that whole body nonshivering thermogenesis can be increased to offset a reduction in shivering activity to maintain endogenous heat production. This demonstrates that short, but intense cold stimulation can elicit rapid metabolic changes in humans, thereby improving our comfort and ability to perform various motor tasks in the cold. Further research is required to determine the nonshivering processes that are upregulated within this short time period.
Spectrum of Thyroid Abnormalities among Children Living with HIV in Lagos, Nigeria
Authors: Akinsete Adeseye , Oyenusi Elizabeth , Odugbemi Babatunde , Odugbemi Tinuola , Temiye Edamisan
Published: March 2019

Thyroid disorders have been described in an adult population but are underreported in the pediatric population. The aim of this study was to determine the prevalence and describe the spectrum of thyroid abnormalities among HIV infected children on Highly Active Antiretroviral Therapy (HAART) in Lagos, Nigeria. This was a cross-sectional study carried out at a teaching hospital with an antiretroviral therapy (ART) center. Serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) were analyzed in 83 children living with HIV on HAART and 51 controls. The prevalence of thyroid dysfunction and correlation of fT3, fT4, and TSH with duration on HAART, age, CD4 count, and nutritional status were assessed. Thyroid abnormalities were seen in 9.6% of the children living with HIV comprising subclinical hypothyroidism in 6%, euthyroid sick syndrome in 2.4%, and overt hypothyroidism in 1.2% as compared to 2% subclinical thyroid disease among the controls (p= 0.15). Hypothyroidism was correlated with CD4 count and viral load. None of the patients had clinical features of thyroid disease. Thyroid abnormalities were more prevalent among children living with HIV and yearly screening with follow-up is advocated.
Relation between Red Cell Distribution Width and Mortality in Critically Ill Patients with Acute Respiratory Distress Syndrome
Authors: Wang Benji , Gong Yuqiang , Ying Binyu , Cheng Bihuan
Published: March 2019

Background. Currently, evidence regarding the predictive significance of red blood cell distribution width (RDW) among patients with acute respiratory distress syndrome (ARDS) remains scarce. The aim of this study was to determine the prognostic value of RDW for critically ill patients with ARDS. Methods. We studied all patients with ARDS from the Multiparameter Intelligent Monitoring in Intensive Care Database III (MIMIC-III) for whom RDW was available. The clinical outcomes were 30-day and 90-day mortality. Analyses included logistic multivariate regression model, Receiver Operating Characteristic (ROC) analysis, and subgroup analysis. Results. A total of 404 eligible ARDS patients were included. After adjustment for several clinical characteristics related to 30-day mortality, the adjusted OR (95% CIs) for RDW levels ≥14.5% was 1.91 (1.08, 3.39). A similar trend was observed for 90-day mortality. The RDW levels ≥14.5% were also an independent predictor of 90-day mortality (OR, 2.56; 95% CI, 1.50 to 4.37; P = 0.0006) compared with the low RDW levels (<14.5%). In subgroup analyses, RDW showed no significant interactions with other relevant risk factors for 30-day mortality. Conclusions. RDW appeared to be a novel, independent predictor of mortality in critically ill patients with ARDS.
Occupational Therapy in Fatigue Management in Multiple Sclerosis: An Umbrella Review
Authors: Salomè Angela , Sasso D’Elia Tullia , Franchini Giorgia , Santilli Valter , Paolucci Teresa
Published: March 2019

Background. Fatigue is one of the most invalidant symptoms of Multiple Sclerosis (MS) that negatively affects occupational and work performance and social participation. Occupational therapy (OT) assessment and treatment of impairments related to fatigue can have a significant and positive impact on the quality of life. Methods. An umbrella review has been carried out to provide rehabilitative decision makers in healthcare with insight into the role of OT in fatigue management in Multiple Sclerosis. The question is, what type of treatment provided by occupational therapist is more effective in reducing fatigue in Multiple Sclerosis? A search of literature published until June 2018 was undertaken by three independent reviewers using PubMed, PEDro, and Cochrane Library database including systematic reviews and meta-analyses of the last 10 years. Results. 10 studies were selected (5 systematic reviews, 1 meta-analysis, 3 reviews, and 1 guideline). Conclusions. Fatigue management programs have moderate evidence; other strategies such as OT strategies and telerehabilitation show low evidence.
Prevention of Calcium Nephrolithiasis: The Influence of Diuresis on Calcium Oxalate Crystallization in Urine
Authors: Baumann Johannes M. , Casella Roberto
Published: March 2019

A high fluid intake is still the most evidence-based measure for the prevention of idiopathic stone disease. The recommendation of current guidelines on urolithiasis to increase diuresis to 2–2.5 L/day is mainly based on a single clinical study. The present paper shows the influence of diuresis on calcium oxalate (CaOx) crystallization and especially aggregation (AGN) which can explain the initial development of Ca stones on papillary calcifications as well as stone growth in the renal pelvic system. Diuresis determines the urinary transit time (UT) through the kidney and together with the afflux of Ca and Ox the state of urinary saturation with respect to CaOx being the most frequent stone mineral. High supersaturation inducing crystallization during UT and a high urinary ion concentration interfering with the inhibition of crystal AGN by urinary macromolecules seem to be critical parameters for stone formation. Using data from the literature the influence of diuresis on these parameters is evaluated for short-term recurrent stone formers (RSF), idiopathic stone patients, and healthy controls, the latter two collectives with and without excessive oxalate ingestion. This investigation suggests that a diuresis of 2 L/day may protect from stone formation even after dietary Ox excesses and in RSF. However, in RSF with a continuously high Ca and Ox afflux into urine a permanent high diuresis is required which is difficult to sustain over 24 hours.
Panax ginseng Inhibits Metabolism of Diester Alkaloids by Downregulating CYP3A4 Enzyme Activity via the Pregnane X Receptor
Authors: Yang Liang , Wang Yuguang , Xu Huanhua , Huang Guangyao , Zhang Zhaoyan , Ma Zengchun , Gao Yue
Published: March 2019

To investigate the effects of P. ginseng C.A. Mey (P. ginseng) on the metabolism of diester alkaloids and explore the potential mechanism. P. ginseng was administered orally to rats for 7 days, after which liver microsome samples were prepared and then incubated with diester alkaloids. Ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry was used to determinate the concentration of diester alkaloids to calculate the clearance rate. The cocktail method was used to evaluate the effects of oral administration of P. ginseng extracts on the activities of cytochrome P450 (CYP) isoforms in rats through the changes in the pharmacokinetic parameters of the probe drugs. The protein and gene expression of CYP3A2 and pregnane X receptor (PXR) in rats were evaluated by western blotting and quantitative PCR. The specific enzyme inhibitor method and human recombinant enzyme method were used to identify the involvement of sub-CYPs in the metabolism of diester alkaloids in human liver microsomes (HLMs). The clearances of aconitine, mesaconitine, and hypaconitine in the P. ginseng groups were lower than those of the control group. The areas under the curve of midazolam were 2.37 ± 1.05, 4.96 ± 0.51, and 6.23 ± 1.30 mg·L−1·h for the low-, medium-, and high-dose P. ginseng groups, respectively, which were higher than that of the control (2.23 ± 0.64 mg·L−1·h). The clearances of midazolam for the medium- (1.87 ± 0.16 L·h−1·kg−1) and high-dose (1.60 ± 0.34 L·h−1·kg−1) P. ginseng groups were lower than that of the control group (4.66 ± 1.43 L·h−1·kg−1). After exposure to P. ginseng extracts, the gene and protein expression levels of CYP3A4 and PXR were decreased. The hepatic metabolism rates of aconitine, mesaconitine, and hypaconitine in HLMs were decreased to 60.37%, 21.67%, and 10.11%, respectively, when incubated with ketoconazole, a specific inhibitor for CYP3A. The kinetic plots indicated that the KM and Vmax values of CYP3A4 were 10.08 ± 3.26 μM and 0.12 ± 0.01nmol·mg protein−1·min−1 for aconitine, 131.3 ± 99.75 μM and 0.73 ± 0.44 nmol·mg protein−1·min−1 for mesaconitine, and 17.05 ± 9.70 μM and 0.16 ± 0.04 nmol·mg protein−1·min−1 for hypaconitine, respectively. The in vitro mean intrinsic clearance rates by CYP3A4 were 0.0119, 0.0056, and 0.0091 mL·nmol CYP−1·min−1 for aconitine, mesaconitine, and hypaconitine, respectively. Therefore we implied that P. ginseng inhibited the metabolism of diester alkaloids in vitro and decreased the CYP3A4 enzyme activity as well as the gene and protein expression of CYP3A4 and PXR in vivo. CYP3A4 had a larger effect on diester alkaloid metabolism than the other human CYP isoforms, CYP1A2, CYP2C9, and CYP2E1.
Competition among Predators and Allee Effect on Prey, Their Influence on a Gause‐Type Predation Model
Authors: González-Olivares Eduardo , Cabrera-Villegas Javier , Córdova-Lepe Fernando , Rojas-Palma Alejandro
Published: March 2019

Interference or competition among predators (CAP) has often been ruled out in depredation models, although there are varied mathematical forms to describe and incorporate it into this interaction. In this work, we present the most known of these descriptions and one of them will be used in a modified Volterra model. Moreover, of this ecological phenomenon, a simple and strong Allee effect affecting the prey population will be considered in the relationship. An important feature of the new model is to have until two positive equilibrium points, to the difference with the Volterra model (without Allee effect); hence different and interesting dynamic situations appear in the system. Conditions for the existence and local stability of equilibria are determined. The boundedness of solutions, the existence of a limit cycle and a separatrix curve are also proven. Besides, the main properties of the model are examined from an ecological point of view. To make a comparative discussion of our results, an Appendix is added with the main properties of models, in which neither the Allee effect nor the competition among predators is considered. Some simulations are shown to endorse our results.
Damping Multimode Switching Control of Semiactive Suspension for Vibration Reduction in a Wheel Loader
Authors: Wei Tao , Zhiqiang Liu
Published: March 2019

The aim of this work is the control design and analysis of a semiactive axle suspension system for vibration reduction in a wheel loader. Unlike a traditional semiactive suspension system with continuously adjustable shock absorber, in this work, a novel axle suspension with multiple damping modes is proposed for the wheel loader. The multimode switching damping characteristics are achieved by just changing the discrete statuses of two high‐speed switch electromagnetic valves, which makes the damping adjustment simpler and more reliable. However, because of the existence of discrete events, i.e., the on‐off statuses of switch electromagnetic valves, the axle suspension proposed for the wheel loader poses a challenging hybrid control problem. To solve this problem, the mixed logical dynamical (MLD) modeling approach for hybrid systems is applied to model the dynamic characteristics of the system damping control procedure. Using this model, a hybrid model predictive control (HMPC) strategy is further designed, which can determine the optimal switching sequences of the discrete damping modes according to the axle suspension performance indices. Finally, to verify the effectiveness of the proposed semiactive axle suspension with multiple damping modes and its control approach, simulation analyses are conducted.
Analysis and Experimental Study of Acceleration Model for Short Interval and Multiple Impact Equipment
Authors: Li Feiyin , Ma Shaojie
Published: March 2019

Short interval and continuous high‐impact experiments have very significant engineering application values, and impact acceleration is a key performance index of these dynamic experiments. This paper aims at the shortcomings of the existing multiple high‐impact equipment, designs a new type of multiple high‐impact equipment based on the collision contact mode by multiple impact components, and studies the composition of acceleration in impact experiment. The research results indicate that it is unreasonable to analyze the impact acceleration only based on rigid body dynamics theory and ignore the effect of the stress wave loading during an impact experiment. On this basis, a line contact model is adopted to modify the equivalent damping coefficient and obtain a nonlinear spring damping contact force model based on the line contact, and then a rigid body acceleration model of the impact experiment is established. A stress wave acceleration model is also established based on the one‐dimensional stress wave transfer theory of the tested specimen. The established acceleration model is verified by different corresponding impact experiments. At the same time, the collision contact process of the impact experiment is also simulated which is combined with the finite element method. The simulation results were fundamentally consistent with the experiments and a fact that proves the correctness of analysis and modeling. The research results not only provide theoretical support for the design and analysis of the impact equipment and a new idea to realize multiple high‐impact loading but also provide a methodology to be applied to the analysis and modeling of acceleration for similar high‐impact experiments.
Association between Duration of Exercise (MET Hours per Week) and the Risk of Decreased eGFR: A Cross-Sectional Study Based on a Large Chinese Population
Authors: Wang Jie , Li Yijun , Chen Kang , Yan Wenhua , Wang Anping , Wang Weiqing , Gao Zhengnan , Tang Xulei , Yan Li , Wan Qin , Luo Zuojie , Qin Guijun , Chen Lulu , Mu Yiming
Published: March 2019

Background. Physical activity is effective in preventing chronic diseases. However, the impact of different durations of exercise on human health is unknown, especially among people with diabetes or prediabetes. Objective. To explore the relationship between high MET hours per week and the change in glomerular filtration rate (eGFR) in the total population and different subgroups. Methods. A total of 43767 individuals from eight provinces, in China, were recruited. Logistic analysis was used to investigate the association. Participants were divided into 3 groups based on MET hours per week. The primary outcome was an eGFR≤90 mL/min/1.73 m2. Results. The average eGFR was 100.10 (92.43-106.43) mL/min/1.732. Logistic regression analysis revealed that more than 7.5 MET hours per week (equivalent to more than 150 minutes of moderate-intensity of exercise) was associated with the higher risk of the decreased eGFR even after adjusting for confounding factors (7.5 to <21: OR=1.18, 95% CI [1.09, 1.29]; ≥21: OR=1.12, 95% CI [1.05, 1.19], p for trend: 0.0047). After adjusting for confounding factors, in stratified analyses, there still existed a significant relationship among participants aged from 55 to less than 65 years, but not among participants younger than 55 or older than 65 years. Similarly, there existed a positive association between high MET hours per week and the decreased eGFR in participants without diabetes and prediabetes, but not in participants with diabetes or prediabetes, and the interactions of age and diabetic states were found. However, there was no significant difference in women or men. Conclusions. More than 7.5 MET hours per week (equivalent to more than 150 minutes per week or 60 minutes per day of moderate-intensity exercise) was associated with decreased eGFR among participants aged from 55 to less than 65 years and participants without diabetes and prediabetes, but not among participants aged younger than 55 years and older than 65 years and participants with diabetes or prediabetes. The importance of planning individualized physical activities is highlighted.
Anatomical Evidence of Acupuncture Meridians in the Human Extracellular Matrix: Results from a Macroscopic and Microscopic Interdisciplinary Multicentre Study on Human Corpses
Authors: Maurer Norbert , Nissel Helmut , Egerbacher Monika , Gornik Erich , Schuller Patrick , Traxler Hannes
Published: March 2019

For more than 2500 years, acupuncture has been applied to support the healing of different diseases and physiologic malfunctions. Although various theories of the meridian system and mechanisms were formulated to explain the functional basis of acupuncture, the anatomical basis for the concept of meridians has not been resolved. The aim of the present study was to search for replicable anatomical structures that could relate to meridians. To this end, four human specimens and additionally two lower legs were dissected anatomically. Our study found evidence that acupuncture meridians were part of the human extracellular matrix and that fascia was an important part of the anatomic substrate of acupuncture meridians. At the same time, we found vessel-nerve-bundles, which were hypothesized to account for 80% of acupuncture points, only in a few acupuncture points. Therefore, our findings contradict the theory that acupuncture points are only located along the nervous channels.
Acupuncture Points and Perforating Cutaneous Vessels Identified Using Infrared Thermography: A Cross-Sectional Pilot Study
Authors: Álvarez-Prats D. , Carvajal-Fernández O. , Valera Garrido F. , Pecos-Martín D. , García-Godino A. , Santafe M. M. , Medina-Mirapeix F.
Published: March 2019

Aims. To evaluate the presence of perforating cutaneous vessels (PCV) in different lower limb acupuncture points (AP) using thermography.Material and Methods. An analytical cross-sectional study was performed on the two lower limbs (n=6) of volunteer subjects. In total, 144 AP and 144 control points (CP) were analysed, one for each AP. First, the AP and CP were located on each individual. Subsequently, both the real and thermographic images were created. In the real images, the location of the AP and the established CP were highlighted with boxes. FLIR Tools Plus and Physio Thermal Imaging software were used to merge the real image with the AP and the CP and to merge the thermographic image with the PCV. By superimposing both images, we were able to verify the presence of PCV among the AP and CP.Results. PCV were identified in 87.5% of the 144 AP examined and in 18.1% of the respective CP. All the AP had a higher percentage of PCV compared to their respective CP, with statistically significant differences in all points, except for ST33 and ST34. The probability of finding PCV in AP was 11 times higher than the probability of not finding it.Discussion. Thermography may serve as a useful tool in the assessment and treatment of patients using acupuncture. The presence of PCV in the area of the acupuncture needle insertion could partially influence the effects generated by the acupuncture technique from the vascular autonomic point of view.Conclusions. There is a high proportion of PCV in the AP area located in the lower limb.
Stroke Risk Status, Anticoagulation Treatment, and Quality-of-Life in Chinese Patients with Atrial Fibrillation: China Registry of Atrial Fibrillation (CRAF)
Authors: Sun Yihong , Zhu Jun , Ma Changsheng , Liu Shaowen , Yang Yanzong , Hu Dayi
Published: March 2019

Objective. To investigate the contemporary status of stroke risk profile, antithrombotic treatment, and quality-of-life (QoL) of patients with all types of atrial fibrillation (AF) in China. Design. This is a multicenter, cross-sectional study. Setting. Tertiary (80%) and Tier 2 hospitals (20%) were identified in different economic regions (Northeast, East, West, and Middle) by using a simple random sampling. Participants. A total of 3562 (85.6%) patients with nonvalvular atrial fibrillation (NVAF) and 599 (14.4%) with rheumatic valvular atrial fibrillation (VAF) were consecutively enrolled from 111 hospitals from July 2012 to December 2012. Data Collection. Patient information was collected and QoL was assessed using Short-Form 36 Health Survey (SF-36) questionnaire. Primary and Secondary Outcome Measures. The risk of stroke was assessed using the CHADS2 and CHA2DS2-VASc. QoL was assessed using Medical Outcomes Study SF-36 questionnaire. Results. Overall, 31.7% of the patients received anticoagulant treatment and 61.2% received antiplatelet treatment. The rate of anticoagulant treatment was higher in patients with VAF than in those with NVAF. The anticoagulant use was the lowest in Northeast and the highest in Middle regions. Independent risk factors associated with underuse of anticoagulants for NVAF were age, systolic blood pressure (SBP), non-Middle regions, nontertiary hospitals, and new-onset or paroxysmal AF. For VAF patients, the independent factors were age, paroxysmal AF, treatment in Tier 2 hospitals, SBP, diastolic blood pressure, history of coronary artery disease, and nonreceipt of antiarrhythmic therapy. Patients receiving anticoagulants fared significantly better in some QoL domains than those who received no antithrombotic therapy. Conclusions. These findings suggest that antiplatelet treatment is overused and anticoagulant treatment is underused both in Chinese patients with VAF and NVAF, even though usage of anticoagulants is associated with better QoL. Risk factors with underuse of anticoagulants were not identical in patients with NVAF and VAF.
Pulmonary Rehabilitation for Exercise Tolerance and Quality of Life in IPF Patients: A Systematic Review and Meta-Analysis
Authors: Yu Xueqing , Li Xuanlin , Wang Liaoyao , Liu Ran , Xie Yang , Li Suyun , Li Jiansheng
Published: March 2019

Objective. The aim of this study is to evaluate the efficacy and safety of pulmonary rehabilitation (PR) in patients with idiopathic pulmonary fibrosis (IPF).Methods. Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and Chinese Biomedical Literature Database (SinoMed) were comprehensively searched. Randomized controlled trials (RCTs) that investigated the effects of PR for IPF patients were included. Literature selection and data extraction were conducted by two review authors independently. The Cochrane Collaboration’s Risk of Bias tool and RevMan software (version 5.3) were used to evaluate the quality of studies and conduct statistical analysis, respectively.Results. Seven studies (190 participants) were included. PR had a significant effect on six-minute walk distance (6MWD) (MD:48.60; 95%CI: 29.03 to 68.18;Z=4.87,P<0.00001), and 6MWD was improved more in subgroup analysis including studies conducted in Asia (MD: 53.62; 95%CI: 30.48 to 76.66;Z=4.54,P<0.00001) and Europe (MD:54.10; 95% CI: 26.65 to 101.56;Z=2.23,P=0.03). Forced vital capacity (FVC%) was higher (MD: 3.69; 95%CI: 0.16 to 7.23;Z=2.05,P=0.04). St. George’s Respiratory Questionnaire (SGRQ)/IPF-specific SGRQ (SGRQ-I) total score was lower (MD: -7.87; 95% CI: -11.44 to -4.30;Z=4.32,P<0.0001). No significant effects were found for lung diffusing capacity determined by the single-breath technique (DLCO%) (MD: 3.02; 95%CI: -0.38 to 6.42;Z=1.74,P=0.08).Conclusions. This study suggests that PR may enhance exercise capacity and improve quality of life in IPF patients. Besides, PR may also delay the decline of lung function of patients with IPF. However, further research should more fully assess the efficacy and safety of PR for IPF.
Finite‐Horizon Optimal Tracking Guidance for Aircraft Based on Approximate Dynamic Programming
Authors: Wan Shizheng , Chang Xiaofei , Li Quancheng , Yan Jie
Published: March 2019

Referring to the optimal tracking guidance of aircraft, the conventional time based kinematics model is transformed into a downrange based model by independent variable replacement. The deviations of in‐flight altitude and flight path angle are penalized and corrected to achieve high precision tracking of reference trajectory. The tracking problem is solved as a linear quadratic regulator applying small perturbation theory, and the approximate dynamic programming method is used to cope with the solving of finite‐horizon optimization. An actor‐critic structure is established to approximate the optimal tracking controller and minimum cost function. The least squares method and Adam optimization algorithm are adopted to learn the parameters of critic network and actor network, respectively. A boosting trajectory with maximum final velocity is generated by Gauss pseudospectral method for the validation of guidance strategy. The results show that the trained feedback control parameters can effectively resist random wind disturbance, correct the initial altitude and flight path angle deviations, and achieve the goal of following a given trajectory.
Interferon-Beta Treatment Differentially Alters TLR2 and TLR4-Dependent Cytokine Production in Multiple Sclerosis Patients
Authors: Oliveira Iara Barreto Neves , Gomes Rodrigo Saar , Gomides Larissa Fonseca , dos Santos Jéssica Cristina , Carneiro Marcos Alexandre Diniz , Ribeiro-Dias Fátima , Diniz Denise Sisterolli
Published: March 2019

Objective: Multiple sclerosis (MS) is a multifactorial chronic disease that affects the central nervous system (CNS). Toll-like receptors (TLRs) play a central role in cytokine production after pathogen- and danger-associated molecular patterns (PAMPs and DAMPs) and contribute to CNS damage in MS patients. Here, we evaluated the effects of interferon (IFN)-β treatment in TLR2 and TLR4-dependent cytokine production and mRNA expression in whole-blood cell cultures from MS patients. Methods: We evaluated cytokine production by ELISA from whole-blood cell culture supernatants and mRNA expression by real-time polymerase chain reaction in peripheral blood mononuclear cells (PBMCs). Results: In patients treated with IFN-β, tumor necrosis factor (TNF)-α production after exposure to TLR2 agonist (Pam3Cys) was lower than in healthy controls and untreated MS patients. However, IFN-β treatment had no significant effect on TNF-α production after TLR4 agonist (LPS) stimulation. On the other hand, interleukin (IL)-10 production was increased in TLR4- but not in TLR2-stimulated whole-blood cell culture from MS patients under IFN-β treatment when compared to the controls. No differences in TNF-α or IL-10 mRNA expression in PBMCs from healthy controls and untreated or treated MS patients were detected, although PBMCs from treated patients presented higher levels of IL-32γ mRNA than those from controls. Conclusions: Our data suggest that IFN-β treatment alters the TLR-dependent immune response of PBMCs from MS patients. This may contribute to the beneficial effects of IFN-β treatment.
Premature Lambs Exhibit Normal Mitochondrial Respiration after Long-Term Extrauterine Support
Authors: Rossidis Avery C. , Angelin Alessia , Lawrence Kendall M. , Baumgarten Heron D. , Kim Aimee G. , Mejaddam Ali Y. , Coons Barbara E. , Hartman Heather A. , Hwang Grace , Monos Stylianos , Peranteau William H. , Davey Marcus G. , Murdock Deborah , Wallace Douglas C. , Flake Alan W.
Published: March 2019

Background: In an effort to mitigate the major morbidities and mortality associated with extreme prematurity, we have developed an EXTrauterine Environment for Neonatal Development (EXTEND) designed to provide physiologic support of extremely premature infants. Objectives: We have previously shown that long-term, physiologic support of premature fetal lambs is possible with EXTEND, but in this study, we sought to demonstrate bioenergetic equipoise at the tissue level. Methods: Four premature fetal lambs were delivered by hysterotomy at gestational ages (GA) of 105–107 days (term ∼145 days), cannulated via the umbilical vessels, and transitioned to support on EXTEND for 3–4 weeks. Five control fetuses were age-matched to the GA of experimental fetuses at the time of study end (128–134 days GA) and immediately sacrificed after hysterotomy. Mitochondria were isolated from the heart, liver, kidney, and skeletal muscle of fetuses at the time of sacrifice, and oxygen consumption rates (OCRs) were measured. Results: There were no differences in basal mitochondrial OCR between EXTEND and control fetuses for heart, kidney, or skeletal muscle. For liver, the basal OCR was higher in EXTEND fetuses compared to controls. There were no differences in physiologic maximal OCR or reserve capacity for any tissue analyzed. Conclusions: Fetal lambs supported by EXTEND demonstrate physiologic mitochondrial function as evidenced by adequate basal and physiologic maximal cellular respiration as well as preserved reserve capacity.
Cell Therapy for Knee Osteoarthritis: Mesenchymal Stromal Cells
Authors: Kim Christopher , Keating Armand
Published: March 2019

Osteoarthritis (OA) is designated the 11th highest contributor of 291 diseases of global disability and the most common cause of chronic disability in elderly people. OA has a devastating impact on quality of life and represents an enormous socio-economic burden. Currently, OA is incurable, and no approved medications, biological therapy, or procedure prevents the progressive destruction of the osteoarthritic knee joint. All current treatments provide symptomatic relief rather than preventative or regenerative results. There is an urgent and compelling need to find, validate, and test new biological therapeutics. Cell-based therapies involving the delivery of mesenchymal stromal cells (MSCs) to the os­teoarthritic knee joint have emerged as a potential solution to overcome this clinical shortcoming. In this review, we address the clinical evidence, challenges, and recent advances surrounding MSC treatment in knee OA.
Is Life Expectancy of French Women Going to Plateau and Oscillate?
Authors: Le Bourg Eric
Published: March 2019

Some authors have hypothesised that life expectancy at birth could reach 100 years in developed countries in the next decades. Using recent data for French women, it is shown that life expectancy changes from 1993 to 2016 are mainly linked to mortality rates of oldest women. In recent years, it happened that life expectancy of French women oscillated, because of for instance influenza epidemics killing mainly oldest frail people. It is hypothesised that in coming years, life expectancy of French women (and one day of men?) will only very slightly increase and will show oscillations because of increased mortality the years of severe influenza, heatwave and other events threatening the life of frail oldest people. This fate could also be that of the other developed countries in the future, which would mean that life expectancy has begun to plateau.
A Clinical Study on Microsurgical Denervation of Spermatic Cord for Refractory Chronic Orchialgia
Authors: Long Huibin , Bai Wenjun , Zhang Xiaowei , Xu Tao
Published: March 2019

Objectives: Microsurgical denervation of the spermatic cord (MDSC) is a treatment option for chronic orchialgia (CO) refractory to conservative treatment. Studies showed specific nerve fibers as the possible cause of CO. We aimed to present the outcomes of ligation of these nerves using targeted MDSC. Methods: We retrospectively reviewed 30 cases who underwent targeted MDSC from August 2014 to February 2018. Patients included were under strict criteria. Pain was assessed preoperatively and postoperatively using a subjective visual analog scale (VAS) and objectively with the standardized and validated Pain Impact Questionnaire-6 (PIQ-6) score. Results: Data were available on 28 cases at repercussion. During a median follow-up of 12 months (range 10–29), 25 cases (89.2%) showed a significant reduction in pain and 3 (9.8%) had no change in pain by subjective VAS scoring. Of cases with a significant reduction in pain, 15 (53.5%) had complete resolution and 19 (67.9%) had a 50% or greater reduction. Objective PIQ-6 analysis showed a significant reduction in pain in 78.6% of patients at 6 months postoperatively, in 82.1% at 1 year, in 82.1% at 2 years. Conclusions: Targeted MDSC is an effective, minimally invasive approach with potential long-term durability in patients with refractory CO.
Burden, Access, and Disparities in Kidney Disease
Authors: Crews Deidra C. , Bello Aminu K. , Saadi Gamal ,   for the World Kidney Day Steering Committee
Published: March 2019

Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is a World Health Organization Sustainable Development Goal. While universal health coverage may not include all elements of kidney care in all countries, understanding what is locally feasible and important with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.
Efficacy of Vonoprazan, a Novel Potassium-Competitive Acid Blocker, in Patients with Proton Pump Inhibitor-Refractory Acid Reflux
Authors: Akiyama Junichi , Hosaka Hiroko , Kuribayashi Shiko , Moriyasu Shiori , Hisada Yuya , Okubo Hidetaka , Watanabe Kazuhiro , Imbe Koh , Nagata Naoyoshi , Kojima Yasushi , Yokoi Chizu , Uemura Naomi , Shimoyama Yasuyuki , Kawamura Osamu , Yamada Masanobu , Kusano Motoyasu
Published: March 2019

Background/Aim: We evaluated the efficacy of vonoprazan (VPZ), a novel potassium-competitive acid blocker, in patients with proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD), exhibiting continued pathological esophageal acid exposure (EAE). Methods: Despite ≥8 weeks of appropriate PPI therapy, patients with ­persistent reflux symptoms and pathological EAE times (EAETs ≥4%) were invited to switch to VPZ treatment. After an 8-week-course of once-daily VPZ (20 mg), multichannel intraluminal impedance-pH (MII-pH) monitoring was repeated to compare gastric acid exposure times (GAETs), EAETs, and other reflux parameters relative to the baseline values. Before each MII-pH study, reflux symptom severities were scored using the Gastrointestinal Symptom Rating Scale; erosive esophagitis and fasting plasma gastrin levels were also assessed. Results: From among the 124 patients undergoing MII-pH monitoring, 13 patients (median age, 69 years; females, 64%) were monitored at baseline (while on PPI therapy) and after VPZ therapy. The median GAET associated with VPZ treatment (23.8%) was less than that for PPI treatment (41.1%; p = 0.01), including both daytime and nighttime measurements. VPZ therapy resulted in better median EAET values (4.5%) than did PPI therapy (10.6%) during the 24-h monitoring period (p = 0.055). EAE normalization was achieved in 46% of VPZ-treated patients and was associated with complete gastric acid suppression (p = 0.005). After switching to VPZ, reflux symptoms (p < 0.01) and erosive esophagitis (p = 0.01) improved. Conclusion: In patients with PPI-refractory GERD, VPZ provides more potent gastric acid suppression, more effective EAE control, enhanced symptom improvement, and better esophagitis healing than PPIs.
Effect of EP1 Receptor Antagonist on Transient Lower Esophageal Sphincter Relaxations in Humans
Authors: Sawada Akinari , Hashimoto Atsushi , Uemura Risa , Yamagami Hirokazu , Tanigawa Tetsuya , Watanabe Toshio , Fujiwara Yasuhiro
Published: March 2019

Background/Aims: Transient lower esophageal sphincter relaxations (TLESRs) are the major cause of gastroesophageal reflux. Recently, an EP1 receptor antagonist, ONO-8539, showed the reduction of TLESRs in monkeys. However, its effect on TLESRs in humans remains unclear. This study investigated the effect of ONO-8539 on postprandial TLESRs in healthy male subjects. Methods: Twenty-seven subjects participated in this placebo-controlled, cross-over study. The subjects received either placebo or ONO-8539 (450 mg) after a standardized breakfast. A 30-min basal recording was performed 4 h after drug administration. Subsequently, TLESR recordings were performed after a high-fat test meal for 3 h. The examination was repeated at least 7 days from the first evaluation for washout. Results: Thirteen patients were ultimately analyzed. The basal lower esophageal sphincter pressure was not different between the 2 groups (16.3 and 18.0 mm Hg for placebo and ONO-8539, respectively; p = 0.88). ONO-8539 significantly reduced the number of TLESRs from 15.0 to 12.0 for 3 h (p < 0.05). The proportion of terminating events of TLESRs was significantly different between the 2 groups (p < 0.05). No events and swallowing terminated more TLESRs with ONO-8539 than with placebo. Conclusions: ONO-8539 suppressed TLESRs mildly. EP1 receptor may be involved with the mechanism of human TLESRs.
Evaluation of a Novel Blue-Colored Ophthalmic Viscoelastic Device Applied during Phacoemulsification in Eyes with Pseudoexfoliation Syndrome
Authors: Borkenstein Andreas F. , Borkenstein Eva-Maria
Published: March 2019

Recently, a new development in the field of ophthalmic viscoelastic devices (OVDs) has been introduced. The blue-colored OVD Pe-Ha-Blue® PLUS combines the viscoelastic properties of OVD together with trypan blue for better visualization during surgery. The objective of this case series is to investigate whether the use of a blue-colored OVD during cataract surgery in patients with pseudoexfoliation syndrome (PXF) and narrow pupils (miosis) has advantages over the use of a clear standard OVD in combination with trypan blue. We included 52 eyes of 52 consecutive cataract patients diagnosed with PXF. Study participants were divided into two groups of 26 patients each, depending on which OVD was used during surgery (group A: blue-colored OVD; group B: standard clear OVD). Intraoperatively, we evaluated the operation time (surgery start to the beginning of phacoemulsification) and the surgeon’s satisfaction with the surgical workflow. Postoperative examinations were performed 6 h, 20 h, and 4 weeks after surgery and included corrected distance visual acuity (CDVA) and intraocular pressure (IOP). Our results show that there was a statistically significant time gain in group A in terms of surgery time. In addition, findings on surgeon satisfaction, postoperative CDVA and IOP suggest further benefits in group A. We discuss further properties and possible advantages which may result from the use of a blue-colored OVD. In summary, a blue-colored viscoelastic device can be a helpful alternative to clear OVD especially in challenging cases to improve the surgical workflow and make the whole procedure even safer and faster.