bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanomaterial-based hydrogels for coronary interventions: a mini review
Authors: Saxena Varun , Pandey Lalit M.
Published: September 2020

Myocardial infarction (MI) has become a major health concern these days. Elevated levels of cholesterol due to improper diet cause severe damage to human health, resulting in the narrowing of blood vessels leading to MI. Different approaches have been used based on surgical and non-surgical treatments for these blockages to cure MI. In this regard, injectable and non-injectable hydrogel-based percutaneous coronary intervention has shown promising applicability for the treatment of cardiac damage and its repair. In this report, we summarize a few hydrogels based on natural polymers such as chitosan, alginate, polyethylene glycol and extracellular matrices to be used for percutaneous coronary intervention in the treatment of MI. Their structure, biological properties and biocompatibilities are discussed, and their existing challenges are also detailed. In addition, the probable solutions to overcome certain set backs are also highlighted.
Real-Time Plant Health Assessment via implementing Cloud-Based Scalable Transfer Learning on AWS DeepLens
Authors: Khan Asim , Nawaz Umair , Ulhaq Anwaar , Robinson Randall W.
Published: September 2020

In the Agriculture sector, control of plant leaf diseases is crucial as it influences the quality and production of plant species with an impact on the economy of any country. Therefore, automated identification and classification of plant leaf disease at an early stage is essential to reduce economic loss and to conserve the specific species. Previously, to detect and classify plant leaf disease, various Machine Learning models have been proposed; however, they lack usability due to hardware incompatibility, limited scalability and inefficiency in practical usage. Our proposed DeepLens Classification and Detection Model (DCDM) approach deal with such limitations by introducing automated detection and classification of the leaf diseases in fruits (apple, grapes, peach and strawberry) and vegetables (potato and tomato) via scalable transfer learning on A.W.S. SageMaker and importing it on AWS DeepLens for real-time practical usability. Cloud integration provides scalability and ubiquitous access to our approach. Our experiments on extensive image data set of healthy and unhealthy leaves of fruits and vegetables showed an accuracy of 98.78% with a real-time diagnosis of plant leaves diseases. We used forty thousand images for the training of deep learning model and then evaluated it on ten thousand images. The process of testing an image for disease diagnosis and classification using AWS DeepLens on average took 0.349s, providing disease information to the user in less than a second.
Reactions Governing Strangeness Abundance in Primordial Universe
Authors: RAFELSKI JOHANN , Yang Cheng Tao
Published: September 2020

Strangeness flavor is abundant and in chemical equilibrium in the primordial Quark-Gluon Plasma(QGP) filling the early Universe. Upon hadronization near to T=150 MeV one may think that relatively short lived massive strange hadrons decay rapidly and strangeness disappears. However, we show using detailed balance considerations for inverse decay reactions that the back reaction repopulate strangeness keeping it in chemical equilibrium at least to the time when strange antibaryons annihilate near T≃30-50 MeV. However, our present study is focused on the meson sector of the hadronic Universe. Specifically, we establish here the temperature range in which the expansion of the Universe becomes faster compared to the production processes which balance natural strangeness decay: In the temperature interval 33MeV<T<20MeV: μ±+νμ→K±, π+π→K and l−+l+→ϕ reactions in sequence become slower compared to the characteristic Hubble time.
Assessing Alluvial Fan of Bergama Using High Resolution DEM Generated from Airborne LiDAR Data
Authors: Hocaoğlu Beycan , Ağca Müge
Published: September 2020

Topography represented by high resolution digital elevation models are able to inform past and present morphological process on the terrain. High resolution LiDAR data taken by the General Directorate of Map at the surroundings of the Bergama city shows great opportunities to understand the morphological process on alluvial fan on which the city is located and the flood plain of Bakırçay river near the alluvial fan. In this paper the LiDAR data collected in 2015 have been used to create DEM’s to understand the geomorphological evolution of the alluvial fan and the flood plain around it. Since the proximal roots and medial parts of the alluvial fan have been the scene for a long human settlement most topographical traces of the morphological process have been distorted. Nevertheless, the traces of past and present morphological process at the distal fan which consist the contact zone with the flood plain are very clear on the DEM created from LiDAR data. The levees and some old courses of Bergama and Bakırçay rivers have been shown on the maps which are also important to understand the ancient roads which follows these levees.
Love Bites – Do Venomous Arachnids Make Safe Pets?
Authors: Hauke Tobias J. , Herzig Volker
Published: September 2020

With a global estimate of tens of thousands of arachnid enthusiasts, spiders and scorpions are gaining increasing popularity as pets in industrialised countries in Europe, Northern America and Asia. As most spiders and all scorpions are venomous and due to their mostly negative image in the public media, several governments are already considering introducing legislation to regulate the domestic care of potentially dangerous captive animals. We aimed to investigate the circumstances and effects of exposure to arachnids kept in captivity. Thus, we collected and analysed data from 335 reported bites and stings attributed to pet arachnids. Our data revealed that on average there were less than 20 recorded envenomations per year with ~90% preventable by due care. We also categorized the severity of the resulting symptoms and found that the vast majority of symptoms were either local (60.9%) or moderate (33.4%), 4.8% were asymptomatic, only 0.9% were severe and no fatalities were recorded. Based on our database of bite and sting reports, we performed a risk assessment for arachnid pet ownership and concluded that with the proper care arachnids can be safely kept as pets and pose a lower risk than many other recreational activities.
Manufacturing, Characterisation and Mechanical Analysis of PAN Membranes
Authors: Tüfekci Mertol , Durak Sevgi Güneş , Pir İnci , Acar Türkan Ormancı , Demirkol Güler Türkoğlu , Tüfekci Neşe
Published: September 2020

In recent years, usage of membranes is quite common in water and wastewater treatment. Polyacrylonitrile (PAN) is a polymeric material used in membrane production. To investigate the effect of Polyvinylpyrrolidone (PVP) addition and consequently porosity, two different sets of membranes are manufactured, since PVP is a widely used poring agent which has an impact on the mechanical properties of the membrane material. The first set (PAN 1) includes PAN and the necessary solvent while the second set (PAN 2) is made of PAN and PVP. These membranes are put through several characterisation processes including tensile testing. The obtained data are used to model the static behaviour of the membranes with different geometries, but similar loading and boundary conditions that represent their operating conditions. This modelling process is undertaken by using finite element method. The main idea is to investigate how geometry affects the load-carrying capacity of the membranes. Alongside membrane modelling, their materials are modelled with representative elements (RE) to understand the impact of porosity on the mechanical properties.
Molecular Characteristics of Extraintestinal Pathogenic E. coli (ExPEC), Uropathogenic E. coli (UPEC), and Multidrug Resistant E. coli Isolated from Healthy Dogs in Spain. Whole Genome Sequencing of Canine ST372 Isolates and Comparison with Human Isolates
Authors: Flament-Simon Saskia-Camille , de Toro María , García Vanesa , Blanco Jesús Eulogio , Blanco Miguel , Alonso María Pilar , Goicoa Ana , Díaz-González Juan , Nicolas-Chanoine Marie-Hélène , Blanco Jorge
Published: September 2020

Under one-health perspective and the worldwide antimicrobial resistance concern, we investigate extraintestinal pathogenic Escherichia coli (ExPEC), uropathogenic E. coli (UPEC), and multidrug resistant (MDR) E. coli from 197 isolates recovered from healthy dogs in Spain between 2013 and 2017. Ninety-one (46.2%) isolates were classified as ExPEC and/or UPEC including 50 clones, among which (i) four clones were dominant (B2-CH14-180-ST127, B2-CH52-14-ST141, B2-CH103-9-ST372 and F-CH4-58-ST64815) and (ii) 15 had been shown to be displayed by previously published isolates causing extraintestinal infections in humans. Twenty-eight (14.2%) isolates were classified as MDR, associated with B1, D and E phylogroups and included 24 clones, of which eight had also been identified among human isolates causing infections. We selected 23 ST372 strains, 21 healthy dogs faecal isolates and two human clinical isolates for whole genome sequencing and built a SNP-tree with these 23 genomes and 174 genomes (128 from canine strains and 46 from human strains) obtained from public databases. The analysis of these 197 genomes allowed to identify six clusters. Cluster 1 comprised 74.6% of the strain genomes that were mostly composed of canine strain genomes (P < 0.00001). Clusters 4 and 6 also included canine strain genomes, while clusters 2, 3 and 5 were significantly associated with human strain genomes. All these findings suggest that dogs are reservoirs of ExPEC, UPEC and MDR E. coli isolates with zoonotic potential.
Initial Multitarget Approach Shows Importance for Improved Caprine Arthritis-encephalitis Virus Control Program in Russia for Hobbyist Goat Farms
Authors: Shuralev Eduard A. , Khammadov Nail I. , Osyanin Konstantin A. , Elizarova Inna A. , Lukmanova Gaysha R. , Shamaev Nikolai D. , Petrov Sergei V. , Kazarian Gevorg G. , Whelan Clare , Saushkin Nikolai Y. , Samsonova Jeanne V. , Galimzyanov Ilsur G. , Efimova Marina A. , Khaertynov Kamil S. , Faizov Tagir K. , Mukminov Malik N. , Ivanov Arkadiy V.
Published: September 2020

In this study we have approached the detection of caprine arthritis-encephalitis virus (CAEV) using a multi target approach testing with both ELISA and an in-house real-time PCR test to investigate the prevalence of CAEV in goats from hobbyist farms in the Republic of Tatarstan, Russia. Animals from three hobbyist farms were used in this study. The animals from two farms (n=13 for F1 and n=8 for F2) had clinical signs of arthritis and mastitis. In the third farm (n=15 for F3), all goats were homebred and had no contact with imported animals. CAEV antibodies (ELISA targets TM ENV and GaG genes) were detected in serum samples from two farms (F1 and F2), indicating a seroprevalence 87.50-92.31%. Specific CAEV antibodies were also detected in milk samples. CAEV proviral DNA was detected in 53.85-62.50%. Results from all tests performed in the third farm (F3) were negative, indicting all tests apparent specificity of 100%. The results of this work show that CAEV is circulating and present in small hobbyist goat farms in Russia. Serological and molecular tests could be of importance for CAEV control and eradication programs in Russia for hobbyist goat farms.
Double Stranded RNA Binding Proteins in the Serum Contribute to Systemic RNAi across Phyla – Towards Finding the Missing Link in Achelata
Authors: Banks Thomas , Wang Tianfang , Fitzgibbon Quinn , Smith Gregory , Ventura Tomer
Published: September 2020

RNA interference (RNAi) has become a widely utilised method to study gene function, yet despite this, many of the mechanisms surrounding RNAi remain elusive. The core RNAi machinery is relatively well understood, however many of the systemic mechanisms, particularly double stranded RNA (dsRNA) transport, are not. Here, we demonstrate that dsRNA binding proteins in the serum contribute to systemic RNAi, and may be the limiting factor in RNAi capacity for species such as spiny lobsters where gene silencing is not functional. Incubating serum from a variety of species across phyla with dsRNA led to a gel mobility shift in species where systemic RNAi has been observed, with this response being absent in species where systemic RNAi has never been observed. Proteomic analysis suggested lipoproteins may be responsible for this phenomenon, and may transport dsRNA to spread the RNAi signal systemically. Following this, we identified the same gel shift in the slipper lobster Thenus australiensis and subsequently silenced the insulin androgenic gland hormone, marking the first time RNAi has been performed in any lobster species. These results pave the way for inducing RNAi in spiny lobsters, and better understanding the mechanisms of systemic RNAi in Crustacea, as well as across phyla.
Analysis of Leonardo Da Vinci’s Architectures through Parametric Modeling: A Method for the Digital Reconstruction of the Centrally Planned Churches Depicted in Ms. B
Authors: Vaienti Beatrice , Apollonio Fabrizio Ivan , Gaiani Marco
Published: September 2020

Among many other themes, Leonardo da Vinci’s Manuscript B contains several drawings of centrally planned churches, some of which are represented using a plan view paired with a bird’s-eye view. The use of a bird’s-eye instead of an elevation represents an innovative depiction technique, which allows to combine the immediacy of the perspective view with the measurability of the façades, and therefore to describe the three-dimensionality of the buildings. To understand the reasons behind the use of this original technique, the edifices’ shape and classify them we decided to use 3D digital reconstruction techniques, for their ability to avoid misunderstandings in the reconstruction process and in the results. This article describes the method to create the digital models of sixteen churches. A Visual programming language (VPL) script was used as 3D base for modelling the churches achieved from a classification code expressing the aggregative rules of the churches. Then, the geometric process for the construction of the plan and its relationship with the elevation measures was studied for each church. Finally, this information was used for the completion of the 3D models, distinguishing more output variants each time there was an inconsistency between plan and perspective view, a variability of one architectural element or an uncertainty.
Potential Pathological Biomarkers in Multiple Sclerosis
Authors: Mathur Deepali , Rout Soumyashree , Mishra Bikash Kumar , Rodas Gerardo Lopez , Vallamkondu Jayalakshmi , Kandimalla Ramesh , Casanova Bonaventura
Published: September 2020

Multiple Sclerosis (MS) is a complex disease of the central nervous system (CNS) that involves the intricate interplay of different immune cells going awry leading to inflammation, demyelination, and neurodegeneration. Its diagnosis is quite arduous because of the baffling number of symptoms it elicits and the varied clinical manifestation it presents. The simplified criteria (in form of Macdonald’s Criteria) which have got modified several times is now the single most important criteria accepted by neurology bodies for diagnosing MS. Biomarkers from time to time have been explored to simplify the diagnosis and prognosticate MS along with anecessity to monitor treatment outcome. In recent years, research on biomarkers has advanced rapidly due to their ability to be easily and rapidly measured, their specificity, safety, and their ability to yield precise results. Biomarkers are classified into various categories including predictive, diagnostic, prognostic, related to disease activity, and monitoring treatment outcome. Each representative of the disease activity category reflects a variety of pathological processes of MS such as neuroaxonal loss, gliosis, demyelination, disability progression, remyelination, etc. This review discusses several promising serum and cerebrospinal fluid biomarkers and imaging biomarkers used in clinical practice. Myelin oligodendrocyte glycoprotein antibody disease which is recently recognized as a definite disease will also be discussed. Furthermore, it sheds light on the criteria and the challenges a biomarker faces to be considered as a standard one.
Direct Binding of Complementary Symmetric Ligands to DNA Nucleotide Pairs by Means of Transcription Factors
Authors: Schaper Charles
Published: September 2020

To activate gene expression, the initiation of transcription is a highly regulated process involving the interaction of proteins and DNA nucleotides at the promoter site, which consists of a small number of base pairs. As it involves interactions at the atomic scale, it is challenging to determine the mechanism of binding responsible for the great specificity between the amino acid residuals comprising the transcription binding protein and the DNA nucleotides comprising the promoter. Here, a new approach to characterize the transcription initiation process is developed and verified from analysis of comparative pharmacological efficacy data and elemental modeling. The newly developed description of a mechanism for transcription initiation involves the direct binding of small molecule ligands of approximately twenty carbon atoms, which are both structurally symmetric to DNA nucleotides, and also chemically complementary in its functional groups for interaction with the oxygen element at the carbon two position of thymine and with the phosphodiester chain. The results indicate that the activating ligands are transported to the DNA nucleotide promoter site by protein transcription factors, which serve as delivery vectors, for transfer of the ligand to the DNA nucleotide pairs. The ligands examined in this study include the steroid hormones, synthetic steroid molecules, derivatives of vitamin D, and prostaglandins, particularly PGJ2 and 15d-PGJ2. The transcription factors evaluated include glucocorticoid receptors, VDR, PPAR, and TBP. Through the developments, it is shown that because of the chemically complementary binding of the ligand to DNA nucleotide pairs, the resultant intermolecular complex produces three hydrogen bonds for the A-T and T-A configurations, which matches that of G-C and C-G. The orientation of the nucleotide base pairs is also seen to adjust as an inversion of the nominal position of the nucleobases to a dimer configuration presented via TBP transcription factor. The developments comprise a new approach to characterizing the initiation of the transcription process comprising the direct binding and interaction of ligands with DNA nucleotides as verified through comparative analysis of pharmacological activity and through perfect structural correspondence between the steroid hormone class as ligands with Watson-Crick DNA nucleotide pairings.
The Strawberry Line’s Breeding Birds and their Biophilic Benefits (Vale of Winscombe Section)
Authors: Garland Lincoln
Published: September 2020

The Strawberry Line is a linear Local Nature Reserve extending along a dismantled railway corridor in North Somerset, England. The Reserve is cherished as a recreational resource by local communities and I am very fortunate to live beside it. During the COVID-19 lockdown of spring 2020, I decided to make use of my permissible daily exercise to record the distribution of breeding birds along my particular ‘patch’ of the Strawberry Line - the Vale of Winscombe section in the Mendip Hills. In describing the Reserve’s birdlife, I hope that I can provide an added layer of interest for locals and visitors, which might help in these difficult times deliver an enhanced dose of ‘Nature’s Fix’ and perhaps also shine a light towards a greater appreciation and connection with the natural world.
Feedback Control Methods for a Single Machine Infinite Bus System
Authors: Vernekar Pratik , Wang Zhongkui , Serrani Andrea , Passino Kevin
Published: September 2020

In this manuscript, we present a high-fidelity physics-based truth model of a Single Machine Infinite Bus (SMIB) system. We also present reduced-order control-oriented nonlinear and linear models of a synchronous generator-turbine system connected to a power grid. The reduced-order control-oriented models are next used to design various control strategies such as: proportional-integral-derivative (PID), linear-quadratic regulator (LQR), pole placement-based state feedback, observer-based output feedback, loop transfer recovery (LTR)-based linear-quadratic-Gaussian (LQG), and nonlinear feedback-linearizing control for the SMIB system. The controllers developed are then validated on the high-fidelity physics-based truth model of the SMIB system. Finally, a comparison is made of the performance of the controllers at different operating points of the SMIB system.
¿Recuperación económica o incremento de la desigualdad urbana? Tendencias de consumo y percepción del precio del agua en los hogares del litoral de Alicante
Authors: Villar Navascués Rubén Alejandro , Hernández Hernández María , Rico Amorós Antonio Manuel
Published: September 2020

El periodo de disminución del consumo urbano de agua iniciado a mediados de la década del 2000 en España se invirtió en algunas áreas litorales del Mediterráneo a partir del año 2014 como resultado de la recuperación económica y el crecimiento de la actividad turística. Sin embargo, a escala inframunicipal este cambio de tendencia no se ha producido de manera homogénea. Con el objetivo de mejorar la comprensión de estas tendencias, se han realizado 171 encuestas personales en hogares de dos municipios del litoral de Alicante y se han solicitado sus datos de facturación de agua agregados por tipología de vivienda y sector urbano. Los resultados del análisis de la evolución del consumo entre 2007 y 2017 y de la percepción del precio del agua indican que se ha producido un incremento de la desigualdad urbana. Mientras que en las áreas urbanas de baja densidad el consumo ha aumentado, especialmente en las viviendas secundarias, en las áreas urbanas de alta densidad la disminución se ha mantenido, llegando a niveles que podrían indicar situaciones de pobreza hídrica, por lo que se propone la revisión de las estructuras tarifarias para fomentar una distribución más justa de los costes del servicio.
The effect of the Presence of Children on Adult Smoking Behaviour: Empirical Evidence Based on China Family Panel Studies
Authors: LIN Haoxiang , Chang Chun , LIU Zhao , Tan huaqing
Published: September 2020

Background: Despite a number of studies linking family and marriage factors with health behaviour, the effects of children on the health behaviour of parents are still understudied. This study explored the association between the presence of children and adults’ smoking behaviours.

Methods: This study used panel data from the China Family Panel Studies 2010 and 2012, and the data set included 23157 households and 45513 adults. Logistic regression was performed to analyse the association of the presence of children on adults’ smoking behaviours. Subgroup regression was used to examine heterogeneous effects.

Results: Full sample regressions showed that the number of children was significantly inversely associated with smoking behaviour (OR=0.93; 95% 0.90-0.96). Further subsample regression finds that such effect is only significant among the high-education group (OR= 0.92; 95% 0.87-0.97), high-skill workers (OR= 0.89; 95% 0.80-0.99) and couples who had an age gap greater than 2 years (OR=0.91; 95% 0.88-0.95).

Conclusions: Our findings confirm the existence of the upward intergenerational effect of the presence of children on adults’smoking behaviour in China. However, such effects are not equal across all demographic characteristics. Future research could explore other parts of the upward mechanism and possible pathways for a stronger effect. In resource-poor areas, targeting cessation activities at those who have children at an early age may be an effective strategy.
Spatial and temporal patterns of Ross River virus in South East Queensland, Australia: identification of hot spots at the rural-urban interface
Authors: Murphy Amanda K. , Clennon Julie A. , Vazquez-Prokopec Gonzalo , Jansen Cassie C. , Frentiu Francesca D. , Hafner Louise M. , Hu Wenbiao , Devine Gregor J.
Published: September 2020

Background: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Public health concern about RRV is increasing due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. Australia experienced its largest recorded outbreak of 9,544 cases in 2015, with the majority reported from South East Queensland (SEQ). This study examined potential links between disease patterns and transmission pathways of RRV. Methods: The spatial and temporal distribution of notified RRV cases, and associated epidemiological features in SEQ, were analysed for the period 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the capital city of Brisbane, and those of 8 adjacent Local Government Areas, and host spot analyses to identify locations with significantly high incidence. Results: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak in cases between February and May. The highest RRV incidence was in adults aged from 30-64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect. Conclusions: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.
Antinociceptive effects of magnesium sulfate for monitored anesthesia care during hysteroscopy: a randomized controlled study
Authors: Gao Peng-fei , Lin Jing-yan , Wang Shun , Zhang Yun-feng , Wang Guo-qiang , Xu Qi , Guo Xiao
Published: September 2020

Background: Opioids are the most effective antinociceptive agents, they have undesirable side effects such as respiratory depressant and postoperative nausea and vomiting. The purpose of the study was to evaluate the antinociceptive efficacy of adjuvant magnesium sulphate to reduce intraoperative and postoperative opioids requirements and their related side effects during hysteroscopy.Methods: 70 patients scheduled for hysteroscopy were randomly divided into 2 groups. Patients in the magnesium group (Group M) received intravenous magnesium sulfate 50 mg/kg in 100 ml of isotonic saline over 15 min before anesthesia induction and then 15 mg/kg per hour by continuous intravenous infusion. Patients in the control group (Group C) received an equal volume of isotonic saline as placebo. All patients were anesthetized under a BIS guided monitored anesthesia care with propofol and fentanyl. Intraoperative hemodynamic variables were recorded and postoperative pain scores were assessed with verbal numerical rating scale (VNRS) 1 min, 15 min, 30 min, 1 hour, and 4 hours after recovery of consciousness. The primary outcome of our study was total amount of intraoperative and postoperative analgesics administered.Results: Postoperative serum magnesium concentrations in Group C were significantly decreased than preoperative levels (0.86 ± 0.06 to 0.80 ± 0.08 mmol/L, P=0.001) while there was no statistical change in Group M (0.86 ± 0.07 to 0.89 ± 0.07 mmol/L, P=0.129). Bradycardia did not occur in either group and the incidence of hypotension was comparable between the two groups. Total dose of fentanyl given to patients in Group M was less than the one administered to Group C [100 (75-150) vs 145 (75-175) μg, median (range); P < 0.001]. There was no statistically significant difference for patients who needed rescue analgesic between the two groups [14 vs 6 subjects in Group C and Group M, RR=0.44 (0.19 to 1.01), P=0.052, NNT 4.349]. In addition, patients receiving magnesium displayed lower VNRS scores at 15 min, 30 min, 1 hour, and 4 hours postoperatively. Conclusions: In hysteroscopy, adjuvant magnesium administration is beneficial to reduce intraoperative fentanyl requirement and postoperative pain without cardiovascular side effects. Our study indicates that if surgical patients have risk factors for hypomagnesemia, assessing and correcting magnesium level will be necessary.Trial registration: www.chictr.org.cn ChiCTR1900024596 date of registration: July 18th 2019.
Common sampling and modeling approaches to analyzing readmission risk that ignore clustering produce misleading results
Authors: Zhao Huaqing , Tanner Samuel , Golden Sherita H. , Fisher Susan , Rubin Daniel J.
Published: September 2020

Background: There is little consensus on how to sample hospitalizations and analyze multiple variables to model readmission risk. The purpose of this study was to compare readmission rates and the accuracy of predictive models based on different sampling and multivariable modeling approaches. Methods: We conducted a retrospective cohort study of 17 284 adult diabetes patients with 44 203 discharges from an urban academic medical center between 1/1/2004 and 12/31/2012. Models for all-cause 30-day readmission were developed by four strategies: logistic regression using the first discharge per patient (LR-first), logistic regression using all discharges (LR-all), generalized estimating equations (GEE) using all discharges, and cluster-weighted (CW) GEE using all discharges. Multiple sets of models were developed and internally validated across a range of sample sizes. Results: The readmission rate was 10.2% among first discharges and 20.3% among all discharges, revealing that sampling only first discharges underestimates a population’s readmission rate. Number of discharges was highly correlated with number of readmissions (r=0.87, P<0.001). Accounting for clustering with GEE and CWGEE yielded more conservative estimates of model performance than LR-all. LR-first produced falsely optimistic Brier scores. Model performance was unstable below samples of 6 000-8 000 discharges and stable in larger samples. GEE and CWGEE performed better in larger samples than in smaller samples. Conclusions: Hospital readmission risk models should be based on all discharges as opposed to just the first discharge per patient and utilize methods that account for clustered data.
Only children or children with siblings: who has greater physical activity and healthier weight?
Authors: Sigmund Erik , Sigmundová Dagmar
Published: September 2020

Background: The influence of parents on the physical activity (PA) and body weight of their children is confirmed by scientific studies. However, it is not known whether only children or those with siblings have a higher level of PA and healthier body weight. One aim of this study is to assess whether there are any differences in the achievement of the daily step count (SC) recommendation and in the prevalence of overweight and obesity between only children and children from families with multiple children. Another aim is to investigate whether the achievement of the daily SC recommendation by children/parents and parental overweight/obesity are associated with childhood obesity. Methods: The analysis included 566 families (10.6% with a single child, 89.4% with two or more children) with complete data of family members for weight status and ambulatory PA monitored with a Yamax pedometer during the spring and autumn in 2013-2019. The cut-point values of the daily SC recommendation amounted to ≥13,000/≥11,000 steps per day for 5-12-year-old sons/daughters and ≥10,000 steps per day for 12-16-year-old adolescents and adults. Pearson’s chi-square test was used to compare the achievement of the daily SC recommendation and the prevalence of overweight and obesity between only children and those with siblings. Binary logistic regression analyses were used to investigate whether the achievement of the daily SC recommendation by children/parents and parental overweight/obesity were associated with obesity in their offspring. Results: A significantly higher proportion of children with siblings (p<0.01) achieved the recommended daily SC (51.8% vs. 31.7%) and showed a lower prevalence of overweight (16.2% vs. 20.0%) and obesity (7.1% vs. 20.0%) compared with only children. The achievement of the daily SC recommendation in children significantly (p<0.05) reduced the odds (OR) of obesity (OR=0.22-0.34). The children with siblings had lower odds (OR=0.41-0.54) of obesity than the only children. The overweight/obesity of mothers significantly increased (p<0.05) the odds of obesity (OR=2.07) in their children. Conclusion: Children with siblings achieve the daily SC recommendation more often at weekends and on average for the whole week and have a lower incidence of overweight and obesity than children from single-child families.
Emergency and Urgent Dental Visits among Medicaid Enrollees from 2013 to 2017
Authors: Fiehn Rebekah , Okunev Ilya , Bayham Mary , Barefoot Steven , Tranby Eric
Published: September 2020

Background: Efforts to combat the spread of COVID-19 have led to guidance to restrict dental practice to treating emergency and urgent dental visits and reduce or eliminate elective dental procedures. Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.
Complementary NAD+ Replacement Strategies Fail to Functionally Protect Dystrophin-Deficient Muscle
Authors: Frederick David , McDougal Alan V. , Semenas Melisa , Vappiani Johanna , Nuzzo Andrea , Ulrich John C. , Stewart Eugene L. , Sévin Daniel C. , Kramer H. Fritz , Becherer J. David , Preugschat Frank
Published: September 2020

Background Duchenne muscular dystrophy (DMD) is a progressive muscle wasting disorder stemming from a loss of functional dystrophin. Current therapeutic options for DMD are limited, as small molecule modalities remain largely unable to decrease the incidence or mitigate the consequences of repetitive mechanical insults to the muscle during eccentric contractions (ECCs). Methods Using a metabolomics approach, we observed distinct and transient molecular phenotypes in muscles of dystrophin-deficient MDX mice subjected to ECCs. Among the most chronically depleted metabolites was nicotinamide adenine dinucleotide (NAD), an essential metabolic cofactor suggested to protect muscle from structural and metabolic degeneration over time. We tested whether the MDX muscle NAD pool can be expanded for therapeutic benefit using two complementary small molecule strategies: provision of a biosynthetic precursor, nicotinamide riboside, or specific inhibition of the NAD-degrading ADP-ribosyl cyclase, CD38. Results Administering a novel, potent, and orally available CD38 antagonist to MDX mice successfully reverted a majority of the muscle metabolome toward the wildtype state, with a pronounced impact on intermediates of the pentose phosphate pathway, while supplementing nicotinamide riboside did not significantly affect the molecular phenotype of the muscle. However, neither strategy sustainably increased the bulk tissue NAD pool, lessened muscle damage markers, or improved maximal hindlimb strength following repeated rounds of eccentric challenge and recovery. Conclusions In the absence of dystrophin, eccentric injury contributes to chronic intramuscular NAD depletion with broad pleiotropic effects on the molecular phenotype of the tissue. These consequences can be more effectively overcome by inhibiting the enzymatic activity of CD38 than by supplementing nicotinamide riboside. However, neither small molecule strategy is sufficient to protect or restore muscle function, undermining the therapeutic approach.
The Effect of Periodic Ketogenic Diet on Newly Diagnosed Overweight or Obese Patients with Type 2 Diabetes
Authors: Li Sumei , Lin Guoxin , Chen Jinxing , Chen Zhenxin , Xu Feipeng , Zhu Feng , Zhang Jintian , Yuan Shouping
Published: September 2020

BackgroundTo observe the effect of periodic ketogenic diet intervention on newly diagnosed overweight or obese patients with type 2 diabetes.Methods60 overweight or obese T2DM patients were randomly divided into ketogenic diet group and diabetes diet control group, 30 patients in each group. The changes and significance of blood glucose, blood lipid, body weight, insulin, uric acid and other indicators before and after the intervention were observed.ResultsThe Weight, BMI, Waist, TG, TC, LDL, HDL, FBG, FINS, HbA1c of the two groups decreased significantly compared with the previous period (P < 0.05). However, UA showed an increasing trend in the ketogenic diet group and no significant change in UA in the diabetic diet control group (P > 0.05). Long-term adherence to the ketogenic diet was not as strong as that of the diabetic diet.ConclusionThe phased-ketogenic diet can control not only weight but also blood glucose and blood lipid in patients with overweight or obese T2DM. But long-term persistence is difficult.
Features and associated factors of bacterial skin infections in hospitalized patients with pemphigus: a single-center retrospective study
Authors: Li Furong , Wu Yejun , Bian Wenjie , Huang Lei , Zhu Xuejun , Chen Xixue , Wang Mingyue
Published: September 2020

Background: Infections were the primary cause of death (34.3%-55.5%) in patients with pemphigus. Skin was usually the origin of infections. The study aimed to explore features and associated factors of bacterial skin infections (BSIs) in inpatients with pemphigus. Methods: One hundred and eighty-four inpatients with pemphigus hospitalizing from November 2014 to April 2019 were continuously recruited through Peking University First Hospital’s inpatient records. Then, we retrieved the clinical and laboratory data to explore the characteristics and associated factors of BSIs.Results: Of patients enrolled, pemphigus vulgaris (PV, n=142) and pemphigus foliaceus (PF, n=9) were most common, followed by pemphigus erythematosus (PE, n=25) and pemphigus vegetans (Pveg, n=1). Eighty-seven of 177 (49.2%) inpatients developed BSIs, and they had a longer length of stay compared with inpatients without BSIs (median: 18.9 days vs. 14.1 days, p = 0.008). Staphylococcus aureus was the most common bacteria(71.3%, 62/87) and highly resistant to penicillin (91.9%, 57/62). Higher levels of anti-Dsg1 autoantibodies (>124.2U/mL) (p<0.001, odds ratio [OR]=3.564, 95% confidence interval [CI]: 1.784-7.123) and anti-Dsg3 autoantibodies (>169.5U/mL) (p = 0.03, OR=1.074, 95% CI: 1.084-3.969) were underlying risk factors of BSIs when analyzed by binary regression analysis. As for Gram’s stain of bacteria, females had a lower rate of Gram-positive infections (p = 0.03). Patients using oral antibiotics (p = 0.05) had a higher rate of Gram-negative infections. Inpatients who were hospitalized in other hospitals within two weeks before the current admission had a higher rate of Gram-negative and co-infections (p = 0.03). Conclusions: Inpatients with pemphigus had a high incidence of BSIs. Some factors were associated with the susceptibility of BSIs and bacterial species.
Mild dyserythropoiesis and b-like globin gene expression imbalance due to the loss of histone chaperone ASF1B
Authors: Papadopoulos Petros , Kafasi Athanassia , de Cuyper Iris , Barroca Vilma , Lewandowski Daniel , Kadri Zahra , Veldthuis Martijn , Berghuis Jeffrey , Gillemans Nynke , Cuesta Celina María Benavente , Grosveld Frank , Zwieten Rob van , Philipsen Sjaak , Vernet Muriel , Gutiérrez Laura , Patrinos George
Published: September 2020

The expression of the human b-like globin genes follows a well-orchestrated developmental pattern, undergoing two essential switches, the first one during the first weeks of gestation (e to g), and the second one during the perinatal period (g to b). The g to b globin gene switching mechanism includes suppression of fetal (g-globin, HbF) and activation of adult (b-globin, HbA) globin gene transcription. In Hereditary Persistence of Fetal Hemoglobin (HPFH), the g-globin suppression mechanism is impaired leaving these individuals with unusual elevated levels of fetal hemoglobin (HbF) in adulthood. Recently, the transcription factors KLF1 and BCL11A have been established as master regulators of the g to b globin switch. Previously a genomic variant in the KLF1 gene, identified by linkage analysis performed on twenty-seven members of a Maltese family, was found to be associated with HPFH. However, variation in the levels of HbF amongst family members, and those from other reported families carrying genetic variants in KLF1, suggest additional contributors to globin switching. ASF1B was downregulated in family members with HPFH. Here, we investigate the role of ASF1B in g to b globin switching and erythropoiesis in vivo. Mouse-human interspecies ASF1B protein identity is 91.6%. By means of knockdown functional assays in human primary erythroid cultures and analysis of the erythroid lineage in Asf1b knockout mice, we provide evidence that ASF1B is a novel contributor to steady-state erythroid differentiation, and while its loss affects the balance of globin expression, it has no major role in hemoglobin switching.
Maternal health among Venezuelan women migrants at the border of Brazil 
Authors: Bahamondes Luis , Laporte Montas , Margatho Deborah , de Amorin Helder , Brasil Cinthia , Charles Charles Mpoca , Becerra Alejandra , Hidalgo Maria Margarethe
Published: September 2020

Background: Guaranteeing the sexual and reproductive health and rights (SRHR) of populations living in fragile and humanitarian settings is essential and constitutes a basic human right. Compounded by the inherent vulnerabilities of women in crises, substantial complications are directly associated with increased risks of poor SRHR outcomes for displaced populations. The migration of Venezuelans, displaced due to current economic circumstances, is one of the largest in Latin America’s history. This study aims to provide an overview of the sexual and reproductive health (SRH) issues affecting migrant Venezuelan women in the state of Roraima, Brazil.Methods: Face-to-face interviews were conducted from 24 to 30 November 2019. Data collection covered various issues involving access to and use of SRH services by 405 migrant Venezuelan women aged 18-49 years. The Minimum Initial Service Package readiness assessment tools, available from the Inter-Agency Working Group on Reproductive Health in Crises, were used in the data collection.Results: Most commonly, the women reported unmet family planning needs. Of these, a significant proportion reported being unable to obtain contraceptive methods, particularly long-acting reversible contraceptives, either due to the woman’s inability to access them or their unavailability at healthcare centres. Although a significant proportion of women were largely satisfied with the attention received at the maternity hospital, both before and during childbirth, 24.0% of pregnant or postpartum women failed to receive any prenatal or postnatal care. Conclusion: Meeting the essential SRHR needs of migrant Venezuelan women in Roraima, Brazil is a challenge that has yet to be fully addressed. Given the size of this migrant population, the Brazilian healthcare system has failed to adapt sufficiently to meet their needs; however, problems with healthcare provision are similar for migrants and Brazilian citizens. Efforts need to be encouraged not only in governmental health sectors, but also with academic, non-governmental and international organisations, including a coordinated approach to ensure a comprehensive SRHR response. Given the current high risks associated with the SARS-CoV-2 pandemic, meeting the SRHR needs of migrant populations has become more critical than ever.
Extending the global-direction stencil with "face-area-weighted centroid" to unstructured finite volume discretization from integral form
Authors: Kong Lingfa , Dong Yidao , Liu Wei , Zhang Huaibao
Published: September 2020

Accuracy of unstructured finite volume discretization is greatly influenced by the gradient reconstruction. For the commonly used k-exact reconstruction method, the cell centroid is always chosen as the reference point to formulate the reconstructed function. But in some practical problems, such as the boundary layer, cells in this area are always set with high aspect ratio to improve the local field resolution, and if geometric centroid is still utilized for the spatial discretization, the severe grid skewness cannot be avoided, which is adverse to the numerical performance of unstructured finite volume solver. In previous work [Chinese Physics B. 2020, In press] , we explored a novel global-direction stencil and combined it with the face-area-weighted centroid on unstructured finite volume methods from differential form to realize the skewness reduction and a better reflection of flow anisotropy. Greatly inspired by the differential form, in this research, we demonstrate that it is also feasible to extend this novel method to the unstructured finite volume discretization from integral form on both second and third-order finite volume solver. Numerical examples governed by linear convective, Euler and Laplacian equations are utilized to examine the correctness as well as effectiveness of this extension. Compared with traditional vertex-neighbor and face-neighbor stencils based on the geometric centroid, the grid skewness is almost eliminated and computational accuracy as well as convergence rate is greatly improved by the global-direction stencil with face-area-weighted centroid. As a result, on unstructured finite volume discretization from integral form, the method also has superiorities on both computational accuracy and convergence rate.