bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatio-temporal distribution and associated factors of anaemia among children aged 6–59 months in Ethiopia: a spatial and multilevel analysis based on the EDHS 2005–2016
Authors: Hailegebreal Samuel , Nigatu Araya Mesfin , Mekonnen Zeleke Abebaw , Endehabtu Berhanu Fikadie
Published: August 2021

Objectives

Anaemia is a global public health problem with major health and socioeconomic consequences. Though childhood anaemia is a major public health problem in Ethiopia, there is limited evidence on the spatio-temporal variability of childhood anaemia over time in the country. Therefore, this study aimed to assess the spatio-temporal distribution and associated factors of childhood anaemia using the Ethiopian Demographic and Health Survey (EDHS) data from 2005 to 2016.

Design

Survey-based cross-sectional study design was employed for the EDHS.

Setting

Data were collected in all nine regions and two city administrations of Ethiopia in 2005, 2011 and 2016.

Participants

The source population for this study was all children in Ethiopia aged 6–59 months. A total of 21 302 children aged 6–59 months were included in this study.

Outcome measure

The outcome variable was child anaemia status.

Results

The prevalence of anaemia declined from 53.9% in 2005 to 44.6% in 2011, but it showed an increase in 2016 to 57.6%. The spatial analysis revealed that the spatial distribution of anaemia varied across the regions. The spatial scan statistics analysis indicated a total of 22 clusters (relative risk (RR)=1.5, p<0.01) in 2005, 180 clusters (RR=1.4, p<0.01) in 2011 and 219 clusters (RR=1.4, p<0. 0.01) in 2016, significant primary clusters were identified. The child’s age, mother’s age, maternal anaemia status, wealth index, birth order, fever, stunting, wasting status and region were significant predictors of childhood anaemia.

Conclusions

In this study, childhood anaemia remains a public health problem. The spatial distribution of childhood anaemia varied significantly across the country. Individual-level and community-level factors were associated with childhood anaemia. Therefore, in regions with a high risk of childhood anaemia, individual-level and community-level factors should be intensified by allocating additional resources and providing appropriate and tailored strategies.
Reducing risks associated with medicines and lifestyle in a residential care population with intellectual disabilities: evaluation of a pharmacy review initiative in England
Authors: Thayer Nick , White Simon , Islam Jasmeen , Jones Wesley , Kenzie Stephanie , Kullu Rajni
Published: August 2021

Objectives

A collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmacist reviews for care home residents with intellectual disabilities (IDs). This study aimed to characterise the medicines and lifestyle risk outcomes of the service and determine how these align with national priority issues in ID.

Design

Descriptive statistical analysis of routinely collected service delivery data.

Setting

Residential care homes in the Wirral, England for people with ID.

Participants

160 residents.

Interventions

Pharmacist review of residents’ medicines and lifestyle risk factors between November 2019 and May 2020.

Primary and secondary outcome measures

Numbers of medicines prescribed, the nature of pharmacists’ interventions/recommendations and general practitioner (GP)/psychiatrist acceptance.

Results

The 160 residents were prescribed 1207 medicines, 74% were prescribed ≥5 medicines and 507 interventions/recommendations were made, averaging 3.3 per resident. The highest proportion (30.4%) were lifestyle risk related, while changing and stopping medicines accounted for 17.9% and 12.8%, respectively. Of the recommendations discussed with GPs/psychiatrists, 86% were accepted. Medicines with anticholinergic properties were prescribed for 115 (72%) residents, of whom 43 (37%) had a high anticholinergic burden score. Pharmacists recommended anticholinergic discontinuation or dose reduction for 28 (24%) residents. The pharmacists made interventions/recommendations about constipation management for 10% of residents and about respiratory medicines for 17 (81%) of the 21 residents with respiratory diagnoses.

Conclusions

The findings indicate considerable polypharmacy among the residents and a high level of pharmacists’ interventions/recommendations about medicines and lifestyle risk, most of which were accepted by GPs/psychiatrists. This included anticholinergic burden reduction and improving respiratory disease and constipation management, which are national priority issues. Wider adoption of collaborative pharmacist review models could have similar benefits for residential populations with ID and potentially reduce pressure on other health services.
Effectiveness of interventions for people living with dementia and their carers in Chinese communities: protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Shi Cheng , Chen Shuangzhou , Salcher-Konrad Maximilian , Choy Jacky C P , Luo Hao , Leung Dara Kiu Yi , Cai Xinxin , Zeng Yue , Dai Ruizhi , Comas-Herrera Adelina , McDaid David , Knapp Martin , Wong Gloria
Published: August 2021

Introduction

As the largest and most rapidly ageing population, Chinese people are now the major driver of the continued growth in dementia prevalence globally. The need for evidence-based interventions in Chinese communities is urgent. Although a wide range of pharmacological and non-pharmacological interventions for dementia have been trialled in Chinese populations, the evidence has not been systematically synthesised. This systematic review and meta-analysis aims to map out the interventions for people living with dementia and their carers in Chinese communities worldwide and compare the effectiveness of these interventions.

Methods and analysis

This protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. We will search Chinese (China National Knowledge Infrastructure, WanFang DATA) and English bibliographical databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODelling Outcome and cost impacts of interventions for DEMentia (MODEM) Toolkit, Cochrane Database of Systematic Reviews), complemented by hand searching of reference lists. We will include studies evaluating the effectiveness of interventions for dementia or mild cognitive impairment in Chinese populations, using a randomised controlled trial design, and published between January 2008 and June 2020. We will use a standardised form to extract data and Version 2 of the Cochrane risk-of-bias tool for randomised trials to assess the risk of bias of the included studies. Collected data will be fully interpreted with narrative synthesis and analysed using pairwise and network meta-analyses to pool intervention effects where sufficient information is available. We will perform subgroup analysis and meta-regression to explore potential reasons for heterogeneity.

Ethics and dissemination

No formal ethics approval is required for this protocol. The findings will facilitate the development of studies on interventions for dementia and timely inform dementia policymaking and practice. Planned dissemination channels include peer-reviewed publications, conference presentations, public events and websites.

PROSPERO registration number

CRD42019134135.
Evaluating the knowledge, attitudes and practices of the UAE community on microbiota composition and the main factors affecting it: a cross-sectional study
Authors: Barqawi Hiba Jawdat , Adra Saryia Farouk , Ramzi Hiba Riad , Abouaggour Mahmoud Alaa , Almehairi Shamma Khamis
Published: August 2021

Objectives

This study aims to explore the knowledge, attitudes and practices (KAP) of the population in the United Arab Emirates (UAE) regarding microbiota and the main factors affecting its composition.

Design/setting

A cross-sectional study, using a self-administered questionnaire, was conducted from May 2018 to September 2018, recruiting participants in public venues via convenience sampling.

Participants

UAE residents (aged 18 years and above) who spoke either Arabic or English.

Results

419 responses were completed and analysed using SPSS V.24. Only 29.3% (n=94) of the participants who defined microbiota correctly had good knowledge. There was a significant difference in knowledge among different age groups (p=0.004) and educational levels (p<0.001). Multiple linear regression (MLR) model indicated that being a university student and a healthcare professional (HCP) are the only significant predictors regarding microbiota knowledge (p=0.014 and p<0.001, respectively). Of the respondents who claimed to be aware of probiotics, only 9.1% (n=15) exhibited good knowledge. MLR model showed that being a postgraduate and an HCP are the only significant predictors for probiotics knowledge (p=0.016 and p<0.001, respectively). 42.4% (n=143) and 34.6% (n=28) of the non-medical and HCP participants, respectively, use antibiotics without a prescription. None of the respondents, with or without a medical background, demonstrated good attitudes and practices toward the use of antibiotics.

Conclusion

Despite the fact that the participants had a basic understanding of microbiota and probiotics, the overall knowledge was substandard. Additionally, the respondents engaged in improper practices that alter the microbiota composition, especially via antibiotics misuse. Campaigns should target the general population as well as HCPs to upheave their overall KAP.
Incidence of lower limb amputation in people with and without diabetes: a nationwide 5-year cohort study in Japan
Authors: Kamitani Fumika , Nishioka Yuichi , Noda Tatsuya , Myojin Tomoya , Kubo Shinichiro , Higashino Tsuneyuki , Okada Sadanori , Akai Yasuhiro , Ishii Hitoshi , Takahashi Yutaka , Imamura Tomoaki
Published: August 2021

Introduction

This study was conducted to investigate the incidence and time trend of lower limb amputation (LLA) among people with and without diabetes.

Research design and methods

This retrospective population-based cohort study was based on the national claims data in Japan, comprising a total population of 150 million. Data of all individuals who had LLA from April 2013 to March 2018 were obtained. We analysed the sex-adjusted and age-adjusted annual LLA rate (every fiscal year) in people with and without diabetes for major and minor amputation. To test for time trend, Poisson regression models were fitted.

Results

In the 5-year period, 30 187 major and 29 299 minor LLAs were performed in Japan. The sex-adjusted and age-adjusted incidence of major and minor LLAs was 9.5 (people with diabetes, 21.8 vs people without diabetes, 2.3, per 100 000 person-years) and 14.9 (people with diabetes, 28.4 vs people without diabetes, 1.9, per 100 000 person-years) times higher, respectively, in people with diabetes compared with those without. A significant decline in the annual major amputation rate was observed (p<0.05) and the annual minor amputation rate remained stable (p=0.63) when sex, age and people with and without diabetes were included as dependent variables.

Conclusions

This is the first report of the national statistics of LLAs in Japan. The incidence of major and minor LLAs was 10 and 15 times higher, respectively, in people with diabetes compared with those without. A significant decline in the major amputation rate was observed, and the annual minor amputation rate remained stable during the observation period. This information can help to create an effective national healthcare strategy for preventing limb amputations, which affect the quality of life of patients with diabetes and add to the national healthcare expenditure.
Association of depressive symptoms with the progression of carotid intima–media thickness in a community-based cohort in Beijing, China
Authors: Liu Mengyuan , Jia Jia , Fan Fangfang , Sun Pengfei , Wu Zhongli , Jiang Yimeng , He Danmei , Liu Bo , Yang Ying , Zhang Yan
Published: August 2021

Objectives

To determine the relationship between depressive symptoms and progression of carotid intima–media thickness (cIMT) in a Beijing community-based population.

Design

Prospective cohort study between 2014 and 2018.

Setting

Dwellers without cardiovascular disease, hypertension or diabetes from a Beijing community.

Participants

3849 Chinese community-dwelling individuals who underwent baseline screening for depressive symptoms were invited to participate in the study in 2014 and follow-up visit in 2018. Among them, 2124 participants completed carotid ultrasound examination both at baseline and a follow-up visit. After further excluding patients with a history of stroke, myocardial infarction or lower extremity arterial stenosis and those with a diagnosis of hypertension or diabetes and ankle–brachial index ≤0.9 at baseline, 1011 eligible participants were finally included.

Primary outcome measure

The rate of mean cIMT change.

Results

Over a median follow-up period of 4.40 years, the overall rate of mean cIMT change was 2.23% (−5.64% to 9.51%). After adjustment for 13 covariates, there was an increase of 2.36% (β=2.36, 95% CI: 0.37 to 4.36, p=0.020) for the rates of mean cIMT change in the depressive group compared with the control group. Furthermore, this association was modified by drinking status (β=3.22, 95% CI: 1.25 to 5.19, P-interaction=0.006).

Conclusion

Depressive symptoms were independently associated with progression of mean cIMT in a community-based cohort in Beijing, China. Furthermore, this relationship was modified by drinking status.
Associations between emergency department crowding and perceptions of interpersonal care in patients presenting with suspected acute coronary syndrome
Authors: Liyanage-Don Nadia A , Edelman David S , Chang Bernard P , Schultebraucks Katharina , Thanataveerat Anusorn , Kronish Ian M
Published: August 2021

Background

Emergency department (ED) crowding is associated with numerous healthcare issues, but little is known about its effect on psychosocial aspects of patient-provider interactions orinterpersonal care. We examined whether ED crowding was associated with perceptions of interpersonal care in patients evaluated for acute coronary syndrome (ACS).

Methods

Patients presenting to a quaternary academic medical centre ED in New York City for evaluation of suspected ACS were enrolled between November 2013 and December 2016. ED crowding was measured using the ED Work Index (EDWIN), which incorporates patient volume, triage category, physician staffing and bed availability. Patients completed the 18-item Interpersonal Processes of Care (IPC) survey, which assesses communication, patient-centred decision-making and interpersonal style. Regression analyses examined associations between EDWIN and IPC scores, adjusting for demographics, comorbidities and depression.

Results

Among 933 included patients, 11% experienced ED overcrowding (EDWIN score >2) at admission, 11% experienced ED overcrowding throughout the ED stay and 30% reported suboptimal interpersonal care (defined as per-item IPC score <5). Higher admission EDWIN score was associated with modestly lower IPC score in both unadjusted (β=–1.70, 95% CI –3.15 to –0.24, p=0.02) and adjusted models (β = –1.77, 95% CI –3.31 to –0.24, p=0.02). EDWIN score averaged over the entire ED stay was not significantly associated with IPC score (unadjusted β=–1.30, 95% CI –3.19 to 0.59, p=0.18; adjusted β=–1.24, 95% CI –3.21 to 0.74, p=0.22).

Conclusion

Increased crowding at the time of ED admission was associated with poorer perceptions of interpersonal care among patients with suspected ACS.
Commencing one-handed chest compressions while activating emergency medical system using a handheld mobile device in lone-rescuer basic life support: a randomised cross-over simulation study
Authors: Park Sang O , Shin Dong Hyuk , Kim Changhoon , Lee Young Hwan
Published: August 2021

Introduction

In conventional basic life support (c-BLS), a lone rescuer is recommended to start chest compressions (CCs) after activating the emergency medical system. To initiate earlier CCs in lone-rescuer BLS, we designed a modified BLS (m-BLS) sequence in which the lone rescuer commences one-handed CCs while calling for help using a handheld cellular phone with the other free hand. This study aimed to compare the quality of BLS between c-BLS and m-BLS.

Methods

This was a simulation study performed with a randomised cross-over controlled trial design. A total of 108 university students were finally enrolled. After training for both c-BLS and m-BLS, participants performed a 3-minute c-BLS or m-BLS on a manikin with a SkillReporter at random cross-over order. The paired mean difference with SE between c-BLS and m-BLS was assessed using paired t-test.

Results

The m-BLS had reduced lag time before the initiation of CCs (with a mean estimated paired difference (SE) of −35.0 (90.4) s) (p<0.001). For CC, a significant increase in compression fraction and a higher number of CCs with correct depth were observed in m-BLS (with a mean estimated paired difference (SE) of 16.2% (0.6) and 26.9% (3.3), respectively) (all p<0.001). However, no significant paired difference was observed in the hand position, compression rate and interruption time. For ventilation, the mean tidal volumes did not differ. However, the number of breaths with correct tidal volume was higher in m-BLS than in c-BLS.

Conclusion

In simulated lone-rescuer BLS, the m-BLS could deliver significantly earlier CCs than the c-BLS while maintaining high-quality cardiopulmonary resuscitation.
Variation in colon cancer survival for patients living and receiving care in London, 2006–2013: does where you live matter?
Authors: Quaresma Manuela , Carpenter James R , Turculet Adrian , Rachet Bernard
Published: August 2021

Background

Marked geographical disparities in survival from colon cancer have been consistently described in England. Similar patterns have been observed within London, almost mimicking a microcosm of the country’s survival patterns. This evidence has suggested that the area of residence plays an important role in the survival from cancer.

Methods

We analysed the survival from colon cancer of patients diagnosed in 2006–2013, in a pre-pandemic period, living in London at their diagnosis and received care in a London hospital. We examined the patterns of patient pathways between the area of residence and the hospital of care using flow maps, and we investigated whether geographical variations in survival from colon cancer are associated with the hospital of care. To estimate survival, we applied a Bayesian excess hazard model which accounts for the hierarchical structure of the data.

Results

Geographical disparities in colon cancer survival disappeared once controlled for hospitals, and the disparities seemed to be augmented between hospitals. However, close examination of patient pathways revealed that the poorer survival observed in some hospitals was mostly associated with higher proportions of emergency diagnosis, while their performance was generally as expected for patients diagnosed through non-emergency routes.

Discussion

This study highlights the need to better coordinate primary and secondary care sectors in some areas of London to improve timely access to specialised clinicians and diagnostic tests. This challenge remains crucially relevant after the recent successive regroupings of Clinical Commissioning Groups (which grouped struggling areas together) and the observed exacerbation of disparities during the COVID-19 pandemic.
Genotype–phenotype correlation in arrhythmogenic right ventricular cardiomyopathy—risk of arrhythmias and heart failure
Authors: Christensen Alex Hørby , Platonov Pyotr G , Jensen Henrik Kjærulf , Chivulescu Monica , Svensson Anneli , Dahlberg Pia , Madsen Trine , Frederiksen Tanja Charlotte , Heliö Tiina , Lie Øyvind Haugen , Haugaa Kristina H , Hastrup Svendsen Jesper , Bundgaard Henning
Published: August 2021

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is predominantly caused by desmosomal genetic variants, and clinical hallmarks include arrhythmias and systolic dysfunction. We aimed at studying the impact of the implicated gene(s) on the disease course.

Methods

The Nordic ARVC Registry holds data on a multinational cohort of ARVC families. The effects of genotype on electrocardiographic features, imaging findings and clinical events were analysed.

Results

We evaluated 419 patients (55% men), with a mean follow-up of 11.2±7.4 years. A pathogenic desmosomal variant was identified in 62% of the 230 families: PKP2 in 41%, DSG2 in 13%, DSP in 7% and DSC2 in 3%. Reduced left ventricular ejection fraction (LVEF) ≤45% on cardiac MRI was more frequent among patients with DSC2/DSG2/DSP than PKP2 ARVC (27% vs 4%, p<0.01). In contrast, in Cox regression modelling of patients with definite ARVC, we found a higher risk of arrhythmias among PKP2 than DSC2/DSG2/DSP carriers: HR 0.25 (0.10–0.68, p<0.01) for atrial fibrillation/flutter, HR 0.67 (0.44–1.0, p=0.06) for ventricular arrhythmias and HR 0.63 (0.42–0.95, p<0.05) for any arrhythmia. Gene-negative patients had an intermediate risk (16%) of LVEF ≤45% and a risk of the combined arrhythmic endpoint comparable with DSC2/DSG2/DSP carriers. Male sex was a risk factor for both arrhythmias and reduced LVEF across all genotype groups (p<0.01).

Conclusion

In this large cohort of ARVC families with long-term follow-up, we found PKP2 genotype to be more arrhythmic than DSC2/DSG2/DSP or gene-negative carrier status, whereas reduced LVEF was mostly seen among DSC2/DSG2/DSP carriers. Male sex was associated with a more severe phenotype.
Exploring the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality early inflammatory arthritis (EIA) care in England and Wales
Authors: Zasada Magdalena , Yates Mark , Ayers Nicola , Ide Zoë , Norton Sam , Galloway James , Taylor Cath
Published: August 2021

Background

Evidence from a national clinical audit of early inflammatory arthritis (EIA) shows considerable variability between hospitals in performance, unexplained by controlling for case-mix.

Objective

To explore the macro-level, meso-level and micro-level barriers and facilitators to the provision of good quality EIA care.

Methods

A qualitative study within 16 purposively sampled rheumatology units across England and Wales. Quality was assessed in relation to 11 quality indicators based on clinical opinion, evidence and variability observed in the data. Data from semi-structured interviews with staff (1–5 from each unit, 56 in total) and an online questionnaire (n=14/16 units) were integrated and analysed using the framework method for thematic analysis using a combined inductive and deductive approach (underpinned by an evidence-based framework of healthcare team effectiveness), and constant comparison of data within and between units and its relationship with the quality criteria.

Findings

Quality of care was influenced by an interplay between macro, meso and micro domains. The macro (eg, shared care arrangements and relationships with general practitioners) and meso (eg, managerial support and physical infrastructure) factors were found to act as crucial enablers of and barriers to higher quality service provision at the micro (team) level. These organisational factors directly influenced team structure and function, and thereby EIA care quality.

Conclusions

Variability in quality of EIA care is associated with an interplay between macro, meso and micro service features. Tackling macro and meso barriers is likely to have a significant impact on quality of EIA service, and ultimately patient experience and outcomes.
Longitudinal uptake of the human papillomavirus vaccine among gay, bisexual and other men who have sex with men in British Columbia, Canada 2012–2019
Authors: Khatra Jatinder , Sang Jordan Mitchell , Wang Clara , Bacani Nicanor , Lachowsky Nathan John , Grennan Troy , Burchell Ann Natalie , Lal Allan , Roth Eric , Hogg Robert , Card Kiffer , Moore David
Published: August 2021

Objectives

In 2015, a publicly funded human papillomavirus (HPV) vaccination programme was implemented for gay, bisexual and other men who have sex with men (gbMSM) up to age 26 years in British Columbia, Canada. We assessed trends and correlates of HPV vaccine uptake from 2012 to 2019 in a cohort of gbMSM in Vancouver.

Methods

We recruited sexually active gbMSM aged ≥16 years using respondent-driven sampling from February 2012 to February 2015 and followed them until July 2019. We evaluated self-reported HPV vaccine trends using mixed-effects logistic regression and identified factors associated with uptake using multivariable mixed-effects Poisson regression.

Results

A total of 719 participants were recruited and completed the baseline visit, of whom 549 were unvaccinated with at least one follow-up visit. The median age was 33 years and 23% were living with HIV. HPV vaccination increased from 4% in 2012 to 28% in 2019 (p<0.001) among gbMSM >26 years, and from 9% in 2012 to 20% in 2017 (p<0.001) among gbMSM ≤26 years. Vaccination uptake increased after September 2015, following vaccination policy expansion (adjusted rate ratio (aRR)=1.82, 95% CI 1.06 to 3.12). In multivariable models, increased vaccination was associated with age ≤26 years vs ≥45 years (aRR=3.90; 95% CI 1.75 to 8.70), age 27–44 vs ≥45 years (aRR=2.86; 95% CI 1.46 to 5.62), involvement in gay community sports teams (aRR=2.31; 95% CI 1.15 to 4.64) and other groups (aRR=1.71; 95% CI 1.04 to 2.79), awareness of HIV-postexposure prophylaxis (aRR=5.50; 95% CI 1.31 to 23.09), recent sexually transmitted infection testing (aRR=2.72; 95% CI 1.60 to 4.60) and recent sex-work (aRR=2.59; 95% CI 1.08 to 6.19).

Conclusions

Although we observed increases in HPV vaccination uptake from 2012, by 2019 HPV vaccination still remained below 30% among gbMSM in Vancouver, BC. Additional interventions are needed to increase vaccine uptake.
Inhibition of PDIA3 in club cells attenuates osteopontin production and lung fibrosis
Authors: Kumar Amit , Elko Evan , Bruno Sierra R , Mark Zoe F , Chamberlain Nicolas , Mihavics Bethany Korwin , Chandrasekaran Ravishankar , Walzer Joseph , Ruban Mona , Gold Clarissa , Lam Ying Wai , Ghandikota Sudhir , Jegga Anil G , Gomez Jose L , Janssen-Heininger Yvonne MW , Anathy Vikas
Published: August 2021

Background

The role of club cells in the pathology of idiopathic pulmonary fibrosis (IPF) is not well understood. Protein disulfide isomerase A3 (PDIA3), an endoplasmic reticulum-based redox chaperone required for the functions of various fibrosis-related proteins; however, the mechanisms of action of PDIA3 in pulmonary fibrosis are not fully elucidated.

Objectives

To examine the role of club cells and PDIA3 in the pathology of pulmonary fibrosis and the therapeutic potential of inhibition of PDIA3 in lung fibrosis.

Methods

Role of PDIA3 and aberrant club cells in lung fibrosis was studied by analyses of human transcriptome dataset from Lung Genomics Research Consortium, other public resources, the specific deletion or inhibition of PDIA3 in club cells and blocking SPP1 downstream of PDIA3 in mice.

Results

PDIA3and club cell secretory protein (SCGB1A1) signatures are upregulated in IPF compared with control patients.PDIA3orSCGB1A1increases also correlate with a decrease in lung function in patients with IPF. The bleomycin (BLM) model of lung fibrosis showed increases in PDIA3 in SCGB1A1 cells in the lung parenchyma. Ablation ofPdia3, specifically in SCGB1A1 cells, decreases parenchymal SCGB1A1 cells along with fibrosis in mice. The administration of a PDI inhibitor LOC14 reversed the BLM-induced parenchymal SCGB1A1 cells and fibrosis in mice. Evaluation of PDIA3 partners revealed that SPP1 is a major interactor in fibrosis. Blocking SPP1 attenuated the development of lung fibrosis in mice.

Conclusions

Our study reveals a new relationship with distally localised club cells, PDIA3 and SPP1 in lung fibrosis and inhibition of PDIA3 or SPP1 attenuates lung fibrosis.
Effect of local heat application during exercise on gene expression related to mitochondrial homeostasis
Authors: O’Reilly Nattie , Collins Christopher , McGlynn Mark L. , Slivka Dustin
Published: August 2021

The aim of this study was to determine the impact of local muscle heating during endurance exercise on human skeletal muscle mitochondrial-related gene expression. Twelve subjects (25 ± 6 yr, 177 ± 8 cm, 78 ± 16 kg, and peak aerobic capacity 45 ± 8 mL·kg–1·min–1) cycled with one leg heated (HOT) and the other serving as a control (CON). Skin and intramuscular temperatures were taken before temperature intervention (Pre), after 30 minutes (Pre30), after exercise (Post) and four hours after exercise (4Post). Muscle biopsies were taken from each leg at Pre and 4Post. Intramuscular temperature increased within HOT (34.4 ± 0.7 °C to 36.1 ± 0.5 °C, p < 0.001) and was higher than CON at Pre30 (34.0 ± 0.7 °C, p < 0.001). However, temperatures at POST were similar (HOT 38.4 ± 0.7 °C, CON 38.3 ± 0.5 °C, p = 0.661). Skin temperature was higher than CON at Post30 (30.3 ± 1.0 °C, p < 0.001) and Post (HOT 34.6 ± 0.9 °C, CON 32.3 ± 1.6 °C, p < 0.001). PGC-1α, VEGF and NRF2 mRNA increased with exercise (p < 0.05) but was not altered with heating (p > 0.05). TFAM increased after exercise with heat application (HOT, p = 0.019) but not with exercise alone (CON, p = 0.422). There was no difference in NRF1, ESRRα, or any of the mitophagy related genes in response to exercise or temperature (p > 0.05). In conclusion, TFAM is enhanced by local heat application during endurance exercise, whereas other genes related to mitochondrial homeostasis are unaffected.

Novelty: The main finding of this study is that localized heating increased TFAM mRNA expression. The normal exercise-induced increased PGC-1α gene expression was unaltered by local muscle heating.
A nested model for tuberculosis: Combining within-host and between-host processes in a single framework
Authors: Pereira Rafael S. , Bauch Chris T. , Penna Thadeu J. P. , Espíndola Aquino L.
Published: August 2021

Tuberculosis (TB) is among the 10 top causes of deaths worldwide, and one-quarter of the world population hosts latent TB pathogens. Therefore, avoiding the emergence of drug-resistant strains has become a central issue in TB control. In this work, we propose a nested model for TB transmission and control, wherein both within-host and between-host dynamics are modeled. We use the model to compare the effects of three types of antibiotic treatment protocols and combinations thereof in an in silico population. For a fixed value of antibiotics clearance rate and relative efficacy against resistant strains, the oscillating intermittent protocol, pure or combined, is the most effective against the sensitive strains. However, this protocol also creates a selective advantage for the resistant strains, returning the worst result in comparison to the other protocols. We suggest that nested models should be further developed, since they might be able to inform decision-makers regarding the optimal TB control protocols to be applied under the specific parameters and other epidemiological factors in different populations.
ON RIEMANN–LIOUVILLE FRACTIONAL DIFFERENTIABILITY OF CONTINUOUS FUNCTIONS AND ITS PHYSICAL INTERPOLATION
Authors: XIAO WEI , LIANG YONG-SHUN
Published: August 2021

In this paper, we mainly research on fractional differentiability of certain continuous functions with fractal dimension one. First, Riemann–Liouville fractional differential of differentiable functions must exist. Then, we prove the existence of Riemann–Liouville fractional differential of continuous functions satisfying the Lipschitz condition, which means that all of their Riemann–Liouville fractional integral of any positive orders in [Formula: see text] are differentiable. For continuous functions which do not satisfy the Lipschitz condition, we give counterexamples of certain continuous functions whose Riemann–Liouville fractional differential does not exist of certain positive order in [Formula: see text]. Riemann–Liouville fractional differentiability of other one-dimensional continuous functions has also been investigated elementary. Fractional differentiability takes interpretation on physical problems like moving particle and transports through porous and percolation medium with residual memory.
R-L ALGORITHM: AN APPROXIMATION ALGORITHM FOR FRACTAL SIGNALS BASED ON FRACTIONAL CALCULUS
Authors: WANG CHENGYUAN , TAN HUOBIN , HU JIAKUI , ZHOU DULAN
Published: August 2021

An important characteristic of a fractal signal is that its graph is not smooth in any small interval. This indicates the difficulty of the approximation of fractal signals, because traditional approximation methods normally require some certain smoothness of the approximated function. However, recent studies have shown that fractal functions that satisfy the Hölder condition can be linearly changed in the fractal dimension of their graphs by the fractional calculus, which implies that we can use the fractional calculus to make graphs of fractal signals smoother, and then approximate these fractal signals. This paper first gives our research background and related theories of fractals and the fractional calculus, and then introduces the main research content, including the following aspects: (1) Proposing a fractal signal approximation algorithm, the R-L algorithm, explaining and deriving how to implement this algorithm. (2) Aiming at a specific fractal signal, carrying out an approximation experiment, and confirming the R-L algorithm is better than a direct approximation. (3) According to the experimental process and conclusions, introducing our future work, such as further optimization of the R-L algorithm, and showing the R-L algorithm may have the predictive capability outside the sampling interval. The R-L algorithm can effectively modify the smoothness of graphs of the fractal signal, so that more types of approximation algorithms can be selected with a better approximation effect.
NUMERICAL SOLUTIONS OF SPACE FRACTIONAL VARIABLE-COEFFICIENT KdV–MODIFIED KdV EQUATION BY FOURIER SPECTRAL METHOD
Authors: HAN CHE , WANG YU-LAN , LI ZHI-YUAN
Published: August 2021

Today, most of the real physical world problems can be modeled with variable-coefficient KdV–modified KdV (vcKdV–mKdV) equation. Besides, the solution methods and their reliabilities are the most important. Therefore, a high precision numerical method is always needed. In this paper, Fourier spectral method is applied to solve the space fractional generalized vcKdV–mKdV equation and the influence of fractional orders on numerical solution of the space fractional generalized vcKdV–mKdV equation is investigated. Numerical simulations in different situations of equation are conducted, including the propagation and interaction of the generalized ball-type, kink-type and periodic-depression solitons. From the numerical experiments pondered here and compared with the other methods, it is found that the numerical solutions match well with the exact solutions, which demonstrate that the Fourier spectral method is a satisfactory and efficient algorithm.
Galois extensions for quasigroupoid magmas
Authors: Rodríguez R. González
Published: August 2021

In this paper, we extend the result proved by Ulbrich about the characterization of Galois extensions linked to group algebras upon the non-associative (quasigroup) quasigroupoid magma setting. Also, as a particular instance of the results contained in this paper, we obtain the ones proved for Galois extensions related with groupoid algebras.
Dynamical Behaviors of Sinusoidal Nanocomposite Plates Subjected to Thermomechanical Loads
Authors: Hoang Vu Ngoc Viet , Ninh Dinh Gia
Published: August 2021

In this paper, a new plate structure has been found with the change of profile according to the sine function which we temporarily call as the sinusoidal plate. The classical plate theory and Galerkin’s technique have been utilized in estimating the nonlinear vibration behavior of the new non-rectangular plates reinforced by functionally graded (FG) graphene nanoplatelets (GNPs) resting on the Kerr foundation. The FG-GNP plates were assumed to have two horizontal variable edges according to the sine function. Four different configurations of the FG-GNP plates based on the number of cycles of sine function were analyzed. The material characteristics of the GNPs were evaluated in terms of two models called the Halpin–Tsai micromechanical model and the rule of mixtures. First, to verify this method, the natural frequencies of new non-rectangular plates made of metal were compared with those obtained by the Finite Element Method (FEM). Then, the numerical outcomes are validated by comparing with the previous papers for rectangular FGM/GNP plates — a special case of this structure. Furthermore, the impacts of the thermal environment, geometrical parameters, and the elastic foundation on the dynamical responses are scrutinized by the 2D/3D graphical results and coded in Wolfram-Mathematica. The results of this work proved that the introduced approach has the advantages of being fast, having high accuracy, and involving uncomplicated calculation.
Optimal Taxes in Atomic Congestion Games
Authors: Paccagnan Dario , Chandan Rahul , Ferguson Bryce L. , Marden Jason R.
Published: August 2021

How can we design mechanisms to promote efficient use of shared resources? Here, we answer this question in relation to the well-studied class of atomic congestion games, used to model a variety of problems, including traffic routing. Within this context, a methodology for designing tolling mechanisms that minimize the system inefficiency (price of anarchy) exploiting solely local information is so far missing in spite of the scientific interest. In this article, we resolve this problem through a tractable linear programming formulation that applies to and beyond polynomial congestion games. When specializing our approach to the polynomial case, we obtain tight values for the optimal price of anarchy and corresponding tolls, uncovering an unexpected link with load balancing games. We also derive optimal tolling mechanisms that are constant with the congestion level, generalizing the results of Caragiannis et al. [8] to polynomial congestion games and beyond. Finally, we apply our techniques to compute the efficiency of the marginal cost mechanism. Surprisingly, optimal tolling mechanism using only local information perform closely to existing mechanism that utilize global information, e.g., Bilò and Vinci [6], while the marginal cost mechanism, known to be optimal in the continuous-flow model, has lower efficiency than that encountered levying
no
toll. All results are tight for pure Nash equilibria and extend to coarse correlated equilibria.
Improved Penalty Function with Memory for Stochastically Constrained Optimization via Simulation
Authors: Han Jungmin , Kim Seong-Hee , Park Chuljin
Published: August 2021

Penalty function with memory (PFM) in Park and Kim [2015] is proposed for discrete optimization via simulation problems with multiple stochastic constraints where performance measures of both an objective and constraints can be estimated only by stochastic simulation. The original PFM is shown to perform well, finding a true best feasible solution with a higher probability than other competitors even when constraints are tight or near-tight. However, PFM applies simple budget allocation rules (e.g., assigning an equal number of additional observations) to solutions sampled at each search iteration and uses a rather complicated penalty sequence with several user-specified parameters. In this article, we propose an improved version of PFM, namely IPFM, which can combine the PFM with any simulation budget allocation procedure that satisfies some conditions within a general DOvS framework. We present a version of a simulation budget allocation procedure useful for IPFM and introduce a new penalty sequence, namely PS
2
+
, which is simpler than the original penalty sequence yet holds convergence properties within IPFM with better finite-sample performances. Asymptotic convergence properties of IPFM with PS
2
+
are proved. Our numerical results show that the proposed method greatly improves both efficiency and accuracy compared to the original PFM.
Autonomic Security Management for IoT Smart Spaces
Authors: Lin Changyuan , Khazaei Hamzeh , Walenstein Andrew , Malton Andrew
Published: August 2021

Embedded sensors and smart devices have turned the environments around us into smart spaces that could automatically evolve, depending on the needs of users, and adapt to the new conditions. While smart spaces are beneficial and desired in many aspects, they could be compromised and expose privacy, security, or render the whole environment a hostile space in which regular tasks cannot be accomplished anymore. In fact, ensuring the security of smart spaces is a very challenging task due to the heterogeneity of devices, vast attack surface, and device resource limitations. The key objective of this study is to minimize the manual work in enforcing the security of smart spaces by leveraging the autonomic computing paradigm in the management of IoT environments. More specifically, we strive to build an autonomic manager that can monitor the smart space continuously, analyze the context, plan and execute countermeasures to maintain the desired level of security, and reduce liability and risks of security breaches. We follow the microservice architecture pattern and propose a generic ontology named Secure Smart Space Ontology (SSSO) for describing dynamic contextual information in security-enhanced smart spaces. Based on SSSO, we build an autonomic security manager with four layers that continuously monitors the managed spaces, analyzes contextual information and events, and automatically plans and implements adaptive security policies.

As the evaluation, focusing on a current BlackBerry customer problem, we deployed the proposed autonomic security manager to maintain the security of a smart conference room with 32 devices and 66 services. The high performance of the proposed solution was also evaluated on a large-scale deployment with over 1.8 million triples.
An Improved Stacked Autoencoder for Metabolomic Data Classification
Authors: Fan Xiaojing , Wang Xiye , Jiang Mingyang , Pei Zhili , Qiao Shicheng
Published: August 2021

Naru3 (NR) is a traditional Mongolian medicine with high clinical efficacy and low incidence of side effects. Metabolomics is an approach that can facilitate the development of traditional drugs. However, metabolomic data have a high throughput, sparse, high‐dimensional, and small sample nature, and their classification is challenging. Although deep learning methods have a wide range of applications, deep learning‐based metabolomic studies have not been widely performed. We aimed to develop an improved stacked autoencoder (SAE) for metabolomic data classification. We established an NR‐treated rheumatoid arthritis (RA) mouse model and classified the obtained metabolomic data using the Hessian‐free SAE (HF‐SAE) algorithm. During training, the unlabeled data were used for pretraining, and the labeled data were used for fine‐tuning based on the HF algorithm for gradient descent optimization. The hybrid algorithm successfully classified the data. The results were compared with those of the support vector machine (SVM), k‐nearest neighbor (KNN), and gradient descent SAE (GD‐SAE) algorithms. A five‐fold cross‐validation was used to complete the classification experiment. In each fine‐tuning process, the mean square error (MSE) and misclassification rates of the training and test data were recorded. We successfully established an NR animal model and an improved SAE for metabolomic data classification.
A Case of Myxoma Arising in the Buccal Mucosa
Authors: Okubo Masahiko , Sano Yoshie , Fukushima Yosuke , Tomoda Taketo , Kokabu Shoichiro , Sato Tsuyoshi
Published: August 2021

Myxomas arising in the oral and maxillofacial areas are extremely rare. This study reports a case of myxoma arising in the soft tissue beneath the buccal mucosa of an 86-year-old man.
Research on Information Resource Sharing and Big Data of Sports Industry in the Background of OpenStack Cloud Platform
Authors: Mou Chuan , Cheng Ye
Published: August 2021

The rapid development of information technology and Internet makes the sports information resources retrieval service more convenient and quick; sports policy in recent years lays a foundation for the development of the Internet + sports, the development of sports industry in the process of our country economy level of development status, and the development of sports industry into the era of information and big data. This paper takes OpenStack cloud platform as the research basis (1) to realize the sharing of sports industry information resources in OpenStack cloud technology and (2) to realize big data analysis of sports industry and (3) empirical research on big data of sports industry. The main content is to realize the construction of sports resources informatization based on the OpenStack cloud platform. Through the analysis and empirical study of the big data of the sports industry, the influence of the development of the sports industry in the process of China’s economic development is discussed. In this paper, the experimental results show that the sports industry showed a positive impact in the process of economic development, the sports economy for the development of the economy, the contribution rate reached 11.77%, the sports industry for the development of the economy, the pull rate of 1.056%, based on the cloud platform of information resources sharing of data analysis, sports industry for the development of the economy has a positive role in promoting.
Blockchain‐Based Privacy Protection Scheme for IoT‐Assisted Educational Big Data Management
Authors: He Xiaoshuang , Guo Hechuan , Cheng Xueyu
Published: August 2021

Adoption of the Internet of Things (IoT) in education brings many benefits. However, the poor implementation of access control of educational data produced by the IoT devices has brought students’ and teachers’ privacy into danger. Attackers can access educational data that they are not permitted to access and even erase the records during access. To tackle this problem, we employ blockchain technology to guarantee the integrity of access control rules and trace the records of access events. In this paper, we propose a blockchain‐based access control scheme for the data produced by IoT devices. The scheme consists of three components: (1) a well‐implemented data collection module that is deployed in smart classrooms, which collects and uploads data about the real‐time situation inside the smart classroom to the data center; (2) a MongoDB‐based data center and its control module that makes access control decisions based on the verification of the permissions of visitors, where the permissions are managed by blockchain; and (3) a customized blockchain system that stores and keeps security policy updates of the role‐based access control module and records access events in a trusted way. Our analysis indicates that the proposed access control scheme guarantees the correctness of the access control process and makes the access of collected educational data auditable and responsible. Our system collectively analyzes the context of the smart classroom and is capable of detecting multiple scenarios such as absence, lateness, and gunshot. We show how the scheme preserves students’ and teachers’ privacy by carrying out extensive experimental studies. The results indicate that the proposed data management system can give correct responses as quickly as a traditional data server does while preserving privacy.