bluuebunny/crossref_metadata_2025 huggingface dataset:
An Technical Condition Evaluation Index Reduction Method Combining Rough Set and Genetic Algorithm
Authors: Wei S , Zeng Q , Chen Y
Published: February 2021

The evaluation of equipment technical condition involves lots of indexes and the relationship between different indexes is complex. It brings a huge workload to the collection of evaluation information, and the interference caused by the correlation between indicators also increases the uncertainty of the evaluation results. Aiming at the problems mentioned above, this paper proposes a reduction method of equipment technical condition evaluation index system based on rough set and genetic algorithm. The rough set and genetic algorithm are used to reduce the state evaluation index, the redundancy is removed, and the best indexes reflecting the change of equipment technical condition status are retained. A reduction case of a gas turbine technical condition status evaluation index system shows that this method can reduce a complex index system to a more concise and clear index system without losing its representativeness and systematicity. This method can reduce the difficulty of information collection, and improve the accuracy of the evaluation results.
Storage Failure Mechanism Analysis and Reliability Improvement Measures for Electromagnetic Relay
Authors: Wang Zhaobin , Li Weiyan , Chen Kangning , Li Zhen , Shang Shang
Published: February 2021

In order to solve the problem of unknown cause of parameter degradation and incomplete failure mechanism, and to obtain the data support required for the storage life evaluation of the whole machine system, a certain type of electromagnetic relay was selected for accelerated storage degradation test. The failure mode, the law and mechanism of electrical parameter change under storage condition were studied. On this basis, the improvement measures of relay reliability are put forward, which is of certain significance to improve the reliability of electromagnetic relay and system.
Distributed Video Compressed Sensing Secondary Reconstruction Based on Inter-Frames Similarity Structure
Authors: Yuchen Yue , Jianhua Luo , Hua Li
Published: February 2021

The emergence of distributed video compressed sensing technology has effectively reduced the computational cost and power consumption of the video system. As the core content of the DCVS research, reconstruction algorithms are mostly focused on improving the reconstruction quality of CS frames, while neglecting the reconstruction quality of the key frame. The key frame is not fully utilized as well. Focus on these problems, the paper proposes a distributed video compressed sensing secondary reconstruction algorithm based on similar structure between frames. In order to eliminate the influence of non-overlapping block CS that may introduce noise and block effects on key frames, firstly, the fractional total variation algorithm is used to initially reconstruct the key frames, which improves the reconstruction quality while reducing the computational complexity. Then, a CS frame secondary reconstruction algorithm based on structural similarity is proposed, which uses SSIM as the matching criterion to search for matching block groups similar to the current frame from multiple reference frames, as a regular term to achieve the secondary reconstruction of CS frames. The experimental results show that the overall performance of the proposed algorithm is better than the current advanced DCVS method. The research results of the thesis can be used for reliable compressed sensing reconstruction of video and image.
Variable structure Copula model and its Comparison with static and time-varying Copula models
Authors: Zhou Ling , He Xiao-Shu
Published: February 2021

Copula model has been increasingly used in reliability modeling of correlation systems. In this paper, the static copula model, time-varying copula model and variable structure copula model are compared. Firstly, variable structure copula model is introduced. Secondly, the procedures of Bayes diagnosis method which is used to diagnose the variable structure points are introduced. Finally, the correctness of Bayes diagnosis method for finding variable structure points is verified by a simple numerical example. The comparison results illustrate that the staged correlation parameter estimated by variable structure Copula model is better than the constant correlation parameter estimated by static Copula model, and also it has a consistent trend with correlation parameter estimated by time-varying Copula model.
Research on Maintenance Method of Safety-level Switching Power Supply Module in Nuclear Power Plant
Authors: Wang Huanyu , Zhu Guixia , Teng Xiaolei , Sun Xin’an , Qian Yugang , Hu Yuying
Published: February 2021

With the technological development in the domestic electronic industry and the urgent demand of cost reduction and efficiency improvement in nuclear power plant, the electrical equipment in nuclear power plant has changed from replacing with brand-new equipment regularly or after failure to reusing after aging mitigation. At present, it is very urgent to research the maintenance methods of safety-level electrical equipment. Through the research on the failure mode and influence analysis, vulnerable components and parts, post-repair test and post-repair service life calculation of the safety-level switching power supply module, the maintenance methods are systematically sorted out. Through specific case analysis, the aging of power supply module can be mitigated and the reliability of it can be improved. At the same time, the method can be extended to other safety-level electrical equipment maintenance with one of the characteristics of unavailability of spare parts, high price, and large quantity or reverse demand.
A Robust Localization Method in Indoor Dynamic Environment
Authors: Huang Shan , Huang Hong-Zhong , Zeng Qi
Published: February 2021

Localization is one of the core technologies for mobile robots to achieve full autonomous movement, and is a prerequisite for other autonomous tasks. The robot working environment is dynamic in most cases, so the localization algorithm must overcome the effects of dynamic changes in the environment. The paper proposed a localization algorithm that allows the robot to perform robust and life-long localization in dynamic environment. The algorithm filter out high-dynamic objects and update semi-static object on the map at the same time, it can also use the information provided in semi-static objects to improve localization performance. In this paper, the processing of dynamic objects is divided into two parts: filtering of high-dynamic objects and updating of semi-static objects. For high dynamic object filtering, a dynamic object detection method combining a delay comparison method and a tracking method is proposed by observed the characteristics of localization system; For the update of semi-static objects, this paper uses the pose graph optimization and occupancy map to implement the dynamic update of the map. The combination of the two methods allows the robot to achieve long-term stable localization in a dynamic environment. The experimental results demonstrate that the proposed method allows the robot achieve long-term localization, overcome the effects of high-dynamic objects and keeping the map always consistent with the environment.
Research on Qualitative Analysis and Quantitative Evaluation Method of BDS Signal-In-Space Integrity
Authors: Gong Peipei , Wei Guanyu , Cao Yueling , Liu Ding , Long Dongteng
Published: February 2021

Aiming at the current status of BDS release of integrity indicators, this paper studies and proposes modeling and qualitative analysis methods for BDS Signal-In-Space(SIS) integrity indicators, which can be used for the allocation and prediction of integrity indicators during system development and construction; The BDS basic navigation service (RNSS) space signal integrity parameter design has proposed a quantitative evaluation method, which can be used for the integrity index test evaluation of the system operation phase. The test results show that the integrity of the new signal of the BDS is 100%.
Summary of software reliability Research
Authors: Yin Shizhuang , Shi Quan , Wang Yadong , Chen Cai
Published: February 2021

This paper summarizes the main contents of software reliability research. With the rapid development of information technology, software plays an increasingly important role. Along with its complexity increasing software faults are becoming more and more. In some key fields due to software failures may even lead to unacceptable consequences. Therefore, it is necessary to study software reliability. Through reading lots of literatures summarizing researches on domestic and foreign scholars this paper puts forward some main problems which need further discussion in software reliability research.
Uncertainty propagation of storage reliability evaluation using two-level MCS/NIPC
Authors: Suo Bin , Li Shun , Zhou Jie
Published: February 2021

In order to solve the problem of limited sample size and life data in the storage reliability evaluation of high-value weapons, the storage reliability evaluation method of electronic product based on storage performance modeling and simulation was studied. The problem of epistemic-aleatory mixed uncertainty propagation in product storage performance model with time degradation factor was discussed emphatically. The calculation method of two-level Monte Carlo simulation and non-intrusive polynomial chaos is proposed, which solved the problem that the computational capacity of storage performance simulation would increase explosivelly when the number of uncertainty parameters is large. Finally, the effectiveness of the method is verified by an example of circuit storage reliability evaluation, and the calculation efficiency is about 100 times higher than that of the two-lever MCS method.
Reliability Analysis Deflector of Underwater Wall Detection Device Based on Finite Element and Response Surface Methodology
Authors: Yang S Q , Yang H L , Bai S L , Xu G H
Published: February 2021

Before the diversion plugging in hydropower project, underwater wall detection device can complete the probe of visual detection and obstacle clearing in high-velocity flow. Deflector which can provide a stronger compress diversion tunnel sluice gate power is the most important part in underwater wall detection device, but the mechanical and uncertainty analysis aren’t enough. In this paper, Finite Element Method and Response Surface Methodology are used to analyze strength and deformation of the deflector, meanwhile, the limit state functions about the maximal bending stress and maximal deformation are developed. Then, though comparing the data with experimental data and the value computed by user formula, the error is less than 2% and the error is allowable in engineering design. Finally, reliability analysis the deflector is achieved with the First-Order Reliability Method. In a word, form the calculating results and engineering operation, we know that the propose method in this paper using finite element method and response surface methodology to develop the function related to the limit functions of deflector under uncertainty is practical and feasible.
Abnormal identification of lubricating oil parameters and evaluation of physical and chemical properties based on machine learning
Authors: Yang Kun , Wang Xia
Published: February 2021

This paper firstly proposes an abnormality identification model for online oil monitoring parameters. The SVR model was established to predict the output power, and the information entropy of the deviation between the predicted value of the regression model and the actual monitoring value was used to identify the abnormal parameters of the oil. The physical and chemical properties of the oil was evaluated and predicted comprehensively. Principal component analysis (PCA) was used to eliminate the correlation between parameters, and then the deviation degree of each principal component is calculated after feature transformation. After adding the deviation degrees of each principal component according to their weights, the performance evaluation index of the oil is obtained. At the same time, a prediction model of oil performance trend based on Gated Recurrent Unit is proposed. The feasibility and applicability of this model are verified by comparing with the results of LSTM neural network and ARIMA model. The evaluation of the physical and chemical properties of the oil can detect the deterioration of the oil condition at the early stage, avoiding or reducing accidents, so as to ensure the safe and reliable operation of the unit.
Effects of load and rotational speed on the friction and wear properties of PTFE composites
Authors: Guaii Tao , Liu Yunsheng , Shou Haiming , Li Feng
Published: February 2021

PTFE composites has a lower hardness and shear strength than steel. Therefore, wear mainly occurs in PTFE composites itself when rubs with steel. For studying the friction and wear properties of PTFE composites, a series of experimental tests were conducted under different sliding velocities and load pressures using block-on-ring testing machine. Through weighting PTFE composites specimens before and after the experiment, we can get the wear mass losses of specimens, then the wear rate of PTFE composites is obtained by combining material density, loading pressure and wear length. At the same time, the friction coefficient is recorded in real time by the monitoring system of the testing machine The analysis results are as follows: at constant sliding velocities, the wear rate of PTFE composites gradually decreases with the increase of loading pressure; at constant loading pressure, the wear rate of PFTE composites decreases gradually with the increase of sliding speed. This leads to further conclusions that motor should not run in low speed range for a long time when PTFE composites is used as motor bearing material.
A PDEM-COM framework for uncertainty quantification of backward issues involving both aleatory and epistemic uncertainties
Authors: Wan Z Q , Chen J B , Beer M
Published: February 2021

Uncertainties that exist in nature or due to lack of knowledge have been widely recognized by researchers and engineering practitioners throughout engineering design and analysis for decades. Though great efforts have been devoted to the issues of uncertainty quantification (UQ) in various aspects, the methodologies on the quantification of aleatory uncertainty and epistemic uncertainty are usually logically inconsistent. For instance, the aleatory uncertainty is usually quantified in the framework of probability theory, whereas the epistemic uncertainty is quantified mostly by non-probabilistic methods. In the present paper, a probabilistically consistent framework for the quantification of both aleatory and epistemic uncertainty by synthesizing the probability density evolution method (PDEM) and the change of probability measure (COM) is outlined. The framework is then applied to the backward issues of uncertainty quantification. In particular, the uncertainty model updating issue is discussed in this paper. A numerical example is presented, and the results indicate the flexibility and efficiency of the proposed PDEM-COM framework.
Research on Structural reliability and reliability sensitivity of EMU pantograph
Authors: Feng Zhou , Chang Wu , Zixu Zhang
Published: February 2021

Due to the uncertainty of the contact state between the pantograph and the power grid when the EMU is running at high speed, as well as the influence of road conditions and environment, the external load applied to the pantograph and the material properties of the pantograph have certain randomness, thus affecting the current collection quality of the pantograph and the service life of the carbon slide plate. Taking a certain type of EMU single arm pantograph as the research object, a three-dimensional model is established, ANSYS Workbench software is used to carry out the finite element analysis to determine the dangerous point and its stress response; the simulation samples of material properties and stress of dangerous points are obtained by using sampling method and test design method based on the principle of normal distribution; the reliability index and reliability of pantograph structure strength are analyzed, based on the random perturbation method and the first-order second- moment method, and using the simulation sample data extracted by Latin hypercube sampling, and the reliability accuracy is verified by Monte Carlo method. Based on the definition of reliability sensitivity, the influence degree of each input variable on the reliability change of pantograph structure is determined as follows: external load > Poisson’s ratio > material density > elastic modulus, which provides reference for improving the reliability, service life and structural optimization design of pantograph
The digital axiograph – a novel tool in bruxism prevention
Authors: Taneva I , Uzunov T , Apostolov N , Filev N
Published: February 2021

Digital (electronic) axiography is an applicable promising technology with proven accuracy that allows registering the spatial location of the mandible and all lower jaw movements: mouth opening and closing, protrusion, left and right laterotrusion, dynamic function. In spite of bruxism treatment still being a controversial topic, occlusal splint application is proven to be the most efficient way of prevention. The purpose of the study is to develop a protocol of planning and producing preventive occlusal splints for bruxism management by means of digital axiography. The implementation of digital technologies reveals new possibilities in diagnosing, treating and tracking bruxism. With great attention to the individual trajectories of the lower jaw movements, the effectiveness of the occlusal splint prophylaxis is no longer hypothetical.
Preparation of graphene oxide membrane-daptomycin/epidermal growth factor dressing and its effect on wound healing
Authors: Zhou Daijun , tian Peng , Li Dong , Li Jianjun , Zhang Tao
Published: February 2021

Herein, a series of environmentally friendly dressings were specially fabricated from graphene oxide (GO) membrane (a high quality substrate with antibacterial function) and Daptomycin (antibacterial function)/Epidermal growth factor (EGF, wound healing function) for the purpose of antibacterial applications. A performance comparison was designed by employing four dressing samples, including the neat GO membrane (Group A), GO membrane-Daptomycin (Group B), GO membrane-EGF (Group C), and GO membrane-Daptomycin/EGF (Group D). The results analyzed using Fourier transform infrared spectroscopy suggested that Daptomycin and EGF might be adhered to the GO membrane. The contact angle test showed that the hydrophilicity of material gradually increased from Group A to Group D. Groups B and D displayed similar in vitro antibacterial activities, better than those of Groups A and C (their antibacterial performances were similar to each other); all the four experimental groups outperformed the control group (P > 0.05). On the other hand, Groups C and D could promote the proliferation effectively within 1–7 days (P < 0.05), and they also showed similar activities in the cell migration, which were higher than those of Groups A and B (close to each other); all the experimental groups outdid the control group (P < 0.05). Moreover, by monitoring the expression levels of PCNA and CD31 , samples from Group D could promote both angiogenesis and cell reproduction when covering the skin defects (P < 0.05). At the seventh days after the injury, the control and experimental groups of A, B, C, and D displayed healing rates of 40.6%, 53.0%, 66.8%, 60.1%, and 68.3%, respectively. Based on a successful fabrication of GO membrane-Daptomycin/EGF dressings, antibacterial effects as well as growth-promoting performance were well realized by samples in Group D. This is benifitial for the wound healing to a great extent.
The effects of Mg2+ concentration, (NH4)2SO4 concentration and current density on electrolytic manganese process
Authors: Wang Hai-Feng , Qin Ji-Tao , Tian Jia-Yu , Wang Jia-Wei , Zhao Ping-Yuan , Lu Fang-hai
Published: February 2021

In this paper, the effects of Mg2+ concentration, (NH4)2SO4 concentration and current density on the current efficiency, cell voltage and morphology of electrolytic manganese metal were studied. The current efficiency of electrolytic manganese decreased with the increase of Mg2+ concentration in the electrolyte; Increasing the concentration of (NH4)2SO4 , the current efficiency of electrolytic manganese showed a gradually increasing trend. By changing the current density, the current efficiency of electrolytic manganese increased first and then decreased. When the current density was 400 A·m−2, the current efficiency was the highest, it was about 66.63%. The cell voltage in the process of manganese electrolysis was independent of Mg2+ concentration and (NH4)2SO4 concentration, but only positively related to current density. Through the macroscopic analysis of the cathode plate, the greater the current efficiency was, the brighter the color of the metal manganese sheet was, it shew a silver white, and the dendritic growth of metal manganese was less. From the microscopic morphology of the manganese metal sheet, the electrolytic manganese metal was formed by stacking metal manganese sheets, each metal manganese sheet exhibited a regular hexagonal structure, the shape was similar to a ‘pyramid’, it had a better compactness, in which the better the current efficiency was, the better the compactness of the electrolytic manganese metal was. Under different experimental conditions, crystal plane (330,411) was the strongest and best orientation for the growth of electrolytic manganese. Cyclic voltammetry experiments showed that Mg2+ was not beneficial to electrodeposition of manganese, the increase of (NH4)2SO4 was beneficial to improve the current efficiency, and it was consistent with the conclusion of electrolysis experiment.
Green synthesis, characterization and antibacterial study on the catechin-functionalized ZnO nanoclusters
Authors: Zhao Baihan , Deng Shixian , Li Jingchao , Sun Congcong , Fu Yujie , Liu Zhiguo
Published: February 2021

Green synthesis of zinc oxide nanomaterials has received recent attention due to the potential application of these nanomaterials as biocidal agents to combat antibiotic resistant organisms. In this paper, we provide a facile, one-step hydrothermal approach to prepare catechin-functionalized ZnO nanoclusters in aqueous solution. The obtained ZnO nanoclusters were characterized by UV spectroscopy (UV), Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), atomic force microscopy (AFM), x-ray diffraction (XRD) and x-ray photoelectron spectroscopy (XPS). The results of FTIR indicated that the catechin molecules were adsorbed on the surface of ZnO nanoclusters. TEM determination revealed that small ZnO nanoparticles tend to aggregate and form nanocluster structures. Antibacterial activity was tested by paper disk diffusion and the catechin-functionalized ZnO nanoclusters showed high biocidal activity against gram-positive bacteria, gram-negative bacteria and fungi.
Ultrahigh resolution integrated optic short range surface plasmon-polariton based sensor for aqueous environment
Authors: Sharma Vinod K
Published: February 2021

We propose a short length plasmonic integrated optic sensor with ultrahigh sensitivity and resolution for aqueous environment. The sensor section is a simple multilayer structure consisting of a dielectric planar waveguide separated from a thin metal film by a low index buffer layer. The sensor is based on the hybrid coupling between the guided mode and the short range plasmonic mode supported by the thin metal film. Periodic coupling between these modes takes place along the length of the sensor. For optimized layer thicknesses, resonant peak appears at very short length of sensing section. The spectral position of resonant peak is strongly dependent on the analyte index. We show theoretically that a spectral sensitivity of 3.2 × 104 nm RIU−1 with FWHM of 2 nm and resolution of 6.2 × 10–8 RIU can be achieved for aqueous environment.
The three-dimensional genome in zebrafish development
Authors: Labudina Anastasia , Horsfield Julia A
Published: February 2021

In recent years, remarkable progress has been made toward understanding the three-dimensional (3D) organisation of genomes and the influence of genome organisation on gene regulation. Although 3D genome organisation probably plays a crucial role in embryo development, animal studies addressing the developmental roles of chromosome topology are only just starting to emerge. Zebrafish, an important model system for early development, have already contributed important advances in understanding the developmental consequences of perturbation in 3D genome organisation. Zebrafish have been used to determine the effects of mutations in proteins responsible for 3D genome organisation: cohesin and CTCF. In this review, we highlight research to date from zebrafish that has provided insight into how 3D genome organisation contributes to tissue-specific gene regulation and embryo development.
DNABERT: pre-trained Bidirectional Encoder Representations from Transformers model for DNA-language in genome
Authors: Ji Yanrong , Zhou Zhihan , Liu Han , Davuluri Ramana V
Published: February 2021

Motivation

Deciphering the language of non-coding DNA is one of the fundamental problems in genome research. Gene regulatory code is highly complex due to the existence of polysemy and distant semantic relationship, which previous informatics methods often fail to capture especially in data-scarce scenarios.

Results

To address this challenge, we developed a novel pre-trained bidirectional encoder representation, named DNABERT, to capture global and transferrable understanding of genomic DNA sequences based on up and downstream nucleotide contexts. We compared DNABERT to the most widely used programs for genome-wide regulatory elements prediction and demonstrate its ease of use, accuracy and efficiency. We show that the single pre-trained transformers model can simultaneously achieve state-of-the-art performance on prediction of promoters, splice sites and transcription factor binding sites, after easy fine-tuning using small task-specific labeled data. Further, DNABERT enables direct visualization of nucleotide-level importance and semantic relationship within input sequences for better interpretability and accurate identification of conserved sequence motifs and functional genetic variant candidates. Finally, we demonstrate that pre-trained DNABERT with human genome can even be readily applied to other organisms with exceptional performance. We anticipate that the pre-trained DNABERT model can be fined tuned to many other sequence analyses tasks.

Availability and implementation

The source code, pretrained and finetuned model for DNABERT are available at GitHub (https://github.com/jerryji1993/DNABERT).

Supplementary information

Supplementary data are available at Bioinformatics online.
Multi-layered network-based pathway activity inference using directed random walks: application to predicting clinical outcomes in urologic cancer
Authors: Kim So Yeon , Choe Eun Kyung , Shivakumar Manu , Kim Dokyoon , Sohn Kyung-Ah
Published: February 2021

Motivation

To better understand the molecular features of cancers, a comprehensive analysis using multi-omics data has been conducted. In addition, a pathway activity inference method has been developed to facilitate the integrative effects of multiple genes. In this respect, we have recently proposed a novel integrative pathway activity inference approach, iDRW and demonstrated the effectiveness of the method with respect to dichotomizing two survival groups. However, there were several limitations, such as a lack of generality. In this study, we designed a directed gene–gene graph using pathway information by assigning interactions between genes in multiple layers of networks.

Results

As a proof-of-concept study, it was evaluated using three genomic profiles of urologic cancer patients. The proposed integrative approach achieved improved outcome prediction performances compared with a single genomic profile alone and other existing pathway activity inference methods. The integrative approach also identified common/cancer-specific candidate driver pathways as predictive prognostic features in urologic cancers. Furthermore, it provides better biological insights into the prioritized pathways and genes in an integrated view using a multi-layered gene–gene network. Our framework is not specifically designed for urologic cancers and can be generally applicable for various datasets.

Availability and implementation

iDRW is implemented as the R software package. The source codes are available at https://github.com/sykim122/iDRW.

Supplementary information

Supplementary data are available at Bioinformatics online.
Crypt4GH: a file format standard enabling native access to encrypted data
Authors: Senf Alexander , Davies Robert , Haziza Frédéric , Marshall John , Troncoso-Pastoriza Juan , Hofmann Oliver , Keane Thomas M.
Published: February 2021

Motivation

The majority of genome analysis tools and pipelines require data to be decrypted for access. This potentially leaves sensitive genetic data exposed, either because the unencrypted data is not removed after analysis, or because the data leaves traces on the permanent storage medium.

Results

: We defined a file container specification enabling direct byte-level compatible random access to encrypted genetic data stored in community standards such as SAM/BAM/CRAM/VCF/BCF. By standardizing this format, we show how it can be added as a native file format to genomic libraries, enabling direct analysis of encrypted data without the need to create a decrypted copy.

Availability and implementation

The Crypt4GH specification can be found at: http://samtools.github.io/hts-specs/crypt4gh.pdf.

Supplementary information

Supplementary data are available at Bioinformatics online.
Prophylactic sublay non-absorbable mesh positioning following midline laparotomy in a clean-contaminated field: randomized clinical trial (PROMETHEUS)
Authors: Pizza F , D’Antonio D , Ronchi A , Lucido F S , Brusciano L , Marvaso A , Dell’Isola C , Gambardella C
Published: February 2021

Background

Incisional hernia is a frequent postoperative complication after midline laparotomy. Prophylactic mesh augmentation in abdominal wall closure after elective surgery is recommended, but its role in emergency surgery is less well defined.

Methods

This prospective randomized trial evaluated the incidence of incisional hernia in patients undergoing urgent midline laparotomy for clean-contaminated surgery. Closure using a slowly absorbable running suture was compared with closure using an additional sublay mesh (Parietex ProGrip™). Patients were randomized just before abdominal wall closure using computer-generated permuted blocks. Patients, care providers, staff collecting data, and those assessing the endpoints were all blinded to the group allocation. Patients were followed up for 24 months by means of clinical and ultrasonographic evaluations.

Results

From January 2015 to June 2018, 200 patients were randomized: 100 to primary closure (control group) and 100 to Parietex ProGrip™ mesh-supported closure (mesh group). Eight patients in the control group and six in the mesh group were lost to follow-up. By 24 months after surgery, 21 patients in the control group and six in the mesh group had developed incisional hernia (P = 0.002). There was no difference between groups in the incidence of haematoma (2 versus 5; P = 0.248) and superficial wound infection (4 versus 5; P = 0.733). Multivariable analysis confirmed the role of mesh in preventing incisional hernia (odds ratio 0.11, 95 per cent c.i. 0.03 to 0.37; P  < 0.001). One patient in the mesh group required mesh removal because of deep infection.

Conclusion

Prophylactic mesh-augmented abdominal wall closure after urgent laparotomy in clean-contaminated wounds is safe and effective in reducing the incidence of incisional hernia. Registration number: NCT04436887 (http://www.clinicaltrials.gov).
Activation of Person Knowledge in Medial Prefrontal Cortex during the Encoding of New Lifelike Events
Authors: Raykov Petar P , Keidel James L , Oakhill Jane , Bird Chris M
Published: February 2021

Our knowledge about people can help us predict how they will behave in particular situations and interpret their actions. In this study, we investigated the cognitive and neural effects of person knowledge on the encoding and retrieval of novel life-like events. Healthy human participants learnt about two characters over a week by watching 6 episodes of one of two situation comedies, which were both centered on a young couple. In the scanner, they watched and then silently recalled 20 new scenes from both shows that were all set in unfamiliar locations: 10 from their trained show and 10 from the untrained show. After scanning, participants’ recognition memory was better for scenes from the trained show. The functional magnetic resonance imaging (fMRI) patterns of brain activity when watching the videos were reinstated during recall, but this effect was not modulated by training. However, person knowledge boosted the similarity in fMRI patterns of activity in the medial prefrontal cortex (MPFC) when watching the new events involving familiar characters. Our findings identify a role for the MPFC in the representation of schematic person knowledge during the encoding of novel, lifelike events.
Effects of fasting on patients with chronic kidney disease during Ramadan and practical guidance for healthcare professionals
Authors: Malik Shafi , Bhanji Amir , Abuleiss Husham , Hamer Rizwan , Shah Shahzad H , Rashad Rafaqat , Junglee Naushad , Waqar Salman , Ghouri Nazim
Published: February 2021

There are an estimated 1.8 billion Muslims worldwide, with the majority of them choosing to fast during the month of Ramadan. Fasting, which requires abstinence from food and drink from dawn to sunset can be up to 20 h per day during the summer months in temperate regions. Fasting can be especially challenging in patients on haemodialysis and peritoneal dialysis. Moreover, there is concern that those with chronic kidney disease (CKD) can experience electrolyte imbalance and worsening of renal function. In this article, current literature is reviewed and a decision-making management tool has been developed to assist clinicians in discussing the risks of fasting in patients with CKD, with consideration also given to circumstances such as the coronavirus disease 2019 pandemic. Our review highlights that patients with CKD wishing to fast should undergo a thorough risk assessment ideally within a month before Ramadan, as they may require medication changes and a plan for regular monitoring of renal function and electrolytes in order to fast safely. Recommendations have been based on risk tiers (very high risk, high risk and low–moderate risk) established by the International Diabetes Federation and the Diabetes and Ramadan International Alliance. Patients in the very high risk and high risk categories should be encouraged to explore alternative options to fasting, while those in the low–moderate category may be able to fast safely with guidance from their clinician. Prior to the commencement of Ramadan, all patients must receive up-to-date education on sick-day rules and instructions on when to terminate their fast or abstain from fasting.
Traditional markers of cardiac toxicity fail to detect marked reductions in cardiorespiratory fitness among cancer patients undergoing anti-cancer treatment
Authors: Howden Erin J , Foulkes Steve , Dillon Hayley T , Bigaran Ashley , Wright Leah , Janssens Kristel , Comie Prue , Costello Benedict , La Gerche André
Published: February 2021

Aims

Left ventricular ejection fraction (LVEF) is standard of care for evaluating chemotherapy-associated cardiotoxicity, although global longitudinal strain (GLS) offers advantages. However, neither change in LVEF or GLS has been associated with short-term symptoms, functional capacity, or long-term heart failure (HF) risk. We sought to determine whether an integrative measure of cardiovascular function (VO2peak) that is strongly associated with HF risk would be more sensitive to cardiac damage induced by cancer treatment than LVEF, GLS, or cardiac biomarkers.

Methods and results

Patients (n = 206, 53 ± 13 years, 35% male) scheduled to commence anti-cancer treatment completed assessment prior to, and within 6 months after therapy. Changes in echocardiographic measures of LV function (LVEF, GLS), cardiac biomarkers (troponin and BNP), and cardiorespiratory fitness (VO2peak) were measured. LV function was normal prior to treatment (LVEF 61 ± 5%; GLS −19.4 ± 2.1), but VO2peak was only 88 ± 26% of age-predicted. After treatment, VO2peak was reduced by 7 ± 15% (equivalent of 7 years normal ageing, P < 0.0001) and the rates of functional disability (defined as VO2peak ≤ 18 mL/min/kg) almost doubled (15% vs. 26%, P = 0.016). In contrast, small, reductions in LVEF (59 ± 5% vs. 58 ± 5%, P = 0.03) and GLS (−19.4 ± 2.1 vs. −18.9 ± 2.2, P = 0.002) and an increase in troponin levels (4.0 ± 6.9 vs. 26.4 ± 26.2 ng/mL, P < 0.0001) were observed.

Conclusion

Anti-cancer treatment is associated with marked reductions in functional capacity that occur independent of reductions in LVEF and GLS. The assessment of VO2peak prior to, and following treatment may be a more sensitive means of identifying patients at increased risk of HF.
True-severe stenosis in paradoxical low-flow low-gradient aortic stenosis: outcomes after transcatheter aortic valve replacement
Authors: Okuno Taishi , Corpataux Noé , Spano Giancarlo , Gräni Christoph , Heg Dik , Brugger Nicolas , Lanz Jonas , Praz Fabien , Stortecky Stefan , Siontis George C M , Windecker Stephan , Pilgrim Thomas
Published: February 2021

Aims

The ESC/EACTS guidelines propose criteria that determine the likelihood of true-severe aortic stenosis (AS). We aimed to investigate the impact of the guideline-based criteria of the likelihood of true-severe AS in patients with low-flow low-gradient (LFLG) AS with preserved ejection fraction (pEF) on outcomes following transcatheter aortic valve replacement (TAVR).

Methods and results

In a prospective TAVR registry, LFLG-AS patients with pEF were retrospectively categorized into high (criteria ≥6) and intermediate (criteria <6) likelihood of true-severe AS. Haemodynamic, functional, and clinical outcomes were compared with high-gradient AS patients with pEF. Among 632 eligible patients, 202 fulfilled diagnostic criteria for LFLG-AS. Significant haemodynamic improvement after TAVR was observed in LFLG-AS patients, irrespective of the likelihood. Although >70% of LFLG-AS patients had functional improvement, impaired functional status [New York Heart Association (NYHA III/IV)] persisted more frequently at 1 year in LFLG-AS than in high-gradient AS patients (7.8%), irrespective of the likelihood (high: 17.4%, P = 0.006; intermediate: 21.1%, P < 0.001). All-cause death at 1 year occurred in 6.6% of high-gradient AS patients, 10.9% of LFLG-AS patients with high likelihood [hazard ratio (HR)adj 1.43, 95% confidence interval (CI) 0.68–3.02], and in 7.2% of those with intermediate likelihood (HRadj 0.92, 95% CI 0.39–2.18). Among the criteria, only the absence of aortic valve area ≤0.8 cm2 emerged as an independent predictor of treatment futility, a combined endpoint of all-cause death or NYHA III/IV at 1 year (OR 2.70, 95% CI 1.14–6.25).

Conclusion

Patients with LFLG-AS with pEF had comparable survival but worse functional status at 1 year than high-gradient AS with pEF, irrespective of the likelihood of true-severe AS.

Clinical Trial Registration

https://www.clinicaltrials.gov. NCT01368250.
Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry
Authors: Cittadini Antonio , Salzano Andrea , Iacoviello Massimo , Triggiani Vincenzo , Rengo Giuseppe , Cacciatore Francesco , Maiello Ciro , Limongelli Giuseppe , Masarone Daniele , Perticone Francesco , Cimellaro Antonio , Perrone Filardi Pasquale , Paolillo Stefania , Mancini Antonio , Volterrani Maurizio , Vriz Olga , Castello Roberto , Passantino Andrea , Campo Michela , Modesti Pietro A , De Giorgi Alfredo , Monte Ines P , Puzzo Alfonso , Ballotta Andrea , D’Assante Roberta , Arcopinto Michele , Gargiulo Paola , Sciacqua Angela , Bruzzese Dario , Colao Annamaria , Napoli Raffaele , Suzuki Toru , Eagle Kim A , Ventura Hector O , Marra Alberto M , Bossone Eduardo ,   the T.O.S.CA. Investigators
Published: February 2021

Aims

Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients.

Methods and Results

The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P < 0.001). Median follow-up was of 36 months. MHDS was independently associated with the occurrence of the primary endpoint [hazard ratio 95% (confidence interval), 1.93 (1.37–2.73), P < 0.001] and identified a group of patients with a higher mortality [2.2 (1.28–3.83), P = 0.01], with a graded relation between HDs and cumulative events (P < 0.01).

Conclusion

MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target.

Trial registration

ClinicalTrials.gov identifier: NCT023358017
Development and validation of a patient-report measure of safety climate for general practice
Authors: Madden Caoimhe , Lydon Sinéad , Murphy Andrew W , O’Connor Paul
Published: February 2021

Background

Patients remain an under-utilized source of information on patient safety, as reflected by the dearth of patient-report measures of safety climate, particularly for use in general practice settings. Extant measures are marked by poor coverage of safety climate domains, inadequate psychometric properties and/or lack of consideration of usability.

Objective

To develop a novel patient-report measure of safety climate specifically for completion by general practice patients, and to establish the validity, reliability and usability of this measure.

Methods

An iterative process was used to develop the safety climate measure, with patient and general practitioner input. A cross-sectional design was employed to examine the validity (content, construct and convergent), reliability (internal consistency), and usability (readability and burden) of the measure.

Results

A total of 584 general practice patients completed the measure. The exploratory factor analysis identified five factors pertaining to safety climate in general practice: Feeling of Safety with GP; Practice Staff Efficiency and Teamwork; Staff Stress and Workload; Patient Knowledge and Accountability, and; Safety Systems and Behaviours. These factors strongly correlated with two global safety measures, demonstrating convergent validity. The measure showed strong internal consistency, and was considered usable for patients as indicated by readability and duration of completion.

Conclusion

Our novel measure of safety climate for use in general practice demonstrates favourable markers of validity, reliability and usability. This measure will provide a mechanism for the patient voice to be heard in patient safety measurement, and to be used to improve patient safety in general practice.
Malesherbes and the Crisis of 1787–8
Authors: Campbell Peter R , Hardman John
Published: February 2021

Chrétien-Guillaume de Lamoignon de Malesherbes (1721–94) was a minister for Louis XVI twice and his second ministry coincided with the pre-revolutionary crisis of 1787–8. He wrote long contemporaneous memoranda for the king that were in the family archives, unavailable until 2010 when they were published. He was a well-placed and acute observer seen here discussing and analysing policy. This article considers how his writings can help us to understand the characteristics of the crisis and the strategies of the ministry, the opposition of the parlementaires, and the way political mismanagement deepened the implications of an escalating and increasingly unmanageable situation for the monarchy. Malesherbes offers an insider’s understanding of the importance of public opinion to the reform agenda, and throws new light on the parlementaires’s call for the Estates-General. The article is a lengthy analysis of newly available primary sources.
Coronary Revascularization and Postoperative Outcomes in People With and Without Alzheimer’s Disease
Authors: Vu Mai , Koponen Marjaana , Taipale Heidi , Kettunen Raimo , Hartikainen Sirpa , Tolppanen Anna-Maija
Published: February 2021

Background

Little is known on the incidence and postoperative outcomes of revascularizations according to electivity in persons with Alzheimer’s disease (AD).

Methods

The Medication Use and Alzheimer’s disease (MEDALZ) cohort includes 70 718 community dwellers diagnosed with incident AD during 2005–2011 in Finland. For each person with AD, 1–4 age-, sex-, and hospital district-matched comparison persons without AD were identified. Altogether 448 persons with AD and 5909 without AD underwent revascularization during the follow-up. The outcomes were 30-day and 90-day re-admission rate after discharge, and all-cause 1-year and 3-year mortality. Risk of outcomes in persons with AD were compared to those without AD using Cox proportional hazard models adjusted with age, sex, comorbidities, statin use, revascularization type, length of stay, and support at discharge.

Result

People with AD had less revascularizations (adjusted hazard ratio 0.24, 95% confidence interval 0.22–0.27). Emergency procedures were more common (42.6% vs 33.1%) than elective procedures (34.2% vs 48.6%) among people with AD. There was no difference in 30-day readmissions (0.97, 0.80–1.17) or 1-year mortality (1.04, 0.75–1.42) and 90 days readmission risk was lower in persons with AD (0.85, 0.74–0.98). People with AD had higher 3-year mortality (1.42, 1.15–1.74), but the risk increase was observed only for emergency (1.71, 1.27–2.31), not for elective procedures (0.96, 0.63–1.46).

Conclusion

People with AD did not have worse readmission and mortality outcomes following elective revascularization. These findings in conjunction with lower revascularization rate especially for elective procedures raise questions on the threshold for elective procedures in people with AD.