bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review
Authors: Hategeka Celestin , Ruton Hinda , Karamouzian Mohammad , Lynd Larry D , Law Michael R
Published: October 2020

Background

When randomisation is not possible, interrupted time series (ITS) design has increasingly been advocated as a more robust design to evaluating health system quality improvement (QI) interventions given its ability to control for common biases in healthcare QI. However, there is a potential risk of producing misleading results when this rather robust design is not used appropriately. We performed a methodological systematic review of the literature to investigate the extent to which the use of ITS has followed best practice standards and recommendations in the evaluation of QI interventions.

Methods

We searched multiple databases from inception to June 2018 to identify QI intervention studies that were evaluated using ITS. There was no restriction on date, language and participants. Data were synthesised narratively using appropriate descriptive statistics. The risk of bias for ITS studies was assessed using the Cochrane Effective Practice and Organisation of Care standard criteria. The systematic review protocol was registered in PROSPERO (registration number: CRD42018094427).

Results

Of 4061 potential studies and 2028 unique records screened for inclusion, 120 eligible studies assessed eight QI strategies and were from 25 countries. Most studies were published since 2010 (86.7%), reported data using monthly interval (71.4%), used ITS without a control (81%) and modelled data using segmented regression (62.5%). Autocorrelation was considered in 55% of studies, seasonality in 20.8% and non-stationarity in 8.3%. Only 49.2% of studies specified the ITS impact model. The risk of bias was high or very high in 72.5% of included studies and did not change significantly over time.

Conclusions

The use of ITS in the evaluation of health system QI interventions has increased considerably over the past decade. However, variations in methodological considerations and reporting of ITS in QI remain a concern, warranting a need to develop and reinforce formal reporting guidelines to improve its application in the evaluation of health system QI interventions.
Comparative analysis of objective and subjective outcomes of two different intraocular lenses: trifocal and extended range of vision
Authors: Pedrotti Emilio , Carones Francesco , Talli Pietro , Bonacci Erika , Selvi Federico , Galzignato Alice , Besutti Andrea , De Gregorio Alessandra , Marchini Giorgio
Published: October 2020

Objective

To evaluate objective and subjective outcomes after bilateral implantation of two different multifocal intraocular lenses, which correct pseudophakic presbyopia in an adequate and homogeneous population court.

Methods and analysis

Fifty patients were evaluated at 3 months after bilateral implantation, at the Eye Clinic of University of Verona and at the Carones Ophthalmology Center Milano, as follows: Tecnis Symfony (25 patients), Alcon PanOptix (25 patients). Main outcomes were uncorrected and best-corrected distance visual acuity (UDVA and BCVA) at 4 m, 60 cm (best distance corrected intermediate visual acuity (BDCIVA) and uncorrected intermediate visual acuity), 40 cm (best distance corrected near visual acuity (BDCNVA) and uncorrected near visual acuity (UNVA)), objective refractive outcome, defocus curve, contrast sensitivity (Modulation Transfer Function (MTF) cut-off), optical quality (Strehl ratio), aberrometry (root mean square RMS 4 mm), subjective quality of life (National Eye Institute Refractive Error Quality of Life score (NEI-RQL-42 score) test).

Results

Symfony and PanOptix showed BCVA and UDVA comparable results. Symfony presented significant better outcomes at BDCIVA (p=0.001), while PanOptix showed better performances at BDCNVA and UNVA (p=0.01). Symfony achieved better results in RMS 4 mm (p=0.024) and in MTF cut-off (p=0.041). In the questionnaire NEI-RQL-42, PanOptix presented better scores in ‘near vision’ and ‘spectacles independence’, whereas Symfony in ‘symptoms’ and ‘clarity of vision’.

Conclusion

Both intraocular lenses are valid options to avoid pseudophakic presbyopia, even though they present different features which make them unique. Symfony allows patients to achieve a better objective and subjective quality of vision and contrast sensitivity; PanOptix provides better outcomes in near vision and spectacles independence requirements.
Multi-method evaluation of a national clinical fellowship programme to build leadership capacity for quality improvement
Authors: Toma Madalina , Blamey Avril , Mahal Dawn , Gray Nicola M , Allison Laura , Thakore Shobhan , Bowie Paul
Published: October 2020

Background

This paper reports the results of the evaluation of the Scottish Quality and Safety Fellowship (SQSF)—a 10-month, lead-level international educational programme established in 2008 with the overarching aim of developing clinicians with advanced quality improvement knowledge, technical ability and essential leadership skills. The evaluation explores four levels of educational and practice outcomes associated with (1) the reaction of fellows to SQSF participation, (2) learning gained, (3) subsequent behaviour changes and (4) the overall impact on national and international level capability and capacity building.

Methods

A theory-informed multi-method design was applied using (1) a search and review of the SQSF organisational database to tabulate personal, professional and demographic characteristics; (2) semi-structured telephone interviews with 16 participants using purposive and self-selected sampling; and (3) a cross-sectional online evaluation survey across all 10 cohorts involving 222 fellows

Results

SQSF was positively perceived as a high-quality learning experience containing a well-balanced mix of theory and practice, with a majority of respondents reporting career changing benefits. Most participants reported improved social, behavioural and emotional skills, knowledge and attitudes and, with sustained support of their host organisations, were able to apply and share learning in their workplace. The impact of the SQSF on a wider national and international level capability and capacity was both mediated and moderated by a wide range of interrelated contextual factors.

Conclusions

This multi-method evaluation demonstrates that SQSF has achieved significant positive outcomes for the great majority of participants. Some tentative recommendations are provided with the aim of further enhancing fellowship content, delivery, transfer and future evaluations of wider impacts at regional, national and international health system levels.
Prognostic value of plasma big endothelin-1 in left ventricular non-compaction cardiomyopathy
Authors: Fan Peng , Zhang Ying , Lu Yi-Ting , Yang Kun-Qi , Lu Pei-Pei , Zhang Qiong-Yu , Luo Fang , Lin Ya-Hui , Zhou Xian-Liang , Tian Tao
Published: October 2020

Objective

To determine the prognostic role of big endothelin-1 (ET-1) in left ventricular non-compaction cardiomyopathy (LVNC).

Methods

We prospectively enrolled patients whose LVNC was diagnosed by cardiac MRI and who had big ET-1 data available. Primary end point was a composite of all-cause mortality, heart transplantation, sustained ventricular tachycardia/fibrillation and implanted cardioverter defibrillator discharge. Secondary end point was cardiac death or heart transplantation.

Results

Altogether, 203 patients (median age 44 years; 70.9% male) were divided into high-level (≥0.42 pmol/L) and low-level (<0.42 pmol/L) big ET-1 groups according to the median value of plasma big ET-1 levels. Ln big ET-1 was positively associated with Ln N-terminal pro-brain natriuretic peptide, left ventricular diameter, but negatively related to age and Ln left ventricular ejection fraction. Median follow-up was 1.9 years (IQR 0.9–3.1 years). Kaplan-Meier analysis showed that, compared with patients with low levels of big ET-1, those with high levels were at greater risk for meeting both primary (p<0.001) and secondary (p<0.001) end points. The C-statistic estimation of Ln big ET-1 for predicting the primary outcome was 0.755 (95% CI 0.685 to 0.824, p<0.001). After adjusting for confounding factors, Ln big ET-1 was identified as an independent predictor of the composite primary outcome (HR 1.83, 95% CI 1.27 to 2.62, p=0.001) and secondary outcome (HR 1.93, 95% CI 1.32 to 2.83, p=0.001).

Conclusions

Plasma big ET-1 may be a valuable index to predict the clinical adverse outcomes in patients with LVNC.
Comparison between deep brain stimulation and magnetic resonance-guided focused ultrasound in the treatment of essential tremor: a systematic review and pooled analysis of functional outcomes
Authors: Giordano Martina , Caccavella Valerio Maria , Zaed Ismail , Foglia Manzillo Livia , Montano Nicola , Olivi Alessandro , Polli Filippo Maria
Published: October 2020

The current gold standard surgical treatment for medication-resistant essential tremor (ET) is deep brain stimulation (DBS). However, recent advances in technologies have led to the development of incisionless techniques, such as magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy. The authors perform a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to compare unilateral MRgFUS thalamotomy to unilateral and bilateral DBS in the treatment of ET in terms of tremor severity and quality of life improvement. PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and SCOPUS databases were searched. 45 eligible articles, published between 1990 and 2019, were retrieved. 1202 patients were treated with DBS and 477 were treated with MRgFUS thalamotomy. Postoperative tremor improvement was greater following DBS than MRgFUS thalamotomy (p<0.001). A subgroup analysis was carried out stratifying by treatment laterality: bilateral DBS was significantly superior to both MRgFUS and unilateral DBS (p<0.001), but no significant difference was recorded between MRgFUS and unilateral DBS (p<0.198). Postoperative quality of life improvement was significantly greater following MRgFUS thalamotomy than DBS (p<0.001). Complications were differently distributed among the two groups (p<0.001). Persistent complications were significantly more common in the MRgFUS group (p=0.042). While bilateral DBS proves superior to unilateral MRgFUS thalamotomy in the treatment of ET, a subgroup analysis suggests that treatment laterality is the most significant determinant of tremor improvement, thus highlighting the importance of future investigations on bilateral staged MRgFUS thalamotomy.
Prevalence and patterns of scavenging by brown bears (Ursus arctos) on salmon (Oncorhynchusspp.) carcasses
Authors: Lincoln A.E. , Wirsing A.J. , Quinn T.P.
Published: October 2020

Scavenging, an underappreciated mechanism of prey consumption for many predators, can contribute substantially to nutritional intake. Facultative scavengers such as brown bears (Ursus arctos Linnaeus, 1758) may both kill and scavenge Pacific salmon (genus Oncorhynchus Suckley, 1861), though the extent of scavenging and factors affecting this behavior are unclear. We tagged 899 sockeye salmon (Oncorhynchus nerka (Walbaum in Artedi, 1792)) carcasses and placed them on streambanks over 5 years at multiple sites in southwestern Alaska (USA) where brown bears annually prey on spawning sockeye salmon. Examination of carcasses revealed overall scavenging rates of 15% after 1 day and 54% after 3 days. Scavenging rate varied by site and year and increased throughout the salmon run. Contrary to predictions, scavenging was more frequent in senescent or bear-killed carcasses than ripe carcasses. Carcass consumption ranged from minimal to almost complete; body and brain tissues were most frequently consumed after 3 days (68% and 63% of carcasses, respectively). We also documented secondary scavenging (i.e., tissue consumption on two separate events) and delayed scavenging (i.e., scavenging observed after 3 days but not 1 day). Taken together, the results indicated that scavenging in these streams contributes significantly to total consumption of salmon by bears, with ramifications for other components of these salmon-dependent ecosystems.
Disc cutter wear prediction based on the friction work principle
Authors: Li Jie , Huang Yuanjun , Zhang Xin , Sun Ye , Guo Jingbo
Published: October 2020

As the main rock-breaking tool of the tunnel boring machine, wear of the disc cutter is affected by geological conditions, equipment factors, and tunneling parameters when it interacts with rock. Because of the complex factors affecting disc cutter wear, it is difficult to accurately predict the wear of the disc cutter. In this study, the rock-breaking mechanism and the force of the disc cutter were analyzed, and a theoretical prediction model of disc cutter wear was established based on the friction work principle. The parameters in the disc cutter wear prediction model were determined by simulation, and a prediction method of disc cutter wear is proposed. Finally, the wear prediction model of the disc cutter was verified by field wear data. The results show that the average error between the predicted value of the disc cutter and the actual wear data from the field is 16.1%. The wear prediction model of the disc cutter has high accuracy and adaptability. The research results provide an effective method for wear prediction of the disc cutter, which is of great significance and engineering value for cutter replacement and construction management.
Classical de Sitter solutions in three dimensions without tachyons?
Authors: Farakos Fotis , Tringas George , Van Riet Thomas
Published: October 2020

We continue the study of compactifications of massive IIA supergravity on G2 orientifolds and demonstrate that breaking supersymmetry with anti-D2 and anti-D6 sources leads to 3d theories for which the typical tachyons haunting classical dS solutions can be absent. However for a concrete torus example the meta-stable dS window disappears after a quantization of fluxes and charges. We discuss the prospects of more general G2 compactifications and argue that they could potentially alleviate the tachyon problem by introducing larger tadpole numbers and warped throats. However, exactly those ingredients then seem to push the vacuum towards the brink of perturbative brane–flux decay in the open string sector. This is either a remarkable illustration of the no-dS swampland conjecture or such vacua live in very difficult to control regions of parameter space.
Marginally bound circular orbits in the composed black-hole-ring system
Authors: Hod Shahar
Published: October 2020

The physical and mathematical properties of the non-linearly coupled black-hole-orbiting-ring system are studied analytically to second order in the dimensionless angular velocity $$M_{\text {ir}}\omega _{\text {H}}$$

M
ir

ω
H

of the black-hole horizon (here $$M_{\text {ir}}$$

M
ir

is the irreducible mass of the slowly rotating central black hole). In particular, we determine analytically, to first order in the dimensionless ring-to-black-hole mass ratio $$m/M_{\text {ir}}$$

m
/

M
ir

, the shift $$\Delta \Omega _{\text {mb}}/\Omega _{\text {mb}}$$

Δ

Ω
mb

/

Ω
mb

in the orbital frequency of the marginally bound circular geodesic that characterizes the composed curved spacetime. Interestingly, our analytical results for the frequency shift $$\Delta \Omega _{\text {mb}}$$

Δ

Ω
mb

in the composed black-hole-orbiting-ring toy model agree qualitatively with the recently published numerical results for the corresponding frequency shift in the physically related (and mathematically much more complex) black-hole-orbiting-particle system. In particular, the present analysis provides evidence that, at order $$O(m/M_{\text {ir}})$$

O
(
m
/

M
ir

)

, the recently observed positive shift in the angular frequency of the marginally bound circular orbit is directly related to the physically intriguing phenomenon of dragging of inertial frames by orbiting masses in general relativity.
GENDERED NETWORKS AND COMMUNICABILITY IN MEDIEVAL HISTORICAL NARRATIVES
Authors: PRADO S. D. , DAHMEN S. R. , BAZZAN A. L. C. , MACCARRON M. , HILLNER J.
Published: October 2020

Since the 1970s, scholars have begun to pay attention to the presentation of women in Bede’s Ecclesiastical History of the English People, the main source for the early history of Britain (from the first century BC to the eighth century AD). Vastly different conclusions have been drawn, ranging from positivist approaches which saw the period as a golden age for women to rather more negative assessments, which argue that Bede suppressed the role of women. By analyzing the concept of communicability and relevance of certain nodes in complex networks, we show how Bede’s Ecclesiastical History affords women complex and nuanced social roles. In particular, we can show the independent importance of certain abbesses, which is a significant result and challenges much of the existing scholarship on Bede’s attitude to female power.
HEARINGS AND MISHEARINGS: DECRYPTING THE SPOKEN WORD
Authors: MEHTA ANITA , LUCK JEAN-MARC
Published: October 2020

We propose a model of the speech perception of individual words in the presence of mishearings. This phenomenological approach is based on concepts used in linguistics, and provides a formalism that is universal across languages. We put forward an efficient two-parameter form for the word length distribution, and introduce a simple representation of mishearings, which we use in our subsequent modeling of word recognition. In a context-free scenario, word recognition often occurs via anticipation when, part-way into a word, we can correctly guess its full form. We give a quantitative estimate of this anticipation threshold when no mishearings occur, in terms of model parameters. As might be expected, the whole anticipation effect disappears when there are sufficiently many mishearings. Our global approach to the problem of speech perception is in the spirit of an optimization problem. We show for instance that speech perception is easy when the word length is less than a threshold, to be identified with a static transition, and hard otherwise. We extend this to the dynamics of word recognition, proposing an intuitive approach highlighting the distinction between individual, isolated mishearings and clusters of contiguous mishearings. At least in some parameter range, a dynamical transition is manifest well before the static transition is reached, as is the case for many other examples of complex systems.
Undecidable Cases of Model Checking Probabilistic Temporal-Epistemic Logic
Authors: Meyden Ron Van Der , Patra Manas K.
Published: October 2020

We investigate the decidability of model checking logics of time, knowledge, and probability, with respect to two epistemic semantics: the clock and synchronous perfect recall semantics in partially observable discrete-time Markov chains. Decidability results are known for certain restricted logics with respect to these semantics, subject to a variety of restrictions that are either unexplained or involve a longstanding unsolved mathematical problem. We show that mild generalizations of the known decidable cases suffice to render the model checking problem definitively undecidable. In particular, for the synchronous perfect recall semantics, a generalization from temporal operators with finite reach to operators with infinite reach renders model checking undecidable. The case of the clock semantics is closely related to a monadic second-order logic of time and probability that is known to be decidable, except on a set of measure zero. We show that two distinct extensions of this logic make model checking undecidable. One of these involves polynomial combinations of probability terms, the other involves monadic second-order quantification into the scope of probability operators. These results explain some of the restrictions in previous work.
What can a bumbling, inarticulate Los Angeles cop teach us about effective communication?
Authors: Yaffe Philip
Published: October 2020

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.

Creative (fiction) writers have an advantage over expository (non-fiction) writers. Fiction is designed to amuse and entertain, which most people look forward to. Exposition is designed to instruct and inform, which most people do not look forward to. "Columbo," the perennially popular TV series (re-runs are still being shown around the world), demonstrates how this inherent handicap can be overcome.
Distinct Spreading Speeds in a Lotka–Volterra Cooperative System
Authors: Pan Shuxia
Published: October 2020

This paper deals with the spreading speeds in the classical Lotka–Volterra cooperative system, of which the bounds have been studied earlier. By introducing an auxiliary cooperative system and constructing an upper solution, we obtain a sufficient condition to confirm two distinct spreading speeds of unknown functions. Due to the different average moving speeds of different level sets, we find the existence of propagation terraces in such a cooperative system with constant coefficients. We also present some numerical results to illustrate our results.
Social-Aware Task Allocation in Mobile Crowd Sensing
Authors: Zhu Weiping , Guo Wenzhong , Yu Zhiyong
Published: October 2020

Task allocation is a significant issue in crowd sensing, which trades off the data quality and sensing cost. Existing task allocation works are based on the assumption that there is plenty of users available in the candidate pool. However, for some specific applications, there may be only a few candidate users, resulting in the poor completion of tasks. To tackle this problem, in this paper, we investigate the task allocation problem with the assistance of social networks. We select a subset of users; if a user can not complete the task, he can propagate the task information to his friends. The object of this problem is to maximize the expected number of completed tasks. We prove that the task allocation problem is an NP-hard and submodular problem and then propose a native greedy selection (NGS) algorithm, which selects the user with maximum margin gain in each round. To improve the efficiency of the NGS algorithm, we further propose a fast greedy selection algorithm (FGS), which selects the user who can actually complete the maximum number of tasks. Experimental results show that although FGS gets slightly worse results in terms of the expected number of completed tasks, it can greatly reduce the running time of seed selection.
Identification of a Set of Genes Improving Survival Prediction in Kidney Renal Clear Cell Carcinoma through Integrative Reanalysis of Transcriptomic Data
Authors: Ruan Banlai , Feng Xianzhen , Chen Xueyi , Dong Zhiwei , Wang Qi , Xu Kai , Tian Jinping , Liu Jie , Chen Ziyin , Shi Wenzhen , Wang Man , Qian Lu , Ding Qianshan
Published: October 2020

Background. With an enormous amount of research concerning kidney cancer being conducted, various treatments have been applied to its cure. However, high recurrence and metastasis rates continue to pose a threat to the survival of patients with kidney renal clear cell carcinoma (KIRC). Methods. Data from The Cancer Genome Atlas were downloaded, and a series of analyses were performed, including differential analysis, Cox analysis, weighted gene coexpression network analysis, least absolute shrinkage and selection operator analysis, multivariate Cox analysis, survival analysis, and receiver operating characteristic curve and functional enrichment analysis. Results. A total of 5,777 differentially expressed genes were identified from the differential analysis. The Cox analysis showed 1,853 significant genes (

P
<
0.01

). Weighted gene coexpression network analysis revealed that 226 genes in the module were related to clinical parameters, including Tumor-Node-Metastasis (TNM) staging. Least absolute shrinkage and selection operator and multivariate Cox analyses suggested that four genes (CDKL2, LRFN1, STAT2, and SOWAHB) had a potential function in predicting the survival time of patients with KIRC. Survival analysis uncovered that a high risk of these four genes was associated with an unfavorable prognosis. Receiver operating characteristic curve analysis further confirmed the accuracy of the risk score model. The analysis of clinicopathological parameters of the four identified genes revealed that they were associated with the progression of KIRC. Conclusion. The gene expression model consisting of CDKL2, LRFN1, STAT2, and SOWAHB is a promising tool for predicting the prognosis of patients with KIRC. The results of this study may provide insights into the diagnosis and treatment of KIRC.
An Asynchronous Data Transmission Method in Heterogeneous Wireless Networks
Authors: Wang Changhao , Li Shining , Li Bingqi , Chen Qianwu
Published: October 2020

With the massive deployment and application of intelligent systems such as smart life, smart medical care, and smart transportation, it is becoming more common for heterogeneous wireless networks such as WiFi, Zigbee, and Bluetooth to coexist in the same physical space. To improve the communication efficiency under the coexistence of heterogeneous wireless networks, this paper proposes an asynchronous data transmission method based on CTC technology, which constantly monitors the sleep and wake-up cycles of heterogeneous devices, makes full use of the wake-up cycle of the receiving terminal, and uses asynchronous methods to achieve cross-technology transmission of data packets. We also give a specific implementation scheme and use the program to simulate the transmission effect. The results show that our proposed method effectively reduces data transmission time and balances channel transmission throughput.
A Collusion-Resistant Identity-Based Proxy Reencryption Scheme with Ciphertext Evolution for Secure Cloud Sharing
Authors: Yao Shimao , Sankar Ravi , Ra In-Ho
Published: October 2020

In order to solve the challenges of user data security in the cloud computing (storage) environment, many encryption solutions with different features have been presented. Among them, proxy reencryption (PRE) based on public-key infrastructure (PKI) is a promising technology for secure cloud sharing. And identity-based proxy reencryption (IBPRE), which uses identity as the public key, eliminates burdensome certificate management and is, therefore, more preferable. However, most of the current IBPRE schemes only focus on the processing of data sharing while overlooking the functions of authorization revocation and ciphertext update, which are more closely related to the security of data itself. Moreover, the few existing schemes that involve ciphertext update turn out to be impractical because the length of ciphertext increases with the reencryption of ciphertext. In this paper, an improved IBPRE scheme, which provides improvements on the inadequacies of the scheme proposed by Ateniese et al. especially in terms of collusion safety and ciphertext evolution, is proposed. To the best of our knowledge, this is a practical IBPRE scheme integrating the functions of access authorization, delegation revocation, ciphertext update, reauthorization, and conditional reservation delegation. The proposed technique has high practicability in the scenario where a large number of ciphertexts need to be updated synchronously. Lastly, the comparative analysis and simulation results show that the two reencryption algorithms in the proposed scheme have the shortest computing time than other schemes.
Numerical Simulation of the Non-Darcy Flow Based on Random Fractal Micronetwork Model for Low Permeability Sandstone Gas Reservoirs
Authors: Li Juhua , Chen Chen
Published: October 2020

Darcy’s law is not suit for describing high velocity flow in the near wellbore region of gas reservoirs. The non-Darcy coefficient

β

of the Forchheimer’s equation is a main parameter for the evaluation of seepage capacity in gas reservoirs. The paper presented a new method to calculate

β

by performing gas and con-water flow simulations with random 3D micropore network model. Firstly, a network model is established by random fractal method. Secondly, based on the network simulation method of non-Darcy flow in the literature of Thauvin and Mohanty, a modified model is developed to describe gas non-Darcy flow with irreducible water in the porous medium. The model was verified by our experimental measurements. Then, we investigated the influence of different factors on the non-Darcy coefficient, including micropore structure (pore radius and fractal dimension), irreducible water saturation (

S

wi

), tortuosity, and other reservoir characteristics. The simulation results showed that the value of the non-Darcy coefficient decreases with the increase in all: the average pore radius, fractal dimension, irreducible water saturation, and tortuosity. The non-Darcy coefficients obtained by the fractal method of microparameters are estimated more precisely than the conventional methods. The method provides theoretical support for the productivity prediction of non-Darcy flow in gas reservoirs.
Control of a Tilting Hexacopter under Wind Disturbance
Authors: Xu Hao , Yang Zhong , Lu Kaiwen , Xu Changliang , Zhang Qiuyan
Published: October 2020

Multicopters are well suited for executing fast maneuvers with high velocity, but they are still affected by the external atmospheric environment because attitude and position cannot be independently controlled. In this paper, we present a novel hexacopter which improves the wind resistance and strong coupling between attitude control and position control. The copter is designed such that the rotor sections can tilt around their respective arm axes. We present the aerodynamic methods to analyze the system dynamics model in windy environments. The entire system is decomposed into six loops based on the model, and the presented flight controller uses the ADRC method to consider both the attitude and the position. The controller introduces the extended state observer to estimate the white noise and wind disturbance. We use the nonlinear state error feedback law to control the output with disturbance compensation. Finally, we linearize the control allocation matrix that the controllers output directly mapped to the rotor velocities and tilting angles. The new theoretical results are thoroughly validated through comparative experiments.
Fault Detection of the Wind Turbine Variable Pitch System Based on Large Margin Distribution Machine Optimized by the State Transition Algorithm
Authors: Tang Mingzhu , Hu Jiahao , Kuang Zijie , Wu Huawei , Zhao Qi , Peng Shuhao
Published: October 2020

Aiming at solving the problem that the parameters of a fault detection model are difficult to be optimized, the paper proposes the fault detection of the wind turbine variable pitch system based on large margin distribution machine (LDM) which is optimized by the state transition algorithm (STA). By setting the three parameters of the LDM model as a three-dimensional vector which was searched by STA, by using the accuracy of fault detection model as the fitness function of STA, and by adopting the four state transformation operators of STA to carry out global search in the form of point, line, surface, and sphere in the search space, the global optimal parameters of LDM fault detection model are obtained and used to train the model. Compared with the grid search (GS) method, particle swarm optimization (PSO) algorithm, and genetic algorithm (GA), the proposed model method has lower false positive rate (FPR) and false negative rate (FNR) in the fault detection of wind turbine variable pitch system in a real wind farm.
A Wnt-Induced Phenotypic Switch in Cancer-Associated Fibroblasts Inhibits EMT in Colorectal Cancer
Authors: Mosa Mohammed H. , Michels Birgitta E. , Menche Constantin , Nicolas Adele M. , Darvishi Tahmineh , Greten Florian R. , Farin Henner F.
Published: October 2020

Tumor progression is recognized as a result of an evolving cross-talk between tumor cells and their surrounding nontransformed stroma. Although Wnt signaling has been intensively studied in colorectal cancer, it remains unclear whether activity in the tumor-associated stroma contributes to malignancy. To specifically interfere with stromal signals, we generated Wnt-independent tumor organoids that secrete the Wnt antagonist Sfrp1. Subcutaneous transplantation into immunocompetent as well as immunodeficient mice resulted in a strong reduction of tumor growth. Histologic and transcriptomic analyses revealed that Sfrp1 induced an epithelial–mesenchymal transition (EMT) phenotype in tumor cells without affecting tumor-intrinsic Wnt signaling, suggesting involvement of nonimmune stromal cells. Blockage of canonical signaling using Sfrp1, Dkk1, or fibroblast-specific genetic ablation of β-catenin strongly decreased the number of cancer-associated myofibroblasts (myCAF). Wnt activity in CAFs was linked with distinct subtypes, where low and high levels induced an inflammatory-like CAF (iCAF) subtype or contractile myCAFs, respectively. Coculture of tumor organoids with iCAFs resulted in significant upregulation of EMT markers, while myCAFs reverted this phenotype. In summary, we show that tumor growth and malignancy are differentially regulated via distinct fibroblast subtypes under the influence of juxtacrine Wnt signals.

Significance:

This study provides evidence for Wnt-induced functional diversity of colorectal cancer–associated fibroblasts, representing a non-cell autonomous mechanism for colon cancer progression.
Glucosamine and Chondroitin Supplements and Risk of Colorectal Adenoma and Serrated Polyp
Authors: Lee Dong Hoon , Cao Chao , Zong Xiaoyu , Zhang Xuehong , O'Connell Kelli , Song Mingyang , Wu Kana , Du Mengmeng , Cao Yin , Giovannucci Edward L. , Kantor Elizabeth D.
Published: October 2020

Background:

Studies have shown an inverse association between use of glucosamine and chondroitin supplements and colorectal cancer risk. However, the association with the precursor lesion, colorectal adenoma and serrated polyp, has not been examined.

Methods:

Analyses include 43,163 persons from the Nurses' Health Study (NHS), Health Professionals Follow-up Study (HPFS), and NHS2 who reported on glucosamine/chondroitin use in 2002 and who subsequently underwent ≥1 lower gastrointestinal endoscopy. By 2012, 5,715 conventional (2,016 high-risk) adenomas were detected, as were 4,954 serrated polyps. Multivariable logistic regression for clustered data was used to calculate OR and 95% confidence intervals (CI).

Results:

Glucosamine/chondroitin use was inversely associated with high risk and any conventional adenoma in NHS and HPFS: in the pooled multivariable-adjusted model, glucosamine + chondroitin use at baseline was associated with a 26% (OR = 0.74; 95% CI, 0.60–0.90; Pheterogeneity = 0.23) and a 10% (OR = 0.90; 95% CI, 0.81–0.99; Pheterogeneity = 0.36) lower risk of high-risk adenoma and overall conventional adenoma, respectively. However, no association was observed in NHS2, a study of younger women (high-risk adenoma: OR = 1.09; 95% CI, 0.82–1.45; overall conventional adenoma: OR = 1.00; 95% CI, 0.86–1.17), and effect estimates pooled across all three studies were not significant (high-risk: OR = 0.83; 95% CI, 0.63–1.10; Pheterogeneity = 0.03; overall conventional adenoma: OR = 0.93; 95% CI, 0.85–1.02; Pheterogeneity = 0.31). No associations were observed for serrated polyps.

Conclusions:

Glucosamine/chondroitin use was associated with lower risks of high-risk and overall conventional adenoma in older adults; however, this association did not hold in younger women, or for serrated polyps.

Impact:

Our study suggests that glucosamine and chondroitin may act on early colorectal carcinogenesis in older adults.
Safety and Efficacy of Vorinostat Plus Sirolimus or Everolimus in Patients with Relapsed Refractory Hodgkin Lymphoma
Authors: Janku Filip , Park Haeseong , Call S. Greg , Madwani Kiran , Oki Yasuhiro , Subbiah Vivek , Hong David S. , Naing Aung , Velez-Bravo Vivianne M. , Barnes Tamara G. , Hagemeister Fredrick B. , Falchook Gerald S. , Karp Daniel D. , Wheler Jennifer J. , Piha-Paul Sarina A. , Garrido-Laguna Ignacio , Shpall Elizabeth J. , Fayad Luis E. , Neelapu Sattva S. , Meric-Bernstam Funda , Kurzrock Razelle , Fanale Michelle A.
Published: October 2020

Purpose:

Preclinical and early clinical data suggested that combining histone deacetylase (HDAC) and mTOR inhibitors can synergistically inhibit Hodgkin lymphoma.

Patients and Methods:

During the dose-escalation study (ClinicalTrials.gov number: NCT01087554) with the HDAC inhibitor vorinostat and the mTOR inhibitor sirolimus (V+S), a patient with Hodgkin lymphoma refractory to nine prior therapies demonstrated a partial response (PR) lasting for 18.5 months, which promoted additional enrollment of patients with Hodgkin lymphoma as well as exploration of an alternative combination of vorinostat and mTOR inhibitor everolimus (V+E).

Results:

A total of 40 patients with refractory Hodgkin lymphoma received V+S (n = 22) or V+E (n = 18). Patients received a median of five prior therapies, including brentuximab (n = 39), autologous stem cell transplantation (n = 26), and allogeneic stem cell transplantation (n = 12). The most frequent grade ≥3 treatment-related adverse event was thrombocytopenia in 55% and 67% of patients treated with V+S and V+E, respectively. Complete response was reported in 6 (27%) patients treated with V+S and 2 (11%) patients treated with V+E, and PR was reported in 6 patients (27%) treated with V+S and 4 (22%) patients treated with V+E (objective response rate of 55% and 33%, respectively). In summary, combined HDAC and mTOR inhibition had encouraging activity in heavily pretreated patients with relapsed/refractory Hodgkin lymphoma and warrants further investigation.

Conclusions:

Combined HDAC and mTOR inhibition has salutary activity in patients with relapsed refractory Hodgkin lymphoma and warrants further investigation.
Montreal Cognitive Assessment as Screening Measure for Mild and Major Neurocognitive Disorder in a Chilean Population
Authors: Bello-Lepe Sebastian , Alonso-Sánchez María Francisca , Ortega Alonso , Gaete Marcelo , Veliz Marcela , Lira Juan , Perez Salas Claudia Paz
Published: October 2020

Background: The Montreal Cognitive Assessment (MoCA) is a sensitive screening instrument for mild neurocognitive disorder (mild NCD). However, cut-off scores and accuracy indices should be established using representative samples of the population. In this context, the aim of this study was to update the normative values, and diagnostic efficiency statistics of the MoCA to detect mild NCD in the Chilean population. Methods: This study included 226 participants from the north, center, and south of the country, classified into 3 groups: healthy elderly (HE; n = 113), mild NCD (n = 65), and major neurocognitive disorder (major NCD; n = 48). Results: The optimal cut-off score to discriminate mild NCD from HE participants was 20 points with a sensitivity of 82.8% and a specificity of 84.1%. The observed balance between sensitivity and specificity shows a good test performance either to confirm or discard a diagnosis. The cut-off between mild NCD and major NCD from HE participants was 19 points with 85.6% of sensitivity and 90.3% of specificity. Conclusion: Overall diagnostic accuracy can be considered as outstanding (AUC ≥0.904) when discriminating HE from both mild NCD and major NCD. These results showed that the MoCA is a suitable tool to identify mild NCD and major NCD.
Immune Checkpoint Inhibitor-Induced Polymyositis and Myasthenia Gravis with Fatal Outcome
Authors: Giglio Daniel , Berntsson Henrik , Fred Åsa , Ny Lars
Published: October 2020

We here report on a 74-year-old man diagnosed with a pT3cN0 BRAF-mutated and mismatch repair-deficient adenocarcinoma in the colon ascendens and 3 liver metastases. After hemicolectomy, the patient received treatment with the PD-1 inhibitor pembrolizumab. Three weeks later (on day 22), laboratory tests showed leukocytosis and an increase in transaminases; immune checkpoint inhibitor (ICI)-induced hepatitis was suspected and prednisolone therapy was initiated. On day 29, the patient was acutely hospitalized due to dyspnea, somnolence and walking difficulties. Dysarthria, hoarseness, muscle pain and weakness had developed and the dose of prednisolone was increased. Serum levels of lactate dehydrogenase, creatine kinase and myoglobin were increased and ICI-induced myositis was suspected. Antibodies against acetylcholine receptor and titin were present, indicating myasthenia gravis. Eventually, bulbar myopathy developed, including dysarthria and dysphagia, and the patient could no longer attain saturation without oxygen. The patient was transferred to the intensive care unit, intubated and given methylprednisolone, intravenous immunoglobulins and infliximab. The patient developed carbon dioxide retention and died on day 39. Microscopical examination of the intercostal musculature, diaphragm, cervical musculature and tongue showed inflammatory infiltration and fibrosis consistent with a pronounced myositis. In the liver, microscopical examination did not show metastases from colorectal cancer but instead a hepatocellular cancer. The cause of death was determined as respiratory insufficiency due to polymyositis. In conclusion, ICIs may induce myositis combined with neurological immune-related adverse events. In patients developing muscle weakness and pain under ICI therapy, myositis should be suspected.
Depression and Diabetes Mellitus Multimorbidity Is Associated With Loss of Independence and Dementia Poststroke
Authors: Ouk Michael , Wu Che-Yuan , Colby-Milley Jessica , Fang Jiming , Zhou Limei , Shah Baiju R. , Herrmann Nathan , Lanctôt Krista L. , Linkewich Elizabeth , Law Marcus , Swartz Richard H. , Kapral Moira K. , Black Sandra E. , MacIntosh Bradley J. , Edwards Jodi D. , Swardfager Walter
Published: October 2020

Background and Purpose:

Many patients with ischemic stroke present with multiple comorbidities that threaten survival and recovery. This study sought to determine the risks of adverse long-term stroke outcomes associated with multimorbid diabetes mellitus and depression.

Methods:

Retrospective analysis of prospectively collected data on consecutive patients without premorbid dementia admitted from the community for a first-ever acute ischemic stroke to comprehensive stroke centers across Ontario, Canada (2003–2013). Premorbid histories of diabetes mellitus and depression were ascertained within 5 years before stroke admission. Adjusted hazard ratios (aHR [95% CI]) of admission to long-term care, incident dementia, readmission for stroke or transient ischemic attack and all-cause mortality, over time among those discharged back into the community poststroke.

Results:

Among 23 579 stroke admissions, n=20 201 were discharged back into the community. Diabetes mellitus and depression were associated with synergistic hazards of admission to long-term care (X
2
=5.4;
P
=0.02) over a median follow-up of 5.6 years. This interaction was observed among women specifically; depression multimorbidity showed particularly high hazards of admission to long-term care (aHR
Depression
=1.57 [1.24–1.98]) and incident dementia (aHR
Depression
=1.85 [1.40–2.44]) among women with diabetes mellitus. In the whole cohort, diabetes mellitus and depression were associated individually with long-term care admission (aHR
Diabetes
=1.20 [1.12–1.29]; aHR
Depression
=1.19 [1.04–1.37]), incident dementia (aHR
Diabetes
=1.14 [1.06–1.23]; aHR
Depression
=1.27 [1.08–1.49]), stroke/transient ischemic attack readmission (aHR
Diabetes
=1.18 [1.10–1.26]; aHR
Depression
=1.24 [1.07–1.42]), and all-cause mortality (aHR
Diabetes
=1.29 [1.23–1.36]; aHR
Depression
=1.16 [1.05–1.29]).

Conclusions:

The risks of dementia and needing long-term care in the years after surviving a stroke were particularly elevated among women when premorbid diabetes mellitus and depression occurred together. Long-term stroke recovery strategies might target high-risk patients with mood and metabolic multimorbidity.
Review of Orbiniidae (Annelida, Sedentaria) from Australia
Authors: ZHADAN ANNA
Published: October 2020

The present study is a review of all known Australian and New Zealand orbiniid species with their redescription based mainly on the collection of the Australian Museum (Sydney). A total of 28 species were examined: seven species of Scoloplos, three species of Leitoscoloplos, five species of Leodamas, three species of Naineris, two species of Orbinia, three species of Phylo, one species of Proscoloplos, and four species of Protoariciella. Leodamas australiensis (Hartmann-Schröder, 1979) is the new combination. Illustrated descriptions and an identification key for Australian and New Zealand orbiniids are provided.
A Climatology of Marine Boundary Layer Cloud and Drizzle Properties Derived from Ground-Based Observations over the Azores
Authors: Wu Peng , Dong Xiquan , Xi Baike
Published: October 2020

In this study, more than 4 years of ground-based observations and retrievals were collected and analyzed to investigate the seasonal and diurnal variations of single-layered MBL (with three subsets: nondrizzling, virga, and rain) cloud and drizzle properties, as well as their vertical and horizontal variations. The annual mean drizzle frequency was ~55%, with ~70% in winter and ~45% in summer. The cloud-top (cloud-base) height for rain clouds was the highest (lowest), resulting in the deepest cloud layer, i.e., 0.8 km, which is 4 (2) times that of nondrizzling (virga) clouds. The retrieved cloud-droplet effective radii rc were the largest (smallest) for rain (nondrizzling) clouds, and the nighttime values were greater than the daytime values. Drizzle number concentration Nd and liquid water content LWCd were three orders and one order lower, respectively, than their cloud counterparts. The rc and LWCc increased from the cloud base to zi ≈ 0.75 by condensational growth, while drizzle median radii rd increased from the cloud top downward the cloud base by collision–coalescence. The adiabaticity values monotonically increased from the cloud top to the cloud base with maxima of ~0.7 (0.3) for nondrizzling (rain) clouds. The drizzling process decreases the adiabaticity by 0.25 to 0.4, and the cloud-top entrainment mixing impacts as deep as upper 40% of the cloud layers. Cloud and drizzle homogeneities decreased with increased horizontal sampling lengths. Cloud homogeneity increases with increasing cloud fraction. These results can serve as baselines for studying MBL cloud-to-rain conversion and growth processes over the Azores.
Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection
Authors: Topf Michael C. , Philips Ramez , Curry Joseph , Magana Linda C. , Tuluc Madalina , Bar-Ad Voichita , Keane William , Goldman Richard A. , Luginbuhl Adam , Cognetti David
Published: October 2020

Objectives:

To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY.

Methods:

Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND.

Results:

Preoperative RT significantly decreased mean LNY from 31.7 to 23.9 nodes ( P < .001). In primary TL patients, age ( P < .001) and positive margins ( P = .044) were associated with decreased OS. In salvage TL patients, only positive margins was associated with poorer OS ( P = .009). No LNY cutoff provided significant OS or DFS benefit.

Conclusions:

Radiotherapy significantly reduces LNY in patients undergoing TL and ND. Within a single institution cohort, positive margins, but not LNY, is associated with survival in both primary and salvage TL patients. Level of Evidence: 4