bluuebunny/crossref_metadata_2025 huggingface dataset:
Turbulence and Coral Reefs
Authors: Davis Kristen A. , Pawlak Geno , Monismith Stephen G.
Published: August 2020

The interaction of coral reefs, both chemically and physically, with the surrounding seawater is governed, at the smallest scales, by turbulence. Here, we review recent progress in understanding turbulence in the unique setting of coral reefs—how it influences flow and the exchange of mass and momentum both above and within the complex geometry of coral reef canopies. Flow above reefs diverges from canonical rough boundary layers due to their large and highly heterogeneous roughness and the influence of surface waves. Within coral canopies, turbulence is dominated by large coherent structures that transport momentum both into and away from the canopy, but it is also generated at smaller scales as flow is forced to move around branches or blades, creating wakes. Future work interpreting reef-related observations or numerical models should carefully consider the influence that spatial variation has on momentum and scalar flux.
Myeloperoxidase instigates proinflammatory responses in a cecal ligation and puncture rat model of sepsis
Authors: Yu Hong , Liu Yajun , Wang Meifang , Restrepo Ricardo J. , Wang Derek , Kalogeris Theodore J. , Neumann William L. , Ford David A. , Korthuis Ronald J.
Published: August 2020

Using two distinct myeloperoxidase (MPO) inhibitors, we show for the first time that MPO plays an important role in producing increases in free 2-chlorofatty aldehyde (2-ClFALD)—a powerful proinflammatory chlorinated lipid in plasma and intestine—a number of cytokines and other inflammatory mediators, leukocyte and platelet rolling and adhesion in postcapillary venules, and lung injury in a cecal ligation and puncture model of sepsis. In addition, the use of a plasminogen activator inhibitor-1 (PAI-1) inhibitor or a mast cell stabilizer prevented inflammatory responses in CLP-induced sepsis. PAI-1 inhibition also prevented the proinflammatory responses to exogenous 2-ClFALD superfusion. Thus, our study provides some of the first evidence that MPO-derived free 2-ClFA plays an important role in CLP-induced sepsis by a PAI-1- and mast cell-dependent mechanism.
Flight Stability of Canard-Guided Dual-Spin Projectiles with Angular Rate Loops
Authors: Zheng Qiushi , Zhou Zhiming
Published: August 2020

Generally, as a precision-guided weapon, the missile has many disadvantage such as high price, difficult maintenance, and low yield. Modern war requires more and more new guided ammunition with high precision, low cost, and low collateral damage. Therefore, as a simple guided conventional ammunition technology, the dual-spin projectile has attracted the attention of ammunition experts recently. This paper proposes a dual-spin projectile scheme based on the rotation control method. Firstly, the concept of the dual-spin projectile is introduced. Secondly, the mathematical model of the dual-spin projectile is established, and the angular motion equation is finally obtained by using some linearized assumptions. Finally, the sufficient and necessary conditions of coning motion stability for dual-spin projectile with angular rate loops are analytically derived and further verified by numerical simulations. It is noticed that the upper bound of the control gain is affected by the delay angle of the control system and the spinning rate of the projectile.
Can Platelet Count and Mean Platelet Volume be Used as Markers of Postdural Puncture Headache in Obstetric Patients?
Authors: Uzundere Osman , Kaçar Cem Kıvılcım , Kaya Sedat
Published: August 2020

Objective. In this study, considering the importance of platelet function in inflammatory processes, we explored whether there are relationships of platelet indices with postdural puncture headache (PDPH) and pain developing after use of spinal needles and whether patient characteristics contribute to the development of PDPH. Methods. This prospective, observational study included 76 patients (Group 1) with PDPH and 93 patients (Group 2) without PDPH. The postoperative hemoglobin, hematocrit, platelet count (PC), and mean platelet volume (MPV) values were recorded, along with age, blood type, Rh factor, gravida, parity, and gestational age. In addition, the time of the onset of pain was recorded in patients who complained of a postspinal headache. Results. Hemoglobin and hematocrit values in Group 1 were significantly lower than in Group 2 (both, p=0.024). The PC of Group 1 was significantly higher than that of Group 2 (p<0.001), whereas the MPV was significantly lower (p<0.001). The area under the curve (AUC) values were significant for hemoglobin, hematocrit, PC, and MPV (p=0.022, p=0.024, p<0.001, and p<0.001, resp.). For MPV, the AUC value was 0.293, sensitivity was 1%, and specificity was 99%. The highest likelihood ratio (LR+) value was 1.22 at a cut-off value of 13.3 fL. For the PC, the AUC value was 0.666, the sensitivity was 9%, and the specificity was 99%, while the highest LR + value was 8.56 at a cut-off value of 352 × 109/L. There was no significant relationship between the parameters examined and the onset of pain. Conclusion. In this study, the PC was higher and MPV was lower in obstetric patients with PDPH compared with the control group. However, we also found that these two values cannot be used as markers of PDPH.
TISNet-Enhanced Fully Convolutional Network with Encoder-Decoder Structure for Tongue Image Segmentation in Traditional Chinese Medicine
Authors: Huang Xiaodong , Zhang Hui , Zhuo Li , Li Xiaoguang , Zhang Jing
Published: August 2020

Extracting the tongue body accurately from a digital tongue image is a challenge for automated tongue diagnoses, as the blurred edge of the tongue body, interference of pathological details, and the huge difference in the size and shape of the tongue. In this study, an automated tongue image segmentation method using enhanced fully convolutional network with encoder-decoder structure was presented. In the frame of the proposed network, the deep residual network was adopted as an encoder to obtain dense feature maps, and a Receptive Field Block was assembled behind the encoder. Receptive Field Block can capture adequate global contextual prior because of its structure of the multibranch convolution layers with varying kernels. Moreover, the Feature Pyramid Network was used as a decoder to fuse multiscale feature maps for gathering sufficient positional information to recover the clear contour of the tongue body. The quantitative evaluation of the segmentation results of 300 tongue images from the SIPL-tongue dataset showed that the average Hausdorff Distance, average Symmetric Mean Absolute Surface Distance, average Dice Similarity Coefficient, average precision, average sensitivity, and average specificity were 11.2963, 3.4737, 97.26%, 95.66%, 98.97%, and 98.68%, respectively. The proposed method achieved the best performance compared with the other four deep-learning-based segmentation methods (including SegNet, FCN, PSPNet, and DeepLab v3+). There were also similar results on the HIT-tongue dataset. The experimental results demonstrated that the proposed method can achieve accurate tongue image segmentation and meet the practical requirements of automated tongue diagnoses.
Characterization of Local Nano‐Heat Transfer Fluids for Solar Thermal Collection
Authors: Millien Kawira
Published: August 2020

Performance of organic oils in solar thermal collection is limited due to their low thermal conductivity when they are compared to molten salt solutions. Extraction of organic oils from plants can be locally achieved. The purpose of this study was to investigate the effect of use of copper nanoparticles in some base local heat transfer fluids (HTFs). Addition of volume fraction of 1.2% of the copper nanoparticles to oil‐based heat transfer fluids improved their thermal conductivity as deduced from the thermal heat they conducted from solar radiation. The oil‐based copper nanofluids were obtained by preparation of a colloidal solution of the nanoparticles. Impurities were added to increase the boiling point of the nano‐heat transfer fluids. Stabilizers were used to keep the particles suspended in the oil‐based fluids. The power output of the oil‐based copper nano‐heat transfer fluids was in the range of 475.4 W to 1130 W. The heat capacity of the steam in the heat exchanger was 93.7% dry and had a thermal capacity of 5.71 × 103 kJ. The heat rate of flow of the oil‐based copper nano‐heat transfer fluids was an average of 72.7 Js−1·kg−1 to 89.1 Js−1·kg−1. The thermal efficiency for the oil‐based copper nano‐heat transfer fluids ranged from 0.85 to 0.91. The average solar thermal solar intensity was in the range 700 Wm−2 to 1180 Wm−2. The heat exchanger used in this study was operating at 4.15 × 103 kJ and a temperature of 500.0°C. The heat transfer fluids entered the exchanger at an average temperature of 381°C and exited at 96.3°C and their heat coefficient ranged between 290.1 Wm−2°C and 254.1 Wm−2°C. The average temperatures of operation ranged between 394.1°C and 219.7°C with respective temperature efficiencies ranging between 93.4% and 64.4%. It was established that utilization of copper nanoparticles to enhance heat transfer in oil‐based local heat transfer fluids can mitigate energy demand for meeting the world’s increasing energy uses, especially for areas inaccessible due to poor land terrain.
Automatic Quantification Software for Geographic Atrophy Associated with Age-Related Macular Degeneration: A Validation Study
Authors: Ruiz-Moreno José M. , Ruiz-Medrano Jorge , Lugo Francisco , Sirvent Belen , Flores-Moreno Ignacio
Published: August 2020

Context. Geographic atrophy (GA) is usually measured manually using fundus autofluorescence (FAF) images, lacking a reliable, automatic method to do so. Aims. To determine the accuracy and repeatability of new software to automatically quantify GA areas associated to age-related macular degeneration (AMD) by swept-source optical coherence tomography (SS-OCT). Settings and Design. Tertiary referral hospital in Spain. Cross-sectional and noninterventional. Methods and Material. Forty-six eyes from 33 AMD patients with GA, without previous choroidal neovascularization, were scanned using a SS-OCT (Topcon Corporation, Japan), including three consecutive 7 × 7 mm OCT scans. Three independent masked observers manually measured the GA area using FAF images. These measures were compared to the three automatic determinations of the GA. Lesions were classified according to their morphology and number as regular/irregular and single/multiple. Statistical Analysis Used. Intraclass correlation coefficients (ICCs) were estimated to study the agreement between the three physicians in manual measurements. ICC through a two-way mixed effects model was used for the software measures, and Lin’s concordance correlation coefficient (CCC) was used to analyse the agreement between the physicians and the software. Results. The mean age was 76.3 ± 11.7 years. Eighteen cases showed regular lesions, and 30 showed single lesions. The CCC between manual and automatic measures was 0.95 for the whole sample. The CCC for the area according to the lesion type was 0.92 and 0.97; it was 0.99 for single lesions and 0.89 for multiple lesions. The ICC between the three physicians was 0.94 for the whole sample and 0.88 in multiple lesions. The ICC between the three automatic measures for the area was 0.98 for the whole sample, regular or irregular lesions, and single or multiple lesions. Conclusions. The accuracy of this new software is substantial for the area with a high degree of repeatability agreement, being very precise in single lesions.
A Simplified Hypervolume-Based Evolutionary Algorithm for Many-Objective Optimization
Authors: Ji Hong , Dai Cai
Published: August 2020

Evolutionary algorithms based on hypervolume have demonstrated good performance for solving many-objective optimization problems. However, hypervolume needs prohibitively expensive computational effort. This paper proposes a simplified hypervolume calculation method which can be used to roughly evaluate the convergence and diversity of solutions. The main idea is to use the nearest neighbors of a particular solution to calculate the volume as the solution’s hypervolume value. Moreover, this paper improves the selection operator and the update strategy of external population according to the simplified hypervolume. Then, the proposed algorithm (SHEA) is compared with some state-of-the-art algorithms on fifteen test functions of CEC2018 MaOP competition, and the experimental results prove the feasibility of the proposed algorithm.
Semianalytical Model for Flow Behavior Analysis of Unconventional Reservoirs with Complex Fracture Distribution
Authors: Shi Dayou , Lu Zhengyuan
Published: August 2020

The secondary fracture spacing/aperture has a great influence on flow behavior of multifractured horizontal wells. In this paper, the effects of secondary fracture spacing/aperture distribution on porosity/permeability of the stimulated reservoir volume are described. A new fractal composite flow model was proposed, which can comprehensively characterize the secondary fracture spacing/aperture heterogeneity in the stimulated reservoir volume. Results showed that the larger the fractal dimension of the secondary fracture aperture is, the greater the dimensionless flow rate will be. The smaller the fractal dimension of the secondary fracture spacing is, the smaller the dimensionless flow rate will be. The secondary fracture spacing distribution had a greater influence on flow behavior than the secondary fracture aperture distribution. If the heterogeneity of the secondary fracture spacing or aperture is not considered, the bottomhole pressure and production curve will change greatly. At last, the proposed model was applied to match the production data of two actual fields.
Laparoscopic and Robotic-Assisted Partial Nephrectomy: An Overview of Hot Issues
Authors: Li Ming , Cheng Liang , Zhang Hongxian , Ma Lulin , Wang Ying , Niu Wanting , Liu Zeqi , Song Yan , Liang Peihe , Zhao Guoan , Wu Bin , Song Yongsheng , Bu Renge
Published: August 2020

Laparoscopic partial nephrectomy and robot-assisted partial nephrectomy are attracting increased attention from urologists. They can achieve the same effect of oncology control as radical nephrectomy; moreover, they can offer better preservation of renal function, thus obtaining long-term living benefits. The indications are also expanding, making it possible for larger and more difficult tumors. Laparoscopic partial nephrectomy and robot-assisted partial nephrectomy can be performed by transperitoneal and retroperitoneal approaches, with their individual advantages and limitations. In addition, the renal tumor scoring systems have been widely used and studied in laparoscopic partial nephrectomy and robot-assisted partial nephrectomy. In ­order to better preserve renal function, the zero-ischemia technique is widely used. The application of intraoperative imaging technology provides convenience and greater benefits. Besides, whether minimal invasive partial nephrectomy can be performed without stop antiplatelet treatment is still disputed. Clinicians perform substantial exploration and practice to achieve the “trifecta” of surgery: complete resection of the tumor, maximum protection of renal function, and no complications.
Anticoagulation Type and Early Recurrence in Cardioembolic Stroke
Authors: Yaghi Shadi , Mistry Eva , Liberman Ava L. , Giles James , Asad Syed Daniyal , Liu Angela , Nagy Muhammad , Kaushal Ashutosh , Azher Idrees , Mac Grory Brian , Fakhri Hiba , Brown Espaillat Kiersten , Pasupuleti Hemanth , Martin Heather , Tan Jose , Veerasamy Manivannan , Esenwa Charles , Cheng Natalie , Moncrieffe Khadean , Moeini-Naghani Iman , Siddu Mithilesh , Scher Erica , Trivedi Tushar , Lord Aaron , Furie Karen , Keyrouz Salah , Nouh Amre , Leon Guerrero Christopher R. , de Havenon Adam , Khan Muhib , Henninger Nils
Published: August 2020

Background and Purpose:

In patients with acute ischemic stroke and atrial fibrillation, treatment with low molecular weight heparin increases early hemorrhagic risk without reducing early recurrence, and there is limited data comparing warfarin to direct oral anticoagulant (DOAC) therapy. We aim to compare the effects of the treatments above on the risk of 90-day recurrent ischemic events and delayed symptomatic intracranial hemorrhage.

Methods:

We included consecutive patients with acute ischemic stroke and atrial fibrillation from the IAC (Initiation of Anticoagulation after Cardioembolic) stroke study pooling data from stroke registries of 8 comprehensive stroke centers across the United States. We compared recurrent ischemic events and delayed symptomatic intracranial hemorrhage between each of the following groups in separate Cox-regression analyses: (1) DOAC versus warfarin and (2) bridging with heparin/low molecular weight heparin versus no bridging, adjusting for pertinent confounders to test these associations.

Results:

We identified 1289 patients who met the bridging versus no bridging analysis inclusion criteria and 1251 patients who met the DOAC versus warfarin analysis inclusion criteria. In adjusted Cox-regression models, bridging (versus no bridging) treatment was associated with a high risk of delayed symptomatic intracranial hemorrhage (hazard ratio, 2.74 [95% CI, 1.01–7.42]) but a similar rate of recurrent ischemic events (hazard ratio, 1.23 [95% CI, 0.63–2.40]). Furthermore, DOAC (versus warfarin) treatment was associated with a lower risk of recurrent ischemic events (hazard ratio, 0.51 [95% CI, 0.29–0.87]) but not delayed symptomatic intracranial hemorrhage (hazard ratio, 0.57 [95% CI, 0.22–1.48]).

Conclusions:

Our study suggests that patients with ischemic stroke and atrial fibrillation would benefit from the initiation of a DOAC without bridging therapy. Due to our study limitations, these findings should be interpreted with caution pending confirmation from large prospective studies.
Navigating Increasing Levels of Relational Complexity: Perceptual, Analogical, and System Mappings
Authors: Kmiecik Matthew J. , Perez Rodolfo , Krawczyk Daniel C.
Published: August 2020

Relational thinking involves comparing abstract relationships between mental representations that vary in complexity; however, this complexity is rarely made explicit during everyday comparisons. This study explored how people naturally navigate relational complexity and interference using a novel relational match-to-sample (RMTS) task with both minimal and relationally directed instruction to observe changes in performance across three levels of relational complexity: perceptual, analogy, and system mappings. Individual working memory and relational abilities were examined to understand RMTS performance and susceptibility to interfering relational structures. Trials were presented without practice across four blocks, and participants received feedback after each attempt to guide learning. Experiment 1 instructed participants to select the target that best matched the sample, whereas Experiment 2 additionally directed participants' attention to same and different relations. Participants in Experiment 2 demonstrated improved performance when solving analogical mappings, suggesting that directing attention to relational characteristics affected behavior. Higher performing participants—those with above-chance performance on the final block of system mappings—solved more analogical RMTS problems and had greater visuospatial working memory, abstraction, verbal analogy, and scene analogy scores compared to lower performers. Lower performers were less dynamic in their performance across blocks and demonstrated negative relationships between analogy and system mapping accuracy, suggesting increased interference between these relational structures. Participant performance on RMTS problems did not change monotonically with relational complexity, suggesting that increases in relational complexity places nonlinear demands on working memory. We argue that competing relational information causes additional interference, especially in individuals with lower executive function abilities.
REALational Perspectives: Strategies for Expanding beyond the Here and Now in Mobile Augmented Reality (AR) Art
Authors: Efrat Liron
Published: August 2020

This article analyzes mobile AR installations in order to demonstrate different strategies for producing a relational sense of place and time. These installations combine multiple narratives in situ; thus, they reshape existing perceptions and influence national identities. By means of exposing actual environments as constructed and therefore as virtual landscapes, mobile AR art exposes our situatedness and becomes a strong tool for activism as it encourages us to think beyond familiar, material reality. As such, it rejects an absolute perception of reality and reconfigures it as a relational domain.
A Simple Trajectory Model for Climatological Study of Tropical Cyclones
Authors: Shan Kaiyue , Yu Xiping
Published: August 2020

The establishment of a tropical cyclone (TC) trajectory model that can represent the basic physics and is practically advantageous considering both accuracy and computational cost is essential to the climatological studies of various global TC activities. In this study, a simple deterministic model is proposed based on a newly developed semiempirical formula for the beta drift under known conditions of the environmental steering flow. To verify the proposed model, all historical TC tracks in the western North Pacific and the North Atlantic Ocean basins during the period 1979–2018 are simulated and statistically compared with the relevant results derived from observed data. The proposed model is shown to well capture the spatial distribution patterns of the TC occurrence frequency in the two ocean basins. Prevailing TC tracks as well as the latitudinal distribution of the landfall TC number in the western North Pacific Ocean basin are also shown to agree better with the results derived from observed data, as compared to the existing models that took different strategies to include the effect of the beta drift. It is then concluded that the present model is advantageous in terms of not only the accuracy but also the capacity to accommodate the varying climate. It is thus believed that the proposed TC trajectory model has the potential to be used for assessing possible impacts of climate change on tropical cyclone activities.
Work-related Transitions Following Hand Injury: Occupational Therapy Scoping Review
Authors: Uys Michelle Elizabeth , Van Niekerk Lana , Buchanan Helen
Published: August 2020

Background.

Occupational therapists who facilitate work-related transitions after hand injury require robust evidence to inform practice.

Purpose.

To identify the occupational therapist’s contribution to facilitate work-related transitions for persons with hand injuries and identify gaps in existing knowledge.

Method.

A systematic search was conducted from 2008 to 2018 to identify articles and doctoral theses published across 14 databases. Data was analysed descriptively.

Findings.

In total, 15 studies from 16 countries (14 high and 2 upper-middle income) were identified. Four strategies to facilitate work-related transitions were identified. Clear differences were evident across country groupings.

Implications.

The paucity of research limits evidence-based practice, especially in low- and middle-income countries, which indicates the need for further research.
Differential Effects of Social Support by Sexual Orientation: A Study of Depression Symptoms Among Older Canadians in the CLSA
Authors: Stinchcombe Arne , Hammond Nicole G. , Wilson Kimberley
Published: August 2020

This study examined differences in symptoms of mental illness, specifically depression, by sexual orientation and examined the protective role of social support among lesbian, gay, and bisexual (LGB) older Canadians. Data were drawn from the Canadian Longitudinal Study on Aging, a national study of adults aged 45–85 years at baseline ( n = 46,157). We examined whether the effect of sexual orientation on depression symptoms was moderated by four types of social support: emotional/informational support, affectionate support, tangible support, and positive social interaction. LGB identification was associated with increased depression symptoms relative to heterosexual participants. After adjustment for covariates, bisexual identity remained a significant predictor of depression symptoms. Low emotional/informational social support was associated with increased depression symptoms, an effect that was most pronounced for lesbian and gay participants. The findings contribute to the growing body of research on the mental health of older LGB people.
Numerical study of secondary mass flow modulation in a Bypass Dual-Throat Nozzle
Authors: Hamedi-Estakhrsar MH , Ferlauto M , Mahdavy-Moghaddam H
Published: August 2020

The fluidic thrust-vectoring modulation on a Bypass Dual-Throat Nozzle (BDTN) is studied numerically. The thrust vectoring modulation is obtained by varying the secondary mass flow, introducing different area contraction ratios of the bypass duct. The scope of present study is twofold: (i) to set up a model for the control of the secondary mass flow that is consistent with the resolution of the nozzle main flow and (ii) to derive a simplified representation of a valve system embedded in the bypass channel. The simulations of the turbulent airflow inside the BDTN and its efflux in the external ambient have been simulated by using RANS approach with RNG [Formula: see text] turbulence modeling. The numerical results have been validated with experimental and numerical data available in the open literature. The nozzle performance and thrust vector angle are computed for different values of the bypass area contraction ratio. The effects of different secondary mass flow rates on the system resultant thrust ratio and discharge coefficient of the bypass dual-throat nozzle have been investigated. By using the proposed approach to the secondary mass flow modulation, the thrust pitch angle has been controlled up to 27°.
Supporting Health Among Young Men Who Have Sex With Men and Transgender Women With HIV: Lessons Learned From Implementing the weCare Intervention
Authors: Tanner Amanda E. , Mann-Jackson Lilli , Song Eunyoung Y. , Alonzo Jorge , Schafer Katherine R. , Ware Samuella , Horridge Danielle N. , Garcia J. Manuel , Bell Jonathan , Hall Elias Arellano , Baker Logan S. , Rhodes Scott D.
Published: August 2020

Young gay, bisexual, and other men who have sex with men and transgender women with HIV, particularly those who are racial or ethnic minorities, often have poor health outcomes. They also utilize a wide array of social media. Accordingly, we developed and implemented weCare, an mHealth (mobile health) intervention where cyberhealth educators utilize established social media platforms (e.g., Facebook, texting, and GPS-based mobile applications [“apps”]) designed for social and sexual networking) to improve HIV-related care engagement and health outcomes. As part of the process evaluation of weCare, we conducted 32 interviews with intervention participants ( n = 18) and HIV clinic providers and staff ( n = 14). This article highlights three key intervention characteristics that promoted care engagement, including that weCare is (1) targeted (e.g., using existing social media platforms, similarity between intervention participants and cyberhealth educator, and implementation within a supportive clinical environment), (2) tailored (e.g., bidirectional messaging and trusting relationship between participants and cyberhealth educators to direct interactions), and (3) personalized (e.g., addressing unique care needs through messaging content and flexibility in engagement with intervention). In addition, interviewees’ recommendations for improving weCare focused on logistics, content, and the ways in which the intervention could be adapted to reach a larger audience. Quality improvement efforts to ensure that mHealth interventions are relevant for young gay, bisexual, and other men who have sex with men and transgender women are critical to ensure care engagement and support health outcomes.
Fetal circulating human resistin increases in diabetes during pregnancy and impairs placental mitochondrial biogenesis
Authors: Jiang Shaoning , Teague April M. , Tryggestad Jeanie B. , Lyons Timothy J. , Chernausek Steven D.
Published: August 2020

Background

Diabetes during pregnancy affects placental mitochondrial content and function, which has the potential to impact fetal development and the long-term health of offspring. Resistin is a peptide hormone originally discovered in mice as an adipocyte-derived factor that induced insulin resistance. In humans, resistin is primarily secreted by monocytes or macrophages. The regulation and roles of human resistin in diabetes during pregnancy remain unclear.

Methods

Fetal resistin levels were measured in cord blood from pregnancies with (n = 42) and without maternal diabetes (n = 81). Secretion of resistin from cord blood mononuclear cells (CBMCs) was measured. The actions of human resistin in mitochondrial biogenesis were determined in placental trophoblastic cells (BeWo cells) or human placental explant.

Results

Concentrations of human resistin in cord sera were higher in diabetic pregnancies (67 ng/ml) compared to healthy controls (50 ng/ml,P < 0.05), and correlated (r = 0.4,P = 0.002) with a measure of maternal glycemia (glucose concentration 2 h post challenge). Resistin mRNA was most abundant in cord blood mononuclear cells (CBMCs) compared with placenta and mesenchymal stem cells (MSCs). Secretion of resistin from cultured CBMCs was increased in response to high glucose (25 mM). Exposing BeWo cells or human placental explant to resistin decreased expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), mitochondrial abundance, and ATP production.

Conclusions

Resistin is increased in fetal circulation of infants exposed to the diabetic milieu, potentially reflecting a response of monocytes/macrophages to hyperglycemia and metabolic stresses associated with diabetes during pregnancy. Increased exposure to resistin may contribute to mitochondrial dysfunction and aberrant energy metabolism characteristic of offspring exposed to diabetes in utero.
Impact of delayed ventricular wall area ratio on pathophysiology of mechanical dyssynchrony: implication from single-ventricle physiology and 0D modeling
Authors: Hayama Yohsuke , Shimizu Shuji , Kawada Toru , Negishi Jun , Sakaguchi Heima , Miyazaki Aya , Ohuchi Hideo , Yamada Osamu , Kurosaki Kenichi , Sugimachi Masaru
Published: August 2020

Electrical disparity can induce inefficient cardiac performance, representing an uncoordinated wall motion at an earlier activated ventricular wall: an early shortening followed by a systolic rebound stretch. Although regional contractility and distensibility modulate this pathological motion, the effect of a morphological factor has not been emphasized. Our strain analysis in 62 patients with single ventricle revealed that those with an activation delay in 60–70% of ventricular wall area suffered from cardiac dysfunction and mechanical discoordination along with prolonged QRS duration. A computational simulation with a two-compartment ventricular model also suggested that the ventricle with an activation delay in 70% of the total volume was most vulnerable to a large activation delay, accompanied by an uncoordinated motion at an earlier activated wall. Taken together, the ratio of the delayed ventricular wall has a significant impact on the pathophysiology due to an activation delay, potentially highlighting an indicator of cardiac dysfunction.
Opening the door: midwives’ perceptions of two models of psychosocial assessment in pregnancy- a mixed methods study
Authors: Schmied. V. , Reilly N. , Black E. , Kingston D. , Talcevska. K. , Mule. V. , Austin M-P
Published: August 2020

Background

One in five women experience psychological distress in the perinatal period. To support women appropriately, Australian guidelines recommend routine depression screening and psychosocial risk assessment by midwives in pregnancy. However, there is some evidence that current screening processes results in higher rates of false positives. The Perinatal Integrated Psychosocial Assessment (PIPA) Project compared two models of psychosocial assessment and referral – Usual Care and the PIPA model – with a view to improving referral decisions. This paper describes midwives’ perspectives on psychosocial assessment, depression screening and referral at the antenatal booking appointment and compares midwives’ experiences with, and perspectives on, the two models of care under investigation.

Methods

A two-phase, convergent mixed methods design was used. Midwives providing antenatal care completed a self-report survey in phase one prior to implementation of the new model of psychosocial assessment (n = 26) and again in phase two, following implementation (n = 27). Sixteen midwives also participated in two focus groups in phase two. Quantitative and qualitative data were compared and integrated in the presentation of results and interpretation of findings.

Results

Midwives supported psychosocial assessment believing it was a catalyst for ‘Opening the door” to conversations with women. Midwives were comfortable asking the questions and tailored their approach to build rapport and trust. Overall. midwives expressed favourable views towards the PIPA model. A greater proportion of midwives relied mostly or entirely on the suggested wording for the psychosocial questions in the PIPA model compared to Usual Care (44.4% vs 12.0%,χ2=5.17,p=.023,φ=-.36). All midwives reported finding the referral or action message displayed at the end of the PIPA psychosocial assessment to be ‘somewhat’ or ‘very’ helpful, compared to 42.3% in Usual Care (χ2 = 18.36,p < .001,φ = −.64). Midwives were also more likely to act on or implement the message often or all of the time) in the PIPA model (PIPA = 69.2% vs Usual Care = 32.0%, (χ2 = 5.66,p < .017,φ = −.37).

Conclusion

The study identified benefits of the new model and can inform improvements in psychosocial screening, referral and related care processes within maternity settings. The study demonstrates that psychosocial assessment can, over time, become normalised and embedded in practice.
Role of complement factor B rs4151667 (L9H) polymorphisms and its interactional role with CFH Y402H and C3 rs2230199 (R102G) risk variants in age-related macular degeneration: a case control study
Authors: Roshanipour Nasrin , Laleh Maryam Ghaffari , Bonyadi Mortaza , Bonyadi Mohammad Hossein Jabbarpoor , Soheilian Masoud , Javadzadeh Alireza , Yaseri Mehdi
Published: August 2020

Background

Age-related Macular Degeneration (AMD) is a complex eye disease, which is genetically associated with different susceptibility loci. We planned to investigate the possible association of Complement Factor B (CFB) rs4151667 (L9H) variants and their possible interaction with Complement Factor H (CFH) Y402H and Complement factor 3 (C3) rs2230199 (R102G) in AMD.

Methods

This case-control association study included 216 advanced type AMD patients and 191 healthy individuals for evaluation. Extracted-DNA samples were genotyped for the polymorphic regions of CFB rs4151667 (L9H), CFH Y402H and C3 rs2230199 (R102G).

Results

The distribution of CFB rs4151667 (L9H) genotypes was not significantly different in the AMD patients compared to that of controls (P = 0.18). The AT genotype frequencies for CFB was non significantly lower in AMD group (6.5% vs. 13.1%, AOR = 0.49, CI = 0.23–1.04, P = 0.064(. The A allele of CFB rs4151667 (L9H) was found to be non-significantly lower in AMD patients. CFB rs4151667 (L9H) had no protective interactional effect against CFH (Y402H) and C3 (R102G) risk variants.

Conclusions

This study showed that the protective role of CFB rs4151667 (L9H) in AMD is not significant and it has no significant protective interactional effect against CFH (Y402H) and C3 (R102G) risk variants.
Breastfeeding patterns in cohort infants at a high-risk fetal, neonatal and child referral center in Brazil: a correspondence analysis
Authors: Silva Maíra Domingues Bernardes , Carvalhaes de Oliveira Raquel de Vasconcellos , Braga José Ueleres , de Almeida João Aprígio Guerra , Melo Enirtes Caetano Prates
Published: August 2020

Background

To investigate the prevalence and patterns of breastfeeding at discharge and in the first six months of life in a high-risk fetal, neonatal and child referral center.

Methods

Prospective, longitudinal study that included the following three steps: hospital admission, first visit after hospital discharge and monthly telephone interview until the sixth month of life. The total number of losses was 75 mothers (7.5%). Exposure variables were sorted into four groups: factors related to the newborn, the mother, the health service and breastfeeding. The dependent variable is breastfeeding as per categories established by the WHO. All 1200 children born or transferred to the high-risk fetal, neonatal and child referral center, within a seven-day postpartum period, from March 2017 to April 2018, were considered eligible for the study, and only 1003 were included. The follow-up period ended in October 2018. For this paper, we performed an exploratory analysis at hospital discharge in three stages, as follows: (i) frequencies of baseline characteristics, stratified by risk for newborn; (ii) a multiple correspondence analysis (MCA); and (iii) clusters for variables related to hospital practice and exclusive breastfeeding (EBF).

Results

The prevalence of EBF at hospital discharge was 65.2% (62.1–68.2) and 20.6% (16.5–25.0) in the six months of life. Out of all at-risk newborns, 45.7% were in EBF at discharge. The total inertia corresponding to the two dimensions in the MCA explained for 75.4% of the total data variability, with the identification of four groups, confirmed by the cluster analysis.

Discussion

Our results suggest that robust breastfeeding hospital policies and practices influence the establishment and maintenance of breastfeeding in both healthy and at-risk infants. It is advisable to plan and implement additional strategies to ensure that vulnerable and healthy newborns receive optimal feeding. It is necessary to devote extra effort particularly to at-risk infants who are more vulnerable to negative outcomes.

Conclusion

At-risk newborns did not exclusively breastfeed to the same extent as healthy newborns at hospital discharge. A different approach is required for at-risk neonates, who are more physically challenged and more vulnerable to problems associated with initiation and maintenance of breastfeeding.
An exploration of evidence-based practice work files for occupational therapy students during clinical placements: a descriptive cross-sectional study
Authors: Johnson Susanne Grødem , Bruset Else Britt , Hjelle Kari Margrete , Mongs Malin , Sveen Unni
Published: August 2020

Background

Bachelor students of occupational therapy are expected to work in accordance with evidence-based practice (EBP). The EBP work file, a learning tool in a Word document format, covering all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine the attitudes and behaviours of occupational therapy students’ in relation to applying evidence-based practice during their second-year clinical placement. We compared cohorts who received training in EBP work files with those who did not receive such training.

Methods

A descriptive, cross-sectional comparative study was conducted. Five cohorts of second-year occupational therapy students took part in the study. The students answered two questionnaires, the EBP Beliefs Scale and the EBP Implementation Scale, after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, mean and standard deviations of all participating students’ scores across both questionnaires. ANOVA with Bonferroni correction was conducted to analyse the differences between the mean totals of the questionnaires.

Results

In this study, 126 occupational therapy students participated (response rate = 57.3%). The students reacted positively to EBP, although few were practicing EBP. The students believed that EBP resulted in the best clinical care for patients, but they lacked confidence in their own ability to apply EBP. The students in Cohort 5, who received extra instruction and assignments via the EBP work file, rated their EBP behaviour statistically lower than the students in Cohort 1, who did not receive extra training on the EBP work file.

Conclusions

Additional EBP work file assignments were insufficient in terms of supporting students in the implementation of EBP during clinical placements. It is, therefore, important to facilitate the learning strategies of EBP skills and demonstrate how students can practise this competency during clinical placements. Including clinical instructors in EBP teaching and learning seems essential.
Development and evaluation of an evidence-based medicine module in the undergraduate medical curriculum
Authors: Al Shahrani Abeer Salem
Published: August 2020

Background

Evidence-based medicine (EBM) is a core competence in both undergraduate and postgraduate medical curricula. However, its integration into curricula varies widely. Our study will help medical colleges develop, implement and evaluate their EBM courses. We assessed the effectiveness of workshops in improving critical appraisal skills among medical students.

Methods

A before-and-after study design without a control group was used. A 5-week short EBM module including lectures, workshops, and online search sessions was conducted with 52 fourth-year medical students during their primary healthcare course at the College of Medicine, Princess Nourah bint Abdulrahman University. Statistical analysis was performed using SPSS statistical software (version 20, SPSS Inc., Chicago, US). Parametric tests as well as Student’s paired t-test for pre- and post-test comparisons were used.

Results

Forty-nine (49) participants completed the pre- and post-training Fresno tests, and 44.9% of the participants had a GPA of 4.0 or higher. The mean Fresno test score increased from 45.63 (SD 21.89) on the pre-test to 64.49 (SD 33.31) on the post-test, with significant improvements in the following items: search strategies, relevance, internal validity, magnitude and significance of results, statistical values of diagnosis studies (sensitivity, specificity, and LR), statistical values of therapy studies (ARR, RRR, and NNT), and best study design for diagnosis and prognosis (P < 0.05).

Conclusion

This study supports that a short course in EBM that is incorporated into the undergraduate curriculum, especially in the clinical years, might be effective in improving medical students’ knowledge and skills in EBM. However, prospective studies are necessary to assess the long-term impact of these interventions and ultimately their effectiveness for clinical decision making.
Longitudinal analysis of subtype C envelope tropism for memory CD4+ T cell subsets over the first 3 years of untreated HIV-1 infection
Authors: Gartner Matthew J. , Gorry Paul R. , Tumpach Carolin , Zhou Jingling , Dantanarayana Ashanti , Chang J. Judy , Angelovich Thomas A. , Ellenberg Paula , Laumaea Annemarie E. , Nonyane Molati , Moore Penny L. , Lewin Sharon R. , Churchill Melissa J. , Flynn Jacqueline K. , Roche Michael
Published: August 2020

Background

HIV-1 infects a wide range of CD4+T cells with different phenotypic properties and differing expression levels of entry coreceptors. We sought to determine the viral tropism of subtype C (C-HIV) Envelope (Env) clones for different CD4+T cell subsets and whether tropism changes during acute to chronic disease progression. HIV-1envswere amplified from the plasma of five C-HIV infected women from three untreated time points; less than 2 months, 1-year and 3-years post-infection. Pseudoviruses were generated from Env clones, phenotyped for coreceptor usage and CD4+T cell subset tropism was measured by flow cytometry.

Results

A total of 50 C-HIVenvswere cloned and screened for functionality in pseudovirus infection assays. Phylogenetic and variable region characteristic analysis demonstrated evolution inenvsbetween time points. We found 45 pseudoviruses were functional and all used CCR5 to mediate entry into NP2/CD4/CCR5 cells. In vitro infection assays showed transitional memory (TM) and effector memory (EM) CD4+T cells were more frequently infected (median: 46% and 25% of total infected CD4+T cells respectively) than naïve, stem cell memory, central memory and terminally differentiated cells. This was not due to these subsets contributing a higher proportion of the CD4+T cell pool, rather these subsets were more susceptible to infection (median: 5.38% EM and 2.15% TM cells infected), consistent with heightened CCR5 expression on EM and TM cells. No inter- or intra-participant changes in CD4+T cell subset tropism were observed across the three-time points.

Conclusions

CD4+T cell subsets that express more CCR5 were more susceptible to infection with C-HIV Envs, suggesting that these may be the major cellular targets during the first 3 years of infection. Moreover, we found that viral tropism for different CD4+T cell subsets in vitro did not change between Envs cloned from acute to chronic disease stages. Finally, central memory, naïve and stem cell memory CD4+T cell subsets were susceptible to infection, albeit inefficiently by Envs from all time-points, suggesting that direct infection of these cells may help establish the latent reservoir early in infection.