bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Pressure Gain and Turbine Inlet Conditions in a Pulse Combustion Gas Turbine
Authors: Sakurai Takashi , Sekiguchi Takehiro , Inoue Sora
Published: October 2022

This study investigates the pressure gain and its improvement on the gas turbine performance. The combustor is comprised from two combustion chambers. One chamber A conducts pulse combustion and the other chamber B conducts continuous, constant-pressure combustion. The burned gases of each chamber are mixed and enter the turbine. The detail time variation of chamber pressure as well as turbine inlet and compressor outlet under the pulse combustion mode were experimentally investigated. The pulse combustion in the chamber A generated the pressure wave that propagated not only downstream to the turbine inlet but also chamber upstream. This pressure wave stagnated the gas flow from the compressor in the chamber A. The gas flow velocities at the chamber inlet and outlet of chamber A were measured. The results showed the large velocity variation in one cycle under the pulse combustion mode. Based on the velocity, the cycle-averaged pressures in the chamber A were evaluated by mass-averaging method. The estimated cycle-averaged pressure ratio became 1.067 means that a pressure gain of 6.7% was obtained in the chamber A. Although the hydrogen fuel mass flow rate in the pulse combustion mode was larger than that in the normal combustion mode, the apparent higher value of specific output power in the pulse combustion mode than in the normal combustion mode demonstrated the feature of pressure-gain combustion.
The STEP 10 MWe sCO2 Pilot Demonstration Status Update
Authors: Marion John , Macadam Scott , McClung Aaron , Mortzheim Jason
Published: October 2022

The Gas Technology Institute (GTI®), Southwest Research Institute® (SwRI®) and General Electric Global Research (GE-GR) are executing the Supercritical Transformational Electric Power, “STEP” project, to design, construct, commission, and operate an integrated and reconfigurable 10 MWe sCO2 [supercritical CO2] Pilot Plant Test Facility. The $156* million project is funded $115 million by the US DOE’s National Energy Technology Laboratory (NETL Award Number DE-FE0028979) and $41* million by the team members, component suppliers, and Joint Industry Program (JIP) members. The facility is currently under final assembly and is located at SwRI’s San Antonio, Texas, USA campus. This project is a significant step toward sCO2 cycle based power generation commercialization and is informing the performance, operability, and scale-up to commercial plants.

Significant progress has been made on this STEP project. The design phase is complete (Phase 1) and included procurements of long-lead time delivery components. Now well into Phase 2, a ground-breaking was held in 2018, and civil work and the construction of a dedicated 22,000 ft2 building was completed in 2020. Most major equipment is in final fabrication or delivered to site as of the end of 2021. These efforts have already provided valuable project learnings for technology commercialization. At time of paper writing most equipment has been received and installed, and commissioning will begin in the first half of 2022. An update on commissioning and experience with sCO2 equipment is given here-in.
Contribution to the knowledge of the oribatid mite genus Megalotocepheus (Acari, Oribatida, Otocepheidae) with a new species from China
Authors: Zheng Li-Hao , Chen Jun
Published: October 2022

A new species of Megalotocepheus from China, Megalotocepheus (Archegotocepheus) octocapillus sp. nov., is found and described based on adult material collected from Southwest China. It can be distinguished from other known species of Megalotocepheus by combination of following characters: eight pairs of notogastral setae, short and rounded sternal apodeme, a pair of arcuate marginalis laterally in upper parts of subcapitulum, lyrifissure ip located between p1 and p2, leg setae pv” on tarsi III–IV and v” on tibia III–IV pinniform. Meanwhile, Megalotocepheus (Archegotocepheus) singularis Mahunka, 1988 is reported in China for the first time. Neotypes of Megalotocepheus (Megalotocepheus) fornicatus Wen, 1999 and Megalotocepheus (Megalotocepheus) hainanensis Wen & Zhao, 1993 were designated, and supplementary descriptions of M. (M.) fornicatus and M. (M.) hainanensis are given. Megalotocepheus (M.) tianshanicus (Krivolutsky, 1969) is transferred to the genus Fissicepheus, M. (M.) ceylonicus Balogh, 1970 and M. (M.) loksai Balogh, 1970 are transferred to the genus Otocepheus. A key to the known taxa of Megalotocepheus is provided.
Exploring Determinants of Exercise-Related Affective Valence in Regular Exercisers Between the Ages of 55 and 69 Years
Authors: Smith-Ricketts Jessica , Beaumont Cory T. , Fleming Jessica K. , Hornbuckle Lyndsey M. , Strohacker Kelley
Published: October 2022

This study aimed to understand determinants of recalled in-task affective valence experienced during a regularly performed aerobic bout in adult exercisers aged 55+. Qualitative data were collected (January to March, 2021, during the COVID-19 pandemic) using interviews wherein individuals (N = 16, 69% women, 61 ± 5 years) recalled deviations in affective valence in response to a regularly completed bout. Using thematic analyses, two themes emerged regarding how COVID-19 impacted regular exercise behaviors: (a) “loss” and (b) “adaptation.” Two themes encompassed the determinants of recalled in-task affective valence: (a) “person-specific conditions” and (b) “external conditions.” Finally, an increase in duration/intensity during a pleasant session was indicated by 44% of the participants, while 75% indicated a decrease in duration/intensity during an unpleasant session. The participants indicated that affective valence was determined by previously cited and novel factors that relate to exercise performed in naturalistic environments. Volitional modifications to planned exercise volume appear more responsive to feelings of displeasure.
Physical Education Curricular Elements in Blended Learning During the COVID-19 Pandemic
Authors: Gil-Espinosa Francisco Javier , López-Fernández Iván , Espejo Rubén , Burgueño Rafael
Published: October 2022

Purpose: To describe the curricular elements in blended physical education (PE) during the COVID-19 pandemic. Method: A survey of PE teachers was conducted regarding curricular elements related to content blocks, instruction, and assessment. A total of 174 Spanish secondary PE teachers (120 men and 54 women) participated in the survey. Results: For the nonface-to-face part, instruction relied mainly on challenge-based learning as an instructional strategy, the learning of the designed individual program as a teaching–learning style, health-based PE as a pedagogical model, and self-assessment as the most used assessment form. Discussion/Conclusion: The study describes an overview of the characteristics of the curricular elements used in the blended learning PE model in secondary education. Both the age of PE teachers and the socioeconomic level of the families are variables to consider.
Identification and characterization of circulating immune complexes in IgA nephropathy
Authors: Matsumoto Yasuyuki , Aryal Rajindra P. , Heimburg-Molinaro Jamie , Park Simon S. , Wever Walter J. , Lehoux Sylvain , Stavenhagen Kathrin , van Wijk Joanna A. E. , Van Die Irma , Chapman Arlene B. , Chaikof Elliot L. , Cummings Richard D.
Published: October 2022

The underlying pathology of immunoglobulin A (IgA) nephropathy (IgAN), the most common glomerulonephritis worldwide, is driven by the deposition of immune complexes containing galactose-deficient IgA1 [Tn(+)IgA1] in the glomerular mesangium. Here, we report that novel anti-Tn circulating immune complexes (anti-Tn CICs) contain predominantly IgM, representing large macromolecular complexes of ~1.2 megadaltons to several megadalton sizes together with Tn(+)IgA1 and some IgG. These complexes are significantly elevated in sera of patients with IgAN, which contains higher levels of complement C3, compared to healthy individuals. Anti-Tn CICs are bioactive and induce specific proliferation of human renal mesangial cells. We found that these anti-Tn CICs can be dissociated with small glycomimetic compounds, which mimic the Tn antigen of Tn(+)IgA1, releasing IgA1 from anti-Tn CICs. This glycomimetic compound can also significantly inhibit the proliferative activity of anti-Tn CICs of patients with IgAN. These findings could enhance both the diagnosis of IgAN and its treatment, as specific drug treatments are now unavailable.
ATR-mediated DNA damage responses underlie aberrant B cell activity in systemic lupus erythematosus
Authors: Manolakou Theodora , Nikolopoulos Dionysis , Gkikas Dimitrios , Filia Anastasia , Samiotaki Martina , Stamatakis George , Fanouriakis Antonis , Politis Panagiotis , Banos Aggelos , Alissafi Themis , Verginis Panayotis , Boumpas Dimitrios T.
Published: October 2022

B cells orchestrate autoimmune responses in patients with systemic lupus erythematosus (SLE), but broad-based B cell–directed therapies show only modest efficacy while blunting humoral immune responses to vaccines and inducing immunosuppression. Development of more effective therapies targeting pathogenic clones is a currently unmet need. Here, we demonstrate enhanced activation of the ATR/Chk1 pathway of the DNA damage response (DDR) in B cells of patients with active SLE disease. Treatment of B cells with type I IFN, a key driver of immunity in SLE, induced expression of ATR via binding of interferon regulatory factor 1 to its gene promoter. Pharmacologic targeting of ATR in B cells, via a specific inhibitor (VE-822), attenuated their immunogenic profile, including proinflammatory cytokine secretion, plasmablast formation, and antibody production. Together, these findings identify the ATR-mediated DDR axis as the orchestrator of the type I IFN–mediated B cell responses in SLE and as a potential novel therapeutic target.
Globally unequal effect of extreme heat on economic growth
Authors: Callahan Christopher W. , Mankin Justin S.
Published: October 2022

Increased extreme heat is among the clearest impacts of global warming, but the economic effects of heat waves are poorly understood. Using subnational economic data, extreme heat metrics measuring the temperature of the hottest several days in each year, and an ensemble of climate models, we quantify the effect of extreme heat intensity on economic growth globally. We find that human-caused increases in heat waves have depressed economic output most in the poor tropical regions least culpable for warming. Cumulative 1992–2013 losses from anthropogenic extreme heat likely fall between $16 trillion and $50 trillion globally. Losses amount to 8% of Gross Domestic Product per capita per year for regions in the bottom income decile, but only 3.5% for regions in the top income decile. Our results have the potential to inform adaptation investments and demonstrate how global inequality is both a cause and consequence of the unequal burden of climate change.
A curious case of metastatic parotid adenoid cystic carcinoma to kidney
Authors: Ho Ning Xuan , O’Meara Sorcha , Moran Tom , McGuire Barry
Published: October 2022

A woman in her 60s presented with a 2-week history of non-specific left-sided abdominal pain. She previously underwent a total parotidectomy and adjuvant radiotherapy for left parotid adenoid cystic carcinoma 13 years prior, with a local recurrence 4 years after. Investigations revealed a large left-sided renal mass with appearances of renal carcinoma and no signs of metastatic disease. Pathology following nephrectomy revealed a metastatic adenoid cystic carcinoma.

Metastatic disease recurred 11 months postradical nephrectomy to the contralateral kidney and lung, and she was referred to medical oncology for further management.

This case history demonstrates the highly aggressive nature of an adenoid cystic carcinoma primary of salivary gland origin with rare metastasis to the kidney.
MRI-negative myelitis associated with cerebral venous thrombosis after COVID-19 infection
Authors: Masaad Dea , Youssef Shaza , Safadi Mhd Firas , Shehadeh Agha Mohamad
Published: October 2022

Transverse myelitis and cerebral venous thrombosis represent some of the described neurological complications of coronavirus disease. A woman in her early 30s presented with headache, left-sided sensory symptoms and voiding difficulty. The patient also reported dry cough, fever, nasal congestion, anosmia and ageusia 2 weeks before presentation. The clinical examination showed sensory disturbances on the left side of the body, starting from the lower abdomen and extending to the left leg, which was consistent with transverse myelitis. The laboratory assessment confirmed a previous infection with coronavirus disease and excluded autoimmune entities. Radiological investigations revealed left transverse sinus thrombosis with no spinal cord abnormalities. The treatment was started with therapeutic anticoagulation and intravenous high-dose steroids. The patient showed significant improvement, and the neurological deficits resolved after 3 months. This is the first documented case of imaging-negative myelitis associated with cerebral venous thrombosis after coronavirus disease.
Sterile endogenous panophthalmitis with uncontrolled diabetes
Authors: Azzopardi Matthew , Ng Benjamin , Chong Yu Jeat
Published: October 2022

A female patient with type 2 diabetes in her 50s presented to casualty with a 1-day history of red, painful right eye. Visual acuity (VA) bilaterally was 6/12, but a right anterior uveitis was noted, with hazy fundal view. She was discharged on topical steroid and mydriatic drops with a 2-day follow-up. VA remained unchanged, but she developed right proptosis, restricted eye movements, lid swelling, relative afferent pupillary defect and an intraocular pressure (IOP) of 39 mm Hg. She was admitted and treated with intravenous and intravitreal antibiotics, intravenous antifungals and IOP-lowering drugs. Blood tests showed raised inflammatory markers and an HbA1c of 127 mmol/mol. Over her admission, right eye vision deteriorated to no light perception. A B-scan ultrasound revealed panophthalmitis and a retinal abscess. All investigations looking for a source were negative. Inflammatory markers settled, but despite aggressive treatment, the panophthalmitis did not improve. She was discharged with a follow-up to consider enucleation.
Comparative analysis of all-terrain vehicles, motorcycle and automobile-related trauma in a rural border community of the USA
Authors: Elzaim Haissam S , Vatcheva Kristina , Torres-Reveron Annelyn , Pequeno Gregery , Betancourt-Garcia Monica M
Published: October 2022

Introduction

There is widespread use of all-terrain vehicles (ATVs) in the USA for both work-related and recreational activities. In this study, we aimed to determine the difference in injury severity, Glasgow Coma scales and length of stay between ATV-related injuries and injuries sustained from motorcycles (MOTOs) and automobiles (AUTOs).

Methods

We retrospectively analysed ATV, MOTO and AUTO injuries from a Level 2 Trauma Center between 01 January 2015 and 31 August 2020. Proportional odds regression analyses, as well as multivariable regression models, were used to analyse the data.

Results

There were significantly more male and paediatric patients that suffered ATV-related injuries compared with MOTO or AUTO injuries. Victims of ATV-related injuries were also more likely to have open fractures. Paediatric patients were less likely to sustain an injury from either AUTO or MOTO accidents compared with ATV accidents. Patients with no drug use during injury and those who used protective equipment such as seat belts and child seats were significantly associated with lower Injury Severity Scores and higher Glasgow Coma Scale scores, indicating less severe injuries.

Discussion

Paediatric patients are very likely to suffer sequela and long-term disability due to the severity of ATV-related injuries. Public awareness campaigns to educate our population, especially our youth, about the danger of ATV use are highly needed.
Recruitmentmanoeuvres during mechanical ventilation with sequential high-flow nasal oxygen after extubation to prevent postoperative pulmonary complications in patients undergone thoracic surgery: a protocol, prospective randomised controlled trial
Authors: Wang Zhen , Wang Bo , Xia Wenxi , Wang Peng , Liang Guopeng , Mei Jian Dong , Zhang Yong-Gang , Yan Kang
Published: October 2022

Introduction

The incidence of postoperative pulmonary complications (PPCs) following thoracic surgery is high, which increases the mortality rate, prolongs the length of hospital stay and increases medical costs. Some studies have confirmed that preoperative risk assessment, intraoperative anaesthesia methods and intraoperative mechanical ventilation strategies, including recruitment manoeuvres (RMs), can reduce the incidence of PPCs. Despite these improved strategies, the incidence of PPCs remains high. However, mechanical ventilation strategies have not been studied in the postoperative period.

Methods and analysis

We assume that RM during mechanical ventilation with sequential high-flow nasal oxygen therapy (HFNO) after extubation can maintain the opening of the postoperative alveoli and ultimately reduce the incidence of PPCs after thoracic surgery. We will include thoracic surgery patients and divide them into the RM with sequential HFNO group and the control group. They will be given RMs and sequential HFNO or be given conventional treatment. The sample size is 654 adult patients (327 per group) undergone thoracic surgery and presenting to the intensive care unit.

Ethics and dissemination

This study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (REC2019-730). It is expected that this study will lead to a randomised controlled trial. We assume that the findings will provide more evidence about PPCs and improve the management of patients undergone thoracic surgery.

Trial registration number

ChiCTR2100046356.
Effects of fun-seeking and external locus of control on smoking behaviour: a cross-sectional analysis on a cohort of working men in Singapore
Authors: Lee Kar Fye Alvin , Lee Eun Hee , Roberts Adam Charles , Car Josip , Soh Chee Kiong , Christopoulos Georgios
Published: October 2022

Objectives

We examined the combined effects of behavioural inhibition and behavioural activation, on one hand, and locus of control, on the other hand, on different categories of smoking behaviour (non-smoking, ex-smoking, occasional smoking, daily smoking).

Design

This study adopted a cross-sectional design. Participants completed questionnaires regarding demographics, smoking patterns, behavioural inhibition/behavioural activation systems and locus of control.

Setting

The study was conducted across four companies from the transportation, cooling plant and education sectors in Singapore.

Participants

Three hundred sixty-nine male working adults were included in the final sample.

Results

Corroborating previous research, a logistic regression model examining behavioural inhibition/behavioural activation systems revealed that the fun-seeking aspect of behavioural activation was a unique predictor in distinguishing non-smokers from daily smokers (OR=1.24, p=0.012). By contrast, in a separate model examining locus of control, external locus of control was found to be a unique predictor in distinguishing non-smokers from daily smokers (OR=1.13, p<0.001). In addition, a third model combining both behavioural inhibition/behavioural activation systems and locus of control found that only external locus of control remained a significant predictor (OR=1.12, p<0.001). Further analyses revealed a mediating effect of external locus of control on the relationship between fun-seeking and smoking behaviour. That is, the increase in the odds of daily smoking due to fun-seeking was explained by external locus of control (direct pathway OR=1.20, p=0.058; indirect pathway OR=1.04, p<0.050).

Conclusions

Overall, fun-seeking through its influence on external locus of control indirectly affects daily smoking behaviour, suggesting a more complex relationship than shown in previous research.
Framework to assess the quality of mHealth apps: a mixed-method international case study protocol
Authors: Tan Yong Yu , Woulfe Fionn , Chirambo Griphin Baxter , Henn Patrick , Cilliers Liezel , Fadahunsi Kayode Philip , Taylor-Robinson Simon D , O'Donoghue John
Published: October 2022

Introduction

Healthcare professionals (HCPs) often recommend their patients to use a specific mHealth app as part of health promotion, disease prevention and patient self-management. There has been a significant growth in the number of HCPs downloading and using mobile health (mHealth) apps. Most mHealth apps that are available in app stores employ a ‘star rating’ system. This is based on user feedback on an app, but is highly subjective. Thus, the identification of quality mHealth apps which are deemed fit for purpose can be a difficult task for HCPs. Currently, there is no unified, validated standard guidelines for assessment of mHealth apps for patient safety, which can be used by HCPs. The Modified Enlight Suite (MES) is a quality assessment framework designed to provide a means for HCPs to evaluate mHealth apps before they are recommended to patients. MES was adapted from the original Enlight Suite for international use through a Delphi method, followed by preliminary validation process among a population predominantly consisting of medical students. This study aims to evaluate the applicability and validity of the MES, by HCPs, in low, middle and high income country settings.

Methods and analysis

MES will be evaluated through a mixed-method study, consisting of qualitative (focus group) and quantitative (survey instruments) research, in three target countries: Malaŵi (low income), South Africa (middle income) and Ireland (high income). The focus groups will be conducted through Microsoft Teams (Microsoft, Redmond, Washington, USA) and surveys will be conducted online using Qualtrics (Qualtrics International, Seattle, Washington, USA). Participants will be recruited through the help of national representatives in Malawi (Mzuzu University), South Africa (University of Fort Hare) and Ireland (University College Cork) by email invitation. Data analysis for the focus group will be by the means of thematic analysis. Data analysis for the survey will use descriptive statistics and use Cronbach alpha as an indicator of internal consistency of the MES. The construct validity of the mHealth app will be assessed by computing the confirmatory factor analysis using Amos.

Ethics and dissemination

The study has received ethical approval from the Social Research Ethics Committee (SREC) SREC/SOM/03092021/1 at University College Cork, Ireland, Malaŵi Research Ethics Committee (MREC), Malaŵi MZUNIREC/DOR/21/59 and Inter-Faculty Research Ethics Committee (IFREC) of University of Fort Hare (REC-2 70 710-028-RA). The results of the study will be disseminated through the internet, peer-reviewed journals and conference presentations.
Accuracy of a self-report prescription opioid use diary for patients discharge from the emergency department with acute pain: a multicentre prospective cohort study
Authors: Daoust Raoul , Paquet Jean , Williamson David , Perry Jeffrey J , Iseppon Massimiliano , Castonguay Véronique , Morris Judy , Cournoyer Alexis
Published: October 2022

Objectives

Self-reported approaches that assess opioid usage can be subject to social desirability and recall biases that may underestimate actual pill consumption. Our objective was to determine the accuracy of patient self-reported opioid consumption using a 14-day daily paper or electronic diary.

Design

Prospective cohort study.

Setting

Multicentre study conducted in four Québec (Canada) emergency departments (ED): three university-affiliated centres, two of them Level I trauma centres and one urban community hospital.

Participants

ED patients aged ≥18 years with acute pain (≤2 weeks) who were discharged with an opioid prescription. Patients completed a 14-day daily diary (paper or electronic) assessing the quantity of opioids consumed. On diary completion, a random sample from the main cohort was selected for a follow-up visit to the hospital or a virtual video visit where they had to show and count the remaining pills. Patients were blinded to the main objective of the follow-up visit.

Outcomes

Quantity of opioid pills consumed during the 2-week follow-up period self-reported in the 14-day diary (paper or electronic) and calculated from remaining pills counted during the follow-up visit. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used to assess accuracy.

Results

A total of 166 participants completed the 14-day diary as well as the in-person or virtual visit; 49.4% were women and median age was 47 years (IQR=21). The self-reported consumed quantity of opioid in the 14-day diary and the one calculated from counting remaining opioid pills during the follow-up visit were very similar (ICC=0.992; 95% CI: 0.989 to 0.994). The mean difference between both measures from Bland-Altman analysis was almost zero (0.048 pills; 95% CI: −3.77 to 3.87).

Conclusion

Self-reported prescription opioid use in a 14-day diary is an accurate assessment of the quantity of opioids consumed in ED discharged patients.

Trial registration number

NCT03953534.
Association of meteorological factors with paediatric intussusception in Hangzhou: an 8-year retrospective cohort study
Authors: Feng Yuqing , Zhou Haichun , Shu Qiang , Li Haomin
Published: October 2022

Objectives

This study aimed to investigate the seasonality of paediatric intussusception and the associations between meteorological factors and paediatric intussusception in Hangzhou, as well as aimed to compare the variance in sex and disease type.

Design

An 8-year retrospective study was conducted from January 2014 to December 2021 in the Children’s Hospital of Zhejiang University, Hangzhou, China.

Setting

This was a single-centre retrospective study review of intussusception cases in a large Children’s Hospital in Hangzhou.

Participants

There were 17 674 patients with intussusception in this study.

Methods

A Spearman correlation analysis and Poisson regression analysis were used to determine the association between weekly intussusception cases and meteorological factors. The seasonality of paediatric intussusception was demonstrated via the t-test and visualised.

Result

In January, May and December, there were relatively more intussusception patients. In February, there was a trough in the number of intussusception patients. Both the Spearman correlation analysis and Poisson regression analysis proved that weekly intussusception cases had significant associations with temperature (λ=−0.205, p<0.01; β=−0.080, p<0.01), feels-like temperature (λ=−0.214, p<0.01; β=−0.012, p<0.01), dew (λ=−0.249, p<0.01; β=0.095, p<0.01), humidity (λ=−0.230, p<0.01; β=−0.037, p<0.01), precipitation (λ=−0.148, p<0.01; β=−0.001, p<0.01), windspeed (λ=−0.135, p<0.01; β=0.005, p<0.01), visibility (λ=−0.206, p<0.01; β=−0.066, p<0.01), sea level pressure (λ=0.171, p<0.01; β=−0.004, p<0.01) and a total of 20 of 25 dynamic meteorological factors (p<0.05). These associations reflected gender differences but showed stronger associations in groups that were prone to recurrence.

Conclusions

Paediatric intussusception in Hangzhou showed a seasonal tendency. Additionally, intussusception was significantly associated with certain meteorological factors in all of the cases. These findings suggest that parents and paediatricians should be more vigilant about the occurrence of intussusception in children regarding seasonal change times and climate change times.
Use of over-the-scope clip (OTSC) versus standard therapy for the prevention of rebleeding in large peptic ulcers (size ≥1.5 cm): an open-labelled, multicentre international randomised controlled trial
Authors: Chan Shannon , Pittayanon Rapat , Wang Hsiu-Po , Chen Jiann-Hwa , Teoh Anthony YB , Kuo Yu Ting , Tang Raymond SY , Yip Hon Chi , Ng Stephen Ka Kei , Wong Sunny , Mak Joyce Wing Yan , Chan Heyson , Lau Louis , Lui Rashid N , Wong Marc , Rerknimitr Rungsun , Ng Enders K , Chiu Philip Wai Yan
Published: October 2022

Introduction

Over-the-scope clip (OTSC) has been used recently for primary haemostasis of peptic ulcers. This study aimed to compare the efficacy of OTSC to standard endoscopic therapy in primary treatment of patients with peptic ulcer bleeding that are of size ≥1.5 cm. The target population accounts for only 2.5% of all upper GI bleeders.

Methods

This was a multicentre international randomised controlled trial from July 2017 to October 2020. All patients with Forest IIa or above peptic ulcers of ≥1.5 cm were included. Primary outcome was 30-day clinical rebleeding. Secondary endpoints include 3-day all-cause mortality, transfusion requirement, hospital stay, technical and clinical success, and further interventions. 100 patients are needed to yield a power of 80% to detect a difference of −0.15 at the 0.05 significance level (alpha) using a two-sided Z-test (pooled).

Results

100 patients were recruited. Success in achieving primary haemostasis was achieved in 46/50 (92%) and 48/50 (96%) in the OTSC and conventional arm, respectively. Among patients who had success in primary haemostasis, 2/46 (4.35%) patients in the OTSC arm and 9/48 (18.75%) patients in the conventional arm developed 30-day rebleeding (p=0.03). However, in an intention-to-treat analysis, there was no difference in rebleeding within 30 days (5/50 (10%) OTSC vs 9/50 (18%) standard, p=0.23) or all-cause mortality (2/50 (4%) OTSC vs 4/50 (8%) standard, p=0.68; OR=2.09, 95% CI 0.37 to 11.95). There was also no difference in transfusion requirement, hospital stay, intensive care unit admission and further interventions.

Conclusion

The routine use of OTSC as primary haemostasis in large bleeding peptic ulcers was not associated with a significant decrease in 30-day rebleeding.

Trial registration number

NCT03160911.
Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials
Authors: Juul Frederik Emil , Garborg Kjetil , Nesbakken Eugen , Løberg Magnus , Wieszczy Paulina , Cubiella Joaquín , Kalager Mette , Kaminski Michael F , Erichsen Rune , Adami Hans-Olov , Ferlitsch Monika , Furholm Siv K B , Zauber Ann G , Quintero Enrique , Bugajski Marek , Holme Øyvind , Dekker Evelien , Jover Rodrigo , Bretthauer Michael
Published: October 2022

Objective

High-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance.

Design

We retrieved data of all patients with low-risk adenomas (one or two tubular adenomas <10 mm with low-grade dysplasia) and high-risk adenomas (3–10 adenomas, ≥1 adenoma ≥10 mm, high-grade dysplasia or villous components) in the European Polyp Surveillance trials fulfilling certain logistic and methodologic criteria. We analysed variations in number of colonoscopies needed to achieve high-quality colonoscopy and enter polyp surveillance by endoscopy centre, and by endoscopists who enrolled ≥30 patients.

Results

The study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%).

Conclusion

There is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.

Trial registration number

NCT02319928.
Irritable bowel syndrome: treatment based on pathophysiology and biomarkers
Authors: Camilleri Michael , Boeckxstaens Guy
Published: October 2022

Objective

To appraise the evidence that pathophysiological mechanisms and individualised treatment directed at those mechanisms provide an alternative approach to the treatment of patients with irritable bowel syndrome (IBS).

Design

A PubMED-based literature review of mechanisms and treatment of IBS was conducted independently by the two authors, and any differences of perspective or interpretation of the literature were resolved following discussion.

Results

The availability of several noninvasive clinical tests can appraise the mechanisms responsible for symptom generation in IBS, including rectal evacuation disorders, abnormal transit, visceral hypersensitivity or hypervigilance, bile acid diarrhoea, sugar intolerances, barrier dysfunction, the microbiome, immune activation and chemicals released by the latter mechanism. The basic molecular mechanisms contributing to these pathophysiologies are increasingly recognised, offering opportunities to intervene with medications directed specifically to food components, receptors and potentially the microbiome. Although the evidence supporting interventions for each mechanism is not at the same level of proof, the current state-of-the-art provides the opportunity to advance the practice from treatment based on symptoms to individualisation of treatment guided by pathophysiology and clinically identified biomarkers.

Conclusion

These advances augur well for the implementation of evidence-based individualised treatment for patients with IBS based on actionable biomarkers or psychological disturbances.
Epidemiology of cruciate ligament reconstruction in the Australian Defence Force and predictors of outcome
Authors: Williams Olivia , Ross V R , Lau C L , Mayfield H J
Published: October 2022

Background

The ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning. This study describes the epidemiology of cruciate ligament reconstruction in the ADF and demonstrates the use of Bayesian networks (BN) to predict the likelihood of fitness for ongoing service under different scenarios.

Methods

Members who had knee cruciate ligament reconstruction through ADF were identified from billing data and matched to electronic medical records to extract demographic and clinical data. Outcome measure was medical fitness for ADF service up to 24 months after reconstruction. BN models were used to compare outcomes between (1) age groups according to military service, and (2) sexes according to body mass index (BMI).

Results

From November 2012 to June 2019, a total of 1199 individuals had knee cruciate ligament reconstruction (average 169 reconstructions/year). Following reconstruction and rehabilitation, 89 (7.4%) were medically unfit for service. Scenario analysis using a tree-augmented naïve BN model showed that, compared with Navy and Air Force, Army members had a higher probability of being unfit in those aged <35 years and a lower probability in those aged ≥35 years. In both sexes, those with obese BMI had the greatest probability of being unfit.

Conclusion

While most ADF members were fit for ongoing military service following cruciate ligament reconstruction, service type, age, sex and BMI influenced outcome. BNs provided an interactive and intuitive method to demonstrate the impact of different variables on the outcome.
Assessment of behavioral energetics model on Puma concolor using doubly labeled water
Authors: Barceló Gonzalo , Pauli Jonathan N. , Alldredge Mathew , Karasov William H.
Published: October 2022

The estimation of energy expenditure is key to resolve ecological questions and conservation strategies. The puma ( Puma concolor (Linnaeus, 1771)) has been the subject of several efforts to measure the daily energy expenditure (DEE). Most of the estimations have been made using movement or activity models that have been questioned because of discrepancies with kill rates. This study looks at one movement model estimation and validates it using doubly labeled water (DLW), which can also account for energy expenditures beyond those associated with activity. We captured six pumas (51.5 ± 9.9 (SD) kg) during the winter in Colorado that were GPS collared and injected with DLW for an approximately 3-week trial. We found that DEE obtained from the DLW (14.5 ± 6.1 MJ·day−1) did not differ from that estimated using the movement model or from the predicted allometric equation based on DLW studies on other mammals. Decreasing air temperature and increasing daily distance movement were correlated with increasing DEE for monitored pumas. Both DLW and movement models provide a reasonable proxy to estimate DEE at the population level but exhibit low precision in estimating individual values for free-ranging puma.
Stochastic resonance behavior of FitzHugh–Nagumo neurons induced by electromagnetic field driven by phase noise
Authors: Zheng Huan , Wu Kaijun , Li Tao
Published: October 2022

Noise widely exists in the nervous system, and plays an extremely important role in the information processing of the nervous system, which can enhance or weaken the ability of the nervous system to process information. Nerve cells exist in complex and changeable electromagnetic fields, and their potential changes are significantly regulated by electromagnetic induction. In response to this, first, a memristor is used to simulate the electromagnetic field environment where the nervous system is located, when using different weak periodic signals as the input of the neuron system, the rich stochastic resonance behavior of the FitzHugh–Nagumo neuron system is analyzed under the drive of phase noise. Second, taking the amplitude, period and intensity of phase noise as the main change parameters, and the changes of the parameters of the memristor and the period of the external signal as auxiliary conditions, the stochastic resonance dynamics analysis is carried out from three perspectives: the amplitude and period of phase noise, the amplitude and intensity of phase noise and the intensity and period of phase noise.
Some interesting aspects of modified Gauss–Bonnet gravity
Authors: Farasat Shamir M. , Saeed Atrooba
Published: October 2022

The main idea behind this paper is to study [Formula: see text] theory of gravity, where [Formula: see text] is Gauss–Bonnet (GB) term and [Formula: see text] is the scalar field. Scalar field has been introduced to explore gravitational interaction between geometry and scalar field. Field equations in Friedmann–Robertson–Walker (FRW) cosmology are constructed and found to be coherent with the existing literature. Exponential solutions are reconstructed. The coupling of the scalar field to the GB term leads to viable results. Further, we probe the oscillating universe in the said gravity model using linear trace term. Energy conditions are explored and graphically analyzed in detail to substantiate our work. Behavior of the Hubble and deceleration parameter is also examined. It is evident from the results that our model provides us with acceptable bouncing solutions for chosen parameters.
An analytical solution of Balitsky–Kovchegov equation using homotopy perturbation method
Authors: Saikia Ranjan , Phukan Pragyan , Sarma Jayanta Kumar
Published: October 2022

An approximate analytical solution of the Balitsky–Kovchegov (BK) equation using the homotopy perturbation method (HPM) is suggested in this work. We carried out our work in perturbative Quantum Chromodynamics (QCD) (pQCD) dipole picture of deep inelastic scattering (DIS). The BK equation in momentum space with some change of variables and truncation of the Balitsky–Fadin–Kuraev–Lipatov (BFKL) kernel can be reduced to Fisher–Kolmogorov–Petrovsky–Piscounov (FKPP) equation. The observed geometric scaling phenomena are similar to the travelling wave solution of the FKPP equation. We solved the BK equation using the HPM. The obtained solution in this work also suggests the travelling wave nature of the measured scattering amplitude [Formula: see text] plotted at various rapidities. We also extracted the saturation momentum, [Formula: see text], from the obtained solution and plotted it against different rapidities. The result obtained in this work can be helpful for various phenomenological studies in high-density QCD.
Spot size estimation of flat-top beams in space-based gravitational wave detectors
Authors: Hao Zhen-Xiang , Haase Tim , Jin Hong-Bo , Tao Ya-Zheng , Wanner Gudrun , Wu Ruo-Xi , Wu Yue-Liang
Published: October 2022

Motivated by the necessity of a high-quality stray light control in the detection of the gravitational waves in space, the spot size of a flat top beam generated by the clipping of the Gaussian beam (GB) is studied. By adopting the mode expansion method (MEM) approach to simulating the beam, a slight variant of the definition of the mean square deviation (MSD) spot size for the MEM beam is proposed. This enables us to quickly estimate the spot size for arbitrary propagation distances. Given that the degree of clipping is dependent on the power ratio within the surface of an optical element, the power ratio within the MSD spot range is used as a measure of spot size. The definition is then validated in the cases of simple astigmatic Gaussian beam and nearly-Gaussian beam profiles. As a representative example, the MSD spot size for a top-hat beam in a science interferometer in the detection of gravitational waves in space is then simulated. As in traditional MSD spot size analysis, the spot size is divergent when diffraction is taken into account. A careful error analysis is carried out on the divergence and in the present context, it is argued that this error will have little effect on our estimation. Using the results of our study allows an optimal design of optical systems with top-hat or other types of non-Gaussian beams. Furthermore, it allows testing the interferometry of space-based gravitational wave detectors for beam clipping in optical simulations. This work will serve as a useful guide in the future system design of the optical bench and the sizes of the optical components.
Generalized Rp-attractor cosmology in the Jordan and Einstein frames: New type of attractors and revisiting standard Jordan frame Rp inflation
Authors: Odintsov S. D. , Oikonomou V. K.
Published: October 2022

In this work, we study a new class of attractor models which we shall call generalized [Formula: see text]-attractor models. This class of models is based on a generalization of the Einstein frame potential of [Formula: see text] [Formula: see text] gravity models in the Jordan frame. We present the attractor properties of the corresponding nonminimally coupled Jordan frame theory, and we calculate the observational indices of inflation in the Einstein frame. As we show, there is a large class of nonminimally coupled scalar theories, with an arbitrary nonminimal coupling which satisfies certain conditions, that yield the same Einstein frame potential, this is why these models are characterized attractors. As we demonstrate, the generalized [Formula: see text]-attractor models are viable and well fitted within the Planck constraints. This includes the subclass of the generalized [Formula: see text]-attractor models, namely the Einstein frame potential of [Formula: see text] inflation in the Jordan frame, a feature also known in the literature. We also highlight an important issue related to the [Formula: see text] inflation in the Jordan frame, which is known to be nonviable. By conformal invariance, the [Formula: see text] inflation model should also be viable in the Jordan frame, which is not. We pinpoint the source of the problem using two different approaches in the [Formula: see text] gravity Jordan frame, and as we demonstrate, the problem arises in the literature due to some standard simplifications made for the sake of analyticity. We demonstrate the correct way to analyze [Formula: see text] inflation in the Jordan frame, using solely the slow-roll conditions.
Bohr Hamiltonian with inversely quadratic Yukawa plus screened Kratzer potential for triaxial nuclei
Authors: Etolo H. D. Yia , Ongodo D. Nga , Anemena E. , Likéné A. Atangana , Ben-Bolie G. H.
Published: October 2022

Bohr Hamiltonian with inversely quadratic Yukawa plus screened Kratzer potential for the [Formula: see text]-part and a harmonic oscillator for the [Formula: see text]-part is investigated. The expressions of energies and wave functions are obtained using the parametric Nikiforov–Uvarov method. The obtained results are used to evaluate the normalized eigen energies, the root mean square deviation and [Formula: see text] transition rates of [Formula: see text]Pt, [Formula: see text]Pt and [Formula: see text]Pt atomic nuclei. The numerical results of our model are compared to those of other relevant theoretical models and experimental data. Furthermore, to test the sensitive signature of triaxiality, we used some indicators such as the staggering effect in the [Formula: see text]-band. It appears that the results provided by our calculations are in accordance with experimental values and improved in comparison with previous models.