bluuebunny/crossref_metadata_2025 huggingface dataset:
Seizure detection based on heart rate variability using a wearable electrocardiography device
Authors: Jeppesen Jesper , Fuglsang‐Frederiksen Anders , Johansen Peter , Christensen Jakob , Wüstenhagen Stephan , Tankisi Hatice , Qerama Erisela , Hess Alexander , Beniczky Sándor
Published: September 2019

Objective

To assess the feasibility and accuracy of seizure detection based on heart rate variability (HRV) using a wearable electrocardiography (ECG) device. Noninvasive devices for detection of convulsive seizures (generalized tonic‐clonic and focal to bilateral tonic‐clonic seizures) have been validated in phase 2 and 3 studies. However, detection of nonconvulsive seizures still needs further research, since currently available methods have either low sensitivity or an extremely high false alarm rate (FAR).

Methods

In this phase 2 study, we prospectively recruited patients admitted to long‐term video–EEG monitoring (LTM). ECG was recorded using a dedicated wearable device. Seizures were automatically detected using HRV parameters computed off‐line, blinded to all other data. We compared the performance of 26 automated algorithms with the seizure time‐points marked by experts who reviewed the LTM recording. Patients were classified as responders if >66% of their seizures were detected.

Results

We recruited 100 consecutive patients and analyzed 126 seizures (108 nonconvulsive and 18 convulsive) from 43 patients who had seizures during monitoring. The best‐performing HRV algorithm combined a measure of sympathetic activity with a measure of how quickly HR changes occurred. The algorithm identified 53.5% of the patients with seizures as responders. Among responders, detection sensitivity was 93.1% (95% CI: 86.6%‐99.6%) for all seizures and 90.5% (95% CI: 77.4%‐97.3%) for nonconvulsive seizures. FAR was 1.0/24 h (0.11/night). Median seizure detection latency was 30 s. Typically, patients with prominent autonomic nervous system changes were responders: An ictal change of >50 heartbeats per minute predicted who would be responder with a positive predictive value of 87% and a negative predictive value of 90%.

Significance

The automated HRV algorithm, using ECG recorded with a wearable device, has high sensitivity for detecting seizures, including the nonconvulsive ones. FAR was low during the night. This approach is feasible in patients with prominent ictal autonomic changes.
Do bankers on the board reduce crash risk?
Authors: Kang Min Jung , Kim Y. Han (Andy) , Liao Qunfeng
Published: September 2019

Commercial banker‐directors (CBDs) bring both financial expertise in risk management and conflicts of interest between shareholders and debtholders. The burgeoning literature on stock price crash risk generates important questions of whether CBDs reduce crash risk. Using BoardEx data from 1999 to 2009, we find supporting evidence that the firms with CBDs experience lower stock price crash risk. Moreover, the reduction of crash risk is more pronounced for high‐risk firms under the monitoring of affiliated banker‐directors. The results of this study are robust to the Heckman selection model, propensity score matching, and alternative measures of crash risk.
Fatty acids and triacylglycerols in the seed oils of Saudi Arabian date (Phoenix dactylifera L.) palms
Authors: Lieb Veronika M. , Kleiber Caroline , Metwali Ehab M.R. , Kadasa Naif M.S. , Almaghrabi Omar A. , Steingass Christof B. , Carle Reinhold
Published: September 2019

Total lipids, fatty acids and triacylglycerols in seeds of the four Saudi Arabian date cultivars ‘Anbra’, ‘Megadwel’, ‘Sacai’ and ‘Sfwai’ were analysed. Total lipid contents ranged between 7.3 and 8.6%. Oleic, lauric and myristic acid represented the most abundant fatty acids in date seed oil. HPLC‐DAD‐ESI‐MSn analysis enabled the identification of 40 triacylglycerols with equivalent carbon number (ECN) 36–54, of which 17 were detected for the first time. Triacylglycerols mainly comprised LaOL, LaLaL, LaML, MML/LaPL and LaOO. ‘Anbra’ oil was characterised by highest proportions of saturated fatty acids and triacylglycerols with ECN 36 and 48–54. Unsaturated fatty acids prevailed in the three remaining varieties. Elevated proportions of triacylglycerols with medium ECNs were found in ‘Megadwel’ and ‘Sfwai’ oils. Aside from highest total lipid contents, ‘Sacai’ seeds predominantly contained triacylglycerols with low ECNs. Multivariate statistical analyses elucidated varietal influences on the fatty acid and triacylglycerol composition of date seed oil.
Cereal bars functionalised with tempeh: nutritional composition, isoflavone content and consumer acceptance
Authors: de Melo Priscila F. , Kalschne Daneysa L. , da Silva‐Buzanello Rosana A. , Amaral Joana S. , Torquato Alex S. , Corso Marinês P. , Falcão Heloisa G. , Colla Eliane , Ida Elza I. , Canan Cristiane
Published: September 2019

The aim of this study was to produce cereal bars (CB) added with tempeh flour (TF) and evaluate the nutritional composition, fatty acids profile, isoflavone content and sensory acceptance. Tempeh was produced from organic soya beans cotyledons fermented by Rhizophus oligosporus followed by freeze‐drying and milling in order to obtain the TF. The addition of 10%, 15% and 20% TF to CB resulted in both protein and lipid content increase and a higher polyunsaturated/saturated fatty acids ratio. The content of isoflavone aglycones, the forms considered to have higher biological activity, was higher in TF than in soya bean, which was also reflected in the CB chemical composition. An acceptance test showed that CB added with TF (up to 15%) were sensory accepted. Overall results suggest that the addition of TF as an ingredient in cereal bars allows improving the chemical and functional characteristics of this type of ready‐to‐eat foods.
Phytochemical profile of Silybum marianum (L.) Gaertn. and Graminis rhizoma and its influence on the bioactivity and shelf life of industrially produced pâté
Authors: Ferysiuk Karolina , Wójciak Karolina M. , Materska Małgorzata
Published: September 2019

The impact of the use of Silybum marianum and G. rhizoma plant powders on the nutritional value of cooked pâté was explored. Three concentrations (5%, 10% and 15%) for S. marianum and two (5% and 10%) for G. rhizoma were added. The phytochemical profile of plant extracts was analysed using HPLC. The pH value, water activity, TBARS, oxidation–reduction potential, total phenolic content, antioxidant capacity, instrumental colour and microbiology of cooked pâtés were determined after 1 and 21 days of storage. Basic chemical composition, dietary fibre, elemental and nitrites/nitrates content were determined, and sensory analysis was performed after product preparation. Phenolic contents and antioxidant activities of fortified patties strongly correlated with the lower level of ORP and TBARS values. The obtained results indicate that the addition of S. marianum at a concentration of 10% is most beneficial for sensory attributes, colour stabilisation and antioxidant capacity.
Fortification of carrot juice with a high‐pressure‐obtained pomegranate peel extract: chemical, safety and sensorial aspects
Authors: Trigo João P. , Alexandre Elisabete M. C. , Oliveira Ana , Saraiva Jorge A. , Pintado Manuela
Published: September 2019

High‐pressure extraction was used to produce pomegranate peel extract, later incorporated in carrot juice. Chemical, microbiological and sensorial analyses were performed during storage to untreated, high‐pressure and thermally processed juices incorporating pomegranate peel extract. Fortified juices showed lower counts for mesophiles and psychrophiles than the nonfortified ones (P < 0.05). Total phenolic and hydrolysable tannin contents, and antioxidant activity had superior values in supplemented juices during storage. The extract did not affect any sensorial parameter. On the 28th day, pressurised juices exhibited lower microbial loads in comparison with heated process, but phenolic compounds, antioxidant activity and several sensorial descriptors were identical between both processing technologies. The β‐ and α‐carotene content decreased after processing, and pressurised juices exhibited higher residual activity for peroxidase (P < 0.05). These data suggest that the application of pomegranate peel extract in treated carrot juices (2.5 mg mL−1) improves their microbial safety and antioxidant capacity, without impairing the sensorial aspects.
Impact of infection on transplantation tolerance
Authors: Yu Shuangjin , Su Chang , Luo Xunrong
Published: September 2019

Allograft tolerance is the ultimate goal of organ transplantation. Current strategies for tolerance induction mainly focus on inhibiting alloreactive T cells while promoting regulatory immune cells. Pathogenic infections may have direct impact on both effector and regulatory cell populations, therefore can alter host susceptibility to transplantation tolerance induction as well as impair the quality and stability of tolerance once induced. In this review, we will discuss existing data demonstrating the effect of infections on transplantation tolerance, with particular emphasis on the role of the stage of infection (acute, chronic, or latent) and the stage of tolerance (induction or maintenance) in this infection‐tolerance interaction. While the deleterious effect of acute infection on tolerance is mainly driven by proinflammatory cytokines induced shortly after the infection, chronic infection may generate exhausted T cells that could in fact facilitate transplantation tolerance. In addition to pathogenic infections, commensal intestinal microbiota also has numerous significant immunomodulatory effects that can shape the host alloimmunity following transplantation. A comprehensive understanding of these mechanisms is crucial for the development of therapeutic strategies for robustly inducing and stably maintaining transplantation tolerance while preserving host anti‐pathogen immunity in clinically relevant scenarios.
Identification of pheromone candidates for the eucalyptus weevil, Gonipterus platensis (Coleoptera, Curculionidae)
Authors: Branco Sofia , Mateus Eduardo Pires , Gomes da Silva Marco Diogo Richter , Mendes Davide , Pereira Maria Manuela Araújo , Schütz Stefan , Paiva Maria Rosa
Published: September 2019

The eucalyptus weevil, Gonipterus platensis (Coleoptera, Curculionidae), is a major pest of eucalyptus plantations worldwide. To date, no pheromones have been identified for this species, despite their valuable potential as tools in monitoring or control strategies. Here we report the detection and identification of pheromones candidates of G. platensis. The weevil's volatile compounds were collected by solid phase micro extraction (SPME) and monolithic material sorption extraction (MMSE). Using Gas Chromatography coupled to Mass Spectrometry (GC/MS) analysis, eleven insect specific compounds were detected and identified: verbenene, cis‐verbenol, trans‐verbenol, verbenone, 2‐oxo‐1,8‐cineole, 9‐hydroxy‐1,8‐cineole, 2‐α‐hydroxy‐1,8‐cineole, 3‐oxo‐1,8‐cineole, 2‐β‐hydroxy‐1,8‐cineole, 3‐α‐hydroxy‐1,8‐cineole and 7‐hydroxy‐1,8‐cineole. Three of these compounds, verbenene, cis‐verbenol and trans‐verbenol, were shown to be male‐specific. Antennal sensitivity towards ten compounds emitted by G. platensis was detected using Gas Chromatography–Mass Spectrometry/Electroantennographic Detection (GC‐MS/EAD). Extracts from virgin males proved to be attractive to virgin females in olfactometer bioassays. Further behavioural bioassays showed that both virgin females and virgin males were attracted to the male‐specific compound cis‐verbenol and that virgin females were attracted to trans‐verbenol. Verbenone was attractive to mated females. Regarding 2‐α‐hydroxy‐1.8‐cineole and 2‐oxo‐1,8‐cineole, which are produced by both sexes, the alcohol was attractive to virgin males and both the alcohol and the ketone were repellant to mated females. This is, to our knowledge, the first identification of pheromones candidates in Gonipterus spp. and also the first evidence of cineole metabolites acting as semiochemicals.
Self‐Regulatory Profiles and Conduct Problems in Youth Referred to Juvenile Diversion
Authors: Piehler Timothy F. , Distefano Rebecca , Ausherbauer Kadie , Bloomquist Michael L. , Almy Brandon , August Gerald J.
Published: September 2019

The current study utilized a person‐centered approach to explore how self‐regulatory profiles relate to conduct problems in an ethnically diverse sample of 197 adolescents referred to juvenile diversion programming. Utilizing a multidomain, multimethod battery of self‐regulation indicators, three common profiles emerged in a latent profile analysis. The profiles represented an Adaptive group, a Cognitively Inflexible group, and an Emotionally Dysregulated group. Group membership was associated with severity and type of conduct problems as well as callous and unemotional traits. The Adaptive group demonstrated lower severity conduct problems when compared to the other groups. The Emotionally Dysregulated group was more likely to commit violent offenses and demonstrated higher levels of some callous and unemotional traits than youth characterized by cognitive inflexibility.
Does geographical location matter for ethnic wage gaps?
Authors: Longhi Simonetta
Published: September 2019

This paper analyzes ethnic wage gaps in Great Britain by comparing minorities to majority workers in the same local labor market and focuses on the variation of wage gaps across areas. As wage gaps vary across areas, using one single national measure may be misleading. Higher wage gaps across groups are associated with higher occupational segregation and ethnic diversity, while higher wage gaps within groups are associated with higher regional specialization and proportion of co‐ethnics. Policies could help by improving job location and selection into occupations across groups.
Widespread Hypersensitivity to Pressure Pain in Men With Cluster Headache During Prolonged Remission Is Not Related to the Levels of Depression and Anxiety
Authors: Gómez‐Mayordomo Víctor , Palacios‐Ceña María , Guerrero‐Peral Ángel , Fuensalida‐Novo Stella , Fernández‐de‐las‐Peñas César , Cuadrado María L.
Published: September 2019

Background

Diminished pressure pain thresholds (PPTs) have been found in patients with cluster headache (CH), suggesting the presence of central sensitization. However, it is not known whether sensitization persists over time during the asymptomatic periods.

Objective

To investigate if men with episodic CH in a long‐lasting remission phase exhibit widespread pressure pain hypersensitivity.

Methods

Forty men with episodic CH and 40 matched controls were enrolled. PPTs were assessed bilaterally over 1 trigeminal (temporalis muscle) and 3 extra‐trigeminal points (C5/C6 zygapophyseal joint, second metacarpal, tibialis anterior muscle) by a blinded assessor. Patients were assessed in a prolonged remission phase, at least 6 months after their last CH attack and without taking any medication. Depression and anxiety levels were assessed with the Hospital Anxiety and Depression Scale (HADS). For each point, differences in PPTs were evaluated with a multivariate mixed‐model analysis of covariance test, with side and group as main factors and depression and anxiety levels as covariates.

Results

PPTs were significantly decreased bilaterally over the temporalis muscle (mean difference: 85 to 100 kPa), C5/C6 zygapophyseal joint (mean difference: 65 to 80 kPa), second metacarpal (mean difference: 65 to 90 kPa), and tibialis anterior muscle (mean difference: 135 to 155 kPa) in patients with CH when compared to headache‐free subjects (all, P < 0.001). No effect of anxiety or depression levels was found.

Conclusions

Patients with CH exhibited bilateral widespread hypersensitivity to pressure pain during long‐lasting remission periods, which was not associated with depression or anxiety. These results support the persistence of central sensitization in episodic CH, even in remote asymptomatic phases.
Transforaminal Epidural Injection of Local Anesthetic and Dorsal Root Ganglion Pulsed Radiofrequency Treatment in Lumbar Radicular Pain: A Randomized, Triple‐Blind, Active‐Control Trial
Authors: De Manish , Mohan Virender K. , Bhoi Debesh , Talawar Praveen , Kumar Ajeet , Garg Bhavuk , Trikha Anjan , Dehran Maya , Kashyap Lokesh , Shende Dilip R.
Published: September 2019

Background

Lumbar radicular pain (LRP) results from inflammation and irritation of lumbar spinal nerves and the dorsal root ganglion (DRG).

Methods

Our study is a prospective, triple‐blind, randomized, activecontrol trial (CTRI/2016/02/006666) comparing transforaminal epidural local anesthetic (LA) injection and pulsed radiofrequency treatment of DRG in patients with chronic LRP. Patients with LRP after failed conservative management for >3 months received selective diagnostic nerve root block with 1 mL 2% lidocaine. Fifty patients showing positive responses were divided into groups of 25 each. The LA group received transforaminal epidural injection of 1 mL 0.5% bupivacaine. The lumbar pulsed radiofrequency (LPRF) group received transforaminal epidural injection of 1 mL 0.5% bupivacaine with 3 cycles of pulsed radiofrequency of the DRG for 180 seconds

Results

Both groups were compared by observing pain intensity on a 0‐ to 100‐point VAS and improvement in functional status by the Oswestry Disability Index (ODI version 2.0) at 2 weeks and 1, 2, 3, and 6 months. All baseline variables were comparable between the 2 groups. Statistically significant reduction in both outcomes was seen in the LPRF group compared to the LA group from 2 weeks to 6 months. One hundred percent of patients in the LPRF group had a ≥20‐ point decrease in VAS and significant percentage reduction in ODI at all time intervals up to 6 months, whereas it was seen in 80% and 28% of patients in the LA group at 3 and 6 months, respectively. No complications were seen in any patients

Conclusion

Pulsed radiofrequency of the DRG applied for longer duration results in long‐term pain relief and improvement in the functional quality of life in patients with chronic LRP.
The Empathic Foundations of Security Dilemma De‐escalation
Authors: Baker Joshua
Published: September 2019

Security dilemma theorists have long recognized the importance of empathy to the de‐escalation of conflict between actors caught in security dilemma dynamics, but they have left empathy undertheorized and have neglected to recognize its deeply contested nature. This article responds to this omission by bringing multidisciplinary literature on empathy to bear on security dilemma thinking. Contrary to some contemporary empathy research that draws attention to its automatic, unconscious, and intuitive properties, the article highlights the deliberate, effortful, and reflexive capacity to empathize across complex social contexts such as security dilemma dynamics. It shows how empathy of this kind can lead actors to moderate their positions on key issues at the heart of a conflict, reinterpret their interests, and broaden the zone of possible agreement between themselves and an adversary. The article demonstrates these notions empirically by locating empathy within the de‐escalation of tensions between the United States and Iran between 2009 and 2016. Drawing on primary interview material with former U.S. officials, the argument is made that the development of specific empathic capacities by key U.S. officials played an important and unrecognized role in the de‐escalation of security dilemma dynamics between the United States and Iran.
The Labeling Algorithm and Kirundi Inversion Structures
Authors: Selvanathan Nagarajan
Published: September 2019

Moro (2009) proposes that Italian inversion structures provide evidence for one of the predictions of the Labeling Algorithm (LA, Chomsky 2013, 2015). This is that in structures in which labeling is ambiguous, one of the constituents must be moved to a higher position, instantiated in Italian inversion as an intermediate focus position. However, Italian provides little independent evidence for movement to such a position and the evidence it does provide is limited to symmetrical structures containing twoDPs. In this paper, I argue that Kirundi Object‐Verb‐Subject (OVS) inversion structures and transitive expletive constructions (TECs) (Ura 1996, Ndayiragije 1999) provide more direct evidence for the type of movement that Moro proposes for Italian. Because of a confluence of Kirundi idiosyncrasies, Kirundi shows unambiguously that when the external argument does not move to Spec,TP, it cannot stay in Spec,vP. Importantly, this ban on remaining in Spec,vPcannot be accounted for by appealing to relativized minimality (Rizzi 1990). Kirundi thus instantiates a key prediction of the LA.
Surgical site infection and risk factors following right lobe living donor liver transplantation in adults: A single‐center prospective cohort study
Authors: Aktas Aydin , Kayaalp Cuneyt , Gunes Orgun , Gokler Cihan , Uylas Ufuk , Cicek Egemen , Ersoy Yasemin , Kose Adem , Bayindir Yasar , Aydin Cemalettin , Yilmaz Sezai
Published: September 2019

Introduction

Surgical site infection (SSI) is an important cause of decreased graft survival, prolonged hospital stay, and higher costs following living donor liver transplantation. There are several risk factors for SSI. In this cohort study, we aimed to investigate the incidence of SSI at our center and the associated risk factors.

Materials and Methods

Adult right lobe living donor liver transplantations were included in this prospective cohort. Patients who died postoperatively within 3 days; patients with infected ascites or open abdomen, cadaveric, or pediatric transplants; and patients with biologic or cryopreserved vascular grafts were excluded. Patients' demographic characteristics and perioperative surgical findings were recorded. SSI follow‐up was continued for 90 days. CDC‐2017 criteria were used to diagnose SSI. In the presence of superficial, deep, and organ/space SSI, only the organ in the poorest condition was included in SSI evaluation. The patients were administered similar to antibiotic prophylaxes and immunosuppressive protocols.

Results

A total of 101 patients were enrolled in this study, of which 30 (29.7%) were diagnosed with SSI. Organ/space, only deep, and only superficial SSI were noted in 90% (27/30), 6.7% (2/30), and 3.3% (1/30) of the patients, respectively. Twenty‐five of 30 patients with SSI had a remote site infection. One or more bacteria observed in cultures were obtained from 28 patients. A donor‐recipient age difference of >10 years, cold ischemia lasting for ≥150 minutes, surgical duration of ≥600 minutes, intraoperative hemorrhage of ≥1000 mL, intraoperative blood transfusion, biliary leak or stricture, prolonged mechanical ventilation, prolonged intensive care unit and hospital stay, remote site infection, and the need for reoperation were associated with increased SSI incidence. Preoperative and intraoperative levels of blood glucose, albumin, and hemoglobin were not associated with SSI. A donor‐recipient age difference of >10 years, remote site infection, and biliary leak were found to be independent risk factors for SSI. Hospital mortality with and without SSIs was 6.7% vs 4.4%, P = .61.

Discussion

Organ/space SSIs were the essential part of SSIs following right lobe living donor liver transplantations. Donor‐recipient age gap, prolonged cold ischemia time, complicated surgery, and postoperative biliary complications were the main causes of SSIs. Although they did not increase the perioperative mortality, they promote increased rate of reoperations, remote infections, prolonged intensive care unit, and hospital stays.
Immune thrombocytopenia (ITP): Pathophysiology update and diagnostic dilemmas
Authors: LeVine Dana N. , Brooks Marjory B.
Published: September 2019

Immune thrombocytopenia (ITP) is a common autoimmune bleeding disorder. The understanding of ITP pathogenesis is rapidly evolving. We now recognize ITP as a complex and heterogeneous syndrome that results from a combination of humoral and cell‐mediated attacks on platelets peripherally and megakaryocytes in the bone marrow. Autoantibody‐mediated ITP also varies in the pathway used to clear platelets, which depends on the platelet glycoprotein being targeted. Moreover, ITP patients present with variable bleeding severities and treatment responses that do not closely correlate with platelet count. A gold standard diagnostic test for ITP is lacking, and biomarkers to assess disease severity are in their infancy. This review provides an update on the immunopathogenesis of ITP and summarizes currently available tests for ITP diagnosis, prediction of disease severity, and treatment responses. Given the heterogeneous pathogenesis and clinical presentation of ITP, we highlight the need for the development of diagnostic and prognostic tests that would allow for the individualized management of a complex disease.
Pain relief during wound care for patients with a deep open wound in an orthopedic trauma department: a best practice implementation project
Authors: Fang Yaxuan , Wang Ning , Shi Lei , Barker Timothy , Zhang Ping
Published: September 2019

Objectives:

The aim of this project was to implement best practice in pain relief during wound care for patients with deep open wounds in the orthopedic trauma department of a tertiary teaching hospital in China.

Introduction:

Patients with deep open wounds often suffer from severe pain during wound care. Inadequate pain relief for these patients calls for evidence-based changes to close the gap between current and best practice.

Methods:

The current quality improvement project was carried out over six months using the JBI Practical Application of Clinical Evidence System (JBI PACES). A baseline and two follow-up audits of wound pain management practice were conducted to identify practice gaps and post implementation compliance in pain management in wound care. The sample comprised 20 patients and two dressing nurses. The Getting Research into Practice tool identified barriers to and strategies for improvement in practice. The patients’ pain experiences were measured following the implementation of changes.

Results:

The baseline audit identified poor compliance with best practice. Following implementation of the recommended changes, some significant improvements in practice were made by the dressing nurses; however, these were inadequately maintained at the second post implementation audit. Patients’ pain scores improved following the nurses’ practice changes (t = 2.272, P > 0.05).

Conclusion:

The implementation of best practice in pain relief during wound care for patients with deep open wounds has led to significant improvement in nurses’ performance in the orthopedic trauma department. The most challenging barriers involved interdisciplinary collaborations and organizational structure.
Erosion in a Melt-Infiltrated SiC/SiC Ceramic Matrix Composite
Authors: Presby M. J. , Gong C. , Kane S. , Kedir N. , Stanley A. , Faucett D. C. , Choi S. R.
Published: September 2019

Erosion phenomenon of ceramic matrix composites (CMCs), attributed to their unique architectural configurations, is markedly different from conventional monolithic ceramic counterparts. Prior to further integration of CMCs into hot-section components of aeroengines subject to erosive environments, their erosion behavior needs to be characterized, analyzed, and formulated. The erosion behavior of a 2D woven melt-infiltrated (MI) SiC/SiC CMC was assessed in this work as a function of variables such as particle velocity and size. The erosion damage was characterized using appropriate analytical tools such as optical and scanning electron microscopy (SEM). A phenomenological erosion model was developed for SiC/SiC CMC material systems with respect to the kinetic energy of impacting particles in conjunction with nominal density, matrix hardness, and elastic modulus of the SiC/SiC CMCs. The model was in reasonable agreement with the experimental data.
Statistical Burnup Distribution of Moving Pebbles in the High-Temperature Reactor HTR-PM
Authors: Vitullo Fanny , Krepel Jiri , Kalilainen Jarmo , Prasser Horst-Michael , Pautz Andreas
Published: September 2019

In the pebble-bed high-temperature reactor under construction in China, called the HTR-PM, the spherical fuel elements continuously flow downward in the cylindrical core. The burnup of each pebble is checked at the core outlet and, according to the achieved burnup level, the pebble might be disposed or reinserted into the upper section of the core. Upon reinsertion, each pebble is radially distributed in a random manner and, according to its downward path, faces different burnup conditions. Hence, the number of passes necessary to achieve the average discharge burnup of 90 MWd/kgU may vary. Discrete element method (DEM) simulations have been carried out to achieve a clear understanding of the movement of the 420000 fuel pebbles in the HTR-PM core. At the same time, neutronics properties have been investigated for a single pebble and for the full core with the Serpent 2 Monte Carlo code. As a result, one-group microscopic cross sections (XS) have been parametrized at the core level. The pebble movement has been loosely coupled with the depletion of a single pebble in a dedicated burnup script called moving pebble burnup (MPB), developed in matlab. 3000 single pebble burnup histories were simulated to obtain sufficient statistics and an insight into the HTR-PM burnup process. The decrease of the average burnup gained per single pass implies that a miss-handling of recirculated fuel elements is unlikely to lead to an excess of the maximum allowed burnup of 100 MWd/kgU. The core demonstrates a self-compensation effect of burnup, meaning that it always compensates burnup under- or over-runs in the successive passes. In addition, gamma detection of 137Cs has been studied as a practical method for monitoring the burnup of the discharged pebbles, turning out to be an applicable measurement technique. Finally, it is possible to conclude that the fuel cycle of the HTR-PM, as it has been laid out, is well designed and feasible.
Tensile Performance of Fused Deposition Modeling PA 6 Polymer Composites With Nanoparticle Reinforcement and/or Continuous Fiber Reinforcement
Authors: Liu Zhihui , Wang Yachao , Shi Jing
Published: September 2019

Fused deposition modeling (FDM) printing of continuous fiber reinforced polymers had been a challenge until about 5 years ago. With the reinforcement of continuous fiber, the mechanical properties of FDM printed polymers are improved by leaps and bounds. In this paper, we aim to investigate the possibility of further improvement in the mechanical properties of three-dimensional (3D) printed continuous fiber reinforced polymers by adding nanoreinforcements to the polymer matrix. Kevlar fiber is selected as the continuous fiber reinforcement, nylon 6 (PA 6) is selected as the polymer matrix material, and carbon nanotubes (CNTs) or graphene nanoplatelets (GNPs) nanoparticles are selected as the nanoreinforcements. In the experiment, CNT or GNP nanoparticles are first mixed with nylon 6 pellets to make nanocomposites, the nanocomposites are then extruded into filaments for 3D printing, and finally, both Kevlar filament and nanocomposite filament are fed through the printing nozzle and deposited on the platform. Tensile specimens are directly printed from pure PA 6 and three types of nanocomposites, namely, CNT/PA 6, GNP/PA 6, and GNP-NH2/PA 6, as well as Kevlar fiber reinforced PA 6 and three types of Kevlar fiber reinforced nanocomposites. The results indicate that although Kevlar fibers dominate the enhancement of mechanical properties for the printed composite materials, the existence of GNP nanofillers also provide a noticeable contribution to the enhancement of tensile strengths and moduli, while the effect of CNTs is much less pronounced.
Synchronization of Spatiotemporal Irregular Wave Propagation Via Boundary Coupling
Authors: Li Liangliang , Huang Yu , Xiao Mingqing
Published: September 2019

Wave dynamics reflect a broad spectrum of natural phenomena and are often characterized by wave equation such as in the development of meta-devices used to steer wave propagation. Modeling synchronization of wave dynamics is critical in various applications such as in communications and neuroscience. In this paper, we study the synchronization problem for oscillations governed by wave equation with nonlinear (van der Pol type) boundary conditions through a single boundary coupling. The dynamics of the master system is self-excited and presents sensitive and rapid oscillations. With the only signal received at one end of the boundary, by constructing a mathematical model, we show the existence of a slave system that can be synchronized with the master system via the study of wave reflections on the boundary to recover the actual wave dynamics. The coupling gain, which represents the strength of the connection between the master system and the slave system, has been identified. The obtained result can be also viewed as an observer construction when the measurable output is only on the boundary. Numerical simulations are provided to demonstrate the effectiveness of the theoretical outcomes.
Geometric Spectral Algorithms for the Simulation of Rigid Bodies
Authors: Li Yiqun , Meiramgul Razikhova , Chen Jiankui , Yin Zhouping
Published: September 2019

Lie group methods are an excellent choice for simulating differential equations evolving on Lie groups or homogeneous manifolds, as they can preserve the underlying geometric structures of the corresponding manifolds. Spectral methods are a popular choice for constructing numerical approximations for smooth problems, as they can converge geometrically. In this paper, we focus on developing numerical methods for the simulation of geometric dynamics and control of rigid body systems. Practical algorithms, which combine the advantages of Lie group methods and spectral methods, are given and they are tested both in a geometric dynamic system and a geometric control system.
Perceptual integration of pitch and duration: Prosodic and psychoacoustic influences in speech perception
Authors: Steffman Jeremy , Jun Sun-Ah
Published: September 2019

Two experiments explored how pitch influences perception of vowel duration as a cue to voicing in light of (1) psychoacoustic interactions between pitch and duration and (2) predicted compensatory effects based on the patterning of pitch and duration in the accentual/prominence-marking system of English. Listeners categorized a “coat”–“code” vowel duration continuum with pitch height on the vowel manipulated. In experiment 1 the expected psychoacoustic effect was observed. In experiment 2 the continuum was altered, highlighting pitch as a prosodic property, resulting in predicted compensatory effects. Results thus indicate prosodic patterns can mediate the perception of durational cues in isolated words.
Multiplicity conversion based on intramolecular triplet-to-singlet energy transfer
Authors: Cravcenco A. , Hertzog M. , Ye C. , Iqbal M. N. , Mueller U. , Eriksson L. , Börjesson K.
Published: September 2019

We demonstrate conversion of an excited triplet state to an excited singlet state through resonance energy transfer.
Experimental test of local observer independence
Authors: Proietti Massimiliano , Pickston Alexander , Graffitti Francesco , Barrow Peter , Kundys Dmytro , Branciard Cyril , Ringbauer Martin , Fedrizzi Alessandro
Published: September 2019

In the quantum domain, there may not be an objective story to tell.
Experimental and theoretical evidence for molecular forces driving surface segregation in photonic colloidal assemblies
Authors: Xiao Ming , Hu Ziying , Gartner Thomas E. , Yang Xiaozhou , Li Weiyao , Jayaraman Arthi , Gianneschi Nathan C. , Shawkey Matthew D. , Dhinojwala Ali
Published: September 2019

Particle size and chemistry determine surface segregation in colloidal assemblies, leading to unique control of structural colors.
Electrostatically controlled surface boundary conditions in nematic liquid crystals and colloids
Authors: Mundoor Haridas , Senyuk Bohdan , Almansouri Mahmoud , Park Sungoh , Fleury Blaise , Smalyukh Ivan I.
Published: September 2019

Controlling surface charging and ionic content within a nematic liquid crystal enables variation of boundary conditions.
A left-sided cerebrospinal fluid hydrothorax and a right ventricular-peritoneal shunt: a unique clinical case study
Authors: Hopkins David , Pattman Stewart , Jones Rhian , Aujayeb Avinash
Published: September 2019

We describe the case of a 84-year-old woman with a right ventricular-peritoneal shunt and a left-sided pleural effusion, the analysis of which was positive for cerebrospinal fluid. We consider the potential causative mechanisms. Our patient was managed conservatively due to her frailty, the effusion being asymptomatic and her preference not to pursue further invasive diagnostic testing. This case report is unique due to the contralateral nature of the effusion to the shunt, which has not been described before in the literature.
Dystrophic calcinosis cutis in autosomal recessive dystrophic epidermolysis bullosa
Authors: Bhari Neetu , Bharti Prashant
Published: September 2019

A 6-year-old girl presented with a history of blistering and scarring in trauma-prone areas. On examination, calcium deposits were seen on bilateral palms and soles within her non-healing wounds. Clinical, genetic and radiological evaluation confirmed the diagnosis of autosomal recessive dystrophic epidermolysis bullosa with dystrophic calcification. The patient was started on topical 10% sodium thiosulfate for her calcinosis cutis. Identification and management of dystrophic calcification are important as it impairs wound healing.
Multiple sleep dimensions and type 2 diabetes risk among women in the Sister Study: differences by race/ethnicity
Authors: McWhorter Ketrell L , Park Yong-Moon , Gaston Symielle A , Fang Kacey B , Sandler Dale P , Jackson Chandra L
Published: September 2019

Objective

Poor sleep has been associated with type 2 diabetes. Since racial/ethnic minorities experience a disproportionately high prevalence of poor sleep and type 2 diabetes, we sought to determine the relationships between multiple sleep dimensions and incident type 2 diabetes and to investigate if these relationships vary by race/ethnicity.

Research design and methods

Prospective data were analyzed from the Sister Study, which enrolled 50 884 women from 2003 to 2009. Participants self-reported sleep duration, sleep latency, night awakenings, and napping at baseline, and a physician’s diagnosis of type 2 diabetes at follow-up. Multivariable-adjusted HRs and 95% CIs were estimated using Cox proportional hazards models.

Results

Among the 39 071 eligible participants, 87% self-identified as white, 8% black and 5% Hispanic/Latina. The mean follow-up period was 8.5±2.1 years and 1785 type 2 diabetes cases were reported. The incidence rate per 1000 person-years was 5.4 for whites, 13.3 for blacks and 11.6 for Hispanics/Latinas. There was a positive but non-significant increased risk of type 2 diabetes among women who reported short sleep, latency >30 min and frequent night awakenings. In fully-adjusted models, frequent napping was associated with a 19% (HR 1.19, 95% CI 1.04 to 1.37) higher type 2 diabetes risk in the overall sample. Poor sleep among racial/ethnic minorities ranged from a 1.4-fold to a 3.2-fold higher type 2 diabetes risk than whites with recommended sleep.

Conclusions

Frequent napping was associated with higher type 2 diabetes risk. Racial/ethnic minorities with poor sleep had a higher type 2 diabetes risk than whites with recommended sleep.
Effects of metformin, acarbose, and sitagliptin monotherapy on gut microbiota in Zucker diabetic fatty rats
Authors: Zhang Minchun , Feng Rilu , Yang Mei , Qian Cheng , Wang Zheng , Liu Wei , Ma Jing
Published: September 2019

Objective

Recent studies have demonstrated that gut microbiota was closely related to metabolic disorders such as type 2 diabetes. Oral antidiabetic medications including metformin, acarbose and sitagliptin lowered blood glucose levels via acting on the gastrointestinal tract. The aim of the study was to observe the comparisons among those medications on gut microbiota composition.

Research design and methods

Zucker diabetic fatty rats (n=32) were randomly divided into four groups, and had respectively gastric administration of normal saline (control), metformin (215.15 mg/kg/day), acarbose (32.27 mg/kg/day), or sitagliptin (10.76 mg/kg/day) for 4 weeks. Blood glucose levels were measured during an intragastric starch tolerance test after the treatments. 16S rRNA gene sequencing was used to access the microbiota in the fecal samples.

Results

Metformin, acarbose, and sitagliptin monotherapy effectively decreased fasting and postprandial blood glucose levels (p<0.001). Acarbose group displayed specific cluster and enterotype mainly composed byRuminococcus 2whileLactobacilluswas the dominant bacterium in the enterotype of the other three groups. The relative abundance of generaRuminococcus 2andBifidobacteriumwas dramatically higher in acarbose group. Metformin and sitagliptin increased the relative abundance of genus Lactobacillus. Metagenomic prediction showed that the functional profiles of carbohydrate metabolism were enriched in acarbose group.

Conclusions

Metformin, acarbose and sitagliptin exerted different effects on the composition of gut microbiota and selectively increased the beneficial bacteria. Supplementation with specific probiotics may further improve the hypoglycemic effects of the antidiabetic drugs.
Vaccinology in sub-Saharan Africa
Authors: Moïsi Jennifer , Madhi Shabir Ahmed , Rees Helen
Published: September 2019

We undertook a landscape analysis of vaccinology research and training in sub-Saharan Africa in order to identify key gaps and opportunities for capacity development in the field . We conducted interviews with regional and global immunisation experts, reviewed university and research centre websites, searched the scientific literature and analysed donor databases as part of our mapping exercise. We found that (1) few vaccinology training programmes are available in the region; (2) vaccinology research sites are numerous but unevenly distributed across countries and subregions and of widely varying capacity; (3) donor funding favours HIV, tuberculosis and malaria vaccine development over other high-burden diseases; (4) lack of vaccine design, manufacturing and regulatory capacity slows the progress of new vaccines through the research and development pipeline and (5) vaccine implementation research garners limited support. Regional efforts to strengthen African vaccinology expertise should develop advanced vaccinology training programmes, support clinical trial and implementation research sites in geographic areas with limited capacity and conduct multidisciplinary research to help design, license and roll out new vaccines.
Effectiveness of a complex intervention on Prioritising Multimedication in Multimorbidity (PRIMUM) in primary care: results of a pragmatic cluster randomised controlled trial
Authors: Muth Christiane , Uhlmann Lorenz , Haefeli Walter E , Rochon Justine , van den Akker Marjan , Perera Rafael , Güthlin Corina , Beyer Martin , Oswald Frank , Valderas Jose Maria , Knottnerus J André , Gerlach Ferdinand M , Harder Sebastian
Published: September 2019

Objectives

Investigate the effectiveness of a complex intervention aimed at improving the appropriateness of medication in older patients with multimorbidity in general practice.

Design

Pragmatic, cluster randomised controlled trial with general practice as unit of randomisation.

Setting

72 general practices in Hesse, Germany.

Participants

505 randomly sampled, cognitively intact patients (≥60 years, ≥3 chronic conditions under pharmacological treatment, ≥5 long-term drug prescriptions with systemic effects); 465 patients and 71 practices completed the study.

Interventions

Intervention group (IG): The healthcare assistant conducted a checklist-based interview with patients on medication-related problems and reconciled their medications. Assisted by a computerised decision support system, the general practitioner optimised medication, discussed it with patients and adjusted it accordingly. The control group (CG) continued with usual care.

Outcome measures

The primary outcome was a modified Medication Appropriateness Index (MAI, excluding item 10 on cost-effectiveness), assessed in blinded medication reviews and calculated as the difference between baseline and after 6 months; secondary outcomes after 6 and 9 months’ follow-up: quality of life, functioning, medication adherence, and so on.

Results

At baseline, a high proportion of patients had appropriate to mildly inappropriate prescriptions (MAI 0–5 points: n=350 patients). Randomisation revealed balanced groups (IG: 36 practices/252 patients; CG: 36/253). Intervention had no significant effect on primary outcome: mean MAI sum scores decreased by 0.3 points in IG and 0.8 points in CG, resulting in a non-significant adjusted mean difference of 0.7 (95% CI −0.2 to 1.6) points in favour of CG. Secondary outcomes showed non-significant changes (quality of life slightly improved in IG but continued to decline in CG) or remained stable (functioning, medication adherence).

Conclusions

The intervention had no significant effects. Many patients already received appropriate prescriptions and enjoyed good quality of life and functional status. We can therefore conclude that in our study, there was not enough scope for improvement.

Trial registration number

ISRCTN99526053.NCT01171339; Results.
Update of a clinical prediction model for serious bacterial infections in preschool children by adding a host-protein-based assay: a diagnostic study
Authors: van Houten Chantal , van de Maat Josephine Sophia , Naaktgeboren Christiana , Bont Louis , Oostenbrink R
Published: September 2019

Objective

To determine whether updating a diagnostic prediction model by adding a combination assay (tumour necrosis factor-related apoptosis-inducing ligand, interferon γ induced protein-10 and C reactive protein (CRP)) can accurately identify children with pneumonia or other serious bacterial infections (SBIs).

Design

Observational double-blind diagnostic study.

Setting

Two hospitals in Israel and four hospitals in the Netherlands.

Patients

591 children, aged 1–60 months, presenting with lower respiratory tract infections or fever without source. 96 of them had SBIs. The original Feverkidstool, a polytomous logistic regression model including clinical variables and CRP, was recalibrated and thereafter updated by using the assay.

Main outcome measures

Pneumonia, other SBIs or no SBI.

Results

The recalibrated original Feverkidstool discriminated well between SBIs and viral infections, with a c-statistic for pneumonia of 0.84 (95% CI 0.77 to 0.92) and 0.82 (95% CI 0.77 to 0.86) for other SBIs. The discriminatory ability increased when CRP was replaced by the combination assay; c-statistic for pneumonia increased to 0.89 (95% CI 0.82 to 0.96) and for other SBIs to 0.91 (95% CI 0.87 to 0.94). This updated Feverkidstool improved diagnosis of SBIs mainly in children with low–moderate risk estimates of SBIs.

Conclusion

We improved the diagnostic accuracy of the Feverkidstool by replacing CRP with a combination assay to predict pneumonia or other SBIs in febrile children. The updated Feverkidstool has the largest potential to rule out bacterial infections and thus to decrease unnecessary antibiotic prescription in children with low-to-moderate predicted risk of SBIs.