bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing Procedures on Materials to Formulate the Ink for 3D Printing
Authors: Charrier Malo , Ouellet-Plamondon Claudiane
Published: March 2020

Three-dimensional (3D) printing has been used in various fields to tackle applications difficult for conventional manufacturing. To realize the full potential of this technology in the transportation sector, it is imperative to identify suitable tests and mixtures for printing “inks” made of mortar. In this study, several conventional and non-conventional tests on mortars and cement pastes were conducted. This work highlights the correlation between the results of slump test and the deformation test that indicates the comportment of the mixture under a stack of printed layers. Moreover, a strong connection between yield stress and mini-slump is observed, demonstrating a simplification of the testing procedure, and a link between the mortar and the cement paste is developed. In the printing ink design phase, this association enables the prediction of flowability. The yield stress and the final radius of the mini-slump tests were very well correlated for the admixture tested. The use of the mini-slump test simplifies the testing procedure and allows for quicker formulations of admixtures in the printing ink.
Temperature Measurements with Depth and Physical Evidence for the Effect of High Temperature Gradients on Top-Down Fatigue Cracking
Authors: Archilla Adrian Ricardo
Published: March 2020

This paper presents the results of pavement temperature measurements with depth over a year obtained with a setup emulating the heat flow on a pavement with 305 mm (12 in.) of hot mix asphalt (HMA) and 152 mm (6 in.) of aggregate base. Several findings related to top-down fatigue cracking (TDFC) in Hawaii were obtained from these measurements. It was observed that pavement temperatures near the surface, which were both the lowest and the highest in the HMA depending on the time of day, were rarely below 20°C, and thus, that most cracking in Hawaii occurs at higher temperatures. It was also observed that passing rains can cause sudden temperature drops of the order of 15°C within short periods (15 min). HMA moduli estimated using measured temperature profiles indicate that high temperature gradients may lead to inverted moduli profiles that when loaded cause the highest tensile and shear strains to occur near the surface, and that these may be a main reason for TDFC in the state. The simulated stresses and strains under high temperature gradients also indicate they may be conducive to delamination problems related to large horizontal shear strains generated near the surface and combined with nearly vertical but small tensile strains at the layer interface. The observation that cracking suddenly and consistently stops under overpass bridges and immediately resumes after them provides strong evidence consistent with the findings of the stress/strain distributions generated from profiles with high surface temperature and high temperature gradients potentially causing TDFC. The paper provides recommendations for further study.
Asymmetric Exchange Rate Effects on Cross-Border Freight Flows between the United States and Canada
Authors: Chi Junwook
Published: March 2020

This paper investigates possible asymmetric influences of the exchange rate on cross-border freight flows between the U.S.A. and Canada. Linear and nonlinear autoregressive distributed lag models are used to test for the existence of long-run asymmetric effects of 1) currency appreciation and depreciation and 2) exchange rate volatility changes on trade flows by truck, rail, air, vessel, and pipeline. This paper provides evidence that both currency value and exchange rate volatility affect the U.S.–Canada freight flows in an asymmetric manner. The long-run results of the nonlinear models show that exchange rate is found to be significantly associated with the bilateral trade flows between the U.S.A. and Canada. Exchange rate volatility tends to be significantly associated with trade flows in the nonlinear models, while its effects are insignificant in most cases in the linear models. These findings suggest that the conventional linear specification may mislead the asymmetric effects of exchange rate uncertainty on cross-border freight flows. It is also found that exchange rate sensitivities of U.S.–Canada trade flows by transport mode can differ significantly from those of aggregate trade flows. The information derived from disaggregate trade data can be useful for traders and shippers to develop a long-term strategic plan for infrastructure investment and service expansion.
Assessment of the Impact of Fiber Types on the Performance of Fiber-Reinforced Hot Mix Asphalt
Authors: Alfalah Ahmad , Offenbacker Daniel , Ali Ayman , Decarlo Christopher , Lein Wade , Mehta Yusuf , Elshaer Mohamed
Published: March 2020

This study aims to evaluate the impact of fiber types on the performance of hot mix asphalt (HMA) mixtures. Specifically, the impacts of fiber type on HMA mix design and laboratory performance are investigated. Four types of fiber (fiberglass, basalt, carbon, and polyolefin/aramid blend) were used to produce four fiber-reinforced HMA mixes, and a control mix without fibers was also prepared. The fiber dosage rates used in this study were 0.16% (fiberglass, basalt, and carbon) and 0.05% (polyolefin/aramid) by total mixture weight, based on manufacturer recommendations. Two mixing procedures for introducing fibers into HMA were also evaluated: dry and 15-s dispersion methods. The dry method involved mixing the fibers with aggregates before the addition of asphalt binder while the 15-s dispersion method involved adding the fibers into the mix every 15 seconds (as aggregates were coated by asphalt binder during the mixing process). All the HMA mixtures (unreinforced and fiber-reinforced) were then subjected to several different laboratory performance tests: dynamic complex modulus, Cantabro durability, asphalt pavement analyzer, flow number, and indirect tensile strength. Analysis of variance was conducted to evaluate statistically the impact of fibers on mix performance. Results showed that fibers affected the volumetric properties, mix durability, and rutting resistance of HMA mixes. It was also found that the process for introducing fibers into the mix (i.e., mixing method) affected the consistency of fiber-reinforced HMA samples. Overall, the results of this study showed that the use of fibers improved the rutting and durability performance of asphalt mixtures in the laboratory.
CT Imaging of Acute Ischemic Stroke
Authors: Byrne D. , Walsh J. P. , Sugrue G. , Nicolaou S. , Rohr A.
Published: March 2020

Although acute ischemic stroke remains one of the most common causes of death and disability worldwide, it is a potentially treatable condition if appropriately managed in a timely manner. The goals of acute stroke imaging include establishing a diagnosis as fast as possible with (1) accurate infarct quantification, (2) intracranial and cervical vasculature assessment, and (3) brain perfusion analysis for detection of infarct core and potentially salvageable penumbra allowing optimal patient selection for appropriate therapy. Given the extensive number of images generated from acute stroke imaging studies and as “time is brain,” this article aims to highlight a logical approach for the radiologist in acute stroke computed tomography imaging in order to accurately interpret and communicate results in a timely manner.
Unravelling the Mysteries of Traumatic Diaphragmatic Injury: An Up-to-Date Review
Authors: Abdellatif Waleed , Chow Brandon , Hamid Saira , Khorshed Dina , Khosa Faisal , Nicolaou Savvas , Murray Nicolas
Published: March 2020

Traumatic diaphragmatic injury (TDI) is an underdiagnosed condition that has recently increased in prevalence due to its association with automobile collisions. The initial injury is often obscured by concurrent thoracic and abdominal injuries. Traumatic diaphragmatic injury itself is rarely lethal at initial presentation, however associated injuries and complications of untreated TDI such as herniation and strangulation of abdominal viscera have serious clinical consequences. There are 2 primary mechanisms of TDIs: penetrating TDI which tend to be smaller, more difficult to detect, and result in fewer complications; and blunt TDIs which are larger and have higher overall mortality due to associated injuries or delayed complications. The anatomy of thoracic and abdominal cavities distinguishes the epidemiology, pathophysiology, symptoms, treatment, and prognosis of right versus left TDI. Although there is no definitive radiologic sign for diagnosing TDI, many signs have been introduced in the literature and the concurrent presence of multiple signs increases the sensitivity of TDI detection. Conservative versus surgical management depends on mechanism of TDI, side, and most importantly the associated injuries.
Cultural and Creative Industries and Urban (Re)Development in China
Authors: Liang Sisi , Wang Qingfang
Published: March 2020

Cultural and creative industries (CCIs) have been regarded as a growth driver for economic and urban development in many cities worldwide. This study first traces the development of CCIs in China, both as the leading top-down approach and as grassroots efforts in local communities. Then, it identifies the driving forces for CCIs’ development and their impacts on urban development and regeneration. The extensive literature review finds that China’s CCIs share many common characteristics with Western cities. Meanwhile, the CCIs in Chinese cities also demonstrate unique characteristics, for example, strong top-down policy guidance; close relation with continuous urbanization especially through the construction of science and technology parks; and extremely weak ties with local communities. Based on the review, the authors suggest future research agendas to better understand the mechanisms that affect CCIs-related urban (re)development and both social and economic impacts from CCI development at multiple scales.
Health Infrastructure Disparities in Punjab: An Inter-district Analysis
Authors: Kumar Gulshan , Singh Jagmohan
Published: March 2020

Economic and social development can be achieved by improving the health conditions of people which, in turn, depend upon the development and provision of health infrastructure facilities in any region or society. Better and sound health infrastructure is of paramount importance to support the health conditions of people in any region. Keeping this in mind, the present study has attempted to examine the inter-district disparities in health infrastructure in Punjab. Using principal component analysis, a district-level health infrastructure index (HII) for Punjab has been constructed at three points of time, that is, 1994, 2008 and 2018. The study detected the presence of inter-district disparities in health infrastructural facilities in Punjab. Barnala, Faridkot, Fatehgarh Sahib, Mansa and Shri Muktsar Sahib have been identified as improving districts, whereas Amritsar, Firozpur, Hoshiarpur, Jalandhar, Kapurthala, Ludhiana, Moga, Patiala and Tarn Taran appeared under deteriorating category. Bathinda, Gurdaspur, Rupnagar and Sangrur have been traced under fluctuating district category while Sahibzada Ajit Singh (SAS) Nagar and Shaheed Bhagat Singh (SBS) Nagar have emerged as stable districts for the study period.

JEL Classification: C38, H54, I19
The state of play – the first national survey of consultation-liaison psychiatry services in New Zealand
Authors: Hopkins John , Cullum Sarah , Sundram Frederick
Published: March 2020

Objective:

The aim of this study was to conduct the first national survey of consultation-liaison psychiatry (CLP) services in New Zealand.

Method:

An online survey based on the Multidimensional Matrix for Consultation-Liaison Psychiatry (mMAX-LP) was circulated to a psychiatrist at each of 12 identified CLP services nationally during April–May 2018. Existing data for Middlemore Hospital (where the lead author is based) were added later for completion.

Results:

Most CLP services in New Zealand are funded and managed by the mental health division, operate within office hours, and have psychologists and other allied health staff external to their service. However, there was significant heterogeneity amongst these services in terms of structure and function and in particular, the coverage of emergency departments and young/older patient groups.

Conclusion:

This first national survey has provided a snapshot of CLP services in New Zealand in 2018 and found striking heterogeneity. The survey has established a baseline for future local and international comparisons.
The migration–tourism nexus in the EU28
Authors: Provenzano Davide
Published: March 2020

This study explores the nexus between tourism and migration on an intra-European scale over the period 2000–2015. Complex-network analysis and gravity models were the investigation methods preferred. For each year under study, we built two country-to-country networks to map and reveal the connections between states as shaped by migration stocks and tourism flows, respectively. Then, the main determinants of the correlation patterns between the two networks were investigated by several econometric analysis. Results point to a quite similar topological structure for the tourism and migration networks as well as to a significant and reciprocal direct influence between tourism and migration movements inside the European Union. No relevant indirect causal relationship is present in the tourism–migration nexus instead.
Self-extrication and selective spinal immobilisation in a polytrauma patient with spinal injuries
Authors: Brown Aidan , Low Adam
Published: March 2020

Methods of extrication and spinal immobilisation following trauma remains controversial. There is a consensus shift towards encouraging patients to self-extricate from vehicles after collisions and reduced use of hard cervical collars. Difficulties in conducting randomised controlled trials in this area means that case reports are important in adding to the existing evidence base. This case of an 81-year-old female polytrauma patient suggests that self-extrication, and not using hard cervical collars is safe practice, even in the context of significant multi-level spinal injuries.
Late Qing parliamentarism and the borderlands of the Qing Empire—Mongolia, Tibet, and Xinjiang (1906–1911)
Authors: Bandeira Egas Moniz
Published: March 2020

The article examines the relationship between the late Qing constitutional movement of 1905–1911 and the vast borderland regions of the Qing Empire–that is, Mongolia, Tibet, and Xinjiang. It traces how intellectuals and officials concerned with devising constitutional policies foresaw the integration of these regions into the nascent parliamentary institutions at the provincial and central levels. The article argues that the status of the borderlands played a significant role in late Qing constitutional debates, and that debates on borderland constitutionalism were a phenomenon of a wider constitutional wave affecting Eurasia in the 1900s. Chinese intellectuals and officials felt the competition of the emerging parliamentary institutions in Russia and the Ottoman Empire, and anticipating that constitutional and parliamentarist movements among Mongols, Tibetans, and Turki could lead to the separation of the respective regions, they hoped that parliamentary representation, albeit limited, would be an instrument against centrifugal tendencies on the borders. Hence, they called for constitutional reforms in China and for the inclusion of the borderland populations into the new parliamentary institutions. Yet, arguing with the sparse population of the borderlands as well as with their alleged economic and cultural backwardness, they denied the direct application of the constitutional plan to these territories. The differentiated policies eventually applied to the borderlands were a lackluster compromise between these conflicting interests.
Condylar Fractures: An Argument for Conservative Treatment
Authors: Vanpoecke Jasper , Dubron Kathia , Politis Constantinus
Published: March 2020

Introduction:

The treatment of mandibular condyle fractures remains a controversial topic in maxillofacial surgery. No uniform treatment protocol is currently available.

Purpose:

We performed a retrospective monocentric cohort study of patients with condylar fractures and their treatment, including long-term follow-up by telephone, followed by a short review of the literature.

Patients and Methods:

The available data on condylar fractures presenting at Leuven University Hospitals between January 1, 2009, and December 31, 2015, were analyzed. Cause, age, sex, fracture level, degree of displacement, associated facial fractures, malocclusion, type of treatment, and complications were noted. Follow-up by telephone was performed after an average 261 weeks for the conservative group.

Results:

A total of 109 condylar fractures were observed with a male/female ratio of 1.14:1. Most fractures were subcondylar, unilateral, displaced, caused by road traffic accidents, and treated conservatively.

Discussion:

In children and intracapsular fractures, conservative management remains the first choice. Maxillomandibular fixation should be used sparingly in children and for as short a time as possible. Some patients indicated for surgery can still have acceptable results if treated conservatively.
Efficacy of anakinra for idiopathic and non-idiopathic pericarditis refractory or intolerant to conventional therapy
Authors: Shaukat Muhammad HS , Singh Sukhraj , Davis Kathryn , Torosoff Mikhail , Peredo-Wende Ruben
Published: March 2020

Background:

Anakinra, a recombinant interleukin-1 receptor antagonist is effective in treatment of idiopathic recurrent pericarditis. However, its efficacy in non-idiopathic pericarditis (secondary to a diagnosed inflammatory condition, or other known etiology) is unclear. We evaluated the efficacy of anakinra in patients with non-idiopathic (secondary to a diagnosed inflammatory condition, or other known etiology) and idiopathic pericarditis, who were intolerant or refractory to conventional therapy (colchicine and corticosteroids).

Methods:

This was a single-center study in which we performed a retrospective chart review of consecutive adult patients hospitalized with pericarditis intolerant or refractory to conventional therapy who were treated with conventional therapy and anakinra between January 2016–October 2018. The control group included age-matched hospitalized pericarditis patients treated with conventional therapy only. Symptom relief at discharge, time to symptom relief and recurrence on treatment were compared. The effect of outpatient continuation of anakinra on post-treatment recurrence risk was assessed.

Results:

Twelve patients received anakinra for pericarditis; 22 age-matched controls were identified. Ten patients (83.3%) in the conventional therapy and anakinra group and 13 patients (54.1%) in the conventional therapy groups had non-idiopathic pericarditis. All conventional therapy and anakinra patients and 16 of 22 patients in the conventional therapy group reported symptom relief at discharge (p=0.04). Time to symptom relief was decreased in the conventional therapy and anakinra group (3.75±1.87 vs 5.63±3.28 days, p=0.08). During treatment, all conventional therapy and anakinra-treated patients continued to be symptom free, while nine of 22 conventional therapy patients (40.9%) experienced recurrence (p=0.009). Recurrence risk after treatment discontinuation was similar in the conventional therapy and anakinra group and the conventional therapy group.

Conclusions:

In hospitalized patients with non-idiopathic or idiopathic pericarditis refractory, or intolerant to, conventional therapy, anakinra is associated with improved symptom relief and decreased recurrence risk during treatment.
Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care
Authors: Li Philip Kam-Tao , Garcia-Garcia Guillermo , Lui Siu-Fai , Andreoli Sharon , Fung Winston Wing-Shing , Hradsky Anne , Kumaraswami Latha , Liakopoulos Vassilios , Rakhimova Ziyoda , Saadi Gamal , Strani Luisa , Ulasi Ifeoma , Kalantar-Zadeh Kamyar
Published: March 2020

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the fifth most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual health care budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions—be it primary, secondary, or tertiary. This article complements this initiative by focusing on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with preexisting kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to disseminate the preventive approach. While national policies and strategies for noncommunicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals, and policy makers.
Response study of the tallest California building inferred from the Mw7.1 Ridgecrest, California earthquake of 5 July 2019 and ambient motions
Authors: Çelebi Mehmet , Ghahari S Farid , Haddadi Hamid , Taciroglu Ertugrul
Published: March 2020

The newly constructed tallest building in California, the 73-story Wilshire Grand in Los Angeles, California, is designed in conformance with performance-based design procedures. The building is designed with concrete core–shear walls, three outriggers with buckling restrained braces (BRBs) located along the height, and two three-story truss-belt structural systems. The building is equipped with a 36-channel accelerometric seismic monitoring array that recorded the recent Mw7.1 Ridgecrest earthquake of 5 July 2019, as well as the Mw6.4 Ridgecrest earthquake of 4 July 2019. In this article, only the Mw7.1 event of 5 July 2019 is studied because of a larger response of the subject building during that earthquake. The earthquake records of 5 July 2019 are specifically studied to determine its dynamic characteristics and building-specific behavior. The structure exhibits torsional behavior most likely due to abrupt asymmetrical changes in the thickness and size in-plan of the core–shear walls. The translational and torsional modes during the earthquake are not closely coupled, which does not lead to a beating effect even though there is an appearance of it in the records. Available ambient records are used only to identify modal frequencies of the building and compare them with those from the Mw7.1 event of 5 July 2019. Due to the relatively low amplitude of shaking during the earthquake, the drift ratios are too small to cause any damage. It is expected that during stronger shaking levels likely to be caused by future events, these characteristics may change and the effect of BRBs can be better assessed.
Seismic performance of squat thin reinforced concrete walls for low-rise constructions
Authors: Hube Matías A , María Hernán Santa , Arroyo Orlando , Vargas Alvaro , Almeida Javier , López Mauricio
Published: March 2020

Thin reinforced concrete (RC) walls with single layer reinforcement have been used for houses and buildings in several Latin American countries. Although some design codes include recommendations for squat thin walls in low-rise constructions, its seismic performance has not been validated adequately in past earthquakes. This article presents the results of an experimental campaign of nine full-scale specimens conducted to characterize the influence of the steel type, the reinforcement ratio, and the wall thickness on the seismic behavior of squat thin RC walls with single layer reinforcement. Both welded wire and deformed bars were used as web reinforcement. Experimental results are used to develop nonlinear models to assess the seismic behavior of a prototype two-story house with welded wire reinforcement and deformed bars by means of incremental dynamic analyses. The experimental results show that the type of steel has the largest influence on wall seismic performance. The numerical results suggest that RC walls with single layer reinforcement are suitable for housing applications up to two stories in high seismicity regions, particularly walls detailed with deformed bars.
Use of palygorskite as a viscosity enhancer in salted water-based muds: effect of concentration of palygorskite and salt
Authors: Santanna Vanessa Cristina , Silva Samara Leandro , Silva Rhaul Phillypi , Castro Dantas Tereza Neuma
Published: March 2020

Drilling fluids are essential for the operation and productivity of petroleum wells. This study compares the efficiency of a salted water-based mud for which the viscosity has been enhanced with polymeric compounds with that of a new salted water-based mud containing palygorskite clay, which mainly functions as a viscosity enhancer. The experiment measured the density, apparent viscosity, plastic viscosity, yield point, American Petroleum Institute filtrate and pH of the samples. The results indicate that the rheological properties of the fluids containing greater amounts of palygorskite were not affected significantly by the addition of salt. However, when the concentration of palygorskite was low, the rheological behaviour of the samples was appropriate to the drilling operation only with lesser amounts of salt. In addition to its good rheological properties, the filtrate volume obtained for samples containing greater concentrations of palygorskite was lower, which suggests that the filtration properties at the bottoms of the wells were controlled appropriately.
Mechanisms of anti-GPIbα antibody–induced thrombocytopenia in mice
Authors: Morodomi Yosuke , Kanaji Sachiko , Won Eric , Ruggeri Zaverio M. , Kanaji Taisuke
Published: March 2020

Immune thrombocytopenia (ITP) is an acquired bleeding disorder characterized by antibody-mediated platelet destruction. Different mechanisms have been suggested to explain accelerated platelet clearance and impaired thrombopoiesis, but the pathophysiology of ITP has yet to be fully delineated. In this study, we tested 2 mouse models of immune-mediated thrombocytopenia using the rat anti-mouse GPIbα monoclonal antibody 5A7, generated in our laboratory. After a single IV administration of high-dose (2 mg/kg) 5A7, opsonized platelets were rapidly cleared from the circulation into the spleen and liver; this was associated with rapid upregulation of thrombopoietin (TPO) messenger RNA. In contrast, subcutaneous administration of low-dose 5A7 (0.08-0.16 mg/kg) every 3 days gradually lowered the platelet count; in this case, opsonized platelets were observed only in the spleen, and TPO levels remained unaltered. Interestingly, in both models, the 5A7 antibody was found on the surface of, as well as internalized to, bone marrow megakaryocytes. Consequently, platelets generated in the chronic phase of repeated subcutaneous 5A7 administration model showed reduced GPIbα membrane expression on their surface. Our findings indicate that evaluation of platelet surface GPIbα relative to platelet size may be a useful marker to support the diagnosis of anti-GPIbα antibody–induced ITP.
Longitudinal and lateral diffusion of solute transport in flow with rigid vegetation
Authors: Lou Sha , Liu Hongzhe , Liu Shuguang , Chen Ming , Zhong Guihui
Published: March 2020

Background

Aquatic vegetation has major influence on the local water environment, affecting flow velocities and solute mixing. Extensive research has been conducted on the flow characteristics of vegetated areas, but little is known about solute transport. In this study, Laboratory experiments were carried out to investigate how solute transport is affected by emergent and submerged rigid vegetation.

Results

Vegetation greatly reduces the mean velocity, especially within the vegetated region. Near the bottom, the solute concentration is greater in the dense vegetation than in the sparse vegetation. The vertical distribution of the solute concentration decreases rapidly with the relative water depth. Generally, the longitudinal and lateral diffusion coefficients are less affected by denser vegetation, but both coefficients are strongly influenced by the relative water depth (submerged vegetation height).

Conclusions

A modified function to estimate the longitudinal diffusion coefficients is proposed under both emergent and submerged vegetation conditions, including cases of variable vegetation height. The key parameters (a’ and b’) for the assessment of the lateral diffusion coefficients are improved considering vegetation height. Results in the present paper can be used as efficient and convenient methods to estimate the longitudinal and lateral diffusion coefficients in flow with rigid vegetation.
Respiratory pattern and phrenic and hypoglossal nerve activity during normoxia and hypoxia in 6-OHDA-induced bilateral model of Parkinson’s disease
Authors: Andrzejewski Kryspin , Jampolska Monika , Zaremba Małgorzata , Joniec-Maciejak Ilona , Boguszewski Paweł M. , Kaczyńska Katarzyna
Published: March 2020

Respiratory disturbances present in Parkinson’s disease (PD) are not well understood. Thus, studies in animal models aimed to link brain dopamine (DA) deficits with respiratory impairment are needed. Adult Wistar rats were lesioned with injection of 6-hydroxydopamine (6-OHDA) into the third cerebral ventricle. Two weeks after hypoxic test was performed in whole-body plethysmography chamber, phrenic (PHR) and hypoglossal (HG) nerve activities were recorded in normoxic and hypoxic conditions in anesthetized, vagotomized, paralyzed and mechanically ventilated rats. The effects of activation and blockade of dopaminergic carotid body receptors were investigated during normoxia in anesthetized spontaneously breathing rats. 6-OHDA injection affected resting respiratory pattern in awake animals: an increase in tidal volume and a decrease in respiratory rate had no effect on minute ventilation. Hypoxia magnified the amplitude and minute activity of the PHR and HG nerve of 6-OHDA rats. The ratio of pre-inspiratory to inspiratory HG burst amplitude was reduced in normoxic breathing. Yet, the ratio of pre-inspiratory time to total time of the respiratory cycle was increased during normoxia. 6-OHDA lesion had no impact on DA and domperidone effects on the respiratory pattern, which indicate that peripheral DA receptors are not affected in this model. Analysis of monoamines confirmed substantial striatal depletion of dopamine, serotonin and noradrenaline (NA) and reduction of NA content in the brainstem. In bilateral 6-OHDA model changes in activity of both nerves: HG (linked with increased apnea episodes) and PHR are present. Demonstrated respiratory effects could be related to specific depletion of DA and NA.
Immunological risk stratification and tailored minimisation of immunosuppression in renal transplant recipients
Authors:   for the South West Thames Renal Transplantation Network, Phanish Mysore K. , Hull Richard P. , Andrews Peter A. , Popoola Joyce , Kingdon Edward J. , MacPhee Iain A. M.
Published: March 2020

Background

The efficacy and safety of minimisation of immunosuppression including early steroid withdrawal in kidney transplant recipients treated with Basiliximab induction remains unclear.

Methods

This retrospective cohort study reports the outcomes from 298 consecutive renal transplants performed since 1st July 2010–June 2013 treated with Basiliximab induction and early steroid withdrawal in low immunological risk patients using a simple immunological risk stratification and 3-month protocol biopsy to optimise therapy. The cohort comprised 225 low-risk patients (first transplant or HLA antibody calculated reaction frequency (CRF ≤50% with no donor specific HLA antibodies) who underwent basiliximab induction, steroid withdrawal on day 7 and maintenance with tacrolimus and mycophenolate mofetil (MMF), and 73 high-risk patients who received tacrolimus, MMF and prednisolone for the first 3 months followed by long term maintenance immunosuppression with tacrolimus and prednisolone. High-risk patients not undergoing 3-month protocol biopsy were continued on triple immunosuppression.

Results

Steroid withdrawal could be safely achieved in low immunological risk recipients with IL2 receptor antibody induction. The incidence of biopsy-proven acute rejection was 15.1% in the low-risk and 13.9% in the high-risk group (including sub-clinical rejection detected at protocol biopsy). One- year graft survival was 93.3% and patient survival 98.5% in the low-risk group, and 97.3 and 100% respectively in the high-risk group. Graft function was similar in each group at 1 year (mean eGFR 61.2 ± 23.4 mL/min low-risk and 64.6 ± 19.2 mL/min high-risk).

Conclusions

Immunosuppression regimen comprising basiliximab induction, tacrolimus, MMF and prednisolone with early steroid withdrawal in low risk patients and MMF withdrawal in high risk patients following a normal 3-month protocol biopsy is effective in limiting acute rejection episodes and produces excellent rates of patient survival, graft function and complications.
Postpartum psychosis in peripartum cardiomyopathy: a case report
Authors: Owuor Odhiambo Henry , Akiruga James Amisi , Laktabai Jeremiah , Ateya Samuel , Omar Salwa Mohamed
Published: March 2020

Background

This case report highlights the rare occurrence of postpartum psychosis in the setting of peripartum cardiomyopathy, which can have rare presentations like arrhythmias and pulmonary edema; and the challenges one should anticipate while managing these conditions together. Caution is advised whenever antipsychotic drugs are to be administered to a patient with a cardiac condition as these drugs potentially increase the risk of arrhythmias and sudden death.

Case presentation

A 35 year old grand multiparous woman who was 1 week into puerperium was admitted with severe difficulty in breathing at rest, chest congestion and pain. She also had easy fatigability, orthopnea, paroxysmal nocturnal dyspnea, edema, tachycardia, tachypnea, irregularly irregular heart rate with a pulse deficit, elevated jugular venous pressure, cardiomegaly, hepatomegaly and pulmonary crepitations. On the sixth day while improving on standard drugs for heart failure, she developed bizarre behavior and confusion. She also had auditory, visual and olfactory hallucinations; violence to the baby and the husband; and refusal to feed and take medication. There was no altered sensorium and the vital signs were normal. She was diagnosed with puerperal psychosis during the management of peripartum cardiomyopathy.

Conclusion

In the rare occurrence of puerperal psychosis in the course of management of peripartum cardiomyopathy one must be acutely aware of the risk of sudden cardiac death occasioned by use of antipsychotics, either directly or due to arrhythmias. Continuous electrocardiogram (ECG) monitoring or use of alternative management modalities is thus highly advised.
Study protocol of a multicenter randomized controlled trial of mindfulness-based intervention versus relaxation to reduce emotional exhaustion in medical students in France: the “Must prevent” study
Authors: Baeza-Velasco Carolina , Genty Catherine , Jaussent Isabelle , Benramdane Myriam , Courtet Philippe , Olié Emilie
Published: March 2020

Background

Medical students are exposed to an emotionally exhausting training/work environment and to stressful academic demands. Consequently, psychopathologies, burnout and suicidal ideation are frequent in this population. These factors can also affect their empathy and quality of care. Therefore, the development and implementation of programs to promote resilience to stress specifically in medical students and the evaluation of their efficiency are a priority. Here, we describe the protocol of the first French study to assess the long-term effectiveness and acceptability of a mindfulness-based intervention (MBI) compared with relaxation training (RT) to reduce emotional exhaustion in medical students.

Methods

This multicenter randomized controlled trial (“Must prevent”) plans to enroll 612 students in the fourth and fifth year of medical studies from nine French universities. After inclusion, they will be assigned randomly to the MBI or RT group. Both interventions are structured around an 8-week program that includes one group class per week and daily at-home exercises. The primary endpoint is the emotional exhaustion score assessed with the Maslach Burnout Inventory at month 12 of the follow-up. Secondary endpoints include anxiety-depressive symptomatology, suicidality, psychoactive substance use, depersonalization, psychological and physical pain, empathy, emotional regulation, self-compassion, mindfulness, quality of life, and program acceptability. Evaluations will be done before and immediately after the 8-week intervention, and at month 6 and 12 of the post-intervention follow-up.

Discussion

If the proposed interventions are well accepted and useful to decrease negative emotions and/or increase wellbeing among medical students, they should be disseminated among this population and even included as part of the training on emotional skills needed for the routine medical practice.

Trial registration

This trial is registered under the number NCT04026594 (July 18, 2019).
Psychosocial and clinical factors associated with depression among individuals with diabetes in Bahir Dar City Administrative, Northwest Ethiopia
Authors: Abate Teshager Woldegiorgis , Gedamu Haileyesus
Published: March 2020

Background

In a context of the potential epidemic nature of both diabetes mellitus (DM) and depression had negative effects in cases of disability and mortality. Coexisting depression had been linked to morbidity and mortality in people with diabetes. Therefore, this study aimed to identify psychosocial and clinical factors associated to develop depression symptoms in diabetes patients.

Methods

A systematic institution based cross-sectional study design was conducted from 1st March to 8th April 2016 among adult diabetes patent. Depression status was assessed by the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed by logistic regression and at P < 0.05 with 95% CI was considered statistically significant.

Result

A total of 416 patients were included in this studied. Based on PHQ-9, self- reported depression symptom was 29.3% [95% CI 25.2, 33.4]. In the performed statistical evaluation, patients whose age was between 45 and 54 years old (AOR = 3.88; 95% CI 1.36, 11.08); being female (AOR = 2.43; 95% CI 1.29, 4.58); who has poor social support (AOR = 6.08; 95% CI 2.98, 12.40); and who has high fear of kidney problems secondary to DM (AOR = 6.12; 95% CI 1.75, 21.23) were statistically associated with depressive symptoms in diabetes patients.

Conclusion

This study demonstrated that complication fears, social support, being female and sexual dysfunction were found significantly associated with co-morbid depression in diabetes. Therefore, availed a social network of family and friends; providing diabetes education to address the patient’s fear of complications; and considered a sexual function is an integral part of overall health in diabetic patients.
Comparison between simple triage and rapid treatment and Taiwan Triage and Acuity Scale for the emergency department triage of victims following an earthquake-related mass casualty incident: a retrospective cohort study
Authors: Lin Yun-Kuan , Niu Kuang-Yu , Seak Chen-June , Weng Yi-Ming , Wang Jen-Hung , Lai Pei-Fang
Published: March 2020

Background

Triage plays a crucial role in the emergency department (ED) management of mass casualty incidents (MCIs) when resources are limited. This study aimed to compare the performance of simple triage and rapid treatment (START) with that of the Taiwan Triage and Acuity Scale (TTAS) for the ED triage of victims following an earthquake-related MCI.

Methods

We retrospectively reviewed the records of victims presenting at our ED with earthquake-related injuries within 24 h of a large-scale earthquake. TTAS was initially used at our ED for this event, and START was performed by retrospectively reviewing the patient records in a blinded manner. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of START and TTAS were determined for predicting ED discharge.

Results

We enrolled 105 patients (predominantly women, 60.0%; median age, 45.0 years) in this study; most of them presented with traumatic injuries and were initially triaged as TTAS level III (78.1%), followed by TTAS level II (11.4%). Although the majority of the victims (81.0%) were discharged, four deaths occurred. A moderate agreement in differentiating emergency from nonemergency patients was observed between START and TTAS. Furthermore, both the triage systems showed similar predictions for ED disposition (START AUC/sensitivity/specificity: 0.709/82.35%/55.00%; TTAS AUC/sensitivity/specificity: 0.709/90.59%/45.00%).

Conclusions

The present study demonstrated that START and TTAS have similar triage accuracy and ability to predict ED disposition. Our findings demonstrate that START may be used as an alternative to TTAS for the ED triage of victims following earthquake-related MCIs.
Transcriptome profiling of pluripotent pig embryonic stem cells originating from uni- and biparental embryos
Authors: Choi Kwang-Hwan , Lee Dong-Kyung , Oh Jong-Nam , Kim Seung-Hun , Lee Mingyun , Kim Sung Woo , Lee Chang-Kyu
Published: March 2020

Objectives

Pig pluripotent stem cells have tremendous potential because the pig is a valuable animal as both an agricultural resource and as a preclinical model of human therapy. To date, a lack of understanding of pig pluripotency has inhibited the derivation of embryonic stem cells (ESCs) and transgene-free induced pluripotent stem cells. Therefore, there has been no accessible or reliable transcriptome data for researching the genuine pig pluripotency network. Our previous study isolated authentic pig ESCs, which had teratoma-forming and direct differentiation ability, that were derived by activating the FGF2, ACTIVIN A, and WNT pathways. Here, we aimed to provide detailed information on transcriptome data of the newly derived pig ESCs and perform a comparative analysis with pig preimplantation embryo transcriptomes in a public database.

Data description

The transcriptome data of ESCs derived from in vitro fertilized and parthenogenetic embryos were generated by HiSeq 2500. Then, differentially expressed genes (DEGs) from each sample were compared with fibroblasts, and gene expression profiling was carried out for comparative analysis. Our data, as the first transcriptome dataset for genuine pig pluripotent cells, could be a general reference for explaining the molecular mechanism of species-specific pluripotency and improving understanding of the embryo development of domestic animals.
Dietary total antioxidant capacity significantly interacts with 6-P21 rs2010963 gene polymorphisms in terms of cardio-metabolic risk factors in patients with metabolic syndrome
Authors: Farhangi Mahdieh Abbasalizad
Published: March 2020

Objective

Gene- nutrient interaction might possibly be involved in the pathogenesis of metabolic syndrome and its components. In the current report, the association between antioxidant potential of the diet with 6P21 rs2010963 gene polymorphism in patients with metabolic syndrome has been evaluated. Two hundred fifty-four patients with metabolic syndrome were enrolled. Total dietary antioxidant capacity (TAC) has been estimated and anthropometric assessments were assessed. Biochemical assays including serum glucose, matrix metalloproteinase-3, liver enzymes and lipid profiles were also assessed. Polymerase chain reaction- restriction fragment length polymorphism (PCR–RFLP) method was used for determination of 6P21 rs2010963 polymorphism.

Results

Dietary vitamin E score was significantly higher in GC genotype compared with other genotypes (P = 0.035). Patients in CC genotype of 6P21 rs2010963 had significantly higher body mass index (BMI), fasting blood sugar and liver enzymes (P < 0.05). Being in the higher dietary TAC scores was also associated with lower liver enzymes. The interaction between 6P21 rs2010963 and dietary TAC significantly affected BMI, FBS and diastolic blood pressure (P < 0.05). According to our findings the CC genotype of 6P21 rs2010963 could be considered as the possible risk factor for obesity and metabolic disorders among patients with metabolic syndrome.
MDC1 depletion promotes cisplatin induced cell death in cervical cancer cells
Authors: Singh Neeru , Bhakuni Rashmi , Chhabria Dimple , Kirubakaran Sivapriya
Published: March 2020

Objective

Cisplatin, the most common chemotherapeutic drug for the treatment of advanced stage cervical cancers has limitations in terms of drugs resistance observed in patients partly due to functional DNA damage repair (DDR) processes in the cell. Mediator of DNA damage checkpoint 1 (MDC1) is an important protein in the Ataxia telangiectasia mutated (ATM) mediated double stranded DNA break (DSB) repair pathway. In this regard, we investigated the effect of MDC1 change in expression on the cisplatin sensitivity in cervical cancer cells.

Results

Through modulation of MDC1 expression in the cervical cancer cell lines; Hela, SiHa and Caski, we found that all the three cell lines silenced for MDC1 exhibited higher sensitivity to cisplatin treatment with inefficiency in accumulation of p γH2AX, Ser 139 foci and increased accumulation of pChk2 Thr 68 at the damaged chromatin followed by enhanced apoptosis. Further, we observed the increased p53 Ser 15 phosphorylation in the MDC1 depleted cells. Our studies suggest that MDC1 expression could be a key determinant in cervical cancer prognosis and its depletion in combination with cisplatin has the potential to be explored for the sensitisation of chemo-resistant cervical cancer cells.
Existence of solution for a quasilinear elliptic Neumann problem involving multiple critical exponents
Authors: Li Yuanxiao , Wang Xiying
Published: March 2020

In this paper, we study the Neumann boundary value problem to a quasilinear elliptic equation with the critical Sobolev exponent and critical Hardy–Sobolev exponent, and prove the existence of nontrivial nonnegative solution by means of variational method.