bluuebunny/crossref_metadata_2025_split huggingface dataset:
Power Matching and Energy Efficiency Improvement of Hydraulic Excavator Driven with Speed and Displacement Variable Power Source
Authors: Ge Lei , Quan Long , Zhang Xiaogang , Dong Zhixin , Yang Jing 
Published: December 2019

AbstractMobile machinery energy efficiency and emission pollution are the national and worldwide issues. This paper contributes in solving these problems by applying a speed variable power source. Unfortunately, almost all of the speed variable systems have the dynamic response problem when the motor starts with full load or heavy load. To address this problem, a hydraulic accumulator is used to balance the load of the power source for assisting starting of the motor and a matching method combined with speed and displacement control of the pump is proposed to improve the energy efficiency and dynamic performance simultaneously under different working conditions. Also, the power source/valve combined control strategy of an independent metering system is designed to realize flow matching of the whole system. Firstly, a test system is established to study the dynamic performance and energy efficiency of the speed variable power source with an auxiliary accumulator. Working performance and energy consumption of the power source under different rotating speeds and different loads are studied. And then, the hydraulic excavator test rig with the proposed system is constructed. Furthermore, the working performance of the excavator with the speed-fixed and speed-variable strategy are studied comparatively. Results show that, compared with fixed-speed strategy, the electric power consumption during the idle period and partial load condition can be reduced about 2.05 kW and 1.37 kW. The energy efficiency of speed variable power source is about 40%‒71%, which is higher than that of the fixed-speed power source by 3%–10%.
Management of paroxysmal atrial flutter that occurred in an outpatient prior to dental surgery: a case report
Authors: Shimoda Hajime , Takahashi Tetsu 
Published: December 2019

Abstract
Background
It is essential to accomplish the appropriate emergency care particularly in patients undergoing stressful dento-oral surgical procedures. Atrial flutter may be induced by sympathetic hypertonia due to excessive mental and physical stress. There is no report regarding dental care in patients with atrial flutter. Herein, we describe a rare case of the antiarrhythmic management in an outpatient who presented with an electrocardiographic finding of paroxysmal atrial flutter before the initiation of the dento-oral surgical procedure.

Case presentation
A 60-year-old male patient was scheduled for a dental extraction. He had a history of angina pectoris, diabetes mellitus, and paroxysmal atrial fibrillation with medication. The preoperative electrocardiogram (ECG) revealed left ventricular hypertrophy and ST-T segment abnormality. Immediately before the dental extraction, II-lead ECG revealed atrial flutter; however, he complained of few subjective symptoms, such as precordial discomfort or palpitation. Observing the vital signs, ECG findings, and the general condition of the patient, low dose diltiazem was immediately administered by continuous infusion in order to control the heart rate and prevent atrial flutter-induced supraventricular tachyarrhythmia. Special attention was paid to prevent any critical cardiovascular condition under a preparation of intravenous disopyramide and verapamil and a defibrillator. The intravenous administration of diltiazem progressively restored the sinus rhythm after converting atrial flutter into atrial fibrillation, resulting in the prevention of tachycardia, and then was found to be appropriate as a prophylactic therapy of tachyarrhythmia.

Conclusions
The present case suggests that it is possible to successfully manage some of such patients using our method during dento-oral surgery which is likely to be associated with mental and physical stress. Therefore, it is essential to accomplish an initial emergency care in parallel to the differential diagnosis of unforeseen serious medical conditions or paroxysmal arrhythmia such as atrial flutter.
Risk factors, costs and complications of delayed hospital discharge from internal medicine wards at a Canadian academic medical centre: retrospective cohort study
Authors: Bai Anthony D. , Dai Cathy , Srivastava Siddhartha , Smith Christopher A. , Gill Sudeep S. 
Published: December 2019

Abstract
Background
Hospitalized patients are designated alternate level of care (ALC) when they no longer require hospitalization but discharge is delayed while they await alternate disposition or living arrangements. We assessed hospital costs and complications for general internal medicine (GIM) inpatients who had delayed discharge. In addition, we developed a clinical prediction rule to identify patients at risk for delayed discharge.

Methods
We conducted a retrospective cohort study of consecutive GIM patients admitted between 1 January 2015 and 1 January 2016 at a large tertiary care hospital in Canada. We compared hospital costs and complications between ALC and non-ALC patients. We derived a clinical prediction rule for ALC designation using a logistic regression model and validated its diagnostic properties.

Results
Of 4311 GIM admissions, 255 (6%) patients were designated ALC. Compared to non-ALC patients, ALC patients had longer median length of stay (30.85 vs. 3.95 days p < 0.0001), higher median hospital costs ($22,459 vs. $5003 p < 0.0001) and more complications in hospital (25.5% vs. 5.3% p < 0.0001) especially nosocomial infections (14.1% vs. 1.9% p < 0.0001). Sensitivity analyses using propensity score and pair matching yielded similar results. In a derivation cohort, seven significant risk factors for ALC were identified including age > =80 years, female sex, dementia, diabetes with complications as well as referrals to physiotherapy, occupational therapy and speech language pathology. A clinical prediction rule that assigned each of these predictors 1 point had likelihood ratios for ALC designation of 0.07, 0.25, 0.66, 1.48, 6.07, 17.13 and 21.85 for patients with 0, 1, 2, 3, 4, 5, and 6 points respectively in the validation cohort.

Conclusions
Delayed discharge is associated with higher hospital costs and complication rates especially nosocomial infections. A clinical prediction rule can identify patients at risk for delayed discharge.
Causal association of type 2 diabetes with amyotrophic lateral sclerosis: new evidence from Mendelian randomization using GWAS summary statistics
Authors: Zeng Ping , Wang Ting , Zheng Junnian , Zhou Xiang 
Published: December 2019

Abstract
Background
Associations between type 2 diabetes (T2D) and amyotrophic lateral sclerosis (ALS) were discovered in observational studies in both European and East Asian populations. However, whether such associations are causal remains largely unknown.

Methods
We employed a two-sample Mendelian randomization approach to evaluate the causal relationship of T2D with the risk of ALS in both European and East Asian populations. Our analysis was implemented using summary statistics obtained from large-scale genome-wide association studies with ~660,000 individuals for T2D and ~81,000 individuals for ALS in the European population, and ~191,000 individuals for T2D and ~4100 individuals for ALS in the East Asian population. The causal relationship between T2D and ALS in both populations was estimated using the inverse-variance-weighted methods and was further validated through extensive complementary and sensitivity analyses.

Results
Using multiple instruments that were strongly associated with T2D, a negative association between T2D and ALS was identified in the European population with the odds ratio (OR) estimated to be 0.93 (95% CI 0.88–0.99, p = 0.023), while a positive association between T2D and ALS was observed in the East Asian population with OR = 1.28 (95% CI 0.99–1.62, p = 0.058). These results were robust against instrument selection, various modeling misspecifications, and estimation biases, with the Egger regression and MR-PRESSO ruling out the possibility of horizontal pleiotropic effects of instruments. However, no causal association was found between T2D-related exposures (including glycemic traits) and ALS in the European population.

Conclusion
Our results provide new evidence supporting the causal neuroprotective role of T2D on ALS in the European population and provide empirically suggestive evidence of increasing risk of T2D on ALS in the East Asian population. Our results have an important implication on ALS pathology, paving ways for developing therapeutic strategies across multiple populations.
Reverse zoonotic tuberculosis transmission from an emerging Uganda I strain between pastoralists and cattle in South-Eastern Nigeria
Authors: Adesokan Hezekiah Kehinde , Akinseye Victor Oluwatoyin , Streicher Elizabeth Maria , Van Helden Paul , Warren Rob Mark , Cadmus Simeon Idowu 
Published: December 2019

Abstract
Background
Tuberculosis remains a major public health challenge globally with increasing risks for inter-transmission between pastoralists and cattle in Nigeria. This study was aimed at using molecular tools to establish zoonotic transmission of tuberculosis between pastoralists and their cattle in Ebonyi State, Nigeria. Sputum (n = 149) and milk (n = 144) samples from pastoralists and cattle, respectively were screened on the assumption of subclinical infections considering unguarded human-livestock interactions. Isolates obtained were analysed using deletion typing, spoligotyping and 24-Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeats (MIRU-VNTR).

Results
Fifty-four MTC were confirmed by deletion typing and were differentiated accordingly (M. tuberculosis: pastoralists =42, cattle = 2; M. bovis: pastoralists =1; M. africanum: pastoralists =9). Spoligotyping indicated 59.2% Uganda I/SIT46 (pastoralists =28; cattle = 1), 16.3% Latin American Mediterranean/SIT61 (pastoralists =8), 2.0% T/SIT53 (pastoralists =1) strains of M. tuberculosis and new strains of M. bovis and M. africanum. The 24-MIRU-VNTR of selected predominant cluster isolates shared by cattle and pastoralists (Uganda I/SIT46: pastoralists =9; cattle = 1) showed the same number of copies at each of the repetitive loci.

Conclusions
Mycobacterium bovis was confirmed in humans and a reverse zoonotic tuberculosis transmission from an emerging Uganda I M. tuberculosis strain between pastoralists and cattle in Nigeria evidenced by MIRU-VNTR. Using molecular tools will help mitigate disease burden through informed epidemiological insights.
Impaired training-induced angiogenesis process with loss of pericyte-endothelium interactions is associated with an abnormal capillary remodelling in the skeletal muscle of COPD patients
Authors: Blervaque Léo , Passerieux Emilie , Pomiès Pascal , Catteau Matthias , Héraud Nelly , Blaquière Marine , Bughin François , Ayoub Bronia , Molinari Nicolas , Cristol Jean-Paul , Perez-Martin Antonia , Mercier Jacques , Hayot Maurice , Gouzi Fares 
Published: December 2019

Abstract
Chronic obstructive pulmonary disease (COPD) is associated with exercise intolerance and limits the functional gains in response to exercise training in patients compared to sedentary healthy subjects (SHS). The blunted skeletal muscle angiogenesis previously observed in COPD patients has been linked to these limited functional improvements, but its underlying mechanisms, as well as the potential role of oxidative stress, remain poorly understood. Therefore, we compared ultrastructural indexes of angiogenic process and capillary remodelling by transmission electron microscopy in 9 COPD patients and 7 SHS after 6 weeks of individualized moderate-intensity endurance training. We also assessed oxidative stress by plasma-free and esterified isoprostane (F2-IsoP) levels in both groups. We observed a capillary basement membrane thickening in COPD patients only (p = 0.008) and abnormal variations of endothelial nucleus density in response to exercise training in these patients when compared to SHS (p = 0.042). COPD patients had significantly fewer occurrences of pericyte/endothelium interdigitations, a morphologic marker of capillary maturation, than SHS (p = 0.014), and significantly higher levels of F2-IsoP (p = 0.048). Last, the changes in pericyte/endothelium interdigitations and F2-IsoP levels in response to exercise training were negatively correlated (r = − 0.62, p = 0.025). This study is the first to show abnormal capillary remodelling and to reveal impairments during the whole process of angiogenesis (capillary creation and maturation) in COPD patients.

Trial registration
NCT01183039 & NCT01183052, both registered 7 August 2010 (retrospectively registered).
Hepatitis C drug prescriptions and Medicaid policies--four states, Indian health care system, USA 2018
Authors: Reilley Brigg , Miller Matt , Hudson Matt , Haverkate Rick , Leston Jessica 
Published: December 2019

AbstractMedicaid, the state-level public insurance in the United States, has widely differing criteria treatment for hepatitis C virus (HCV) such as stage of liver fibrosis, documented sobriety, and specialist consultation. In a rural health network, facilities located in two less restrictive states prescribed HCV drugs at a significantly higher rate than two more restrictive states (rate ratio 4.7, CI 2.6–8.5). Prescription rates per population were highly associated with HCV treatment policies.
Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention: a retrospective cohort study
Authors: Dai Xin-Ya , Zheng Ying-Ying , Tang Jun-Nan , Yang Xu-Ming , Guo Qian-Qian , Zhang Jian-Chao , Cheng Meng-Die , Song Feng-Hua , Liu Zhi-Yu , Wang Kai , Jiang Li-Zhu , Fan Lei , Yue Xiao-Ting , Bai Yan , Zhang Zeng-Lei , Zheng Ru-Jie , Zhang Jin-Ying 
Published: December 2019

Abstract
Background
It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome. However, to the best of our knowledge, only a few studies with small sample sizes have investigated the relationship between THR and coronary artery disease (CAD). Therefore, we aimed to assess the correlation between the THR and long-term mortality in patients with CAD after undergoing percutaneous coronary intervention (PCI) in our study that enrolled a large number of patients.

Methods
A total of 3269 post-PCI patients with CAD were enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The mean follow-up time was 37.59 ± 22.24 months. Patients were divided into two groups according to their THR value: the lower group (THR < 2.84, n = 1232) and the higher group (THR ≥ 2.84, n = 2037). The primary endpoint was long-term mortality, including all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs).

Results
In our study, ACM occurred in 124 patients: 30 (2.4%) in the lower group and 94 (4.6%) in the higher group (P = 0.002). MACEs occurred in 362 patients: 111 (9.0%) in the lower group and 251 (12.3%) in the higher group (P = 0.003). The number of MACCEs was 482: 152 (12.3%) in the lower group and 320 (15.7%) in the higher group (P = 0.008). Heart failure occurred in 514 patients: 89 (7.2%) in the lower group and 425 (20.9%) in the higher group (P < 0.001). Kaplan–Meier analyses showed that elevated THR was significantly related to long-term ACM (log-rank, P = 0.044) and the occurrence of heart failure (log-rank, P < 0.001). Multivariate Cox regression analyses showed that the THR was an independent predictor of long-term ACM (adjusted HR = 2.042 [1.264–3.300], P = 0.004) and heart failure (adjusted HR = 1.700 [1.347–2.147], P < 0.001).

Conclusions
An increased THR is an independent predictor of long-term ACM and heart failure in post-PCI patients with CAD.
Isolation of microglia-derived extracellular vesicles: towards miRNA signatures and neuroprotection
Authors: Lemaire Quentin , Raffo-Romero Antonella , Arab Tanina , Van Camp Christelle , Drago Francesco , Forte Stefano , Gimeno Jean-Pascal , Begard Séverine , Colin Morvane , Vizioli Jacopo , Sautière Pierre-Eric , Salzet Michel , Lefebvre Christophe 
Published: December 2019

AbstractThe functional preservation of the central nervous system (CNS) is based on the neuronal plasticity and survival. In this context, the neuroinflammatory state plays a key role and involves the microglial cells, the CNS-resident macrophages. In order to better understand the microglial contribution to the neuroprotection, microglia-derived extracellular vesicles (EVs) were isolated and molecularly characterized to be then studied in neurite outgrowth assays. The EVs, mainly composed of exosomes and microparticles, are an important cell-to-cell communication process as they exhibit different types of mediators (proteins, lipids, nucleic acids) to recipient cells. The medicinal leech CNS was initially used as an interesting model of microglia/neuron crosstalk due to their easy collection for primary cultures. After the microglia-derived EV isolation following successive methods, we developed their large-scale and non-targeted proteomic analysis to (i) detect as many EV protein markers as possible, (ii) better understand the biologically active proteins in EVs and (iii) evaluate the resulting protein signatures in EV-activated neurons. The EV functional properties were also evaluated in neurite outgrowth assays on rat primary neurons and the RNAseq analysis of the microglia-derived EVs was performed to propose the most representative miRNAs in microglia-derived EVs. This strategy allowed validating the EV isolation, identify major biological pathways in EVs and corroborate the regenerative process in EV-activated neurons. In parallel, six different miRNAs were originally identified in microglia-derived EVs including 3 which were only known in plants until now. The analysis of the neuronal proteins under the microglial EV activation suggested possible miRNA-dependent regulation mechanisms. Taken together, this combination of methodologies showed the leech microglial EVs as neuroprotective cargos across species and contributed to propose original EV-associated miRNAs whose functions will have to be evaluated in the EV-dependent dialog between microglia and neurons.
Network topology dynamics of circulating biomarkers and cognitive performance in older Cytomegalovirus-seropositive or -seronegative men and women
Authors: Di Benedetto Svetlana , Müller Ludmila , Rauskolb Stefanie , Sendtner Michael , Deutschbein Timo , Pawelec Graham , Müller Viktor 
Published: December 2019

AbstractBackgroundCytokines are signaling molecules operating within complex cascade patterns and having exceptional modulatory functions. They impact various physiological processes such as neuroendocrine and metabolic interactions, neurotrophins’ metabolism, neuroplasticity, and may affect behavior and cognition. In our previous study, we found that sex and Cytomegalovirus (CMV)-serostatus may modulate levels of circulating pro- and anti-inflammatory cytokines, metabolic factors, immune cells, and cognitive performance, as well as associations between them.ResultsIn the present study, we used a graph-theoretical approach to investigate the network topology dynamics of 22 circulating biomarkers and 11 measures of cognitive performance in 161 older participants recruited to undergo a six-months training intervention. For network construction, we applied coefficient of determination (R2)that was calculated for all possible pairs of variables (N = 33) in four groups (CMV−men and women; CMV+men and women). Network topology has been evaluated by clustering coefficient (CC) and characteristic path length (CPL) as well as local (Elocal) and global (Eglobal) efficiency, showing the degree of network segregation (CCandElocal) and integration (CPLandEglobal). We found that networks under consideration showed small-world networks properties with more random characteristics. MeanCC,as well as local and global efficiency were highest andCPLshortest in CMV−males (having lowest inflammatory status and highest cognitive performance). CMV−and CMV+females did not show any significant differences. Modularity analyses showed that the networks exhibit in all cases highly differentiated modular organization (withQ-value ranged between 0.397 and 0.453).ConclusionsIn this work, we found that segregation and integration properties of the network were notably stronger in the group with balanced inflammatory status. We were also able to confirm our previous findings that CMV-infection and sex modulate multiple circulating biomarkers and cognitive performance and that balanced inflammatory and metabolic status in elderly contributes to better cognitive functioning. Thus, network analyses provide a useful strategy for visualization and quantitative description of multiple interactions between various circulating pro- and anti-inflammatory biomarkers, hormones, neurotrophic and metabolic factors, immune cells, and measures of cognitive performance and can be in general applied for analyzing interactions between different physiological systems.
The effect of orthopaedic surgeons’ and interventional radiologists’ availability on the priority treatment sequence for hemodynamically unstable pelvic fractures: a survey of US Level I trauma centers
Authors: Jarvis S. , Orlando A. , Blondeau B. , Banton K. , Reynolds C. , Berg G. M. , Patel N. , Meinig R. , Carrick M. , Bar-Or D. 
Published: December 2019

Abstract
Background
Most guidelines recommend both pelvic packing (PP) and angioembolization for hemodynamically unstable pelvic fractures, however their sequence varies. Some argue to use PP first because orthopaedic surgeons are more available than interventional radiologists; however, there is no data confirming this.

Methods
This cross-sectional survey of 158 trauma medical directors at US Level I trauma centers collected the availability of orthopaedic surgeons and interventional radiologists, the number of orthopaedic trauma surgeons trained to manage pelvic fractures, and priority treatment sequence for hemodynamically unstable pelvic fractures. The study objective was to compare the availability of orthopaedic surgeons to interventional radiologists and describe how the availability of orthopaedic surgeons and interventional radiologists affects the treatment sequence for hemodynamically unstable pelvic fractures. Fisher’s exact, chi-squared, and Kruskal-Wallis tests were used, alpha = 0.05.

Results
The response rate was 25% (40/158). Orthopaedic surgeons (86%) were on-site more often than interventional radiologists (54%), p = 0.003. Orthopaedic surgeons were faster to arrive 39% of the time, and interventional radiologists were faster to arrive 6% of the time. There was a higher proportion of participants who prioritized PP before angioembolization at centers with above the average number (> 3) of orthopaedic trauma surgeons trained to manage pelvic fractures, as among centers with equal to or below average, p = 0.02. Arrival times for orthopaedic surgeons did not significantly predict prioritization of angioembolization or PP.

Conclusions
Our results provide evidence that orthopaedic surgeons typically are more available than interventional radiologists but contrary to anecdotal evidence most participants used angioembolization first. Familiarity with the availability of orthopaedic surgeons and interventional radiologists may contribute to individual trauma center’s treatment sequence.