bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonlinear Dynamics of a Rotary Energy Harvester With a Double Frequency Up-Conversion Mechanism
Authors: Nezami Saman , Lee Soobum 
Published: May 2020

Abstract
This paper develops a mathematical model of a two degree-of-freedom piezoelectric energy harvester (PEH) in which vibration is driven by disk swing motion. The proposed device converts slow mechanical rotation into piezoelectric vibration using gravity force and magnetic repelling force. The harvester consists of a disk and a piezoelectric cantilevered beam. The disk with an unbalanced mass swings on a rotating object (e.g., wind turbine blade) and two magnets attached to both the beam and the disk can transfer the kinetic energy of the disk to the beam without physical contact. The energy method is used to derive three coupled equations to model the motion of the disk, vibration of the beam, and the piezoelectric voltage output. The effect of harvester orientation on power generation performance is studied as the rotational speed changes, and the simulation results are experimentally verified. Possible application of this energy harvester to a power-sustainable sensor node for large-scale wind turbine blades monitoring is discussed.
A New Analytical Theory for the Strength Calculation of the Two Different Tubesheets in Floating-Head Heat Exchangers
Authors: Zhu Guodong , Qian Caifu , Xue Mingde 
Published: May 2020

Abstract
Strength calculation for tubesheets in floating-head heat exchangers (FHXs) in current standards is based on analytical theory which assumes that the two tubesheets are symmetrical with same thickness, same material. This assumption results in a design that is not optimized for the requirement of the FHXs. In this paper, a new analytical theory is proposed which is able to perform strength calculation for tubesheets of different size and materials in FHXs. Comparison of the analytical stresses with those obtained by finite element simulation shows that the new theory proposed here is reliable and applicable. In addition, this new theory covers the symmetric one adopted in current standards such as ASME and is effective for the optimization design of the floating tubesheet (FT) as well as other relevant elements in the FHXs.
Using incognito standardised patients to evaluate quality of eye care in China
Authors: Nie Jingchun , Zhang Lifang , Gao Jiayuan , Li Jason , Zhou Qian , Shi Yaojiang , Sylvia Sean , Congdon Nathan 
Published: May 2020

Background/aimsFew studies have objectively examined the quality of eye care in China. We assessed refractive care using the incognito standardised patient (SP) approach, a gold standard for evaluating clinical practice.MethodsA total of 52 SPs were trained to provide standardised responses during eye examinations, and underwent automated and non-cycloplegic, subjective refraction by a senior ophthalmologist from Zhongshan Ophthalmologic Center, a national-level clinical and research centre. SPs subsequently received subjective refraction and eye exams at a randomly selected sample of 40 public hospitals and 93 private optical shops in Shaanxi, Northwestern China. Difference between expert and local refraction in the better-seeing eye was calculated by the vector diopteric method, and completeness of exams assessed against national standards. SP and provider demographic information and provider clinical experience were recorded.ResultsSPs (n=52, mean (range) age, 25.7 (22–31) years, 28.8% male) underwent 133 eye exams (mean total duration 15.0±11.7 min) by 133 local refractionists (24–60 years, 30.3% male). Only 93 (69.9%), 121 (91.0%) and 104 (78.2%) of local refractionists assessed vision, automated and subjective refraction, respectively. The median inaccuracy was −0.25 diopters (D), while 25.6% of results differed by an absolute value of ≥1.0 D and 6.0% by ≥2.0 D. Predictors of inaccurate refraction included spectacle power <−6.0 D (OR=2.66; 95% CI, 1.27 to 5.56), service at a public (vs private) hospital (OR=2.01; 95% CI, 1.11 to 3.63) and provider male sex (OR=2.03; 95% CI, 1.11 to 3.69).ConclusionInaccurate refractions are common in Northwestern China, particularly in public facilities. Important assessments, including subjective refraction, are frequently omitted.
Income, income inequality and schizophrenia in China: a population-based multilevel analysis
Authors: Ding Ruoxi , Zhang Lei , He Ping , Song Xinming , Zheng Xiaoying 
Published: May 2020

BackgroundPrevious studies have suggested that socio-environmental factors interact with genetic risk in the genesis of schizophrenia. This study aimed to investigate the relationship between income, income inequality and schizophrenia and its heterogeneity among different geographic scales and subgroups.MethodsWe used data from the Second China National Sample Survey on Disability (2006). The sample consisted of 1 909 205 participants aged 18 years or older. Individuals who were suspected to be psychiatrically disabled were administered the WHO Disability Assessment Schedule, Version II and the International Statistical Classification of Diseases, Tenth Revision Symptom Checklist for Mental Disorders by trained clinical psychiatrists to diagnose schizophrenia. Gross household income per capita was used to calculate the Gini coefficient to measure income inequality. Multilevel logistic regression with cross-level interaction was applied to examine the association of income, income inequality and schizophrenia.ResultsA total of 7 628 persons (0.40%) were identified as having schizophrenia. Income was independently associated with schizophrenia. At the province level, greater income inequality was significantly associated with a higher risk of schizophrenia (OR﻿, 1.03﻿; 95% CI 1.00 to 1.06), and no significant association was observed at the county level. The analysis with cross-level interaction showed that the association at the province level was most pronounced in the highest income quartile (OR, 1.02; 95% CI 1.00 to 1.03).ConclusionThe significant association between income and schizophrenia was consistent with the absolute income hypothesis. The adverse effect of income inequality on the risk of schizophrenia starts to operate at a larger area level, and it is more pronounced for the affluent population in China. This finding further supports the relative income hypothesis and social causation pathway for schizophrenia and calls attention to the vulnerability of high-income groups.
Elevated N-terminal pro-brain natriuretic peptide is associated with increased mortality in patients with COVID-19: systematic review and meta-analysis
Authors: Pranata Raymond , Huang Ian , Lukito Antonia Anna , Raharjo Sunu Budhi 
Published: May 2020

AbstractObjectivesThis systematic review and meta-analysis aimed to assess the association between N-terminal pro-brain natriuretic peptide (NT-proBNP) and mortality in patients with COVID-19.MethodsSystematic literature search from several electronic databases were performed. The outcome was mortality (non-survivor) in patients with COVID-19 pneumonia. NT-proBNP data were in continuous variable (pg/mL), dichotomous data (elevated/non-elevated) and effect estimate adjusted to cardiac injury/elevated biomarkers of cardiac injury.ResultsA total of 967 patients from six studies were included in this analysis. NT-proBNP was higher in non-survivor group (standardised mean difference 0.75 (0.44, 1.07), p&lt;0.001; I2: 61%). Elevated NT-proBNP was associated with increased mortality (RR 3.63 (92.21, 5.95), p&lt;0.001; I2: 60%). Sensitivity analysis by removing a study reduces heterogeneity (risk ratio 3.47 (2.36, 5.11), p&lt;0.001; I2: 49%). Pooled adjusted HR (adjusted to cardiac injury/elevated biomarkers of cardiac injury) showed that elevated NT-proBNP was independently associated with mortality (HR 1.37 (1.19, 1.57), p&lt;0.001; I2: 0%, p=0.77). Pooled analysis of multiple cut-off point resulted in a sensitivity of 76% (46%–92%) and specificity of 88% (71%–96%). Summary receiver operating characteristic curve analysis demonstrates an area under curve of 0.90 (0.87–0.93). Elevated NT-proBNP has a likelihood ratio (LR) +6.4 and LR -0.3.ConclusionElevated NT-proBNP level was associated with increased mortality in COVID-19 pneumonia.
Prospects for discovering supersymmetric long-lived particles with MoEDAL
Authors: Felea D. , Mamuzic J. , Masełek R. , Mavromatos N. E. , Mitsou V. A. , Pinfold J. L. , de Austri R. Ruiz , Sakurai K. , Santra A. , Vives O. 
Published: May 2020

AbstractWe present a study on the possibility of searching for long-lived supersymmetric partners with the MoEDAL experiment at the LHC. MoEDAL is sensitive to highly ionising objects such as magnetic monopoles or massive (meta)stable electrically charged particles. We focus on prospects of directly detecting long-lived sleptons in a phenomenologically realistic model which involves an intermediate neutral long-lived particle in the decay chain. This scenario is not yet excluded by the current data from ATLAS or CMS, and is compatible with astrophysical constraints. Using Monte Carlo simulation, we compare the sensitivities of MoEDAL versus ATLAS in scenarios where MoEDAL could provide discovery reach complementary to ATLAS and CMS, thanks to looser selection criteria combined with the virtual absence of background. It is also interesting to point out that, in such scenarios, in which charged staus are the main long-lived candidates, the relevant mass range for MoEDAL is compatible with a potential role of Supersymmetry in providing an explanation for the anomalous events observed by the ANITA detector.
Estrogen receptor modulation of some polyphenols extracted from Daucus carota as a probable mechanism for antifertility effect: An in silico study
Authors: Ganguly Mausumi , Hazarika Jnyandeep , Sarma Shruti , Bhuyan Pranjal , Mahanta Rita 
Published: May 2020

The seeds of Daucus carota, traditionally used by women in many countries to prevent conception, were proved to have negative impact on reproductive hormone levels as well as on the estrous cycles in albino mice affecting the fertility status. This study is an attempt to investigate the possible role of polyphenols present in the seeds in hampering the reproductive processes. The Molecular Docking, Molecular Dynamics (MD) simulation and binding free energy calculation studies reveal that six polyphenols present in the seeds can bind with the active sites of human Estrogen Receptor (ER) and may interfere in the estrogen signaling in human. These polyphenols were found to bind to a conservative pocket of ER[Formula: see text], which is comprised of residues 343–388, 421–428 and 525–540. Docking studies indicated the presence of strong hydrogen bonding, pi–pi interactions and numerous hydrophobic interactions that stabilize the ER[Formula: see text]-polyphenol complexes. The docked complexes were further subjected to MM/GBSA analysis to calculate binding free energies. Molecular dynamic simulation studies carried out for a period of 20[Formula: see text]ns revealed low RMS deviation values suggesting high accuracy of the docking poses and stability of the complexes. Out of the six polyphenols, catechin and epicatechin have shown highest binding affinity towards the ER[Formula: see text] receptor. These findings will help in identifying ER modulators of plant origin targeting ER alpha and predicting their effects on the reproductive hormone homeostasis. Moreover, this study may form preliminary basis for further identification of potential herbal antifertility agents.
An Integrated Approach for Preventing Oral Cavity and Oropharyngeal Cancers: Two Etiologies with Distinct and Shared Mechanisms of Carcinogenesis
Authors: El-Bayoumy Karam , Christensen Neil D. , Hu Jiafen , Viscidi Raphael , Stairs Douglas B. , Walter Vonn , Chen Kun-Ming , Sun Yuan-Wan , Muscat Joshua E. , Richie John P. 
Published: May 2020

AbstractHead and neck squamous cell carcinoma (HNSCC) was the 7th most common malignancy worldwide in 2018 and despite therapeutic advances, the overall survival rate for oral squamous cell carcinoma (OSCC; ∼50%) has remained unchanged for decades. The most common types are OSCC and oropharyngeal squamous cell carcinoma (OPSCC, survival rate ∼85%). Tobacco smoking is a major risk factor of HNSCC. In the developed world, the incidence of OSCC is declining as a result of tobacco cessation programs. However, OPSCC, which is also linked to human papillomavirus (HPV) infection, is on the rise and now ranks as the most common HPV-related cancer. The current state of knowledge indicates that HPV-associated disease differs substantially from other types of HNSCC and distinct biological differences between HPV-positive and HPV-negative HNSCC have been identified. Although risk factors have been extensively discussed in the literature, there are multiple clinically relevant questions that remain unanswered and even unexplored. Moreover, existing approaches (e.g., tobacco cessation, vaccination, and chemoprevention) to manage and control this disease remain a challenge. Thus, in this review, we discuss potential future basic research that can assist in a better understanding of disease pathogenesis which may lead to novel and more effective preventive strategies for OSCC and OPSCC.
Single-Cell RNA Sequencing to Dissect the Immunological Network of Autoimmune Myocarditis
Authors: Hua Xiumeng , Hu Gang , Hu Qingtao , Chang Yuan , Hu Yiqing , Gao Linlin , Chen Xiao , Yang Ping-Chang , Zhang Yu , Li Mingyao , Song Jiangping 
Published: May 2020

Background:
Myocarditis can develop into dilated cardiomyopathy, which may require heart transplantation. The immunological network of myocarditis phases remains unknown. This study aimed to investigate the immunological network during the transition from myocarditis to cardiomyopathy and to identify the genes contributing to the inflammatory response to myocarditis.

Methods:

Mice were treated with myosin heavy chain-α peptides to generate an experimental autoimmune myocarditis (EAM) model. We performed single-cell RNA sequencing analysis of
Cd45
+
cells extracted from mouse hearts during different EAM phases, including normal control, acute inflammatory, subacute inflammatory, and myopathy phases. Human heart tissues were collected from the surgically removed hearts of patients who had undergone heart transplantation.

Results:

We identified 26 cell subtypes among 34 665 cells. Macrophages constituted the main immune cell population at all disease phases (>60%), and an inflammation-associated macrophage cluster was identified in which the expression of
Hif1a
-regulated genes was upregulated. The neutrophil population was increased after the induction of EAM, and neutrophils then released
Il-1
to participate in the EAM process. T cells were observed at the highest percentage at the subacute inflammatory phase. T-helper 17 cells, in which the expression of
Hif1a
-regulated genes was upregulated, constituted the main T-cell population detected at the acute inflammatory phase, whereas regulatory T cells were the main T-cell population detected at the subacute inflammatory phase, and γδ T cells releasing
Il-17
were the main T-cell population observed at the myopathy phase. Moreover, the
Hif1a
expression level correlated with the extent of inflammation. In addition, PX-478 could alleviate the inflammatory responses of the different EAM phases. Last,
HIF1A
was expressed at higher levels in patients with acute autoimmune myocarditis than in patients with dilated cardiomyopathy and healthy control subjects.

Conclusions:

We present here a comprehensive single-cell landscape of the cardiac immune cells in different EAM phases. In addition, we elucidate the contribution of
Hif1a
to the inflammatory response through the regulation of immune cell activity, particularly of macrophage cluster 2 and T-helper 17 cells. Moreover, an
Hif1a
inhibitor alleviated inflammatory cell infiltration of the EAM model and may serve as a potential therapeutic target in the clinic.
Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic
Authors: Belhadjer Zahra , Méot Mathilde , Bajolle Fanny , Khraiche Diala , Legendre Antoine , Abakka Samya , Auriau Johanne , Grimaud Marion , Oualha Mehdi , Beghetti Maurice , Wacker Julie , Ovaert Caroline , Hascoet Sebastien , Selegny Maëlle , Malekzadeh-Milani Sophie , Maltret Alice , Bosser Gilles , Giroux Nathan , Bonnemains Laurent , Bordet Jeanne , Di Filippo Sylvie , Mauran Pierre , Falcon-Eicher Sylvie , Thambo Jean-Benoît , Lefort Bruno , Moceri Pamela , Houyel Lucile , Renolleau Sylvain , Bonnet Damien 
Published: May 2020

Background:
Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention.

Methods:
Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state.

Results:
Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2–16 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was <30% in one-third; 80% required inotropic support with 28% treated with extracorporeal membrane oxygenation. Inflammation markers were suggestive of cytokine storm (interleukin-6 median, 135 pg/mL) and macrophage activation (D-dimer median, 5284 ng/mL). Mean BNP (B-type natriuretic peptide) was elevated (5743 pg/mL). Thirty-one of 35 patients (88%) tested positive for SARS-CoV-2 infection by polymerase chain reaction of nasopharyngeal swab or serology. All patients received intravenous immunoglobulin, with adjunctive steroid therapy used in one-third. Left ventricular function was restored in the 25 of 35 of those discharged from the intensive care unit. No patient died, and all patients treated with extracorporeal membrane oxygenation were successfully weaned.

Conclusions:
Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.
Atrial Cardiopathy in the Absence of Atrial Fibrillation Increases Risk of Ischemic Stroke, Incident Atrial Fibrillation, and Mortality and Improves Stroke Risk Prediction
Authors: Edwards Jodi D. , Healey Jeff S. , Fang Jiming , Yip Kathy , Gladstone David J. 
Published: May 2020

Background

Atrial fibrillation (
AF
) is a major, often undetected, cardiac cause of stroke. Markers of atrial cardiopathy, including left atrial enlargement (
LAE
) or excessive atrial ectopy (
EAE
) increase the risk of
AF
and have shown associations with stroke. We sought to determine whether these markers improve stroke risk prediction beyond traditional vascular risk factors (eg
CHA
2
DS
2
‐
VAS
c score).

Methods and Results

Retrospective longitudinal cohort of 32 454 consecutive community‐dwelling adults aged ≥65 years referred for outpatient echocardiogram or Holter in Ontario, Canada (2010–2017). Moderate‐severe
LAE
was defined as men >47 mm and women >43 mm, and
EAE
was defined as >30
APB
s per hour. Cause‐specific competing risks Cox proportional hazards used to estimate risk of ischemic stroke (primary), incident
AF
, and death (secondary). C‐statistics, incremental discrimination improvement and net reclassification were used to compare
CHA
2
DS
2
‐
VAS
c with
LAE
and
EAE
to
CHA
2
DS
2
‐
VAS
c alone. Each 10 mm increase in left atrial diameter increased 2‐ and 5‐year adjusted cause‐specific stroke hazard almost 2‐fold (
LAE
: 2‐year hazard ratio (HR), 1.72;
P
=0.007; 5‐year
HR
, 1.87;
P
<0.0001), while
EAE
showed no significant associations with stroke (2‐year
HR
, 1.00;
P
=0.99; 5‐year
HR,
1.08,
P
=0.70), adjusting for incident
AF
. Stroke risk estimation improved significantly at 2 (C‐statistics=0.68–0.75,
P=
0.008) and 5 years (C‐statistics=0.70–0.76,
P
=0.003) with
LAE
and
EAE
.

Conclusions

LAE
was independently associated with an increased risk of ischemic stroke in the absence of
AF
and both
LAE
and
EAE
improved stroke risk prediction. These findings have implications for stroke risk stratification,
AF
screening, and stroke prevention before the onset of
AF
.
SARS-CoV-2 and Stroke in a New York Healthcare System
Authors: Yaghi Shadi , Ishida Koto , Torres Jose , Mac Grory Brian , Raz Eytan , Humbert Kelley , Henninger Nils , Trivedi Tushar , Lillemoe Kaitlyn , Alam Shazia , Sanger Matthew , Kim Sun , Scher Erica , Dehkharghani Seena , Wachs Michael , Tanweer Omar , Volpicelli Frank , Bosworth Brian , Lord Aaron , Frontera Jennifer 
Published: May 2020

Background and Purpose:
With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic complications including ischemic stroke. However, there is limited data on the clinical characteristics, stroke mechanism, and outcomes of patients who have a stroke and COVID-19.

Methods:
We conducted a retrospective cohort study of consecutive patients with ischemic stroke who were hospitalized between March 15, 2020, and April 19, 2020, within a major health system in New York, the current global epicenter of the pandemic. We compared the clinical characteristics of stroke patients with a concurrent diagnosis of COVID-19 to stroke patients without COVID-19 (contemporary controls). In addition, we compared patients to a historical cohort of patients with ischemic stroke discharged from our hospital system between March 15, 2019, and April 15, 2019 (historical controls).

Results:

During the study period in 2020, out of 3556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging proven ischemic stroke. Cryptogenic stroke was more common in patients with COVID-19 (65.6%) as compared to contemporary controls (30.4%,
P
=0.003) and historical controls (25.0%,
P
<0.001). When compared with contemporary controls, COVID-19 positive patients had higher admission National Institutes of Health Stroke Scale score and higher peak D-dimer levels. When compared with historical controls, COVID-19 positive patients were more likely to be younger men with elevated troponin, higher admission National Institutes of Health Stroke Scale score, and higher erythrocyte sedimentation rate. Patients with COVID-19 and stroke had significantly higher mortality than historical and contemporary controls.

Conclusions:
We observed a low rate of imaging-confirmed ischemic stroke in hospitalized patients with COVID-19. Most strokes were cryptogenic, possibly related to an acquired hypercoagulability, and mortality was increased. Studies are needed to determine the utility of therapeutic anticoagulation for stroke and other thrombotic event prevention in patients with COVID-19.