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Changes of left ventricular function induced by carboplatin combined with paclitaxel...
Zijing Zhai
WenJuan   QIN

Zijing Zhai

and 8 more

May 12, 2020
Ovarian cancer (OC) is the most common reproductive system tumor threatening women’s health. Its incidence rate is increasing year by year. At present, the main treatment of ovarian cancer in the world is the combination of surgery and chemotherapy, and paclitaxel combined with platinum drugs is the first choice for chemotherapy. However, at the same time, studies have shown that platinum and paclitaxel drugs can lead to heart function damage, and serious cases can lead to heart failure. Two dimensional ultrasound and MRI have their own limitations, such as failure to detect lesions early, price and time-consuming, so they are not widely used, and three-dimensional speckle tracking imaging (3D-STE) technology has the advantages of convenience, rapidity, effectiveness and repeatability, which can early detect heart disease. In this paper, 3D-STE technology was used to compare the results of ovarian cancer patients and normal people in different chemotherapy cycles, and compared with the results of MRI. It will be confirmed that 3D-STE technology has more clinical application value than two-dimensional ultrasound and MRI, and provide basis for clinical diagnosis and application.
How do soil microbes exert impact on soil respiration and its temperature sensitivity...
Di Tong
Zhongwu Li

Di Tong

and 6 more

May 12, 2020
Understanding how soil microorganisms influence the direction and magnitude of soil carbon feedback to global warming is vital to predict future climate change. Although microbial activities are major contributors to soil respiration (RS) and its temperature sensitivity (Q10), the mechanisms underpinning microbial influence on RS and Q10 remain unclear. In this study, structural equation modeling (SEM) was conducted to illustrate that bacteria mainly affect RS by shifting beta diversity (denoted NMDS ordinations) instead of richness. In contrast, Q10 values are governed by the richness and NMDS ordinations of bacteria. We also found that soil water content (SWC) was the factor key to changing bacterial properties (P < 0.05, R2 ≥ 0.33). Network analysis demonstrated that only Proteobacteria were positively associated with RS (P < 0.05, R > 0.5). Illuminating the mechanisms underpinning the influence of soil microbes on RS and Q10 values is fundamental to understanding mechanistic soil-climate carbon cycles.
Herbivory effects on leaf litter decomposition vary with special leaf area in tempera...
Yanchun Liu
Xiaojing Liu

Yanchun Liu

and 4 more

May 12, 2020
Insect herbivore has great impacts on biogeochemical cycling in forest ecosystem, but experimental tests on the herbivory-decomposability relationship at the inter-specific level are rare. We conducted a 400-day field decomposition experiment in a temperate mixed deciduous forest and measured mass remaining rate, decomposition constant, total loss of carbon (C) and nitrogen (N) of litter leaf with/without obvious damage by chewing insects for different tree species. We found that herbivory effect on initial litter quality (C: N ratio) varied with species, showing a markedly negative effect on M. alba (-5.78%) and positive effect on Q. acutissima (+5.35%). Herbivory damage increased decomposition constant for M. alba and L. formosana with higher special leaf area, but decreased it for D. kaki and Q. acutissima with lower special leaf area. The contrasting effects of insect herbivory on litter decomposition could be attributed to the variability of litter initial quality caused by herbivory. Our finding that herbivore damage showed inter-specific variability in both litter quality and decomposition rate suggests that herbivory induced feedbacks to nutrient cycling and ecosystem function should be estimated at the species level in multi-species mixed deciduous forest.
Re: Assisted Vaginal Birth: Green-top Guideline No. 26
Pauline McDonagh Hull
Kim Thomas

Pauline McDonagh Hull

and 4 more

May 12, 2020
Letter to the Editor, BJOG Exchange
Chemical and Geochemical Characterization of the Evolution of Soils of Krakatau Islan...
Dian Fiantis
Frisa Ginting

Dian Fiantis

and 5 more

July 31, 2020
The Krakatau volcano erupted in 1883 and created a unique ecosystem where the surrounding islands were completely sterilised. While volcanic activity and plant succession have been extensively studied in the Krakatau islands, the soils received less attention. As the age of the parent material is known precisely, and the islands are isolated, soils of Krakatau islands could provide insights on the first stages of weathering in tropical volcanic regions. This study aims to characterize soils from the Krakatau islands. In 2015, ten sampling sites were selected from Mt. Anak Krakatau, Rakata, Panjang, and Sebesi islands, all making part of the Krakatau island complex. Field morphology was observed from representative profiles on each island. Soil samples were collected and analysed for physical and chemical properties. The geochemical analysis was carried out using the X-ray fluorescence (XRF). Linear discriminant analysis was used to separate materials from the four islands based on their chemical and geochemical concentrations. While the four islands were nearby and influenced by the 1883 eruption of Mt. Krakatau, the analysis showed that the chemical and geochemical characteristics of volcanic ash for each island are distinct. Discriminant analysis of chemical and geochemical properties differentiated soils of Anak Krakatau as the youngest ones, and soils of Sebesi are the most developed ones. The following sequence of the soil weathering degree was established: Sebesi > Rakata > Panjang > Anak Krakatau.
Insects as potential vectors of African swine fever virus in the Republic of Korea
Hachung Yoon
Seong-Keun  Hong

Hachung Yoon

and 3 more

May 12, 2020
African swine fever (ASF) is a fatal disease in swine. Concentration of cases over summer and outbreaks in farms with high levels of biosecurity might support the hypothesis of ASF virus transmission via insects. A total of 28,718 insects were collected from 14 pig farms affected by ASF in the Republic of Korea. The insects collected were flies (N = 27,310, 95.1%), mosquitoes (N = 1,198, 4.2%), and cockroaches (N = 24, 0.1%). The remaining 0.6% (N = 186) could not be taxonomically classified. All the insects collected showed no trace of ASF Virus-DNA was detected by laboratory analysis. It is premature to conclude on the role of insects in the transmission of ASFV. However, the possibility of the virus spreading via insects should not be overlooked.
Impact of a poor functional capacity on the clinical outcomes in patients with a pace...
Takanori Arimoto
Eiichi Watanabe

Takanori Arimoto

and 10 more

May 12, 2020
Introduction: To know whether cardiac pacemaker implantations improve the functional capacity (FC) and affect the prognosis. Methods and Results: We prospectively enrolled 621 de-novo pacemaker recipients (age 76±9 years, 50.7% male) between April 2015 and September 2016. The FC was assessed by the metabolic equivalents (METs) during the implantation and periodically thereafter. The patients were a priori classified into a poor FC (<2 METs, n=40 [6.4%]), moderate FC (24 METs, n=342 [55.1%]). Three months after the pacemaker implantation, poor FC or moderate FC patients improved to a good FC by 43%. The distribution of the three FCs remained at those levels by the end of the follow-up (p=0.18). During a median follow-up of 2.4 years, 71 patients (11%) had cardiovascular hospitalizations and 35 (5.6%) all-cause death. A multivariate Cox analysis revealed that a poor FC at baseline was an independent predictor of both a cardiovascular hospitalization (hazard ratio [HR] 2.494, 95% confidence interval [CI] 1.227-5.070, p=0.012) and all-cause death (HR 3.338, 95% CI 1.254-8.886, p=0.016). One year after the pacemaker implantation, the 19 patients whose poor FC improved to a good FC did not die, however, the 8 who remained with a poor FC had a high mortality rate of 37.5% (p<0.01). Conclusion: Approximately half of the poor or moderate FC patients improved to a good FC 3 months after the pacemaker implantation. The baseline FC predicted the prognosis, and patients with an improved FC after the pacemaker implantation had a better prognosis.
Ablation in Atrial Fibrillation with Ventricular Pacing Results in Similar Catheter S...
Matthew Dai
Chirag Barbhaiya@nyumc.org

Matthew Dai

and 10 more

May 12, 2020
Background: Improved catheter stability is associated with decreased arrhythmia recurrence after atrial fibrillation (AF) ablation. Recently, atrial voltage mapping in AF was demonstrated to correlate better with scar as compared to mapping in sinus rhythm (SR). However, it is unknown whether ablation of persistent AF in sinus rhythm with atrial pacing or in atrial fibrillation with ventricular pacing results in differences in catheter stability or arrhythmia recurrence. Methods: We analyzed 53 consecutive patients undergoing first-time persistent AF ablation with pulmonary vein and posterior wall isolation: 27 were cardioverted, mapped, and ablated in sinus rhythm with atrial pacing, and 26 were mapped and ablated in AF with ventricular pacing. Ablation data was extracted from the mapping system and analyzed using custom MATLAB software to determine high-frequency (60Hz) catheter excursion as a novel metric for catheter spatial stability. Results: There was no difference in catheter stability as assessed by maximal catheter excursion, mean catheter excursion, or contact force variability between the atrial-paced and ventricular-paced patients. Ventricular-paced patients did have significantly greater mean contact forces compared to atrial-paced patients. One year arrhythmia-free survival was similar between the atrial paced and ventricular paced patients (78% vs 67%, p = 0.31). Conclusion: For patients with persistent AF, ablation in AF with ventricular pacing results in similar catheter stability and arrhythmia recurrence as compared to cardioversion and ablation in sinus rhythm with atrial pacing. Given the improved fidelity of mapping in AF, mapping and ablating during AF with ventricular pacing may be preferred.
Higher quantity and lower frequency of N addition and mowing improved gross N turnove...
C Wang
Jianping Sun

C Wang

and 2 more

May 12, 2020
1. Anthropogenic effects, such as nitrogen (N) enrichment and mowing, are constantly changing the function and structure of grassland ecosystems. In order to test whether the magnitude and frequency of N addition, as well as occurrence of mowing, affects gross N turnover. We designed a long-term field experiment which included 5 levels of N addition (0, 2, 10, 20, and 50 g N m-2 yr-1) and mowing in a typical grassland of northern China. 2. To test the effects of N addition frequency, the amount of N applied was separated evenly by two times (twice a year, low frequency) or twelve times (monthly, high frequency) that results were compared against a control site where none of the treatments were applied. Mowing effects were also considered at each N treatment levels. 3. Our results showed that the N level, the frequency of N addition, and mowing significantly influenced gross ammonification (GA) and nitrification (GN) rates. Specifically, the effect of N addition frequency was significantly different under the highest N addition level (50 g N m-2 yr-1), lower frequency (twice a year) significantly increased N turnover rates. Mowing significantly increased the GA rate, while decreased GN rate both under the highest N addition level (50 g N m-2 yr-1) and lower N addition frequency. Further long-term study of the effects of the interactions between N addition and mowing on N turnover will be needed for understanding the mechanisms by which nutrient cycling in typical grassland ecosystems may change in the future.
Bugs scaring bugs: enemy-risk effects in biological control systems
Michael Culshaw-Maurer
Andrew Sih

Michael Culshaw-Maurer

and 2 more

August 14, 2020
Enemy-risk effects, often referred to as non-consumptive effects (NCEs), are an important feature of predator-prey ecology, but their significance has had little impact on the conceptual underpinning or practice of biological control. We provide an overview of enemy-risk effects in predator-prey interactions, discuss ways in which risk effects may impact biocontrol programs, and suggest avenues for further integration of natural enemy ecology and integrated pest management. Enemy-risk effects can have important influences on different stages of biological control programs, including natural enemy selection, efficacy testing, and quantification of non-target impacts. Enemy-risk effects can also shape the interactions of biological control with other pest management practices. Biocontrol systems also provide community ecologists with some of the richest examples of behaviorally-mediated trophic cascades and demonstrations of how enemy-risk effects play out among species with no shared evolutionary history, important topics for invasion biology and conservation.  We conclude that the longstanding use of ecological theory by biocontrol practitioners should be expanded to incorporate enemy-risk effects, and that community ecologists will find many opportunities to study enemy risk effects in biocontrol settings.
Stream order-dependent ecological impacts of agricultural and urban land use across e...
Olaf Büttner
James Jawitz

Olaf Büttner

and 2 more

May 12, 2020
Why have ecological targets for the majority of water bodies in Europe not been met despite decades of water protection programs? We hypothesize that restoration strategies have not adequately accounted for whole-river network perspectives, including interactions between stream orders, spatial patterns of pollutant sources, and ecoregion-dependent susceptibility. We used high-resolution data from Germany to identify relationships between urban wastewater-river discharge fraction (UDF), agricultural land use fraction (ALF), and ecological status by stream order across three ecoregions. We found ecological status of good or better in less than 8% of all river sections with the highest proportions in low-order streams and complete disappearance at higher orders. Increasing ALF impaired the ecological status for river reaches across all stream orders. In contrast, relationships between UDF and ecological status impairment were significant only in low-order streams, independent from ecoregion. Concentrating integrative restoration efforts in low-order streams would maximize the potential to mitigate anthropogenic impacts.
POSITIVE EFFECTS OF LEGUMES ON SOIL ORGANIC CARBON STORAGE DISAPPEAR AT HIGH LEGUME P...
Antonio Rodríguez
Rosa Canals

Antonio Rodríguez

and 2 more

May 12, 2020
Soil is the largest terrestrial carbon pool, making it crucial for climate change mitigation. To disentangle the relationships of plant guild diversity with soil organic carbon (SOC) storage at broad spatial scales, we applied diversity-interaction models to a regional grassland database. The questions were if: 1) positive effects of plant guild diversity on SOC at broad spatial scales are similar to experiments; 2) the enhancement of SOC by legumes is constant in natural grasslands; and 3) the effects of legumes on SOC depend on interactions with other guilds. SOC increased with legume proportion up to 15-20%, then decreased, across broad spatial scales. Additionally, legume effects were enhanced when grasses were dominant, which could be related to the strong capacity of grasses for capturing nitrogen; grass carbon exudates; the balance symbiotic/non-symbiotic nitrogen. Our findings can facilitate the elaboration of regional and local strategies to ameliorate the soil capacity to absorb carbon.
Seroprevalence of Bovine Foot and Mouth Disease (FMD) and Its Associated Risk Factors...
Teshager Tegegne
Tesfaw Mitiku

Teshager Tegegne

and 2 more

May 12, 2020
Foot and mouth disease is an extremely contagious transboundary disease of livestock that causes significant economic losses in Ethiopia. A cross sectional study was conducted from November 2018 to May 2019 to estimate seroprevalence and to assess associated risk factors in selected districts of afar region. Purposive and simple random sampling technique was employed to select the study areas and animals respectively. A total of 384 sera were collected from 72 herds and seroprevalence of the disease was determined using 3ABC-ELISA technique. Data generated from laboratory reports and questionnaire survey was recorded and coded using Microsoft Excel spreadsheet and analyzed using STATA version 14. Potential risk factors of the disease were also assessed using logistic regression analysis. Out of 384 sera tested, the overall seroprevalence of FMDV was 19.8% (n=76; 95% CI=15.8-23.79) at animal level and 56.94% at herd level. The herd level seroprevalence was higher in animals tested from Dubti (85%, n=17) than those from Asayita (48.13%, n=13) and Chifra (44%, n=11). Among the associated risk factors, age, herd size, district and contact with wild life were statistically associated with FMDV serostatus (P<0.05). Medium and large herd size animals were 2.49 (95% CI: 1.33-6.63) and 6.05(95% CI: 2.54-14.43) times more likely to develop the disease as compared to those animals from small herd size respectively. Adult cattle were 2.97 times more likely to have a chance of contracting the disease as compared to young cattle. The current study finding revealed that FMD was more prevalent and economically significant disease in the study districts. Hence, further studies ought to be conducted to estimate the region wise magnitude of the disease and to identify and characterize the circulating serotypes and strains in the areas.
A perspective Study on oral-fecal transmission of COVID-19, its Prevention and Manage...
Abdullah Abdullah
Shah Faisal

Abdullah Abdullah

and 5 more

May 12, 2020
The novel coronavirus outbreak arose in Wuhan, China in Dec, 2019. It is declared the 6th public health emergency by the WHO and named as COVID-19. SARS-CoV-2 is non-segmented positive sense ssRNA virus, belongs to the Coronaviridae under the Nidovirales and spread largely in human being and other mammals. Person to person, airborne and surface transmission is common, the virus get entered to host through nose, mouth, eyes, food, water and feces. An infected patients can transmit the virus to 2.2 healthy individuals. A patient in the US showed gastrointestinal symptoms vomiting, nausea and pass loose stools. Later the patient declared positive for SARS-CoV-2 on the basis of viral detection in stools and respiratory samples. The gastrointestinal symptoms like diarrhea, nausea, vomiting, abdominal discomfort and detection of SARS-CoV-2 in stools of infected and recovered patients indicates potential oral-fecal transmission route, it could be potential risk for the spread of COVID-19. The flatus is gas produced by aerophagia or bacterial fermentation in intestine and expelled out through esophagus or anus. It consists of Hydrogen, Oxygen, Nitrogen, Carbon dioxide and Methane, their percentage composition is 99%. Previous study showed that bacteria can transmit through bare-bottom farting. The gastrointestinal manifestation and possible oral-fecal transmission, the flatulence could be the risk of transmission for COVID-19. Personal hygiene must be adapted to prevent the spread of disease.
Greater awareness is the first step in the fight against Ovarian Cancer in Jordan
Ibrahim Alsharaydeh
Nail  Obeidat

Ibrahim Alsharaydeh

and 3 more

May 12, 2020
Objective: This study was undertaken to assess the awareness of the risk factors, signs, and symptoms of Ovarian cancer, among health care professionals. And to evaluate possible measures to enhance ovarian cancer care in Jordan. Methods: Real time surveys were completed by 75 family medicine trainees from Jordan’s Ministry of Health, and 75 final year medical students from Jordan University of Science and Technology. The survey included a case scenario with three extended match questions to cover diagnosis, initial investigations and referral to a specialised cancer unit for further review and management. Results: Only 5 (6.7%) family medicine trainees and 2 (2.7%) final year medical students managed to answer the three questions correctly. 60% of family medicine trainees and 40% of final year medical students correctly answered the first question on cancer diagnosis, 8% of family medicine trainees and 3% of final year medical students correctly answered the second question on the initial investigations in the primary care. 35% of family medicine trainees and 40% of final year medical students correctly answered the third question on the referral to cancer unit for further management and review. Conclusion: There is an obvious need to improve awareness of risk factors, signs and symptoms of ovarian cancer, to implement a robust ovarian cancer reporting system, cancer networks, and to develop a country-wide strategy to enhance ovarian cancer care in Jordan.
Maternal and perinatal Health Research Collaboration, India (MaatHRI): establishing a...
Manisha Nair
Babul  Bezbaruah

Manisha Nair

and 27 more

May 12, 2020
Objective: To describe the processes used to establish and standardise a UK-India collaborative platform for maternal and perinatal health research (MaatHRI). Design: Hospital-based research platform. Setting: India Population: Pregnant women Methods: MaatHRI is adapted from the UK Obstetric Surveillance System (UKOSS) and built on a pilot model (IndOSS-Assam), which has been extensively standardised using the following methods: (i) establishing a network of hospitals; (ii) setting up a secure system for data collection, storage and transfer; (iii) developing a standardised laboratory infrastructure; and (iv) developing and implementing regulatory systems. Results: MaatHRI was established in September 2018. Fourteen hospitals participate across four states in India – Assam, Meghalaya, Uttar Pradesh and Maharashtra. The Indian research team includes 20 nurses, a project manager, 16 obstetricians, two pathologists, a public health specialist, a general physician and a paediatrician. The UK partners include clinicians and epidemiologists from the University of Oxford. MaatHRI has advanced standardisation of data and laboratory parameters, monitoring data and participant safety, and secure transfer of data. An integral component of MaatHRI is bi-directional capacity building. It is overseen by a steering committee and a data safety and monitoring board which ensure equitable partnerships between the collaborating institutions. Conclusion: MaatHRI is the first prototype of UKOSS and other similar platforms in a low and middle income country (LMIC). The model used to develop the platform can be replicated in other LMICs. Funding: Medical Research Council Career Development Award to Manisha Nair (Ref:MR/P022030/1).
Excess Curvature
Benedict Irwin

Benedict Irwin

March 13, 2026
ABSTRACT We consider a notion of excess curvature, which is simple in definition but quickly produces hard problems. Compare the arclength or curvature integral of a standard function plotted in a region. We can compare this to a flat line, and look at the difference across the entire integration domain. For probability distributions this produces a finite constant which is often unknown. INTRODUCTION If the arclength of a curve f(x) in a region x ∈ [a, b] is given by $$ _a^b[f] = \int_a^b {\partial x}\right)^2} \; dx $$ and for the curve f(x)=c, for some constant, we have 𝒜ab[c]=b − a we can consider the _excess_ curvature as the difference 𝒜ab[f]−𝒜ab[c] which is curvature beyond the domain range. As an integral this is simply $$ _a^b[f] = \int_a^b {\partial x}\right)^2} -1 \; dx $$ the reason for doing this is to extend to an infinite (a → −∞,b → ∞) or semi-infinite domain, where the individual 𝒜 terms diverge, but the difference is convergent. We can then remove the limits a and b, as long as we are clear on the support being integrated over. EXAMPLES Consider the unit Gaussian $$ f(x) = {} e^{-x^2/2} $$ we then have ℬ[f]=0.069796988349688... which does not immediately have a clear closed form. If we shift the mean of this distribution it has no effect on the final result, as the hump is the same distortion to the line as before. We can get closed forms for a few very simple distributions, for example the unit triangle t(x) and it’s normalised powers which give $$ [t(x)] = 2 - 2 \\ \left[{2}t^2(x)\right] = +(3) - 2 \\ \left[2t^3(x)\right] = }{3} -2 - {3}F(i((1+i)),-1) $$ where F is the elliptic F function, showing how complicated these closed forms get. Because the support of these is always [ − 1, 1], there is always a term of −2 which is the base curvature of that support. For infinite support it is less clear how this factor will look. For a function which is not a probability distribution, such as f(x)=ex, the excess curvature in the infinite limit is unbounded. But we can find closed forms for ^y_{-\infty}[e^x] = -(y+1) + } + \left(}}{3-5 }}\right) it is apparent that the term −(y + 1) looks like the support term, and is separable even in this semi infinite case. On the range [0, ∞), we have \left[}{2}\right] = }{2} -1 - (2) + \log(4) on the symmetric full support for which this is a normalised distribution we can double this as \left[}{2}\right] = -2 - 2(2) + 4\log(2) In general it seems on the range [0, ∞), we have \left[}{2}\right] = -{a} + }{2a} - {a}\left({a^2}\right) + {a} - {a} COMBINATIONS For combinations of unit triangles t(x) we have non-additive effects. $$ t(x) \to (2-2) \\ {2}(t(x-\delta)+t(x+\delta)) \to (2 - 4), \delta \ge 1 $$ in between this, there is some kind of overlap function, where the curvature of the combination is different to the pair or the individual. $$ 2 \left(-2\right) & d>1\lor d\leq -1 \\ -2 \left(-2\right) d & -1<d\leq -{2} \\ 2 \left(-2\right) d & {2}\leq d\leq 1 \\ 2 \left(-1\right) (2 d+1) & d=0 \\ -2 \left(- d+2 d-+1\right) & 0<d<{2} \\ 2 \left(- d+2 d+-1\right) & $$ for three triangles fully separated we have $2 - 6$, for four we have $2 -8$. In general it seems $2-2n$ for n non-overlapping triangles scaled by 1/n. If the triangles are not scaled, then we have additive curvature as expected to give $2n(-1)$. We could potentially see this as a form of convolution, excess curvature convolution, for a pulse f(x) we measure $$ [f * f](t) = ^\infty -1 \; dx $$ or with averaging $$ [f * f](t) = ^\infty {4}\left(f'(x)+f'(x-t)\right)^2}-1 \; dx $$ WHY DO THIS? Is there an ’energy’ associated with curvature? Consider a probability density of a particle or wavepacket, or a deformation in a surface such as a wave. What about constructive and destructive interference? Consider calculus of variations trying to minimise a quantity. If we take an ensemble of particles each with Gaussian density, what is the minimum curvature configuration? For the triangular function above, the minimum comes with (t(x)+t(x − 1))/2. This brings the particles together but does not overlap them and does not push them too far apart. What is the forcefield associated with such dynamics? Can we define a potential energy function V(x) or pairwise interaction which has the same minimum and gradients? Upgrading to a Gaussian means the tails will interact over distance. For a unit Gaussian, the equilibrium point lies somewhere between a shift of 2.447 and 2.451, another minimum is full separation of the two bodies.
Selective Modulation of Monocyte and Neutrophil Responses with Activated Protein C in...
Hassan Eliwan
Bill Watson

Hassan Eliwan

and 15 more

May 12, 2020
Background: Inflammation is associated with many disorders of preterm infants including periventricular leukomalacia, chronic lung disease and necrotising enterocolitis. Activated Protein c (APC) has shown positive immunomodulatory effects. Objectives: We aimed to study neutrophil and monocyte function in response to lipopolysaccharide (LPS) and APC stimulation ex vivo in preterm infants <32 weeks gestation over the first week of life compared to neonatal and adult controls. Methods: Peripheral blood was taken on day 1, 3 and 7 and stimulated with LPS in the absence or presence of APC. Expression of Toll-like receptor 4 (TLR4) and CD11b and reactive oxygen intermediate release from neutrophils and monocytes was examined by flow cytometry. Results: LPS induced neutrophil ROI in adults and preterm infants and was significantly reduced by APC. Baseline and LPS-induced monocyte ROI production in preterm neonates was increased compared to adult and term controls. Neutrophil TLR4 baseline expression was higher in term controls compared to preterm infants. Conclusion: Increased systemic ROI release in preterm infants may mediate tissue damage, ROI was reduced by APC. However, due to the high risk of haemorrhage further examination of APC mutant forms with anti-inflammatory but decreased anticoagulant properties is merited.
Traffic Detection Using OpenCV
Siddharth Bose
Cline Colaco

Siddharth Bose

and 2 more

May 12, 2020
In this paper, we explain our Traffic Detection technique using OpenCV concept, Neural Networks, Tensorflow, and how it is successfully detecting and identifying vehicles and other roadside attributes such as pedestrians, signs, and lane markings for a thorough analysis through a road surveillance camera image. Our pre-trained SVM model is highly efficient and accurate in performing the desired task successfully. The paper should be of interest to readers in the areas of Image processing, neural networks, and machine learning.
A New Technique in Asian Nasal Tip Plasty: Non-Incisional, Back-to-Back, Bent Double-...
Young Woong Mo
Gyu Yong Jung

Young Woong Mo

and 1 more

May 12, 2020
Background: The columellar strut graft based on the use of back-to-back autogenous conchal cartilage is one of the most commonly employed invisible grafts used for nasal tip projection. This graft provides an effective means of achieving nasal tip projection but is limited by its flexibility, especially with respect to cephalic rotation. We designed an effective technique that addresses these limitations. Method: A total of 38 patients received a non-incisional, back-to-back, bent double-layered conchal cartilage and pagoda-shaped onlay graft. Projection and location of the nasal tip, nasal length, and nasolabial angle were measured using lateral view photographs. Preoperative and postoperative results were compared. Result: Preoperative and postoperative nasal tip projection ratios and nasal tip location ratios were significantly different. Revision surgery was not required in any case and no direct graft-associated complication occurred. Conclusion: We performed tip plasty with a modified columellar strut graft, that is, a non-incisional, back-to-back, bent double-layered conchal cartilage columellar strut graft. In most cases, this method resulted in a significant tip projection increase.
Personal protective equipment (PPE) and infection among healthcare workers – what is...
Zixing Tian
Mike Stedman

Zixing Tian

and 5 more

May 12, 2020
The worldwide outbreak of coronavirus disease-19 (COVID-19) has already put healthcare workers (HCWs) at a high risk of infection. The question of how to give HCWs the best protection against infection is a priority. Our literature review has indicated that the degree of protection required in looking after people with COVID-19 infection, is dependent on the particular environment to which the HCW is exposed. Covering more of the body could provide better protection for HCWs. Of importance, it is not just the provision of PPE but the skills in donning and doffing of PPE that are important, this being a key time for potential transmission of pathogen to the HCW and in due time from them to others. In relation to face masks, the evidence indicates that a higher-level specification of face masks (N95) seems to be essential to protect HCWs from Coronavirus infection. Evidence specifically around PPE and protection from the COVID-19 virus is minimal and at the level of anecdotal reports only.
Effect of Middle Ear Gelfoam on Hearing and Healing Process after Tympanoplasty: A Pr...
Jae Sang Han
Jung-Ju Han

Jae Sang Han

and 5 more

May 12, 2020
Introduction: This prospective randomized case-control study was performed to compare the surgical outcomes of our swing-door overlay tympanoplasty with or without absorbable gelatine sponge (AGS, gelfoam) packing in the middle ear cavity, according to the surgical procedure. Subjects and Methods: Fifty-seven patients who underwent swing-door overlay tympanoplasty by a single surgeon were enrolled in the study. The data of 30 patients of the gelfoam-packing group (GPG) and 27 patients of the non-gelfoam-packing group (NGPG) were prospectively collected and compared. Results: Closure of the tympanic membrane was found to be successful in all patients at postoperative 3 months evaluation. NGPG showed a statistically better healing process compared to GPG; earlier epithelialization and less fascia edema in NGPG than in GPG (P<0.05). The air-bone gap (ABG) measured at postoperative 1 and 2 months was smaller in NGPG than GPG, although there were no statistical differences. Conclusion: Swing-door overlay tympanoplasty showed good surgical outcomes in terms of graft uptake rate regardless of AGS packing. However, this study revealed earlier healing process and faster recovery of ABG in NGPG, thereby indicating that the gelfoam in the middle ear may interfere with both hearing recovery and the healing process of neodrum. Non-gelfoam packing in the middle ear cavity appeared to be superior to gelfoam packing in swing-door overlay tympanoplasty.
Maternal health and pregnancy outcome in Marfan syndrome: A register-based study
Kristian Groth
Birgitte Nielsen

Kristian Groth

and 5 more

May 12, 2020
Objective In Marfan syndrome, pregnancy is considered as high-risk due to connective tissue insufficiency and increased risk of aortic dissection. The objective was to demonstrate the consequences on maternal health, including aortic events in women with Marfan syndrome. Furthermore, to investigate outcome in undiagnosed with Marfan syndrome at the time of pregnancy. Design Information on aortic operations, aortic dissections, and pregnancy related outcome, from a national cohort of women with Marfan syndrome (n=195) were compared to an age-matched background population (n=19,500). The women with Marfan syndrome were divided according to whether the Marfan syndrome diagnosis was known at the time of pregnancy or not. Setting National health care registers Methods Main outcomes measures Registered events from the National Patient Registry in Denmark Results Significantly fewer women with Marfan syndrome gave birth, compared to the background population. In Marfan syndrome, complications related to cervix were increased (HR: 19.8 (95% CI: 2.2-177.5)) and the number of caesarean sections was higher (HR: 2.09 (95% CI: 1.41-3.08)). No women with known Marfan syndrome had a pregnancy related aortic dissection and the consequences of pregnancy and delivery on future aortic events seemed limited. Among undiagnosed women with Marfan syndrome there were more foetal deaths and all delivery-related dissections came from this subgroup. Conclusion The surveillance program for pregnant women with Marfan syndrome seems appropriate and only women with undiagnosed Marfan syndrome experienced a pregnancy-related aortic dissection. However, there is still an increased risk of complications during pregnancy, but the overall outcome data are quite reassuring.
Values and Knowledge Education combined with Team Based Learning for medical students...
Yuri Perlitz
Yakir Lidani

Yuri Perlitz

and 4 more

May 12, 2020
Background: Team-based learning (TBL) is a structured form of small-group learning for students which emphasizes out-of-class preparation towards guided application of knowledge in class. Values and knowledge education (VaKE) is a teaching method in which a “dilemma” is used as a motivation and trigger of knowledge acquisition. The goal of this study was to compare and evaluate medical students’ knowledge and achievements in a combination of these two methods (TBL+VaKE) vs. TBL alone. Methods: Every academic year we teach 3-4 groups of 8-10 medical students in each group, at their 5th year of MD studies. We recruited all groups of students since we started the study and alternately used one of the educational approaches on them, TBL or TBL+VaKE. Our study’s module was “diabetes in pregnancy”. Results: On all issues, the TBL+VaKE received higher scores. The difference for “complexity of decision making” question reached statistical significance. Furthermore, when we compared the two groups questionnaire answers, we detected statistical significance of p=0.02 (T test) for the difference between the two sets of scores. Conclusions: “Diabetes and pregnancy” module for 5th year meducal school students had better knowledge acquisition when a moral dilemma was added to the module (TBL+VaKE vs TBL).
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