Hindawi Publications

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Open Access
Liver Injury Patterns and Hepatic Toxicity among People Living with and without HIV and Attending Care in Urban Uganda.
(Hindawi Limited, 2023) Wekesa, Clara; Parkes-Ratanshi, Rosalind; Kirk, Gregory D; Ocama, Ponsiano; Wekesa, Clara [0000-0001-6064-237X]; Ocama, Ponsiano [0000-0002-6120-1055]
INTRODUCTION: The evaluation of the patterns of liver injury, derived from liver chemistry panels, often may narrow on probable causes of the liver insult especially when coupled with clinical history, examination, and other diagnostic tests. METHODS: Among people living with and without HIV and attending care, we used the R ratio to evaluate for liver injury patterns. Liver injury patterns were defined as cholestatic (R < 2), mixed (R = 2-5), and hepatocellular (R > 5). RESULTS: Overall, the proportions of participants with cholestatic liver injury, mixed liver injury, and hepatocellular liver injury were 55%, 34%, and 4%, respectively, with similar distribution when stratified by HIV status. Alcohol use among participants without HIV was associated with all patterns of liver injury (cholestatic liver injury (OR = 4.9 CI (1.0-24.2); p = 0.054), mixed liver injury (OR = 5.3 CI (1.1-27.3); p = 0.043), and hepatocellular liver injury (OR = 13.2 CI (1.0-167.3); p = 0.046)). Increasing age was associated with cholestatic liver injury among participants with HIV (OR = 2.3 CI (1.0-5.3); p = 0.038). Despite a high hepatitis B prevalence among participants with HIV, there was no association with liver injury. CONCLUSIONS: Liver injury is prevalent among both people living with and without HIV in care, and cholestatic liver injury is the most common pattern. Alcohol is associated with all patterns of liver injury and increasing age associated with cholestatic liver injury among people living without HIV and people living with HIV, respectively.
Open Access
Solution Uptake in Cylindrical Carbon-Fibre-Reinforced Polymer (CFRP) Tendons
(Hindawi Limited, 2022) Scott, P; Toumpanaki, E; Lees, JM; Toumpanaki, E [0000-0002-4208-3284]; Lees, JM [0000-0002-8295-8321]
Salt water exposure conditions relevant to carbon-fibre-reinforced polymer (CFRP) prestressed concrete structures in marine environments are investigated. The diffusion into relatively small diameter CFRP tendons can be a lengthy process so the prediction of the long-term moisture uptake using short-term experiments on thin films of epoxy would be advantageous. However, the fibre inclusions within a composite introduce complexities, and factors are typically required for correlation with pure epoxy specimens. Diffusion parameters based on moisture uptake result from CFRP tendons exposed to salt water solution at 20°C and 60°C are compared with those obtained using equivalent thin film specimens. The higher temperature is selected to accelerate the moisture uptake. It is found that the measured ratios of tendon and epoxy diffusivity were temperature dependent, and the combination of the higher temperature and salt solution leads to an increased propensity for moisture uptake in the tendon. Existing analytical models to predict the CFRP tendon diffusivity from that of a thin film of epoxy did not appear to capture the observed trends. However, predictions using a unit cell with a fibre interface zone suggest that this may be due to an increased diffusivity in the interphase region.
Open AccessPublished version Peer-reviewed
Trans-myocardial Extraction of Endothelin-1 Correlates with Increased Microcirculatory Resistance following Percutaneous Coronary Intervention.
(Hindawi Limited, 2022) Abraham, George R; Nyimanu, Duuamene; Kuc, Rhoda E; Maguire, Janet J; Davenport, Anthony P; Hoole, Stephen P; Abraham, George R [0000-0003-1442-4835]; Nyimanu, Duuamene [0000-0002-6212-9518]; Kuc, Rhoda E [0000-0003-4673-1602]; Maguire, Janet J [0000-0002-9254-7040]; Davenport, Anthony P [0000-0002-2096-3117]; Hoole, Stephen P [0000-0002-3530-3808]
Objective: Coronary microvascular dysfunction (CMD) can complicate successful percutaneous coronary intervention (PCI). The potent endogenous vasoconstrictor peptide Endothelin-1 (ET-1) may be an important mediator. To investigate the mechanism, we sought to define the peri-procedural trans-myocardial gradient (TMG-coronary sinus minus aortic root levels) of ET-1 and its precursor peptide - Big ET-1. We then assessed correlation with pressure-wire indices of CMD: coronary flow reserve (CFR) and index of microvascular resistance (IMR). Methods: Paired blood samples from the guide catheter and coronary sinus were collected before and after pressure-wire-guided PCI from patients with stable angina. Plasma was analysed using a specific enzyme-linked immunosorbent assay for quantification of ET-1 peptides and correlated with pressure-wire data. Non normally distributed continuous variables are presented as median [IQR]. Results: ET-1 and Big ET-1 increased post-PCI in the aorta (ET-1: 0.98 [0.76-1.26] pg/ml to 1.20 [1.03-1.67] pg/ml, P < 0.001 and Big ET-1: 2.74 [1.78-2.50] pg/ml to 3.36 [2.33-3.97] pg/ml, P < 0.001) and coronary sinus (ET-1: 1.00 [0.81-1.28] pg/ml to 1.09 [0.91-1.30] pg/ml, P = 0.03 and Big ET-1: 2.89 [1.95-3.83] pg/ml to 3.56 [2.66-4.83] pg/ml, P = 0.01). TMG of ET-1 shifted negatively compared with baseline following PCI reflecting significantly increased extraction (0.03 [-0.12-0.17] pg/ml pre-PCI versus -0.16 [-0.36-0.07] pg/ml post-PCI, P = 0.01). Increased ET-1 trans-myocardial extraction correlated with higher IMR (Pearson's r = 0.293, P = 0.02) and increased hyperemic transit time (Pearson's r = 0.333, P < 0.01). In subgroup analysis, mean ET-1 trans-myocardial extraction was higher amongst patients with high IMR compared with low IMR (0.73 pg/ml, SD:0.78 versus 0.17 pg/ml, SD:0.42, P = 0.02). There was additionally a numerical trend towards increased ET-1 trans-myocardial extraction in subgroups of patients with low CFR and in patients with Type 4a Myocardial Infarction, albeit not reaching statistical significance. Conclusions: Circulating ET-1 increases post-PCI and upregulated ET-1 trans-myocardial extraction contributes to increased microcirculatory resistance.
Open AccessPublished version Peer-reviewed
Dynamics of DNA Replication during Male Gametogenesis in the Malaria Parasite Plasmodium Falciparum
(Wiley, 2022) Matthews, Holly; McDonald, Jennifer; Totanes, Francis; Merrick, Catherine; Matthews, H [0000-0002-3890-9098]; McDonald, J [0000-0003-2208-1246]; Totañes, FIG [0000-0002-3419-5243]; Merrick, CJ [0000-0001-7583-2176]
Malaria parasites undergo a single phase of sexual reproduction in their complex lifecycle. It involves specialised, sexually committed cells called gametocytes, which develop rapidly into mature gametes and mate upon entering the mosquito midgut. Gamete development is unique, involving unprecedentedly fast replication to produce male gametes. Within ~15 minutes a male gametocyte replicates its ~23 Mb genome three times to produce 8 genomes, segregates these into newly-assembled flagellated gametes and releases them to seek female gametes. Here, for the first time, we use fluorescent labelling of de novo DNA synthesis to follow this process at the whole-cell and single-molecule levels. We make several novel observations, including characterising the origin recognition complex protein Orc1 for the first time in gametocytes, finding that cytokinesis is uncoupled from DNA replication (implying a lack of cell cycle checkpoints), and that the single-molecule dynamics of DNA replication are entirely different from the dynamics in asexual schizogony.
Open Access
Rabies Elimination: Is It Feasible without Considering Wildlife?
(Hindawi Limited, 2022) Acharya, Krishna Prasad; Chand, Rakesh; Huettmann, Falk; Ghimire, Tirth Raj; Acharya, Krishna Prasad [0000-0002-4208-7592]; Ghimire, Tirth Raj [0000-0001-9952-1786]
Rabies is a vaccine-preventable fatal viral disease that is zoonotic in nature. In this article, we provide a justification why the agreement of the World Health Organization (WHO), the Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and Global Alliance for Rabies Control (GARC) on The Global Strategic Plan to End Human Deaths from Dog-mediated Rabies by 2030 should also include a more holistic approach and ecologic views.
Open Access
Effectiveness and Safety of Nonvitamin K Oral Anticoagulants Rivaroxaban and Apixaban in Patients with Venous Thromboembolism: A Meta-Analysis of Real-World Studies.
(Hindawi Limited, 2022) Wu, Olivia; Morris, Stephen; Larsen, Torben Bjerregaard; Skjøth, Flemming; Evans, Alex; Bowrin, Kevin; Wojciechowski, Piotr; Margas, Wojciech; Huelsebeck, Maria; Wu, Olivia [0000-0002-0570-6016]; Morris, Stephen [0000-0002-5828-3563]; Larsen, Torben Bjerregaard [0000-0002-8485-8674]; Skjøth, Flemming [0000-0003-2975-647X]; Evans, Alex [0000-0002-8549-0146]; Bowrin, Kevin [0000-0001-9165-471X]; Wojciechowski, Piotr [0000-0001-8400-1171]; Margas, Wojciech [0000-0002-9936-0932]; Huelsebeck, Maria [0000-0002-3147-9945]
Background: Rivaroxaban and apixaban are the most widely used nonvitamin K oral anticoagulants (NOACs) in patients with venous thromboembolism (VTE). This meta-analysis evaluates the effectiveness and safety of both NOACs versus standard of care (SoC) in real-world practice. Methods: Real-world evidence (RWE) studies were identified through a systematic literature review conducted between January 2012 and July 2020, using Embase, MEDLINE, and the websites of cardiological, hematological, and oncological associations. Eligible RWE studies recruited adult patients with deep vein thrombosis and/or pulmonary embolism and presented a comparison between rivaroxaban and apixaban versus SoC, consisting either of vitamin K antagonists, heparins, or combinations thereof. Hazard ratios (HRs) for the comparison between NOACs and SoC were extracted from the relevant studies or estimated based on the reported binary data. The between-treatment contrasts were reported as HRs with associated 95% confidence intervals. Results: A total of 65 RWE studies were identified and considered relevant for the meta-analysis. Compared with SoC, both rivaroxaban and apixaban were associated with reduced risks of recurrent VTE and a lower rate of major bleeding events. Patients treated with rivaroxaban were at a lower risk of all-cause death compared with those receiving SoC (HR = 0.56 [0.39-0.80]), while evidence for apixaban from the identified studies was insufficient to demonstrate a statistically significant change in mortality (HR = 0.66 [0.30-1.47]). Conclusion: This analysis indicates that in real-world practice, rivaroxaban and apixaban are associated with a lower risk of recurrent VTE and major bleeding events compared with SoC. Survival benefit in patients treated with rivaroxaban was also observed.
Open Access
Physiological Response of the Freshwater Mussel Unio douglasiae in Microcystis aeruginosa Bloom Waters.
(Hindawi Limited, 2022) Li, Zhun; Kim, Young-Hyo; Aldridge, David C; Kim, Baik-Ho; Li, Zhun [0000-0001-8961-9966]; Kim, Baik-Ho [0000-0002-7144-0770]
In the present study, we evaluated the effects of different environments on the filtering rate (FR), mortality, and biodeposition (BD) of the freshwater mussel Unio douglasiae in bloom waters containing the toxic cyanobacterium Microcystis aeruginosa. The mean FR of 19 selected individuals (shell length, 5.0-9.8 cm) was 0.30 ± 0.03 L g-1 h-1 (range = 0.24-0.35 L g-1 h-1). Shell length was strongly correlated with both net and gross BD of mussels (P < 0.0001). The mean FR was higher in river water (0.405 ± 0.052 L g-1 h-1) than in lake water (0.304 ± 0.051 L g-1 h-1). In contrast, the BD of mussels was higher in RW (0.671 ± 0.609 mg g-1 h-1) than in LW (0.275 ± 0.027 mg g-1 h-1). For algal species, the FR of mussels ranged from 0.114 ± 0.024 to 0.553 ± 0.019 L g-1 h-1. The FR of U. douglasiae was higher in river water (mainly diatoms), whereas BD was higher in lake water (mainly Microcystis). U. douglasiae did not prefer toxic M. aeruginosa, which was significantly accumulated in pseudofaeces and faeces. The maximum FR of U. douglasiae in algal bloom water was recorded at a water temperature of 25°C and water depth of 50 cm. Moreover, the in situ mortality of U. douglasiae was strongly affected by water temperature and nitrogen concentration. Overall, U. douglasiae can enhance water quality in eutrophic areas by removing dominant cyanobacteria, although its removal efficiency depends on environmental parameters and site of introduction.
Open Access
Waveform Distortion of Gaussian Beam in Atmospheric Turbulence Simulated by Phase Screen Method
(Hindawi Limited, 2022-02-21) Yang, ZQ; Yang, LH; Gong, L; Wang, L; Wang, X; Yang, ZQ [0000-0002-3288-9698]
The atmospheric turbulence phase screen is generated based on the power spectrum inversion method, and the multiple transmission processes are statistically averaged. The waveform distortion of the Gaussian beam in the atmospheric turbulence is analyzed; the simulation results show that the property of Gaussian beam has been destroyed after its passing through the atmospheric turbulence. When the beam waist radius is close to a certain radius, the degree of change becomes larger. When it approaches the critical value, the wave surface no longer changes sharply, and as the turbulence intensity increases, the phase fluctuation becomes more and more severe, the coherence of the beam is destroyed, and the spot may be split into several pieces. Finally, the relationship of intensity fluctuation, amplitude fluctuation, and bit error rate with distance is analyzed.
Open Access
Multivariate and Online Prediction of Closing Price Using Kernel Adaptive Filtering.
(Hindawi Limited, 2021) Mishra, Shambhavi; Ahmed, Tanveer; Mishra, Vipul; Kaur, Manjit; Martinetz, Thomas; Jain, Amit Kumar; Alshazly, Hammam; Mishra, Shambhavi [0000-0002-9593-4820]; Ahmed, Tanveer [0000-0003-0732-3016]; Mishra, Vipul [0000-0002-3649-1388]; Kaur, Manjit [0000-0001-6259-2046]; Martinetz, Thomas [0000-0002-4539-4475]; Jain, Amit Kumar [0000-0001-7939-7810]; Alshazly, Hammam [0000-0002-9942-8642]
This paper proposes a multivariate and online prediction of stock prices via the paradigm of kernel adaptive filtering (KAF). The prediction of stock prices in traditional classification and regression problems needs independent and batch-oriented nature of training. In this article, we challenge this existing notion of the literature and propose an online kernel adaptive filtering-based approach to predict stock prices. We experiment with ten different KAF algorithms to analyze stocks' performance and show the efficacy of the work presented here. In addition to this, and in contrast to the current literature, we look at granular level data. The experiments are performed with quotes gathered at the window of one minute, five minutes, ten minutes, fifteen minutes, twenty minutes, thirty minutes, one hour, and one day. These time windows represent some of the common windows frequently used by traders. The proposed framework is tested on 50 different stocks making up the Indian stock index: Nifty-50. The experimental results show that online learning and KAF is not only a good option, but practically speaking, they can be deployed in high-frequency trading as well.
Open Access
A Fine-Grained IoT Data Access Control Scheme Combining Attribute-Based Encryption and Blockchain
(Hindawi Limited, 2021) Lu, X; Fu, S; Jiang, C; Lio, P; Lu, X [0000-0003-1033-164X]; Fu, S [0000-0003-3136-3747]; Jiang, C [0000-0002-2064-3754]; Lio, P [0000-0002-0540-5053]
IoT technology has been widely valued and applied, and the resulting massive IoT data brings many challenges to the traditional centralized data management, such as performance, privacy, and security challenges. This paper proposes an IoT data access control scheme that combines attribute-based encryption (ABE) and blockchain technology. Symmetric encryption and ABE algorithms are utilized to realize fine-grained access control and ensure the security and openness of IoT data. Moreover, blockchain technology is combined with distributed storage to solve the storage bottleneck of blockchain systems. Only the hash values of the data, the hash values of the ciphertext location, the access control policy, and other important information are stored on the blockchain. In this scheme, smart contract is used to implement access control. The results of experiments demonstrate that the proposed scheme can effectively protect the security and privacy of IoT data and realize the secure sharing of data.
Open Access
Iatrogenic Complications of Compulsory Treatment in a Patient Presenting with an Emotionally Unstable Personality Disorder and Self-Harm.
(Hindawi Limited, 2021) Burrin, Charlotte; Daniels, Natasha Faye; Cardinal, Rudolf N; Hayhurst, Catherine; Christmas, David; Zimbron, Jorge; Burrin, Charlotte [0000-0002-2341-448X]; Daniels, Natasha Faye [0000-0003-0384-0542]; Cardinal, Rudolf N [0000-0002-8751-5167]; Christmas, David [0000-0001-5423-0221]; Zimbron, Jorge [0000-0002-9598-2080]
Attempted suicide and deliberate self-harm are common and challenging presentations in the emergency department. A proportion of these patients refuse interventions and this presents the clinical, legal, and ethical dilemma as to whether treatment should be provided against their will. Multiple factors influence this decision. It is difficult to foresee the multitude and magnitude of complications that can arise once it has been decided to treat individuals who do not consent. This case illustrates a particularly complex chain of events that occurred after treating someone against their will who presented with self-harm and suicidal ideation. These consequences are contrasted with those of not intervening when similar situations arose with the same patient.
Open Access
Robust Multisensor MeMBer Filter for Multiple Extended-Target Tracking
(Hindawi Limited, 2021) Lu, X; Zhang, Z; Li, Q; Sun, J; Zhang, Z [0000-0003-4377-9192]; Li, Q [0000-0003-0297-4346]
This paper develops a robust extended-target multisensor multitarget multi-Bernoulli (ET-MS-MeMBer) filter for enhancing the unsatisfactory quality of measurement partitions arising in the classical ET-MS-MeMBer filter due to increased clutter intensities. Specifically, the proposed method considers the influence of the clutter measurement set by introducing the ratio of the target likelihood to the clutter likelihood. With the constraint of the clutter measurement set, it can obtain better multisensor measurement partitioning results under the original two-step greedy partitioning mechanism. Subsequently, the single-target multisensor likelihood function for the clutter case is derived. Simulation results reveal a favorable comparison to the ET-MS-MeMBer filter in terms of accuracy in estimating the target cardinality and target state under conditions with increased clutter intensities.
Open Access
Reference Values for DXA-Derived Visceral Adipose Tissue in Adults 40 Years and Older from a European Population: The Tromsø Study 2015-2016.
(Hindawi Limited, 2021) Lundblad, Marie W; Jacobsen, Bjarne K; Johansson, Jonas; De Lucia Rolfe, Emanuella; Grimsgaard, Sameline; Hopstock, Laila A; Lundblad, Marie W [0000-0002-7111-6401]; Jacobsen, Bjarne K [0000-0003-0781-3349]; Johansson, Jonas [0000-0001-7912-5786]; De Lucia Rolfe, Emanuella [0000-0003-3542-2767]; Grimsgaard, Sameline [0000-0002-0601-0344]; Hopstock, Laila A [0000-0003-0072-7421]
BACKGROUND: Reference values for visceral adipose tissue (VAT) are needed and it has been advocated that body composition measures depend on both the technique and methods applied, as well as the population of interest. We aimed to develop reference values for VAT in absolute grams (VATg), percent (VAT%), and as a kilogram-per-meters-squared index (VATindex) for women and men, and investigate potential differences between these measures and their associations with cardiometabolic risk factors (including metabolic syndrome (MetS)). METHODS: In the seventh survey of the population-based Tromsø Study, 3675 participants (aged 40-84, 59% women) attended whole-body DXA scans (Lunar Prodigy GE) from where VAT was derived. We used descriptive analysis, correlations, receiver operating characteristics (ROC), and logistic regression to propose reference values for VAT and investigated VAT's association with cardiometabolic risk factors, MetS and single MetS components. Further, Youden's index was used to suggest threshold values for VAT. RESULTS: VATg and VATindex increased until age 70 and then decreased, while VAT% increased with age across all age groups. VAT (all measurement units) was moderate to highly correlated and significantly associated with all cardiometabolic risk factors, except for total cholesterol. Associations between MetS, single MetS components, and VATg and VATindex were similar, and VAT% did not contribute any further to this association. CONCLUSION: These VAT reference values and thresholds, developed in a sample of adults of Norwegian origin, could be applied to other studies with similar populations using the same DXA device and protocols. The associations between VAT and cardiometabolic risk factors were similar across different measurement units of VAT.
Open Access
Robust Multisensor MeMBer Filter for Multiple Extended-Target Tracking
(2021-05-20) Lu, Xiaoke; Zhang, Zhiguo; Li, Qing; Sun, Jinping
This paper develops a robust extended-target multisensor multitarget multi-Bernoulli (ET-MS-MeMBer) filter for enhancing the unsatisfactory quality of measurement partitions arising in the classical ET-MS-MeMBer filter due to increased clutter intensities. Specifically, the proposed method considers the influence of the clutter measurement set by introducing the ratio of the target likelihood to the clutter likelihood. With the constraint of the clutter measurement set, it can obtain better multisensor measurement partitioning results under the original two-step greedy partitioning mechanism. Subsequently, the single-target multisensor likelihood function for the clutter case is derived. Simulation results reveal a favorable comparison to the ET-MS-MeMBer filter in terms of accuracy in estimating the target cardinality and target state under conditions with increased clutter intensities.
Open Access
Rapid Whole Genome Sequencing of Serotype K1 Hypervirulent Klebsiella pneumoniae from an Undocumented Chinese Migrant.
(Hindawi Limited, 2021) Macleod, CK; Khokhar, FA; Warne, B; Wick, R; Butcher, R; Cassimon, B; Hayden, P; Holt, K; Török, ME; Wick, R [0000-0001-8349-0778]; Butcher, R [0000-0003-0435-2655]; Török, ME [0000-0001-9098-8590]
BACKGROUND: Hypervirulent Klebsiella pneumoniae causes severe disseminated infections, typically with hepatic and central nervous system involvement including endophthalmitis. Case Presentation. We report a fatal case of an undocumented Chinese migrant in her 60s who presented to the emergency department with abdominal pain, lethargy, and headache over the preceding two weeks. She had a new diagnosis of diabetes mellitus on admission. Computed tomography scan of the thorax, abdomen, and pelvis showed bilateral pneumonia with liver abscesses. The patient was treated with empirical broad-spectrum antibiotics before K. pneumoniae was isolated from cerebrospinal fluid and blood cultures. The isolate was further characterised as a ST23 (ST: sequence type), serotype K1 hypervirulent strain using Nanopore sequencing. Despite admission to the intensive care unit, the patient died within 48 hrs of admission. CONCLUSIONS: This case demonstrates the need for increased awareness of hypervirulent K. pneumoniae, even in countries where it occurs infrequently. Novel, rapid, sequencing technologies can support diagnosis in unusual presentations.
Open Access
Sea Cucumber-Derived Peptides Alleviate Oxidative Stress in Neuroblastoma Cells and Improve Survival in C. elegans Exposed to Neurotoxic Paraquat.
(Hindawi Limited, 2021) Lu, Meng; Mishra, Ajay; Boschetti, Chiara; Lin, Jing; Liu, Yushuang; Huang, Hongliang; Kaminski, Clemens F; Huang, Zebo; Tunnacliffe, Alan; Kaminski Schierle, Gabriele S; Lu, Meng [0000-0001-9311-2666]; Boschetti, Chiara [0000-0003-4552-3975]; Kaminski Schierle, Gabriele S [0000-0002-1843-2202]
Oxidative stress results when the production of oxidants outweighs the capacity of the antioxidant defence mechanisms. This can lead to pathological conditions including cancer and neurodegeneration. Consequently, there is considerable interest in compounds with antioxidant activity, including those from natural sources. Here, we characterise the antioxidant activity of three novel peptides identified in protein hydrolysates from the sea cucumber Apostichopus japonicus. Under oxidative stress conditions, synthetic versions of the sea cucumber peptides significantly compensate for glutathione depletion, decrease mitochondrial superoxide levels, and alleviate mitophagy in human neuroblastoma cells. Moreover, orally supplied peptides improve survival of the Caenorhabditis elegans after treatment with paraquat, the latter of which leads to the production of excessive oxidative stress. Thus, the sea cucumber peptides exhibit antioxidant activity at both the cellular and organism levels and might prove attractive as nutritional supplements for healthy ageing.
Open Access
Treatment of Severe Emotionally Unstable Personality Disorder with Comorbid Ehlers-Danlos Syndrome and Functional Neurological Disorder in an Inpatient Setting: A Case for Specialist Units without Restrictive Interventions.
(Hindawi Limited, 2021) Henry, Jessica; Collins, Eddie; Griffin, Amanda; Zimbron, Jorge; Henry, Jessica [0000-0002-8325-6540]; Zimbron, Jorge [0000-0002-9598-2080]
We present the case of a young woman with an Emotionally Unstable Personality Disorder (EUPD) diagnosis suffering from high-risk self-injurious behaviour. She was also diagnosed with Ehlers-Danlos Syndrome and Functional Neurological Disorder, manifesting as nonepileptic seizures and immobility. Our patient, "A," endured traumatic childhood abuse and became highly dependent on services in her late teens. Recurrent suicide attempts resulted in twenty to thirty acute psychiatric admissions, Intensive Care Unit stays, and multiple failed trials of psychological therapy. Nonepileptic seizures and wheelchair dependency made her "too complex" for many specialist services. She was eventually admitted to Springbank ward in Fulbourn Hospital, Cambridge. The EUPD specialist unit prides itself on evidence-based treatments, shared values, and a least restrictive approach. At discharge, our patient was self-harm free and able to walk unaided and no longer met EUPD diagnostic criteria. We include "A's" personal views on her illness and how Springbank ward facilitated her recovery, together with results from structured clinical outcome measures.
Open Access
Isolation and Functional Determination of SKOR Potassium Channel in Purple Osier Willow, Salix purpurea.
(Hindawi Limited, 2021) Chen, Yahui; Peng, Xuefeng; Cui, Jijie; Zhang, Hongxia; Jiang, Jiang; Song, Zhizhong; Jiang, Jiang [0000-0001-5058-8664]; Song, Zhizhong [0000-0002-9793-8614]
Potassium (K+) plays key roles in plant growth and development. However, molecular mechanism studies of K+ nutrition in forest plants are largely rare. In plants, SKOR gene encodes for the outward rectifying Shaker-type K+ channel that is responsible for the long-distance transportation of K+ through xylem in roots. In this study, we determined a Shaker-type K+ channel gene in purple osier (Salix purpurea), designated as SpuSKOR, and determined its function using a patch clamp electrophysiological system. SpuSKOR was closely clustered with poplar PtrSKOR in the phylogenetic tree. Quantitative real-time PCR (qRT-PCR) analyses demonstrated that SpuSKOR was predominantly expressed in roots, and expression decreased under K+ depletion conditions. Patch clamp analysis via HEK293-T cells demonstrated that the activity of the SpuSKOR channel was activated when the cell membrane voltage reached at -10 mV, and the channel activity was enhanced along with the increase of membrane voltage. Outward currents were recorded and induced in response to the decrease of external K+ concentration. Our results indicate that SpuSKOR is a typical voltage dependent outwardly rectifying K+ channel in purple osier. This study provides theoretical basis for revealing the mechanism of K+ transport and distribution in woody plants.
Open Access
Quality of Sleep and Its Correlates among Yemeni Medical Students: A Cross-Sectional Study.
(Hindawi Limited, 2021) Attal, Bothaina Ahmed; Bezdan, Mohammed; Abdulqader, Abdulwahab; Attal, Bothaina Ahmed [0000-0002-3650-7415]; Bezdan, Mohammed [0000-0002-6734-695X]; Abdulqader, Abdulwahab [0000-0003-1037-0315]
BACKGROUND: Sleep disturbance is particularly common among medical students worldwide and affects their wellbeing and academic performance. However, little is known about this issue in Yemen. This study looks at sleep quality and its association with personal and life-style factors and self-reported academic performance among medical students at the largest Yemeni university. METHODS: A cross-sectional survey was conducted at Sana'a University, Yemen, in 2017. The Pittsburgh Sleep Quality Index (PSQI), consisting of 19 items and 7 components (score range = 0-3), was used to assess sleep quality. The summation of the components' scores yields the global PSQI score (range = 0-21). A global PSQI value higher than 5 indicates poor quality of sleep. Logistic regression was applied to look at relationships. RESULTS: 240 male (41%) and female (59%) medical students took part in the study with 54% being preclinical and 46% clinical with an average age of 23.3 years (SD = 1.7). The mean global score (SD) was 6.85 (2.8), and 68% of the students (N = 163) were identified as poor sleepers. The mean global PSQI score (SD) and proportion of poor sleepers were higher among males (7.7 (2.8) and 81%, respectively) than females (6.27 (2.42) and 59.2%, respectively), p ≤ 0.001. Good sleep quality was more likely (OR (95% CI)) among females (3.4 (1.3-8.8)), the unmarried (2.8 (1-7.8)), those in good health (2.3 (1.1-4.5)), and nonkhat chewers (4.9 (1.4-17.1)). Nonsmokers were less likely to have good quality sleep compared to occasional smokers (0.185 (0.071-.485)). Stress (30%) and academic workload (21%) were the most commonly reported causes of poor sleep quality. Almost two-thirds of the students (65%) mentioned that disturbed sleep undermined their academic performance. CONCLUSIONS: Poor sleep quality is common among Sana'a medical students and impacts their academic performance. Specific stress management and sleep hygiene promoting programs should be incorporated early on in medical education.
Open Access
The Optimization of a Virtual Dual Production-Inventory System under Dynamic Supply Disruption Risk
(Hindawi Limited, 2020) Chen, Y; Liu, L; Shi, V; Zhang, Y; Zhu, J; Liu, L [0000-0002-9658-2468]
Major events such as the COVID-19 pandemic, Olympic Games, and G20 Summit bring about supplier disruption risks and challenges to supply chain management. To help deal with these risks, a virtual dual-sourcing production-inventory system can be deployed. In this paper, we study such a system which consists of a raw material supplier, a manufacturer, and a virtual dual-sourcing contingency supplier. The manufacturer needs to determine the production, procurement, and inventory plan of raw materials. When its supplier is interrupted, the manufacturer may need to adjust the production and inventory plan and work with the contingency supplier. We develop a system dynamics method to simulate the operations in this production-inventory system to identify the approximately optimal order-up-to-level inventory policies. We find that the virtual dual production-inventory strategy can be the optimal contingency policy to deal with supplier dynamic disruption risks. Furthermore, for disruption risk with low frequency and long duration, the manufacturer should increase the safety inventory level before the disruption. Otherwise, it should increase the safety inventory level in every cycle.